Application of the developed prehabilitation complex for total knee arthroplasty

Authors:

Kotelnikov Gennady Petrovich – Grand PhD in Medical Science (Dr. Med. Sci.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: g.p.kotelnikov@samsmu.ru.

Kolsanov Alexander Vladimirovich – Grand PhD in Medical Science (Dr. Med. Sci.), Professor of the Russian Academy of Sciences, Honored Scientist of the Russian Federation, Head of the Department of Operative Surgery and Topographic anatomy, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: a.v.kolsanov@samsmu.ru.

Moseev Oleg Igorevich – Postgraduate student of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; email: o.i.moseev@samsmu.ru.

Kudashev Dmitry Sergeevich – Grand PhD in Medical Science (Dr. Med. Sci.), Associate Professor, Associate Professor of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: dmitrykudashew@mail.ru.

Larcev Yuri Vasil’evich – Grand PhD in Medical Science (Dr. Med. Sci.), Professor, Head of the Department of Traumatology, Orthopedics and Extreme Surgery named after Academician of the Russian Academy of Sciences A.F. Krasnov, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: yu.v.lartsev@samsmu.ru.

Zuev-Ratnikov Sergej Dmitrievich – PhD in Medical Science (Cand. Med. Sci.), Associate Professor, Associate Professor of the Department of Traumatology, Orthopedics and Extreme Surgery of the Academy named after A.F. Krasnov, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: stenocardia@mail.ru.

Shishkina Anna Anatol’evna – PhD in Medical Science (Cand. Med. Sci.), Associate Professor, Head of the Department of Medical Rehabilitation, Sports Medicine, Physiotherapy and Balneology, Samara State Medical University, 89 Chapaevskaya Street, 443099 Samara, Russian Federation; e-mail: a.a.shishkina@samsmu.ru.

Annotation:

Introduction. Osteoarthritis (OA) is one of the most significant medical, social and economic problems. In Russia, the prevalence of knee joint OA ranges from 6 to 12% among the adult population aged 18 to 75 years. At the same time, the most effective surgical method for the treatment of end-stage knee OA is total knee arthroplasty (TKA). However, in a number of studies, the authors note that from 30 to 40% of patients remain dissatisfied with the results of TKAs, even with the correct positioning of the endoprosthesis components and the absence of their instability. At the same time, the authors note in their research that the use of complex prehabilitation is recommended for a more pronounced and meaningful result after the TKA. As a result of analyzing the data on the research topic, we have developed and implemented in clinical practice a new method of prehabilitation during knee replacement.

Aim. Evaluation of clinical and functional results of the application of the developed prehabilitation complex in the postoperative period in total knee arthroplasty.

Materials and methods. The study evaluated and analyzed the results of using the developed prehabilitation complex in a patient with verified stage 3 knee OA who was prescribed surgical treatment – total knee arthroplasty. The results of using the developed prehabilitation complex were evaluated 72 hours before surgery, as well as 72 hours, 4 and 12 weeks after surgery. Specialized scales, questionnaires, motor tests, and electroneuromyography were used to evaluate the results.

Results. Clinical case description: Patient A., born in 1961, sought advice from the Traumatology and Orthopaedic Department No. 2 of the Clinics of the Federal State Budgetary Educational Institution of Higher Medical Education of the Ministry of Health of the Russian Federation on November 7, 2024. According to the results of the clinical and instrumental examination, the patient was diagnosed with Stage 3 osteoarthritis of the right knee joint and surgical treatment was recommended – total arthroplasty of the right knee joint. Based on the results of the assessment of the clinical and functional condition, the patient was assigned a pre-rehabilitation complex developed by us. After completing the developed pre-rehabilitation complex, the patient was re-evaluated for her clinical and functional condition 72 hours before surgery, as well as 72 hours, 4 and 12 weeks after surgery, followed by an analysis of the results obtained and an assessment of the effectiveness of the developed pre-rehabilitation complex.

Discussion. Conducting a complex of prehabilitation in TKA may be a significant factor in achieving patientsatisfying clinical and functional results in the postoperative period. In our opinion, the positive effect of prehabilitation, manifested in an early reduction of pain, an increase in the strength of the muscles of the lower extremities and an increase in the volume of movements in the knee joint, can also affect a reduction in the length of hospital stay and the recovery time of physical and psycho-emotional state after TKA.

Conclusion. The described clinical case of successful application of the prehabilitation complex shows that effective restoration of knee joint functionality contributes to a significant increase in patient satisfaction with the clinical and functional results of surgical treatment.

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