DOI: https://doi.org/10.15674/0030-59872019412-17

Stratographic measurements in patients after total knee replacement

Volodymyr Filipenko, Zorik Arutunan, Volodymyr Mezentsev, Oleksiy Tankut, Olena Karpinska, Mykhaylo Karpinsky

Abstract


Total knee arthroplasty in patients with knee osteoarthritis allows to relieve the pain, restore axial relationship in the joint, but reduced muscle strength of the limb delays the recovery of its function. Rehabilitation measures help to improve the knee joint status, which can be controlled using statographic studies. Objective: basing on statographic studies to prove the ef­fectiveness of rehabilitation measures in patients with knee contracture after total knee arthroplasty. Methods: 18 patients with two-side knee osteoarthritis and knee joint contractures after bilateral knee replacement were included in the study. Patients were divided into two groups: 11 patients underwent rehabilitation, 7 patients without rehabilitation. The range of motion in the knee joints was measured; the support ability was evaluated using statography. Results: several types of standing and features of the balance support have been identified. In case of double-standing there are: I type — displacement of the common center of mass (CCM) in the direction of a shortened limb, the CCM projection extended in the sagittal (back and forth) direction; II — the CCM projection has the form of a wide spot with a spread of 20 mm or more. For one-bearing standing there are: I type — the patient is not able to fully support on a limb, so the projections are close to the center gravity, II — during standing body movement in the direction to doubly-standing was detected. Parameters of standing in patients after rehabili­tation were much better than in case of its absence. The symmetry of the load of the feet improved statistically significant (p < 0.05), but the imbalance persisted, as evidenced by the sig­nificant area of the CCM projection. Conclusion: the improving balance and restoration of foot load to almost normal in patients who underwent rehabilitation was confirmed by statography.

Keywords


knee osteoarthritis; flexion and extension contractures; knee joint; total arthroplasty; statography; the common center of mass

References


Filipenko, V. A., Tankut, V. О, Melnyk-Kahliak, N., Kosiakov, O. & Sokhan, S. (2016). Modern trends in development of artificial joints for human (literature review). Orthopaedics, Traumatology and Prosthetics, 4, 102–110. doi: 10.15674/0030-598720164102-110 [in Ukrainian]

Zhu, S., Qian, W., Jiang, C., Ye, C., & Chen, X. (2017). Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis. Postgraduate Medical Journal, 93 (1106), 736–742. doi:10.1136/postgradmedj-2017-134991

Review Manager (RevMan). 5.3 ed. Copenhagen: The Nordic Cochrane Centre: The Cochrane Collaboration. 2014. Retrieved from: https://community.cochrane.org/ help/tools-and-software/revman-5.

Kizilova, N., Karpinsky, M., Griskevicius, J. & Daunoraviciene, K. (2009). Posturographic study of the human body vibrations for clinical diagnostics of the spine and joint pathology. Mechanika, 80 (6), 37–41. doi: 10.5755/ j01.mech.80.6.15500.

Kizilova, N., Karpinska, E., & Karpinsky, M. (2014). Quasi-regular and chaotic dynamics of postural sway in human. In Jan Awrejacewicz. Applied Non-Linear Dynamical Systems. Springer : Proceedings in Mathematics & Statistics, 2014, 103–114. doi:10.1007/978-3-319-08266-0_8

Meier, W., Mizner, R., Marcus, R., Dibble, L., Peters, C., & Lastayo, P. C. (2008). Total Knee Arthroplasty: Muscle Impairments, Functional Limitations, and Recommended Rehabilitation Approaches. Journal of Orthopaedic & Sports Physical Therapy, 38 (5), 246–256. doi: 10.2519/jospt.2008.2715

Valtonen, A., Poyhonen, T., Heinonen, A., & Sipila, S. (2009). Muscle Deficits Persist After Unilateral Knee Replacement and Have Implications for Rehabilitation. Physical Therapy, 89 (10), 1072–1079. doi:10.2522/ptj.20070295

Filippenko, V. A., Kolesnichenko, V. A., Mezentsev, V. A., Tankut, A. V., & Arutunan, Z. A. (2019). Prophylaxis of knee joint contractures after primary knee replacement with kinesiotherapy (metaanalysis and literature review). Orthopedics, traumatology and prosthetics, 1, 107–114. doi: 10.15674/0030-598720191107-114 [in Russian].

Labraca, N. S., Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Arroyo-Morales, M., Sánchez-Joya, M. D., & Moreno-Lorenzo, C. (2011). Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial. Clinical Rehabilitation, 25 (6), 557–566. doi: 10.1177/0269215510393759

Artz, N., Elvers, K. T., Lowe, C. M., Sackley, C., Jepson, P., & Beswick, A. D. (2015). Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskeletal Disorders, 16 (1), 15. doi:10.1186/s12891-015-0469-6

Tyazhelov, O. А., Karpinsky, M. Yu., Karpinska, O. D. & Yaremin S. Yu. (2014). Justification and analysis of geometric parameters of statographic data for evaluation the musculoskeletal system of human. Orthopaedics, Traumatology and Prosthetics, 3, 62–68. doi: 10.15674/0030-59872014362-67 [in Ukrainian]

De Souza Moreira, A. C., Luiz Cardoso, F., Zarpellon Mazo, G., & Santos, G. M. (2019). Influence of the clinical in postural balance in woman with knee osteoarthritis. International Physical Medicine & Rehabilitation Journal, 4 (4), 135–143. doi:10.15406/ipmrj.2019.04.00188

Mitelev, Z. M., Karpinsky, M. Yu., Kokorovets, V. Ya. & Kruzhilin, G. I. (1997). A system for complex assessment of the condition of the musculoskeletal and vestibular apparatus of the person «Statograph», Medicine and ..., 1, 35–36. [in Russian]

Tyazhelov, O. A., Karpinsky, M. Yu., Karpinska, O. D. Yaremyn, S. Yu. (2014). Features of dynamic characteristics of statogram when fixing the joints of the lower limbs/ Trauma, 15, 2, 88–93. doi: 10.22141/1608-1706.2.15.2014.81375 [in Ukrainian]

Ruhe, A., Fejer, R., & Walker, B. (2011). Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: a systematic review of the literature. European Spine Journal, 20 (3), 358–368. doi:10.1007/s00586-010-1543-2

Yamamoto, T., Smith, C. E., Suzuki, Y., Kiyono, K., Tanahashi, T., Sakoda, S., … & Nomura, T. (2015). Universal and individual characteristics of postural sway during quiet standing in healthy young adults. Physiological Reports, 3(3), e12329. doi:10.14814/phy2.12329

Massin, P., Lautridou, C., Cappelli, M., Petit, A., Odri, G. … & Société d'Orthopédie de l'Ouest (2009). Total knee arthroplasty with limitations of flexion. Orthopaedics & Traumatology: Surgery & Research, 95 (4 Suppl 1), S1–S6. doi: 10.1016/j.otsr.2009.04.002.

Judge, A., Cooper, C., Williams, S., Dreinhoefer, K., & Dieppe, P. (2010). Patient-reported outcomes one year after primary hip replacement in a European Collaborative Cohort. Arthritis Care & Research, 62 (4), 480–488. doi:10.1002/acr.20038




Copyright (c) 2020 Volodymyr Filipenko, Zorik Arutunan, Volodymyr Mezentsev, Oleksiy Tankut, Olena Karpinska, Mykhaylo Karpinsky

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.