Quadriceps muscle group function and after total knee arthroplasty-asystematic narrative update

Area of Science:

• Orthopedic surgery
• Musculoskeletal rehabilitation

Background:

• Quadriceps muscle function is crucial for recovery after total knee arthroplasty (TKA).
• Evidence from the last 20 years on pre- and post-operative factors influencing quadriceps recovery is systematically reviewed.
• PRISMA methodology guided the selection of high-level evidence studies.

Purpose of the Study:

• To systematically summarize evidence on factors influencing quadriceps muscle recovery post-TKA.
• To identify pre-operative and post-operative strategies for optimizing functional recovery.
• To highlight areas for future research in TKA rehabilitation.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Inclusion of meta-analyses and high-level evidence studies (prospective and retrospective trials).
• Searches conducted on PubMed and Cochrane databases, yielding 54 selected articles from 582 initially identified.

Main Results:

• High-pressure tourniquet use negatively impacts quadriceps function.
• Minimally invasive surgical approaches promote faster quadriceps recovery.
• An eight-week rehabilitation program including balance training and nutraceuticals is associated with improved outcomes.

Conclusions:

• Minimizing tourniquet pressure and employing minimally invasive techniques are key for quadriceps recovery.
• Structured rehabilitation programs incorporating balance training and nutraceuticals enhance functional recovery.
• Pre-habilitation, analgesic strategies, and implant choice require further investigation.