The effect of immediate post-operative knee range of motion photographs on post-operative range of motion after total kn
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ORIGINAL PAPER
The effect of immediate post-operative knee range of motion photographs on post-operative range of motion after total knee arthroplasty An assessor-blinded randomized controlled clinical trial in sixty patients Piya Pinsornsak 1 & Supakit Kanitnate 1 & Krit Boontanapibul 2 Received: 31 July 2020 / Accepted: 9 November 2020 # SICOT aisbl 2020
Abstract Purpose We attempted to determine the effect of immediate post-operative knee range of motion (ROM) photographs on improving ROM after total knee arthroplasty (TKA). Methods Sixty patients, scheduled for unilateral primary TKA, were randomized into two groups. The photo group (n = 30) were immediately shown post-TKA knee ROM photographs as motivation for rehabilitation. The non-photo group (n = 30) received identical post-operative pain control and rehabilitation programs. Post-operative knee ROM and Knee Society Scores (KSS) at day three, six weeks, three months, six months, one year, and two years were evaluated. Outcome assessors were blinded to the groups during the study. Results Patients in the photo group had better knee flexion on day three (99.9° ± 15.3°, 95% confidence interval (CI) 94.1-105.7° vs. 92.3° ± 11.4°, 95% CI 87.9-96.8°; p = 0.038) and at six weeks (120.9° ± 13.4°, 95% CI 115.7-126.0° vs. 112.5° ± 13.6°, 95% CI 107.2-117.8°; p = 0.023); however, there were no differences in range of flexion beyond six weeks post-operatively. Knee extension did not significantly differ throughout. Clinical KSS was significantly higher in the photo group at six weeks (90.7° ± 6.2° vs. 86.6° ± 6.4°, p = 0.017). Functional KSS showed no differences between groups during follow-up. Conclusion Showing knee ROM photographs seemed to result in significant improvement of knee flexion and clinical KSS in the first 6 weeks post-TKA and may be recommended as part of post-TKA rehabilitation. Keywords Knee range of motion . Photograph . Motivation . Knee flexion . Total knee arthroplasty . Rehabilitation
Introduction
* Piya Pinsornsak [email protected] Supakit Kanitnate [email protected] Krit Boontanapibul [email protected] 1
Department of Orthopedics, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani 12120, Thailand
2
Department of Orthopedics, Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani 12120, Thailand
Total knee arthroplasty (TKA) is recognized as the most successful procedure for treating knee osteoarthritis. A crucial factor in generating optimal post-operation outcomes is the degree of knee range of motion (ROM) [1, 2]. Providing greater ROM means patients have superior capabilities to participate in activities of daily living such as stair climbing, moving from sitting to standing, and, for Asian populations, floor activities such as squatting, kneeling, and sitting with both legs crossed [3]. Increased ROM translates into better significant functional outcomes [4] and higher patient satisfaction after surgery [5, 6]. The major preoperative considerations affecti
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