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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2001 June;37(2):115-24
Complications after total knee arthroplasty
Rucco V., Zanetti R., Colonnello V.
From the Department of Rehabilitation ASS N. 6 “Friuli Occidentale”, Pordenone (Italy)
The success rates of total knee arthroplasty have improved with the use of aseptic techniques, advanced materials, antithrombotic and antibiotic prophylaxis, and more rigorous surgical protocols. So too in rehabilitation, projects and programs have become more precise with the definition of objectives for each phase. Despite the apparent simplicity of such programs, however, the future of patients receiving knee prostheses is often associated with a high risk of complications. Late diagnosis and inappropriate treatment can be effectively avoided by a well trained rehabilitation team (physiatrician, physical therapist, nurse) that works together to recognize and solve problems. Moreover, close collaboration with the orthopedic surgeon will help avoid sending contradictory messages to the patient.
The approach to patient care should start with preoperative evaluation to determine the basic clinical and social aspects for designing the project and the rehabilitation program. Accurate assessment of the intervention itself is vital, taking into account surgical access and weakening of the extensor apparatus following the anterior approach, prosthesis model, sacrifice of the posterior cruciated ligament, type of anchoring of the prosthesis to the bone, and intraoperative problems.
Assessment of the clinical and functional postoperative situation should include examination of the skin and the wound, passive joint movement, stability of the collateral ligaments, and pain in movement or loading. Attention to social aspects is essential in planning the pathway management of the patient after discharge from the orthopedics unit and through the rehabilitation services. Another important consideration is continuous monitoring of the patient over the days, months and years following the operation.
The aim of this review is to examine 1) complications after primary total knee arthroplasty and the phases in which they can arise, 2) the relationship with operative procedures, 3) the various solutions medical, rehabilitative and surgical therapy can offer.