Preoperative rehabilitation before total knee arthroplasty (TKA) has not been proven to be effective. Latest meta-analyzes do not find any improvement of motor performance during gait 6 months after surgery. However, most of the previous studies did not specifically target muscle atrophy to design rehabilitation protocol. Pre-operative muscle atrophy, although not systematic, is often observed. The preoperative muscles volumes of thigh muscles have been poorly identified and never used to adjust the pre operative rehabilitation strategy. As part of the "FOLLOWKNEE" (RHU) project, which attempts to implement a personalized management of TKA and its follow-up, this study wants to explore the potential effect of adapted treatment to improve muscle force and muscle volume before TKA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
15
Patient with knee arthroplasty indication. After clinical assessment and a MRI measurement of muscle volume, patients start a 2 hours daily rehabilitation including 2 times 20 minutes of electrostimulation of atrophied muscles, 3 days per week during 4 weeks.
Patient with knee arthroplasty indication. After clinical assessment and a MRI measurement of muscle volume, patient start a 2 hours daily rehabilitation targeting muscles groups with strengthening and stretching exercises, 3 days per week during 4 weeks.
CHRU de Brest
Brest, France, France
Difference of isometric strength D0-W4p
Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W4 will be calculated as follows : (QSW4p-QSD0)+(HSW4p-HSD0). Personalized rehabilitation will first be compared to classic rehabilitation and if positive to global rehabilitation.
Time frame: Day 0 to Week 4 postoperative
Difference of isometric strength D0-W4
Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W4 (W4) will be calculated.
Time frame: Day 0 to Week 4
Difference of isometric strength D0-W12p
Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W12postoperative (W12p) will be calculated.
Time frame: Day 0 to Week 12 postoperative
Muscles volumes
Quadriceps and hamstring volume as well as all muscles volume of each muscles groups will be evaluated in MRI.
Time frame: Day 0, Week 4, Week 2 postoperative
Walking speed on 10 meters
The patient will be timed when walking 10meters on a graduated corridor. They will be allowed to stop or use a technical help.
Time frame: Day 0, Week 4, Week 4 postoperative, Week 12 postoperative
Time up and go test (TUG)
The patient must get up from the sitting position and walk three meters from the chair and then retrace his steps (turn 180 degrees) and sit down again. The time that the person puts to this activity is timed by the evaluator.
Time frame: Day 0, Week 4, Week 4 postoperative, Week 12 postoperative
Western Ontario McMaster Osteoarthritis Index (WOMAC)
WOMAC is a medical scale for hip and osteoarthritic knee consisting of 24 questions scored between 0 and 4. The questions are about pain, joint stiffness and function.
Time frame: Day 0, Week 4, Week 4 postoperative, Week 12 postoperative
Pain in Analogic Visual Scale (AVS)
The pain during the 5 last days will be evaluated by Analogic Visual Scale. Pain is evaluated on a scale between 0 and 10. 0 is no pain and 10 the worse pain.
Time frame: Day 0, Week 4, Week 4 postoperative, Week 12 postoperative
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