Effect of Postoperative Edema on Proprioception in The Early Period After Total Knee Arthroplasty
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https://doi.org/10.5281/zenodo.10721831Keywords:
Pain, Physiotherapy and Rehabilitation, Postoperative Edema, Proprioception, Total Knee ArthroplastyAbstract
Introduction: Osteoarthritis is the most common degenerative joint disease, with symptoms such as pain, joint stiffness, edema, limitation of range of motion, muscle weakness, and proprioception losses. Total knee arthroplasty (TKA) further increases edema and proprioception losses. We aimed to investigate the effect of postoperative edema after TKA on the loss of proprioception, which adversely affects the quality of life and levels of independence.
Material and Method: Postoperative edema and proprioception measures were taken on 35 volunteer participants one month after TKA. Circumference measurements were converted to volumetric form using the Frustom formula. An Angle-Reproduction test was used for the measurement of proprioception at 40° and 60° knee flexion.
Results: The postoperative edema and proprioception loss in the participants were statistically determined (p<0.05). Volumes above the patella and total volume both had an effect on knee proprioception at 40° knee flexion (p<0.05). Nevertheless 60° knee flexion proprioception was not affected by postoperative edema (p>0.05).
Discussion: Proprioception is processed by stimuli from the bone periosteum, skin, and muscle fibers. Surgical techniques and postoperative edema cause autogenic inhibition in muscles, especially by triggering the spinal inhibitory mechanisms of motor neurons in the Quadriceps Femoris muscle, reducing muscle activity. Periarticular structures located above the patella due to postoperative edema affect proprioception of 40° knee flexion, while postoperative edema below the patella may not have an effect on proprioception.
Conclusion: This study reveals that postoperative edema affects proprioception in early period after TKA. Reducing postoperative edema is of primary importance in physiotherapy programs planned after TKA.
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