[Clinical results of critical rehabilitation pathway after total knee arthroplasty]

To investigate the clinical results of the application of critical rehabilitation pathway in the rehabilitation after total knee arthroplasty.

From March 2015 to December 2019, 67 patients with total knee arthroplasty (TKA) were included. There were 49 females and 18 males, 42 cases on the left and 25 cases on the right, with an average age of 60 to 81(70.72±5.92) years old. Critical rehabilitation paths included intensive strength and gait rehabilitation exercises. All patients were evaluated before operation and 3, 12 months after operation. The evaluation indexes included stair climbing test (SCT), six minute walk test (6MWT), quadriceps and hamstring strength, range of motion, visual pain scale (VAS), Western Ontario McMasterUniversity Osteoarthritis score(WOMAC).

All the patients completed the entire pathway and the assessment. The results of pre-operative, 3 months after surgery and 12 months after surgery were as follows respectively. SCT-up: (16.32±3.58) s, (18.16±2.46) s, (11.00±1.29) s, F=193.448, P<0.05;SCT-down:(17.40±2.94) s, (18.96±2.61) s, (12.16± 1.91) s, F=208.028, P<0.05;6MWT:(276.00±57.70) m, (318.00±46.18) m, (435.12±57.36) m, F=326.408, P<0.05;Quadriceps strength: (70.08±8.17) N, (52.40±6.67) N, (78.84±4.56) N, F=286.375, P<0.05;Hamstring muscle strength: (44.88± 7.53) N, (44.28 ±4.63) N, (47.04 ±4.77) N, F =3.620, P <0.05;Knee flexion angle: (115.56 ±13.04) ° , (113.16 ±8.84) ° , (120.28±5.23) °, F=11.228, P<0.05;Knee extension angle:(2.16±3.51) °, (-0.28±2.05) °, (-0.72±1.21) °, F=45.460, P< 0.05;VAS 7.52±1.26, 3.44±0.87, 1.76±0.60, F=723.110, P<0.05;WOMAC pain index:7.88±1.05, 3.60±0.65, 1.96±0.54, F=1 186.196, P<0.05;WOMAC stiffindex:3.00±0.50, 2.20±0.50, 1.68±0.56, F=177.944, P<0.05;WOMAC function index: 30.24±1.76, 26.16±2.08, 13.52±1.53, F=2 227.287, P<0.05.

Critical rehabilitation path is safe and effective. The knee function of patients who receive critical rehabilitation path after TKA is significantly improved in the first 12 months after operation.