Effects of intesive rehabilitation on functional ability after total knee arthroplasty

To evaluate the effectiveness of a pre- and post-operative intensive functional rehabilitation [IFR] program in the first three months after primary total knee arthroplasty [TKA] for severe osteoarthritis on functional ability and muscle isokinetics. Twenty severe osteoarthritis knee patients underwent primary total knee arthroplasty. They were divided randomly into 2 groups of 10 each. The first group received intensive program of rehabilitation, the second received ordinary rehabilitation program. All patients were subjected to clinical examination, functional assessment using WOMAC score, knee range of motion, 6 Minute Walk test, Timed Up and Go test, and Isokinetic Assessment, at start, 6 and 12 weeks afterwards. Total WOMAC score, pain, stiffness, and difficulty WOMAC scores showed a significant decrease after 6 and 12 weeks in both groups. The first group showed more decrease than ordinary program. Timed Up and Go test showed a significant decrease after 12 weeks in both groups p=0.003, shorter time in the first group than the second. Isokinetic parameters as peak torque and peak torque per body weight showed significant increase after 6 weeks in first group p=0.01, but not in second p>0.05. After 12 weeks there was a statistical significant increase in both groups p<0.001, higher in first group p<0.05]. Total work, average power, and maximum repetition total work showed better improvement in first group. IRP applied in the first 3 months after TKA is effective in promoting better functional ability, less pain and stiffness and results in better ROM and longer distance walked

Effect of hypogonadism on bone mineral density in young males

A study of the relationship between bone mineral density and the level of testosterone in young hypogonadal males. The patients' group consisted of 20 hypogonadal men. A group of 20-euogonadal age matched men served as a control group. All were subjected to history taking, thorough clinical examination, measurement of serum testosterone levels with ELISA and assessment of bone mineral density [BMD] with dual energy X-ray absorptiometry [DEXA] for left femur, forearm and spine. The mean age of patients was 2 7.1 +/- 2.79 [years] with a mean body mass index [BMI] 24.23 +/- 4.67 kg/m[2]. Testosterone levels were highly significantly lower in patients vs. controls p<0.001. Patients showed highly significant reduction of BMD for left femur, forearm and spine than control group p<0.001. Testosterone levels and BMD were highly significantly lower in patients with delayed onset of puberty compared to those with normal onset puberty p<0.001. There was no significant difference in BMD or serum testosterone between patients with 1ry or 2ry hypogonadism p>0.05. A highly significant positive correlation was found between serum testosterone and T-score at all sites. Hypogonadal patients have lower serum testosterone level and lower BMD than age-matched controls. The more testosterone is deficient, the worse the BMD. Patients with history of delayed puberty have lower BMD than those with normal onset of puberty, and the more the delay the more the reduction in BMD. The spine is the most affected site with osteopenia in hypogonadal men