Early assessment of knee function and quality of life in patients after total knee replacement.

BACKGROUND: The aim of the study was to assess knee function and changes of the perceived quality of life before total knee replacement surgery and after four weeks of post-operative rehabilitation. MATERIAL AND METHODS: The study involved 200 patients with Kellgren III/IV osteoarthritis of the knee who received a total cemented knee endoprosthesis and underwent comprehensive post-operative rehabilitation for four weeks. The Lysholm and Gilquist Knee Scale was used to assess the clinical status of the patients and the SF-36 Questionnaire served to evaluate the quality of life. Patients were evaluated before the operation and after the four-week rehabilitation. RESULTS: A significant improvement in the following knee functions was observed after four weeks of rehabilitation: walking, climbing stairs, stability, and turning around on one leg. The pain, swelling and limp decreased. The quality of life after the four-week rehabilitation was considerably better in the domains of physical function and emotional status. CONCLUSIONS: The positive effects of surgery and rehabilitation on knee function and quality of life can be observed as early as after four weeks of rehabilitation following total knee replacement.

Rehabilitation of patients with trochanteric hip fractures treated surgically with an angular nail-plate.

Background. The angular nail-plate is still one of the most common materials used in Poland to achieve union of the bone fragments in fractures of the proximal femur. The main goal of post-surgical rehabilitation is for the patient to recover locomotion and the ability to perform activities of daily living. Material and method. We examined 102 patients treated surgically at the Cracow Rehabilitation Center for trochanteric hip fractures, using an angular nail-plate. This population was randomly divided into two groups. The experimental group received, in addition to the standard rehabilitation applied in the control group, also continuous passive motion (CPM). The patients were tested four times over 12 days to assess progress in rehabilitation, range of movement in the hip and knee, muscle strength in the operated limb (Lovett scale), surgical wound healing, thigh circumference, commencement of locomotion, and ability to use crutches. We also recorded the patients' subjective reactions to rehabilitation and pain symptoms on the visual analogue scale (VAS). Results. CPM had a significant impact on muscle strength after 12 days (p=0.0001). The thigh circumference was greater in the experimental group. These patients were also more satisfied with the rehabilitation outcome. Conclusions. The application of continuous passive motion in the rehabilitation program for trochanteric fracture of the hip joint after surgical treatment with angular nail-place has a positive impact on the rehabilitation process.