Perioperative management of elderly patients with osteoarthritis requiring total knee arthroplasty

Study on the effect of internet plus continuous nursing on functional recovery and medication compliance of patients with knee joint replacement

OBJECTIVE

To evaluate the effect of "Internet + " continuity of care on postoperative functional recovery and medication compliance in patients with knee arthroplasty.

METHODS

In this retrospective study, 100 patients who underwent knee replacement in our hospital between January 2021 and December 2022 were recruited and assigned to receive routine care (routine group) or "Internet + " continuity of care (continuity group), with 50 patients in each group. Outcome measures included knee function, sleep quality, emotional state, medication compliance, and self-care ability.

RESULTS

Patients in the continuity group showed better knee function after discharge and during follow-up versus those in the routine group (P < 0.05). Continuity care resulted in significantly lower Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores versus routine care (P < 0.05). Patients in the continuity group showed higher treatment compliance, ability of daily living (ADL) scores, and nursing satisfaction than those in the routine group (P < 0.05).

CONCLUSION

The "Internet + " continuity of care is highly feasible and can effectively promote the postoperative functional recovery of knee replacement patients, improve patients' medication compliance, sleep quality, and self-care ability, mitigate negative emotions, and provide enhanced home care.

Analysis of the Covid-19 pandemic impact on osteoarthritis patient visits at physiotherapy clinics in Indonesia – A retrospective cohort study

Objectives

This study aimed to determine the impact of visits by knee OA patients to physiotherapy clinics in Indonesia during the Covid-19 pandemic.

Method

This retrospective cohort study collected data from knee OA patients seeking treatment at a physiotherapy clinic in Makassar, Indonesia, from January to December 2021. The number of patient visits per month was compared using descriptive statistics. The treatment outcomes were measured in Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and analyzed using inferential statistics.

Result

During the Covid-19 pandemic, there was a decrease in knee OA patient visits to physiotherapy clinics. Knee OA patient visits increased after the vaccination program was implemented, especially for patients who had been vaccinated with the full dose.

Conclusion

The frequency of knee OA patient visits to physiotherapy clinics decreased during the Covid-19 pandemic. It impacted the outcome of treatment received by the patients. However, patient visits increased after the vaccination program was implemented.

Effects of Resistance Training Prior to Total Hip or Knee Replacement on Post-operative Recovery in Functional Performance: A Systematic Review and Meta-Analysis

Objective

To evaluate the effectiveness of pre-operative resistance training in patients allocated to TJR surgery on selected post-operative outcomes, via a meta-analysis of studies using exercise modalities and loading intensities objectively known to promote gains in muscle size and strength in adults of young-to-old age.

Design

A systematic review and meta-analysis.

Literature Search

Cochrane Central, MEDLINE, EMBASE, and PEDro were searched on August 4th 2021.

Study Selection

Randomized Controlled Trials (RCTs) were included if (i) they compared pre-operative lower-limb-exercises before elective TJR with standard care, (ii) explicitly reported the exercise intensity, and (iii) reported data on functional performance.

Data Synthesis

This systematic review and meta-analysis is reported in accordance with the PRISMA reporting guidelines. A random effects model with an adjustment to the confidence interval was performed for pooling the data.

Results

One thousand studies were identified. After applying exclusion criteria, five RCTs were located including 256 participants (mean age ranged from 61 to 72 years, 54% women). Moderate-to-large improvements in functional performance and maximal knee extensor strength were observed at 3 months after surgery along with small-to-moderate effects 12 months post-operatively. For patient-reported outcomes, small-to-moderate improvements were observed at 3 months post-operatively with no-to-small improvements at 12 months.

Conclusion

Prehabilitation efforts involving progressive resistance training provides an effective means to improve post-operative outcomes related to functional performance, knee extensor strength and patient-reported outcome in patients undergoing TJR. Due to large methodological diversity between studies, an optimal loading intensity remains unknown.

Systematic Review Registration

Prospero ID: CRD42021264796.