PROGRAM FISIOTERAPI PADA KASUS POST ARTHROPLASTY TOTAL KNEE REPLACEMENT SINISTRA ET CAUSA OSTEOARTHRITIS KNEE: CASE REPORT
Authors: Vitamara Yohanna , Santoso Totok Budi , Larasati Prihantoro 
Published: January 2024

ABSTRAK
Pendahuluan: Total Knee Replacement (TKR) adalah prosedur pembedahan yang ditujukan untuk mengembalikan fungsi dan penyembuhan nyeri pada pasien Osteoartritis lutut (OA lutut). Semakin meningkatnya prevalensi OA lutut dengan tingkat keparahan yang tinggi, maka meningkat pula prevalensi TKR. Meskipun TKR efektif untuk mengurangi rasa nyeri dan meningkatkan fungsi fisik pada pasien OA lutut, pasien yang menjalani operasi TKR sangat memungkinkan masih mengalami gangguan fungsional yang cukup besar pasca operasi. Fisioterapi pada pasien post op TKR secara umum dilakukan dengan tujuan optimalisasi pasca hasil operasi, termasuk kekuatan otot, fungsi fisik, dan pengurangan rasa nyeri, hingga dapat kembali lagi ke aktivitas normal sehari-hari. Tujuan: Untuk mengetahui efektivitas dan pengaruh pemberian intervensi fisioterapi dengan modalitas Transcutaneous Electrical Nerve Stimulation (TENS) dan Closed Kinetic Chain (CKC) exercise pada pasien dengan kondisi post operasi artoplasti Total Knee Replacement (TKR). Metode: Single-subject research yang dilakukan kepada seorang wanita berusia 54 tahun dengan kondisi post op Total Knee Replacement sinistra. Subjek diberikan intervensi TENS dan Closed Kinetic Chain Exercise (CKC) sebanyak 3 kali pertemuan selama 3 minggu. Hasil: Evaluasi dilakukan dengan menggunakan instrumen pengukuran Numeric Pain Rating Scale (NPRS), Range of Motion (ROM), Manual Muscle Testing (MMT), dan WOMAC indeks. Simpulan: Terdapat perubahan kondisi pasien ke arah baik yaitu penurunan rasa nyeri, peningkatan ROM, MMT, dan kemampuan aktivitas fungsional.
Kata Kunci: total knee replacement, osteoartritis lutut, nyeri, TENS, closed kinetic chain exercise

ABSTRACT
Introduction: Total Knee Replacement (TKR) is a surgical procedure aimed at restoring function and healing pain in patients with Osteoarthritis knee (OA of the knee). With the increasing prevalence of knee OA with a high level of severity, the prevalence of TKR also increases. Although TKR is effective in reducing pain and improving physical function in patients with knee OA, it is very likely that patients who undergo TKR surgery still experience significant functional impairment after surgery. Physiotherapy in TKR post-op patients is generally carried out to optimize postoperative results, including muscle strength, physical function, and pain reduction so that they can return to normal daily activities. Objective: To determine the effectiveness and effect of providing physiotherapy interventions with Transcutaneous Electrical Nerve Stimulation (TENS) and Closed Kinetic Chain (CKC) exercise modalities in patients with postoperative Total Knee Replacement (TKR) arthroplasty conditions. Methods: Single-subject research was conducted on a 54-year-old woman with post-op Total Knee Replacement left. Subjects were given TENS intervention and Closed Kinetic Chain Exercise (CKC) 3 meetings for 3 weeks. Results: The evaluation was carried out using the Numeric Pain Rating Scale (NPRS), Range of Motion (ROM), Manual Muscle Testing (MMT), and the WOMAC index. Conclusion: There is a change in the patient's condition in a good direction, namely a decrease in pain, an increase in ROM, MMT, and ability to function.
Keyword: total knee replacement, osteoarthritis knee, pain, TENS, closed kinetic chain exercise