Rehabilitation after orthopedic surgery

INTRODUCTION: Total knee arthroplasty (TKA) has the highest annual incidence among all joint replacement surgeries. Below-knee amputation (BKA) is another common procedure to treat lower-limb-threatening pathologies. These two procedures are commonly performed individually, but an ipsilateral TKA performed on a BKA patient is rare. While ipsilateral amputation is not a contraindication for TKA, it presents orthopaedic surgeons with a unique case and necessitates thoughtful pre-operative planning regarding proper positioning, alignment determination, surgical technique, and rehabilitation for the best outcome...

INTRODUCTION: A patient presented for recalcitrant right hip pain secondary to femoroacetabular impingement (FAI) after blunt motor vehicle trauma and following the development of a 12 cm heterotopic ossification (HO). FAI is an increasingly recognized diagnosis where the hip joint is exposed to repeated femoral microtrauma from high-level physical activity or trauma, often causing labral ossification, and perhaps underlying a similar biological mechanism to HO. CASE REPORT: In this case report, we have an otherwise healthy 49-year-old male who was involved in a high-speed motor vehicle collision who was diagnosed with right hip FAI secondary to HO (Brooker's Class IV) and indicated for surgical excision of the HO anterior to the right proximal femur...

INTRODUCTION: Gunshot injuries, while relatively uncommon in pediatric patients, can have lasting consequences, both physically and psychologically. Physeal injuries to the distal tibia are very common just second distal radius physis. Disruption of physis often leads to growth disturbances and deformities if not managed appropriately. This case report discusses the experience of a 9-year-old girl who sustained a gunshot injury to her left ankle injuring her distal tibial epiphysis. The report highlights the importance of long-term follow-up and rehabilitation in pediatric gunshot injury cases...

OBJECTIVE: Preoperative frailty and surgical waiting times are associated with the occurrence of adverse outcomes in patients with hip fractures. Specifically, we aimed to investigate the influence of frailty status and surgical timing on the risk of serious adverse events during hospitalization. METHODS: This study utilized an observational single cohort design and included patients aged ≥60 years with a primary diagnosis of hip fracture. Frailty was assessed using the chart-derived frailty index (CFI), which was calculated based on demographic and routine laboratory variables...

BACKGROUND: Excellent hip joint function facilitates limb recovery and improves the quality of survival. This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management. AIM: To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients...

Anterior cruciate ligament (ACL) tears are one of the most common orthopedic injuries among athletes. Although a small proportion of patients with isolated tears can return to sports after completing a nonsurgical rehabilitation program, ACL reconstruction is frequently recommended for young athletes, especially those with concomitant knee injuries or symptomatic knee instability. Alongside emerging evidence for the effect of prehabilitation, the current standard of care for postoperative ACL physical therapy includes pain control, range of motion, quadriceps strengthening, weight bearing, postoperative bracing, and dynamic limb stabilization and control...

This study investigates the impact of perioperative tourniquet on skeletal muscle cells during total knee arthroplasty (TKA) and its effects on the gene expression of apoptotic, inflammatory, and angiogenic pathways. The randomized controlled trial included 44 patients undergoing TKA. The patients were randomized to undergo surgery with (n = 23) or without (n = 21) tourniquet. The tourniquet was inflated before skin incision and deflated before wound closure in the tourniquet group...

Preoperative rehabilitation is an important stage to both physically and mentally prepare patients for anterior cruciate ligament reconstruction (ACLR) and postoperative rehabilitation. This study aimed to investigate the current preoperative rehabilitation practice after anterior cruciate ligament injury among licensed physical therapists in Saudi Arabia. This was an online-based cross-sectional survey. A total of 114 physical therapists completed the survey. The survey consisted of 16 mandatory questions about management strategies, prescribed exercises, patients' physical and psychological concerns, and discussions about nonoperative management...

BACKGROUND: There is no consensus among sports medicine surgeons in North America on postoperative rehabilitation strategy after meniscus repair. Various meniscal tear types may necessitate a unique range of motion (ROM) and weightbearing rehabilitation protocol. PURPOSE: To assess the current landscape of how sports medicine practitioners in the American Orthopedic Society for Sports Medicine (AOSSM) rehabilitate patients after the repair of varying meniscal tears...

STUDY DESIGN: Retrospective Review. OBJECTIVE: The purpose of this study is to evaluate the efficacy of postoperative cervical orthoses to prevent fixation failure and loss of reduction after operative treatment of cervical spine fractures. SUMMARY OF BACKGROUND DATA: While cervical orthoses are most times tolerated in trauma patients, it is not clear that postoperative bracing is effective at reducing the rate of fixation failure or nonunion in this patient population...

