Effect of Fast Inpatient Rehabilitation After TKA

Study Overview
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Brief Summary
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Rehabilitation is an important part of the post-operative treatment after TKA by consensus. This study intends to analysis whether fast inpatient rehabilitation after TKA can improve knee joint or general function, and ultimately explore for effects and values of fast inpatient rehabilitation after TKA.

Detailed Description
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Rehabilitation, which is an important part of the post-operative treatment after TKA, could effectively alleviate symptoms of pain and swell, as well as improve knee joint and general function. It has reached a consensus that post-TKA rehabilitation should contain muscle strengthening, ROM, proprioceptive, balance training and physical factor therapy, etc. This study intends to use observational cohort study methods with exposure factor of fast inpatient rehabilitation after TKA, establish a TKA exposure group and a control group of TKA without inpatient rehabilitation, analysis whether fast inpatient rehabilitation after TKA can improve knee joint or general function, and ultimately explore for effects and values of fast inpatient rehabilitation after TKA.

Official Title
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Effect of Fast Inpatient Rehabilitation After Total Knee Arthroplasty

Conditions
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Total Knee Arthroplasty, Rehabilitation

Intervention / Treatment
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* Combination Product: Fast Inpatient Rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Initial unilateral TKA patients due to osteoarthritis, rheumatoid arthritis, etc. Satisfactory operative knee joint ROM: knee flexion ≥120° and extension ≥ 0°. Prior informed consent by patients. Exclusion Criteria: Complication of other medical conditions and disability to cooperate with rehabilitation. Complication of other conditions affecting bilateral lower limbs such as fracture, tumor, neurologic disorder, etc. Deep venous thrombosis of lower limbs with exception of inter-muscular venous thrombosis.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Exposed Group<br>Both exposed group and control group are undertaken TKA surgery and routine postoperative management for 2 days in orthopedics department. Exposed group patients are transferred from orthopedics department to rehabilitation department on 2nd day after TKA, and accept fast inpatient rehabilitation for 1 week before hospital discharge, while control group patients continue to accept routine peri-operative management and conventional oral instructions of exercises in orthopedics department until hospital discharge. | Combination Product: Fast Inpatient Rehabilitation<br>* Routine inpatient rehabilitation protocol, administered by licensed Physical Therapist, duration period of 1.5h-2h each time, 2 times for weekdays and 1 time for weekends, totally lasting for 1 week, are applied to the exposed group. After the fast inpatient rehabilitation for 1 week, the patients can get discharged if reaching to the rehabilitation goals of symptoms of pain and swell reduced, knee flexion ≥ 90° and knee extension ≥ 0°, quadriceps femurs and hamstrings muscle strength enhanced, recovery to aided standing and walking, and acquiring of rehabilitation training methods.<br>|
| Control Group<br>Both exposed group and control group are undertaken TKA surgery and routine postoperative management for 2 days in orthopedics department. Exposed group patients are transferred from orthopedics department to rehabilitation department on 2nd day after TKA, and accept fast inpatient rehabilitation for 1 week before hospital discharge, while control group patients continue to accept routine peri-operative management and conventional oral instructions of exercises in orthopedics department until hospital discharge. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bilateral knee Rang Of Motion (ROM) | bilateral knee flexion and extension ROM are measured by articular protractor | 1 day after TKA | 
| bilateral quadriceps femurs | measured by manual muscle test (MMT) | 1 day after TKA | 
| hamstrings muscle strength | measured by manual muscle test (MMT) | 1 day after TKA | 
| Hospital for Special Surgery-Knee Rating scale (HSSKR) | to measure knee function, with the minimum 0 and maximum 100, higher score means a better outcome | 1 day after TKA | 
| modified Barthel Index (mBI) | to measure ADL, with the minimum 0 and maximum 100, higher score means a better outcome | 1 day after TKA | 
| Numerical Rating Scale (NRS) for pain | the minimum is 0 and maximum 10, higher score means a worse outcome | 1 day after TKA | 
| NRS for pain |  | 6 weeks after TKA | 
| NRS for pain |  | 3 months after TKA | 
| NRS for pain |  | 6 months after TKA | 
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | to measure knee function and global function, with the minimum 0 and maximum 100, higher score means a better outcome | 1 day after TKA | 
| KOOS |  | 6 weeks after TKA | 
| KOOS |  | 3 months after TKA | 
| KOOS |  | 6 months after TKA | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total Knee Arthroplasty, Fast Rehabilitation, Inpatient Rehabilitation