Indian Journal of Physiotherapy and Occupational Therapy - An International Journal
  • Year: 2011
  • Volume: 5
  • Issue: 3

Is Knee Range of Movement on Discharge Important After Total Knee Replacement - A prospective audit based study

  • Author:
  • Ross Darch1, Jonathan Swan2, Tom Wainwright3, Robert Middleton4
  • Total Page Count: 4
  • Page Number: 10 to 13

1The Royal Bournemouth and Christchurch Hospitals NHS Trust, England, The Royal Bournemouth Hospital Visiting Associate, CoPMRE, Bournemouth University, U.K.

2The Royal Bournemouth and Christchurch Hospitals NHS Trust, England, The Royal Bournemouth Hospital Visiting Associate, CoPMRE, Bournemouth University, U.K.

3The Royal Bournemouth and Christchurch Hospitals NHS Trust, England, The Royal Bournemouth Hospital Visiting Associate, CoPMRE, Bournemouth University, U.K.

4The Royal Bournemouth and Christchurch Hospitals NHS Trust, England, The Royal Bournemouth Hospital Visiting Associate, CoPMRE, Bournemouth University, U.K.

Online published on 1 October, 2011.

Abstract

Is knee range of movement on discharge important after total knee replacement? Is there a difference in flexion over 6 weeks post TKR between sub-groups based on varying flexion scores on discharge?

A prospective audit utilising a repeated measures design was adopted, using a 6-week follow-up period to allow for initial post-op tissue healing and a physiotherapy treatment intervention to commence.

A convenience sample of 24 patients undergoing TKR was measured prior to discharge and then at their routine 6-week follow-up.

A standard hand-held goniometer was used to measure subjects’ knee flexion and extension on discharge and at a six-week follow-up in both sitting on the edge of a plinth and supported long sitting respectively using 5° measurement intervals.

During the first six-weeks post TKR, all patients significantly increased their knee flexion (CI 95%, P<0.0001). It is also apparent that knee excursion also significantly increased over the same time period regardless the patient's movement at discharge. There was a statistically significant change in knee extension scores in all patients post TKR (CI 95%, P<0.004). This showed a reduced ability to extend the knee after a TKR. There was no significant difference in flexion scores between groups over the six weeks (CI 95%, P<0.5).

This study supports the notion that range of movement at discharge is not essential as all patients improved their knee flexion and total movement over a six-week follow-up and differences between groups were not significant. Further research is needed to support the outcome of reduced knee extension post TKR and the implications it has on rehabilitation post TKR.