What are the novel rehabilitation methods in knee arthroplasty? A bibliographic review

Issue title: Special Section: Future Arthroplasty

Guest editors: Mustafa Citak

Article type: Review Article

Authors: Kara, Seher^a | Nokay, Aziz Emre^{b; *}

Affiliations: [a] Erenköy Physical Therapy and Rehabilitation Hospital, Istanbul, Turkey | [b] Helios ENDOKlinik, Hamburg, Germany

Correspondence: [*] Corresponding author: Aziz Emre Nokay, Helios ENDOKlinik, Hamburg, Germany. E-mail: [email protected].

Abstract: BACKGROUND: Total knee arthroplasty (TKA) is a common procedure for treating end-stage degenerative knee osteoarthritis (OA). Despite the generally excellent outcomes, postoperative complications such as loss of muscle strength and joint limitation can occur. Therefore, postoperative physical rehabilitation is crucial for regaining strength, functionality, and managing pain. Various rehabilitation strategies employ different methods to reduce pain severity, regain muscle strength, assist patients in returning to daily activities, and increase functionality. In recent years, technological advancements have transformed rehabilitation methods. In addition to traditional applications, new methods have been incorporated into treatment plans. OBJECTIVE: This study aimed to evaluate novel physical rehabilitation methods and options following OA. METHODS: A literature review was conducted to identify and investigate recent and commonly used novel rehabilitation methods. The search terms “Total Knee Arthroplasty,” “New Rehabilitation TKA,” “Novel Rehabilitation” “Novel Rehabilitation in Arthroplasty” and “Technology Knee Rehabilitation” were searched across PubMed and Google Scholar databases, covering literature from the past 15 years. Studies on telerehabilitation, functional electric stimulation, virtual reality, yoga, and their reported outcomes were evaluated using specific keywords. The results of various studies on novel rehabilitation methods were gathered and compared to traditional treatment plans based on functionality and applicability. RESULTS: Several studies reported that telerehabilitation was not inferior to traditional rehabilitation, with some showing positive outcomes. Telerehabilitation following TKA demonstrated positive effects on functionality and patient satisfaction. Functional electric stimulation showed significant improvements in muscle strength and pain reduction. Virtual reality demonstrated superior effects on proprioception and posture outcomes. The use of yoga in rehabilitation also resulted in improved proprioception and pain reduction. CONCLUSION: In addition to traditional rehabilitation methods, new approaches have shown significant positive outcomes for patients who have received TKA. We are in an era of digital development, and as such, new rehabilitation techniques, particularly those involving digital advancements, will continue to emerge. With the trend toward personalized approaches in medicine, more new techniques or methods will be incorporated into rehabilitation plans, leading to better recovery outcomes from TKA.

Keywords: TKA, rehabilitation, technology, telerehabilitation, virtual reality, functional electric stimulation, novel methods in rehabilitation

DOI: 10.3233/THC-240628

Journal: Technology and Health Care, vol. 32, no. 5, pp. 3643-3648, 2024