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General Orthopaedics

POST TOTAL KNEE ARTHROPLASTY HOME PHYSIOTHERAPY FOR A PERIOD OF SIX WEEKS REDUCES THE RATE OF POST TOTAL KNEE ARTHROPLASTY MANIPULATION UNDER ANAESTHESIA

International Society for Technology in Arthroplasty (ISTA) 31st Annual Congress, London, England, October 2018. Part 1.



Abstract

OBJECTIVE

Post TKR manipulation under anesthesia is required when post operatively patients don't achieve desired range of motion. The rates quoted in various western literature ranges from 1 to 2 %. A knee is considered to be stiff when the patient fails to achieve 60 degrees of flexion. The objective of the study was to find out the differentiating factor responsible for low rate of MUA in Indian post TKR patients as compared to Anglo-Saxon population

MATERIAL & METHODS

We studied 100 consecutive patients operated from January 2016. The following parameters of these 100 patients were recorded.

  1. Pre-op ROM

  2. Age and Sex of the TKR patient

  3. Duration of home physiotherapy

  4. Post opROM

All patients received post operative physiotherapy at home every day for first 2 weeks, 3 times a week for next 2 weeks and then once a week for next two weeks. The implant used was Maxx Freedom knee (PS design).

RESULTS

Of the 300 TKR patients 270 were females and 30 were males. The age range for male patients was 65 to 87 years with a mean of 73 years. The age range of female patients was 65 to 83 years with a mean of 71 years. The mean range of motion achieved was 121 degrees. Only one of our patient required manipulation under anesthesia.(0.333%).

CONCLUSION

Our rate of MUA is totally different from that of reported from Western world. According to us home physiotherapy is the main differentiating factor responsible for this low rate. Hence we strongly advocate personalized home physiotherapy post TKR with constant feedback mechanism between the operating doctor and the treating physiotherapist.


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