Volume 10,Issue 9
Effects of Rehabilitation Training on Range of Motion after Total Knee Arthroplasty
Total knee arthroplasty (TKA) serves as an effective intervention for end stage knee osteoarthritis and other related disorders. Postoperative recovery of knee range of motion (ROM) directly determines patients’ daily functional performance and quality of life. By reviewing domestic and international recent literature, this paper summarizes functional requirements and influencing factors of postoperative ROM, early stage rehabilitation training, continuous passive motion, muscle strength and proprioception training, pain and swelling management, multi modal rehabilitation strategies, and synergistic application of Mongolian traditional therapies. Available evidence demonstrates that systematic rehabilitation training following the principles of early intervention, gradual progression, active exercise priority and individualization can significantly improve postoperative knee flexion extension ROM, and reduce the incidence of joint stiffness and adhesion. Multi modal rehabilitation guided by enhanced recovery after surgery (ERAS) as well as integrated Mongolian Western medicine rehabilitation pathways exhibit promising clinical prospects.
[1] Chinese Orthopaedic Association of Chinese Medical Association, 2021, Chinese Guidelines for Diagnosis and Treatment of Osteoarthritis (2021 Edition). Chinese Journal of Orthopaedics, 41(18): 1291–1314.
[2] Chinese Orthopaedic Association of Chinese Medical Association, 2018, Guidelines for the Diagnosis and Treatment of Osteoarthritis (2018 Edition). Chinese Journal of Orthopaedics, 38(12): 705–715.
[3] Lü H, 1998, Artificial Joint Surgery. Beijing: Science Press.
[4] Cao W, Liu Y, 2008, Advances in Rehabilitation Therapy After Total Knee Arthroplasty. Journal of Clinical Orthopaedics, 11(1): 104–106.
[5] Laubenthal K, Smidt G, Kettelkamp D, 1972, A Quantitative Analysis of Knee Motion During Activities of Daily Living. Physical Therapy, 52(1): 34–43.
[6] Chinese Orthopaedic Association of Chinese Medical Association, 2016, Chinese Expert Consensus on Peri-Operative Management for Enhanced Recovery After Hip and Knee Arthroplasty. Chinese Journal of Bone and Joint Surgery, 9(1): 1–9.
[7] Xie Z, Zhang X, Wang N, 2019, Research Progress of Enhanced Recovery After Surgery Concept Applied in Peri-Operative Period of Total Knee Arthroplasty. Chinese Journal of Orthopaedic Trauma, 27(17): 1575–1578.
[8] Bade M, Stevens-Lapsley J, 2011, Early High-Intensity Rehabilitation Following Total Knee Arthroplasty Improves Outcomes. Journal of Orthopaedic & Sports Physical Therapy, 41(12): 932–941.
[9] Salter R, Simmonds D, Malcolm B, et al., 1980, The Biological Effect of Continuous Passive Motion on the Healing of Full-Thickness Defects in Articular Cartilage: An Experimental Investigation in the Rabbit. The Journal of Bone and Joint Surgery-American Volume, 62(8): 1232–1251.
[10] O’Driscoll S, Giori N, 2000, Continuous Passive Motion (CPM): Theory and Principles of Clinical Application. Journal of Rehabilitation Research and Development, 37(2): 179–188.
[11] Bruun-Olsen V, Heiberg K, Mengshoel A, 2009, Continuous Passive Motion as an Adjunct to Active Exercises in Early Rehabilitation Following Total Knee Arthroplasty: A Randomized Controlled Trial. Disability and Rehabilitation, 31(4): 277–283.
[12] Harvey L, Brosseau L, Herbert R, 2014, Continuous Passive Motion Following Total Knee Arthroplasty in People with Arthritis. Cochrane Database of Systematic Reviews, 2014(2): CD004260.
[13] Cheng Q, Hu S, 2012, Research Progress on Effects of Continuous Passive Motion on Knee Joint Function After Total Knee Arthroplasty. Nursing Research, 26(1): 19–20.
[14] Mizner R, Petterson S, Stevens J, et al., 2005, Preoperative Quadriceps Strength Predicts Functional Ability One Year After Total Knee Arthroplasty. The Journal of Rheumatology, 32(8): 1533–1539.
[15] Zhang X, Piao C, 2016, Research Progress of Proprioceptive Training Applied in Rehabilitation After Knee Arthroplasty. Journal of Nursing Science, 31(4): 104–106.
[16] Li T, Wang B, Jiang X, et al., 2016, Expert Consensus on Multi-Modal Peri-Operative Analgesia for Total Knee Arthroplasty. Chinese Journal of Bone and Joint Surgery, 9(4): 281–285.
[17] Bai Q, 1992, Chinese Medical Encyclopedia·Mongolian Medicine. Shanghai: Shanghai Science and Technology Press.
[18] Burendala, Baiynamula, 2016, Curative-Effect Observation on Mongolian-Medicine Warm Acupuncture Combined with Massage for Knee Osteoarthritis. Journal of Chinese Ethnic Medicine, 22(2): 9–11.
[19] Minns Lowe C, Barker K, Dewey M, 2007, Effectiveness of Physiotherapy Exercise After Knee Arthroplasty for Osteoarthritis: Systematic Review of Randomised Controlled Trials. British Medical Journal, 335(7624): 812–815.
[20] Li J, Huang X, 2018, Rehabilitation Medicine. 3rd ed. Beijing: People’s Medical Publishing House.
