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Muto T1, Tanikawa H2, Okuma K3
1Saitama Municipal Hospital, Rehabiritation Medcine, Saitama, Japan, 2Saiseikai Yokohamashi Tobu Hospital, Department of Orthopedics Surgery, Yokohama, Japan, 3Saitama Municipal Hospital, Department of Orthopedics Surgery, Saitama, Japan
Background: Proprioceptive deficiencies due to osteoarthritis and arthroplasty have been repeatedly reported. But as for the course of the proprioceptive function after TKA, certain views have not been obtained at present.
Purpose: The purpose of this study was to clarify the course of the knee proprioception after TKA.
Methods: 33 subjects (28 female, 5 male; age, 72.2±7.4 years) who underwent TKA for knee osteoarthritis were enrolled.The physiotherapy intervention started that standing and walking exercises from the next day after surgery and CKC exercise such as leg lunge were done from the early postoperative stage.Biodex System3 was used. The subjects were seated on the dynamometer with hip and knee joint 90°flexion position. The Subjects were intercepted the sight and auditory and skin information. When the subjects were pushed, the transitive at each speed 2.0deg/sec, and to make it hold beforehand in the feeling of a set value reached the position of 45°. Measured reposition error. The mean value of three times was requested. This item measured before surgery, at hospital discharge, postoperative 2 month (2POM), and 3 POM. One-way ANOVA was used to compare the timing (P 0.05).
Results: KP measurements at preoperative, hospital discharge, 2POM, and 3POM were 5.7±3.4°, 6.0±2.8°, 5.0±2.2°, 4.7±1.7°respectively．There was a significant difference in the KP measurements between hospital discharge and 3POM (P 0.05).
Conclusion(s): In this research, KP measurements were significantly better in the 3POM than the hospital discharge. Some authors report on benefits from the operation, similar to our reports, but others did not observe any improvement. In previous studies, regular exercise may attenuate the age-related proprioceptive decline (Fernando et al;2010), position sense acuity is, to a large extent, dependent upon muscle spindle activity (Proske;2005). It was the greater improvements in joint reposition sense in the WB exercise compared with NWB exercise participants（Mei-Hwa et al;2009）.
It is thought that Closed kinetic chain(CKC) exercise has a positive effect on knee proprioception, and it seems to support our research that intervened with CKC from early postoperative stage. Therefore, when summarizing these, I thought that not only improvement of the pain, the structural changes and improvement of joint smoothness for the having undergone TKA but also aggressive exercise intervention in the early postoperative stage was effected improvement of the knee proprioception in organization outside joint capsule.
Implications: Since KP relates to balance function, we think that it is necessary to understand the process of improvement of KP after TKA.
Keywords: knee proprioception, propriocertor, TKA
Funding acknowledgements: We gratefully acknowledge the patients who participated in the study.
Purpose: The purpose of this study was to clarify the course of the knee proprioception after TKA.
Methods: 33 subjects (28 female, 5 male; age, 72.2±7.4 years) who underwent TKA for knee osteoarthritis were enrolled.The physiotherapy intervention started that standing and walking exercises from the next day after surgery and CKC exercise such as leg lunge were done from the early postoperative stage.Biodex System3 was used. The subjects were seated on the dynamometer with hip and knee joint 90°flexion position. The Subjects were intercepted the sight and auditory and skin information. When the subjects were pushed, the transitive at each speed 2.0deg/sec, and to make it hold beforehand in the feeling of a set value reached the position of 45°. Measured reposition error. The mean value of three times was requested. This item measured before surgery, at hospital discharge, postoperative 2 month (2POM), and 3 POM. One-way ANOVA was used to compare the timing (P 0.05).
Results: KP measurements at preoperative, hospital discharge, 2POM, and 3POM were 5.7±3.4°, 6.0±2.8°, 5.0±2.2°, 4.7±1.7°respectively．There was a significant difference in the KP measurements between hospital discharge and 3POM (P 0.05).
Conclusion(s): In this research, KP measurements were significantly better in the 3POM than the hospital discharge. Some authors report on benefits from the operation, similar to our reports, but others did not observe any improvement. In previous studies, regular exercise may attenuate the age-related proprioceptive decline (Fernando et al;2010), position sense acuity is, to a large extent, dependent upon muscle spindle activity (Proske;2005). It was the greater improvements in joint reposition sense in the WB exercise compared with NWB exercise participants（Mei-Hwa et al;2009）.
It is thought that Closed kinetic chain(CKC) exercise has a positive effect on knee proprioception, and it seems to support our research that intervened with CKC from early postoperative stage. Therefore, when summarizing these, I thought that not only improvement of the pain, the structural changes and improvement of joint smoothness for the having undergone TKA but also aggressive exercise intervention in the early postoperative stage was effected improvement of the knee proprioception in organization outside joint capsule.
Implications: Since KP relates to balance function, we think that it is necessary to understand the process of improvement of KP after TKA.
Keywords: knee proprioception, propriocertor, TKA
Funding acknowledgements: We gratefully acknowledge the patients who participated in the study.
Topic: Musculoskeletal: lower limb; Musculoskeletal; Orthopaedics
Ethics approval required: Yes
Institution: saitama municipal hospital
Ethics committee: saitama municipal hospital
Ethics number: A2200
All authors, affiliations and abstracts have been published as submitted.
