Brian J Loyd1, Scott Stackhouse2, Michael Dayton3, Craig Hogan3, Michael Bade4, Jennifer Stevens-Lapsley5. 1. The University of Colorado Denver AMC, Department of Physical Medicine and Rehabilitation, United States of America. Electronic address: brian.loyd@health.utah.edu. 2. University of New England, United States of America. 3. The University of Colorado Denver AMC, Department of Orthopedics, United States of America. 4. The University of Colorado Denver AMC, Department of Physical Medicine and Rehabilitation, United States of America. 5. The University of Colorado Denver AMC, Department of Physical Medicine and Rehabilitation, United States of America; Veterans Affairs Geriatric Research, Education and Clinical Center, Denver, CO, United States of America.
Abstract
BACKGROUND: The relationships between swelling after total knee arthroplasty (TKA) and quadriceps strength and functional performance are poorly understood. Therefore, the aim of this study was to examine the relationships between lower extremity swelling, measured using bioelectrical impedance assessment (SF-BIA), and quadriceps strength and timed up and go (TUG) times following TKA. METHODS: 53 participants (64 ± 9.5 y/o, 43% male) undergoing primary unilateral TKA were recruited for the longitudinal observational study with repeated measures. Quantities of swelling were examined for contribution to two and six-week outcomes of strength and TUG time using hierarchical regression controlling for age, sex, and the baseline value of the dependent variable. Swelling was assessed using bioelectrical impedance assessment and quantified as the peak level of swelling and cumulative swelling (integral) over the post-TKA time window. Maximum isometric quadriceps strength (MVIC) was measured using a electromechanical dynamometer and participant functional performance measured using the TUG. RESULTS: Neither peak swelling nor cumulative swelling significantly contributed to the variance of two-week quadriceps strength. At six weeks, peak swelling significantly improved the variance in maximal quadriceps strength by an additional four percent (p = 0.05), while cumulative swelling did not significantly contribute. Peak swelling significantly contributed to the variance in two-week (16%) and six-week (five percent) TUG times (p < 0.05), but the cumulative swelling did not. CONCLUSIONS: Peak swelling represents a value of post-TKA swelling that is associated with strength and function. Reducing the peak level of swelling, occurring early after surgery, may improve patient functional recovery. LEVEL OF EVIDENCE: Level II - Prospective observational study.
BACKGROUND: The relationships between swelling after total knee arthroplasty (TKA) and quadriceps strength and functional performance are poorly understood. Therefore, the aim of this study was to examine the relationships between lower extremity swelling, measured using bioelectrical impedance assessment (SF-BIA), and quadriceps strength and timed up and go (TUG) times following TKA. METHODS: 53 participants (64 ± 9.5 y/o, 43% male) undergoing primary unilateral TKA were recruited for the longitudinal observational study with repeated measures. Quantities of swelling were examined for contribution to two and six-week outcomes of strength and TUG time using hierarchical regression controlling for age, sex, and the baseline value of the dependent variable. Swelling was assessed using bioelectrical impedance assessment and quantified as the peak level of swelling and cumulative swelling (integral) over the post-TKA time window. Maximum isometric quadriceps strength (MVIC) was measured using a electromechanical dynamometer and participant functional performance measured using the TUG. RESULTS: Neither peak swelling nor cumulative swelling significantly contributed to the variance of two-week quadriceps strength. At six weeks, peak swelling significantly improved the variance in maximal quadriceps strength by an additional four percent (p = 0.05), while cumulative swelling did not significantly contribute. Peak swelling significantly contributed to the variance in two-week (16%) and six-week (five percent) TUG times (p < 0.05), but the cumulative swelling did not. CONCLUSIONS: Peak swelling represents a value of post-TKA swelling that is associated with strength and function. Reducing the peak level of swelling, occurring early after surgery, may improve patient functional recovery. LEVEL OF EVIDENCE: Level II - Prospective observational study.
Authors: Riann M Palmieri; James A Tom; Jeffery E Edwards; Arthur Weltman; Ethan N Saliba; Danny J Mistry; Christopher D Ingersoll Journal: J Electromyogr Kinesiol Date: 2004-12 Impact factor: 2.368
Authors: Ryan L Mizner; Stephanie C Petterson; Jennifer E Stevens; Michael J Axe; Lynn Snyder-Mackler Journal: J Rheumatol Date: 2005-08 Impact factor: 4.666
Authors: Brian J Loyd; Scott K Stackhouse; Craig Hogan; Michael R Dayton; Jennifer E Stevens-Lapsley; Andrew J Kittelson Journal: J Bone Joint Surg Am Date: 2019-09-04 Impact factor: 5.284
Authors: Andrew J Kittelson; Jesse C Christensen; Brian J Loyd; Kristine L Burrows; Johna Iannitto; Jennifer E Stevens-Lapsley Journal: Disabil Rehabil Date: 2020-03-06 Impact factor: 2.439