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The time course of quadriceps strength recovery after total knee arthroplasty is influenced by body mass index, sex, and age of patients : systematic review and meta-analysis
ID Paravlić, Armin (Author), ID Meulenberg, Cécil J. W. (Author), ID Drole, Kristina (Author)

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Abstract
Introduction: For patients with osteoarthritis who have undergone total knee arthroplasty (TKA), quadriceps strength is a major determinant of general physical function regardless of the parameters adopted for functional assessment. Understanding the time course of quadriceps strength recovery and effectiveness of different rehabilitation protocols is a must. Therefore, the aim of this study was to: (i) determine the magnitude of maximal voluntary strength (MVS) loss and the time course of recovery of the quadriceps muscle following TKA, (ii) identify potential moderators of strength outcomes, and (iii) investigate whether different rehabilitation practices can moderate the strength outcomes following TKA, respectively. Design: General scientific databases and relevant journals in the field of orthopedics were searched, identifying prospective studies that investigated quadriceps’ MVS pre- to post-surgery. Results: Seventeen studies with a total of 832 patients (39% males) were included. Results showed that in the early post-operative days, the involved quadriceps’ MVS markedly declined, after which it slowly recovered over time in a linear fashion. Thus, the greatest decline of the MVS was observed 3 days after TKA. When compared to pre-operative values, the MVS was still significantly lower 3 months after TKA and did not fully recover up to 6 months following TKA. Furthermore, a meta-regression analysis identified that the variables, time point of evaluation, patient age, sex, and BMI, significantly moderate the MVS of the quadriceps muscle. Conclusion: The analyzed literature data showed that the decrease in strength of the involved quadriceps muscles following TKA is considerable and lasts for several months post-surgery. Therefore, we recommend to specifically target the strengthening of knee extensor muscles, preserve motor control, and apply appropriate nutrition to ensure a holistic quadriceps muscle recovery. Since age, sex, and BMI were found to be moderating factors in patients’ recovery, further research should include specific analyses considering these moderators.

Language:English
Keywords:knee osteoarthritis, total knee arthroplasty, rehabilitation, functional performance, voluntary activation, obesity, body mass index, BMI, total knee replacement
Work type:Article
Typology:1.02 - Review Article
Organization:FŠ - Faculty of Sport
Publication status:Published
Publication version:Version of Record
Year:2022
Number of pages:16 str.
Numbering:Vol. 9, art. 865412
PID:20.500.12556/RUL-145340 This link opens in a new window
UDC:796.012.1:617.3
ISSN on article:2296-858X
DOI:10.3389/fmed.2022.865412 This link opens in a new window
COBISS.SI-ID:109287427 This link opens in a new window
Publication date in RUL:18.04.2023
Views:390
Downloads:47
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Record is a part of a journal

Title:Frontiers in medicine
Shortened title:Front. med.
Publisher:Frontiers Media
ISSN:2296-858X
COBISS.SI-ID:523095065 This link opens in a new window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Language:Slovenian
Keywords:totalna artroplastika kolena, funkcionalne zmogljivosti

Projects

Funder:ARRS - Slovenian Research Agency
Project number:P5-0147
Name:Kineziologija monostrukturnih, polistrukturnih in konvencionalnih športov

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