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.
| Original language | English |
|---|---|
| Pages (from-to) | 382-391 |
| Number of pages | 10 |
| Journal | Knee |
| Volume | 26 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 2019 |
Funding
This work was supported by the National Institutes of Health ( R01-HD06590 ), the National Institutes of Health University of Colorado, Center on Aging Training Grant ( NIH T32 AG000279 ), and The Foundation for Physical Therapy . The authors would also like to acknowledge Kristen Burrows, BS for her contributions to study development, participant enrollment, and study support. This work was supported by the National Institutes of Health (R01-HD06590), the National Institutes of Health University of Colorado, Center on Aging Training Grant (NIH T32 AG000279), and The Foundation for Physical Therapy. The authors would also like to acknowledge Kristine Burrows, BS for her contributions to study development, participant enrollment, and study support. None of the authors report any conflicts of interest related to the submitted work titled ?THE RELATIONSHIP BETWEEN SWELLING, QUADRICEPS STRENGTH, AND FUNCTIONAL PERFORMANCE FOLLOWING TOTAL KNEE ARTHROPLASTY?. This study was approved by and followed all ethical standards of the Colorado Multiple Institutional Review Board (COMIRB #15-1419). This study was approved by and followed all ethical standards of the Colorado Multiple Institutional Review Board (COMIRB #15-1419).
| Funder number |
|---|
| R01-HD06590 |
| T32AG000279 |
| 15-1419 |