Prophylaxis of knee joint contractures after primary knee replacement with kinesiotherapy (metaanalysis and literature review)

Volodymyr Filipenko, Vera Kolesnichenko, Volodymyr Mezentsev, Oleksiy Tankut, Zorik Arutunan


Primary knee replacement is one of the most common orthopedic procedures. However, in some cases, after surgical treatment, functional disorders in the form of joint contractures, reduced strength of periarticular muscles, persistent pain syndrome, and a high level of disability can persist.

Methods: we analyzed randomized controlled studies which reflect the results of kinesiotherapy before and after primary knee replacement in patients with knee joints osteoarthritis. Study included the results of rehabilitation programs for patients with hip and knee joints osteoarthritis, who underwent a primary total replacement of the affected joint. A literature search was conducted in the MEDLINE database for the period 2009–2017.

Results: present methods of kinesiotherapy are aimed at early mobilization of patients and the achievement of functional independence. A comparative analysis of the data of the primary (before the beginning of rehabilitation activities) and control (after the end of treatment) examinations in the main and control groups of patients revealed a significant improvement in joint function (p < 0.05). However, in the long-term follow-up, 12 months or more after the end of the kinesiotherapy program, the differences in the studied parameters between the participants of the main and control groups were not significant. The presence of unfavorable results of the primary knee replacement to a certain extent is associated with a decrease in the functional capabilities of the quadriceps femoris due to the development of degenerative disorders and reflex arthrogenic muscle inhibition.

Conclusions: there are no individual kinesiotherapy programs that determine the regimen, dosage, and intensity of physical exercises in this category of patients, depending on the initial functionality level of the knee joint and the musculoskeletal system as a whole, and the features of the postoperative recovery period.


primary knee replacement; kinesiotherapy programs; special exercises; metaanalysis


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