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

Author:

Morelli Ilaria1,Maffulli Nicola234,Brambilla Lorenzo1,Agnoletto Marco5,Peretti Giuseppe Maria56,Mangiavini Laura56

Affiliation:

1. Residency Program in Orthopaedics and Traumatology, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy

2. San Giovanni di Dio e Ruggi D'Aragona Hospital "Clinica Orthopedica" Department, Hospital of Salerno, Via San Leonardo, 84125 Salerno, Italy

3. Institute of Science and Technology in Medicine, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, Staffordshire ST5 5BG United Kingdom

4. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, United Kingdom

5. IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161, Milan, Italy

6. Department of Biomedical Sciences for Health, University of Milan, via Luigi Mangiagalli 31, 20133 Italy

Abstract

Abstract Background This article systematically summarizes the present evidences, published in the last 20 years, regarding the pre- and post-operative factors, which may influence recovery of the function of the quadriceps muscle group following total knee arthroplasty (TKA). We following the PRISMA methodology, including meta-analyses and high-level evidence studies (prospective trials, and, when unavailable, retrospective studies). Sources of data Pubmed and Cochrane databases: 582 articles were identified and 54 of them were selected. Areas of agreement Tourniquets inflated at high pressure exert a detrimental effect on the quadriceps muscle group. Faster quadriceps recovery takes place using mini-invasive approaches, an eight-week rehabilitation period including balance training and the use of nutraceuticals. Areas of disagreement Pre-habilitation and pre-operative factors, analgesic methods and different TKA implants. Growing points and areas timely for developing research Telerehabilitation seems a cost-effective tool for rehabilitation after TKA. Patients’ optimization protocols before TKA should include standardized nutraceuticals intake.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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4. Muscle rehabilitation: its effect on muscular and functional performance of patients with knee osteoarthritis;Fisher;Arch Phys Med Rehabil,1991

5. Knee extensor and flexor torque characteristics before and after unilateral total knee arthroplasty;Rossi;Am J Phys Med Rehabil,2006

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