In total knee arthroplasty (TKA), the relationship between implant design, soft tissue balance, neuromuscular contributions, and rehabilitation strategies on patient satisfaction and functional outcomes is highly complex and poorly understood. The investigators will prospectively study the effects of these factors using in vivo assessments preoperatively, and postoperatively. Computer simulation models will also be used to analyze lower extremity biomechanics.
Total knee arthroplasty (TKA) is the primary treatment for end-stage knee osteoarthritis and effectively relieves pain and improves function after surgery. Nevertheless, as many as 1 in 5 patients are dissatisfied with the postoperative outcome, and knee instability remains one of the top indications for revision surgery. Implant design, soft tissue balance, neuromuscular capabilities, and rehabilitation strategies can all influence postoperative outcomes. However, the relationship between these factors and the most effective therapeutic approach for total knee arthroplasty has yet to be identified. The investigators will study preoperative and postoperative functional measures and patient satisfaction along with implant design and specific intraoperative data, which may help inform a targeted approach for optimal outcomes after total knee arthroplasty and improve future care of patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
38
The intervention group will perform unsupervised home strengthening exercises for the hip abductors in addition to standard physical therapy, while the control group will receive standard physical therapy alone.
Physician determined standard of care for individual TKA patients.
Assessments will include: * TUG (timed up and go test) \>12 sec indicates increased fall risk * Tandem balance test \< 10 sec indicates increased fall risk * Sit to Stand test (age based norms) * Knee Range Of Motion (ROM) * Quadriceps and hamstring strength (MMT or hand held dynamometer) * Lower Extremity Functional Score (LEFS questionnaire)
UF & Shands Orthopaedics and Sports Medicine Institute
Gainesville, Florida, United States
UF Health Florida Surgical Center
Gainesville, Florida, United States
UF Health at the University of Florida
Gainesville, Florida, United States
UF Health Cancer Hospital
Gainesville, Florida, United States
Top declined walking speed before and after TKA.
Top walking speed is defined as the maximum speed a patient feels that they can safely walk without running. Patients will walk on an instrumented treadmill declined at seven degrees.
Time frame: Tested preoperatively, and once during the two to four months after TKA
Bilateral isometric quadriceps, hamstrings, and gluteus medius strength before and after TKA
Maximum isometric quadriceps, hamstrings, and gluteus medius strength as measured by a dynamometer.
Time frame: Tested preoperatively, and once during the two to four months after TKA
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