ORIGINAL PAPER
Strength and balance deficits affecting patient satisfaction with total knee replacements
1
California State University, Long Beach, CA, USA
2
University of Tennessee, Knoxville, TN, USA
3
Tennessee Orthopaedic Clinics, Knoxville, TN, USA
Submission date: 2019-10-18
Acceptance date: 2020-10-05
Publication date: 2021-04-22
Hum Mov. 2021;22(4):83-92
KEYWORDS
TOPICS
ABSTRACT
Purpose:
Patient satisfaction with total knee replacement has been commonly assessed with self-reported surveys. Up to 19% of patients were dissatisfied with total knee replacement outcomes; however, very little is known about their objective physical abilities. Restoring knee strength is crucial for an increase in functional abilities. Improved balance is an essentialmeasure of total knee replacement success. However, it is unknown how dissatisfied patients differ from satisfied ones with respect to strength and balance abilities. The purpose of this study was to examine how knee flexor and extensor strength and balance abilities differed for dissatisfied total knee replacement patients compared with satisfied patients and healthy controls.
Methods:
The study involved 9 dissatisfied and 15 satisfied total knee replacement patients and 15 healthy controls. Participants performed isokinetic knee flexion and extension tests at 60°/s and 180°/s using an isokinetic dynamometer. Bilateral and unilateral static and dynamic balance trials employed a Biodex Balance System. Stair ascent/descent tests and a chair rise test served to examine speed of activity.
Results:
Dissatisfied patients showed reduced peak extension (180°/s) and flexion (60°/s) torque compared with satisfied patients. No balance differences were evident, although an increased percentage of dissatisfied patients were unable to complete the static and dynamic unilateral balance tests. Stair ascent and descent times and pain levels were increased in the dissatisfied group.
Conclusions:
Strength increase may provide a more symmetrical movement pattern and better function. The inability to balance and longer functional test times indicate reduced functional ability and continuous pain.
Patient satisfaction with total knee replacement has been commonly assessed with self-reported surveys. Up to 19% of patients were dissatisfied with total knee replacement outcomes; however, very little is known about their objective physical abilities. Restoring knee strength is crucial for an increase in functional abilities. Improved balance is an essentialmeasure of total knee replacement success. However, it is unknown how dissatisfied patients differ from satisfied ones with respect to strength and balance abilities. The purpose of this study was to examine how knee flexor and extensor strength and balance abilities differed for dissatisfied total knee replacement patients compared with satisfied patients and healthy controls.
Methods:
The study involved 9 dissatisfied and 15 satisfied total knee replacement patients and 15 healthy controls. Participants performed isokinetic knee flexion and extension tests at 60°/s and 180°/s using an isokinetic dynamometer. Bilateral and unilateral static and dynamic balance trials employed a Biodex Balance System. Stair ascent/descent tests and a chair rise test served to examine speed of activity.
Results:
Dissatisfied patients showed reduced peak extension (180°/s) and flexion (60°/s) torque compared with satisfied patients. No balance differences were evident, although an increased percentage of dissatisfied patients were unable to complete the static and dynamic unilateral balance tests. Stair ascent and descent times and pain levels were increased in the dissatisfied group.
Conclusions:
Strength increase may provide a more symmetrical movement pattern and better function. The inability to balance and longer functional test times indicate reduced functional ability and continuous pain.
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