INTRODUCTION: The aim of this study was to estimate the incidence of stiffness during the first 6 months after rotator cuff repair and to evaluate postoperative stiffness with respect to its risk factors and its influence on the outcome at 6 months postoperatively. METHODS: In a prospective cohort of 117 patients (69 women, 48 men; average age 59) from our institutional rotator cuff registry, who underwent either arthroscopic (n = 77) or open (n = 40) rotator cuff repair, we measured shoulder range of motion (ROM) at 3 and 6 months post-surgery...

This study presents a mechanical model of a novel medical device designed to optimize the osseointegration process in upper and lower limb amputees, leading to the promotion of optimal rehabilitation. The medical device is developed to reduce the risk of implant failure, leading to re-amputation above the implant. The proposed model serves several purposes: 1) to guide the osseointegration process by providing electrical endo-stimulation directly to the bone-implant contact site, using an invasive electrical stimulation system, which is implanted in the bone permanently, 2) to locally transmit stem cells after implantation, without the need for opening the skin or perforating the bone, which is particularly useful for regenerative medicine after partial healing of the implant, 3) to transmit necessary nutrients from the bone, also without opening the skin or puncturing the bone, and 4) to combat infections by locally administering drugs after implantation...

OBJECTIVE: The results of surgical versus conservative treatment of acute Achilles tendon ruptures are still controversial. The objective of this study was to compare surgical and conservative treatment at a minimum follow-up of 1 year in terms of the complications, functional outcomes and clinical results. HYPOTHESES: There is no difference in the complications, clinical results and functional outcomes between the two treatment groups. There is no difference in the occurrence of complications or the clinical results due to the immobilization or rehabilitation protocols...

BACKGROUND: In-person hand therapy is commonly prescribed for rehabilitation after thumb carpometacarpal (CMC) arthroplasty but may be burdensome to patients because of the need to travel to appointments. Asynchronous, video-assisted home therapy is a method of care in which videos containing instructions and exercises are provided to the patient, without the need for in-person or telemedicine visits. The purpose of the present study was to evaluate the effectiveness of providing video-only therapy (VOT) as compared with scheduled in-person therapy (IPT) after thumb CMC arthroplasty...

OBJECTIVE: To investigate the effects of perioperative general anesthesia (GA) and spinal anesthesia (SA) on postoperative rehabilitation in elderly patients with lower limb surgery. METHODS: This retrospective propensity score-matched cohort study included patients aged 65 years or older who underwent lower limb surgery between January 1, 2020, and May 31, 2023. The GA and SA were selected at the request of the orthopedic surgeon, patient, and their family members...

Introduction Physical therapy (PT) is an effective nonoperative treatment for various orthopedic diagnoses. However, patients may have many reasons to dismiss PT, including favoring another intervention for their injury, time constraints, transportation, and cost. This dismissal of PT may contribute to inadequate patient compliance. This study aimed to elucidate patient compliance with a basic PT prescription and whether PT led to subjective injury improvement. Methods This is a retrospective study of patients observed in Stony Brook Orthopedic clinics from 08/01/2022 to 12/23/2022...

BACKGROUND: The main objective of the present study was to present the biomechanical properties of the wrist in patients who underwent scaphotrapeziotrapezoid arthrodesis when compared to a healthy control hand. METHODS: The study group consisted of 29 consecutive patients who underwent a scaphotrapeziotrapezoid wrist arthrodesis at least 1 year before the research onset. Both hands of all patients were examined in 4 main categories. RESULTS: Average score obtained in the VAS, before the surgery, without motion of the wrist was 5...

Knee osteoarthritis is a degenerative disorder of the knee, which leads to joint pain, stiffness, and inactivity and significantly affects the quality of life. With an increased prevalence of obesity and greater life expectancies, total knee arthroplasty (TKA) is now one of the major arthroplasty surgeries performed for knee osteoarthritis. When enhanced recovery after surgery (ERAS) was introduced in TKA, clinical outcomes were enhanced and the economic burden on the healthcare system was reduced. ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response...

Background: Lower limb osteoarthritis (OA) often generates musculoskeletal pain causing functional impairment and decreasing mobility, autonomy, and quality of life. Patients with OA are commonly prescribed specific care for total hip arthroplasty or total knee arthroplasty (THA or TKA), when patients present symptoms that are refractory to nondrug treatments. Currently, when patients are discharged from orthopedic surgery, they are either referred to a rehabilitation department, or sent directly home with assistance such as remote monitoring by teleconsultation or a mobile application...

BACKGROUND: Little is known about the effect of surgical approach on return to braking after total hip arthroplasty (THA), and few studies have investigated braking after THA with modern surgical techniques and rehabilitation protocols. METHODS: In a prospective comparative design, we enrolled 65 patients who received right-sided primary THA at our institution from April 2018 through March 2020, 34 with a direct anterior approach (DAA) and 31 with a posterior approach (PA)...