Thomas P.1, Venkata Ramanaiah M.1, Dikshith S.2, Reddy K.2, Rajanikanth D.1, Sunil deepak K.3
1Apollo Health City, Physiotherapy and Rehabilitation, Hyderabad, India, 2Apollo Health City, Orthopaedics, Hyderabad, India, 3Apollo health city, Rehabilitation, Hyderabad, India
Background: Total knee replacements are among the the most commonly performed surgical procedures in India.Squatting and high flexion is necessary after total knee arthroplasty in Indian population in their day to day activities and toilet habits. We propose a high intensity rehabilitation protocol for achieving squatting and high flexion in Indian scenario.
Purpose: The objective of this study is to maximize a persons function and independence to near normal activities and achieve squatting and sitting cross - legged using high intensity rehabilitation protocol.
Methods: A total of 100 patients who underwent total knee arthroplasty between august 2014 to august 2016 were taken into study.All patients underwent aggressive,high intensity multi-joint exercise regime for 6 months.Post operative exercise regime was started within first 5 hours after surgery. The rehabilitation protocol was continued during the patients hospital stay and home based rehabilitation care for a period of 6 months. At the end of 6 months patients were evaluated with the following parameters
1. range of motion at hip
2. range of motion at knee
3. range of motion at ankle
4. ability to squat
5. ability to sit cross -legged
Results: Of the 100 patients,65 patients achieved high flexion, ability to squat fully on the floor and use Indian toilets.10 patients lost for follow-up, 8 patients were non complaint with physiotherapy regime. Remaining 17 patients couldn´t achieve high flexion and squatting. Patients with thigh-calf index more than 90 degrees couldn´t achieve satisfactory results.
Conclusion(s): In Indian scenario,squatting and high flexion are required in their day to day functional requirements. Early high intensity rehabilitation protocol with multi-joint exercise regime is found to be beneficial in achieving the same within 6 months. Patients compliance for physiotherapy, calf-thigh index are the factors which affect attainment of high knee flexion.
Implications: High intensity rehabilitation protocol if started early both in hospital and at home gives good results pertaining to knee and hip range of motion as well as achieving full squatting and sitting cross-legged.
Funding acknowledgements: self
Topic: Orthopaedics
Ethics approval: apollo health city
All authors, affiliations and abstracts have been published as submitted.
