Differences in Background Factors and Functional Recovery during the Early Postoperative Period and Their Effect on the Variance in Gait Acquisition of Patients Undergoing Total Knee Arthroplasty Tetsuya Amano 1,2 , Kotaro Tamari 3 , Shigehiro Uchida 4 , Hideyuki Ito 5 , Shigeharu Tanaka 6 , Shinya Morikawa 7 , Kenji Kawamura 2 1Tokoha University 2Graduate School of Health Science, KIBI International University 3JICA Guatemala Office 4Hiroshima International University 5Yamaguchi Allied Health College 6Kawasaki Junior College of Rehabilitation 7Hohsyasen Daiichi Hospital Keyword: 人工膝関節全置換術 , total knee arthroplasty , 変形性膝関節症 , knee osteoarthritis , 歩行獲得 , gait acquisition , 術後経過 , postoperative course , クリティカルパス , critical path pp.723-731
Published Date 2016/9/18
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Abstract Objective:The aim of this study was to examine the relationships between the timing of gait acquisition and the length of hospitalization, and to clarify the differences in background factors and functional recovery during the early postoperative period and their effect on the variability in gait acquisition.

Methods:We recruited 148 patients who underwent total knee arthroplasty (TKA) at three hospitals. The participants were divided into two groups on the basis of the number of days needed to achieve independent gait at ≤ 14 days after surgery (group A) and > 14 days after surgery (group B). We compared the background factors between the two groups. Additionally, we compared the preoperative and postoperative function in each group.

Results:We observed a significant positive correlation between the number of days needed to achieve independent gait and the length of hospitalization. In group A, the significant background factors were younger age and higher preoperative activity level. In group A, compared with the level of preoperative function, the postoperative maximum knee extension angle on the operated side and pain had significantly improved. In both groups, the postoperative knee extensor strength on the operated side, knee extensor strength on the nonoperated side, knee flexion strength on the operated side, maximum knee flexion angle on the operated side, and walking speed were significantly reduced.

Conclusion:During early rehabilitation, it is necessary to consider the age and previous activities of patients. In addition, we suggest that early rehabilitation with a focus on reducing pain by alleviating inflammation and improving maximum knee extension angle on the operated side may be effective for fast acquisition of gait.

Copyright © 2016, The Japanese Association of Rehabilitation Medicine. All rights reserved.


電子版ISSN 印刷版ISSN 1881-3526 日本リハビリテーション医学会