Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial.

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p = 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p = 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p = 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.

Are Western Knee Designs Dimensionally Correct for Korean Women? A Morphometric Study of Resected Femoral Surfaces during Primary Total Knee Arthroplasty.

BACKGROUND: The purpose of this study was to determine the shape of the distal femur of Korean women compared with the prostheses currently available in Korea. METHODS: Morphometric data (5 parameters) were measured in 356 resected femurs of Korean women undergoing primary total knee arthroplasty (TKA) utilizing the LCS knee implant (DePuy). The data were then compared with 5 additional contemporary TKA implant systems. RESULTS: Implant designs based on Caucasian population data do not ideally match the distal femoral morphology of Korean women. Overhang at the anterior mediolateral width was observed in 84.8% for the LCS while a gender-specific implant resulted in undercoverage of the bone in 86%. Posterior overhang was observed in up to 51.2%. Most implant designs have a narrower intercondylar notch than the morphologic data of Korean women. CONCLUSIONS: Since there is some difference between the shape of distal femur of Korean women and that of the implants, surgeons should have this in mind when selecting an implant for a patient. These data may also be used as a guideline for future prosthetic design options for Korean women population.