Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study
Purpose The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups. Methods In a prospective, r...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2014-12, Vol.22 (12), p.3067-3073 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Kömürcü, Erkam Yüksel, Halil Yalçın Ersöz, Murat Aktekin, Cem Nuri Hapa, Onur Çelebi, Levent Akbal, Ayla Biçimoğlu, Ali |
| description | Purpose
The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.
Methods
In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.
Results
No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (−4.2 %) than in Group 1 (−23.1 %).
Conclusion
For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.
Level of evidence
II. |
| doi_str_mv | 10.1007/s00167-014-2896-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1635029230</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1635029230</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-ebe12aa4ed4df0177f183d93317ddbfe9fc0549a7c32700c6e19ba7a3bb8df063</originalsourceid><addsrcrecordid>eNqNkU1vFDEMhiMEokvhB3BBkbhwYIrzMcmGW1WVD6kSFzhHmYyzTJlNliSDuv31ZLUFIaRKPSWxH7-28xLyksEZA9DvCgBTugMmO742qlOPyIpJITotpH5MVmAk7zj06oQ8K-UaoF2leUpOuOyZUZyvSLwMAX2lKdCy5M3k3Uz9nMoUN3SKtKbaAj8iInW5fs9pN7tS99RVGma8mVKkKVO8qRhLe7ynju5yKrsmOf3CtzS7OKbtdIsjLXUZ98_Jk-Dmgi_uzlPy7cPl14tP3dWXj58vzq86L3VfOxyQceckjnIMwLQObC1GIwTT4zgENMFDL43TXnAN4BUyMzjtxDCsW4ESp-TNUbdN83PBUu12Kh7n2UVMS7FMiR644QIegLYWmgnoG_r6P_Q6LTm2RQ6UYszoft0odqR8-4mSMdhdnrYu7y0De_DNHn2zzTd78M0e5n11p7wMWxz_VvwxqgH8CJSWihvM_7S-V_U3Dqqj2A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1626119758</pqid></control><display><type>article</type><title>Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Access via Wiley Online Library</source><creator>Kömürcü, Erkam ; Yüksel, Halil Yalçın ; Ersöz, Murat ; Aktekin, Cem Nuri ; Hapa, Onur ; Çelebi, Levent ; Akbal, Ayla ; Biçimoğlu, Ali</creator><creatorcontrib>Kömürcü, Erkam ; Yüksel, Halil Yalçın ; Ersöz, Murat ; Aktekin, Cem Nuri ; Hapa, Onur ; Çelebi, Levent ; Akbal, Ayla ; Biçimoğlu, Ali</creatorcontrib><description>Purpose
The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.
Methods
In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.
Results
No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (−4.2 %) than in Group 1 (−23.1 %).
Conclusion
For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.
Level of evidence
II.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-014-2896-6</identifier><identifier>PMID: 24519622</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Arthritis ; Arthroplasty, Replacement, Knee - methods ; Body mass index ; Double-Blind Method ; Female ; Hospitals ; Humans ; Joint replacement surgery ; Knee ; Knee Joint - physiopathology ; Knee Joint - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Muscle Strength ; Muscle, Skeletal - physiopathology ; Neuromuscular diseases ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - surgery ; Patients ; Physical therapy ; Posture ; Prospective Studies ; Range of Motion, Articular ; Recovery of Function ; Rehabilitation ; Torque</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014-12, Vol.22 (12), p.3067-3073</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-ebe12aa4ed4df0177f183d93317ddbfe9fc0549a7c32700c6e19ba7a3bb8df063</citedby><cites>FETCH-LOGICAL-c475t-ebe12aa4ed4df0177f183d93317ddbfe9fc0549a7c32700c6e19ba7a3bb8df063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-014-2896-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-014-2896-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24519622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kömürcü, Erkam</creatorcontrib><creatorcontrib>Yüksel, Halil Yalçın</creatorcontrib><creatorcontrib>Ersöz, Murat</creatorcontrib><creatorcontrib>Aktekin, Cem Nuri</creatorcontrib><creatorcontrib>Hapa, Onur</creatorcontrib><creatorcontrib>Çelebi, Levent</creatorcontrib><creatorcontrib>Akbal, Ayla</creatorcontrib><creatorcontrib>Biçimoğlu, Ali</creatorcontrib><title>Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.
Methods
In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.
Results
No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (−4.2 %) than in Group 1 (−23.1 %).
Conclusion
For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.
Level of evidence
II.</description><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Body mass index</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Knee Joint - physiopathology</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Muscle Strength</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Neuromuscular diseases</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Patients</subject><subject>Physical therapy</subject><subject>Posture</subject><subject>Prospective Studies</subject><subject>Range of Motion, Articular</subject><subject>Recovery of Function</subject><subject>Rehabilitation</subject><subject>Torque</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1vFDEMhiMEokvhB3BBkbhwYIrzMcmGW1WVD6kSFzhHmYyzTJlNliSDuv31ZLUFIaRKPSWxH7-28xLyksEZA9DvCgBTugMmO742qlOPyIpJITotpH5MVmAk7zj06oQ8K-UaoF2leUpOuOyZUZyvSLwMAX2lKdCy5M3k3Uz9nMoUN3SKtKbaAj8iInW5fs9pN7tS99RVGma8mVKkKVO8qRhLe7ynju5yKrsmOf3CtzS7OKbtdIsjLXUZ98_Jk-Dmgi_uzlPy7cPl14tP3dWXj58vzq86L3VfOxyQceckjnIMwLQObC1GIwTT4zgENMFDL43TXnAN4BUyMzjtxDCsW4ESp-TNUbdN83PBUu12Kh7n2UVMS7FMiR644QIegLYWmgnoG_r6P_Q6LTm2RQ6UYszoft0odqR8-4mSMdhdnrYu7y0De_DNHn2zzTd78M0e5n11p7wMWxz_VvwxqgH8CJSWihvM_7S-V_U3Dqqj2A</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Kömürcü, Erkam</creator><creator>Yüksel, Halil Yalçın</creator><creator>Ersöz, Murat</creator><creator>Aktekin, Cem Nuri</creator><creator>Hapa, Onur</creator><creator>Çelebi, Levent</creator><creator>Akbal, Ayla</creator><creator>Biçimoğlu, Ali</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study</title><author>Kömürcü, Erkam ; 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The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.
Methods
In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.
Results
No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (−4.2 %) than in Group 1 (−23.1 %).
Conclusion
For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.
Level of evidence
II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24519622</pmid><doi>10.1007/s00167-014-2896-6</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014-12, Vol.22 (12), p.3067-3073 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1635029230 |
| source | MEDLINE; SpringerNature Journals; Access via Wiley Online Library |
| subjects | Aged Arthritis Arthroplasty, Replacement, Knee - methods Body mass index Double-Blind Method Female Hospitals Humans Joint replacement surgery Knee Knee Joint - physiopathology Knee Joint - surgery Male Medicine Medicine & Public Health Middle Aged Muscle Strength Muscle, Skeletal - physiopathology Neuromuscular diseases Orthopedics Osteoarthritis Osteoarthritis, Knee - surgery Patients Physical therapy Posture Prospective Studies Range of Motion, Articular Recovery of Function Rehabilitation Torque |
| title | Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study |
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