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unicompartmental knee protocols
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unicompartmental knee protocols - July 1, 2002 3:54:00 PM
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scollins
Posts: 13
Joined: February 12, 2000
From: Lowell, MA. USA
Status: offline
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Does anyone out here have a protocol for post op rehab for a unicompartmental knee replacement? How does it differ from a THR?
If there are any answers, is there a reference for your protocol? Thanks for any thoughts.
------------------
Sean Collins
Assistant Professor
University of Massachusetts Lowell
3 Solomont Way, Suite 5
Lowell, MA. 01854-5124
978-934-4375
[This message has been edited by scollins (edited July 01, 2002).]
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Re: unicompartmental knee protocols - July 1, 2002 6:23:00 PM
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Bobcat
Posts: 493
Joined: July 13, 1999
Status: offline
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Did you mean THR or TKR?
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Re: unicompartmental knee protocols - July 2, 2002 11:48:00 AM
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scollins
Posts: 13
Joined: February 12, 2000
From: Lowell, MA. USA
Status: offline
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Sorry, I mean TKR. My bad.
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Re: unicompartmental knee protocols - July 20, 2002 11:28:00 AM
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Bobcat
Posts: 493
Joined: July 13, 1999
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You know, I've asked around, and I haven't found any therapists that have actually rehab-ed a unicompartmental knee replacement. Is this being done where you are?
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Re: unicompartmental knee protocols - September 14, 2002 6:39:00 PM
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brascoptocs
Posts: 4
Joined: September 4, 2002
Status: offline
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protocols are limited as are surgeons who are choosing to perform this technique with the success that 2nd generation high tibial osteotomies have had. I am known as the protocol man at work, and I haven't seen a specific protocol for a uni knee, but I'll keep looking...
check out [URL=http://www.orthoclinics.com]www.orthoclinics.com[/URL] for some cool animations of the uni knee, and others plus links
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Re: unicompartmental knee protocols - September 16, 2002 5:56:00 AM
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PTupdate.com
Posts: 1477
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Here is an abstract I did on my site regarding development of an impingement syndrome in these patients...something to keep your eyes out for and consider when treating or dealing with a complaint of PF pain:
PATELLAR IMPINGEMENT FOLLOWING UNICOMPARTMENTAL ARTHROPLASTY. The Journal of Bone and Joint Surgery, Vol. 84-A, No. 7, July 2002.
P. Hernigou, MD G. Deschamps, MD
ABSTRACT
There has been sporadic reporting of patellofemoral compartment impingement and osteoarthritic changes to the patellofemoral joint following unicompartmental arthroplasty. These authors assessed 99 knees that received unicompartmental replacement between 1978 and 1988, with a minimum 10 year follow-up, to determine if this surgical procedure leads to these conditions and possible reasons as to why.
The average age of these patients at surgery was 70, and at time of follow-up was 84 years. 28 of the knees checked demonstrated impingement of the femoral condyle on a 90-degree skyline radiograph. 29 other knees demonstrated osteoarthritic changes to the PF joint in the compartment, which was opposite the one with the replacement. The incidence of patellar impingement was significantly greater in lateral compartment replacements than medial, and no knee showed both impingement and osteoarthritis to the opposite compartment at the same time. The persons with signs of impingement had the greatest degree of pain with patellofemoral questions, especially when climbing stairs or rising from a seated position. Knees that had decent pre-operative congruity of the PF joint prior to surgery were more likely to maintain some degree of congruency at the time of follow-up. 3 knees had the femoral component placed in an extension position, which resulted in impingement. 41 patients had the femoral component placed too far anteriorly, and 19 of these patients had impingement.
COMMENTS
This procedure is on a significant increase in this country, and some flaws such as this may become apparent over the years. The next step is determining what can be done via physical therapy to avoid or alleviate the problem. If radiographs prior to the development of pain show impingement, would bracing or some form of home mobilization, or even exercise reduce the risk? Seeing these patient’s years down the road once the condition is severe may be too difficult to treat. I recently spoke with a surgeon regarding this procedure, and he informed me that while it has benefit and merit, he has seen it done inappropriately, even on patients with confirmed tri-compartmental disease. A PT needs to be aware of the condition and causes for those times that a patient with this prosthesis arrives in their clinic.
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: unicompartmental knee protocols - December 29, 2002 5:49:00 PM
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DianaDud
Posts: 1
Joined: December 28, 2002
From: Whitby, Ontario, Canada
Status: offline
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I had the Oxford Unicompartmental knee replacement the first week of February, 2000. It was done in Toronto by Dr. Chapman at the Scarborough Hospital. It was done on a Monday morning with an epidural. I was back to my room by 12.30 pm. I was discharged on the Tuesday afternoon (next day) after having done all the necessary requirements my surgeon needed. ie walking down 12 stairs and back up again with my crutches.
One week later I started physiotherapy, had three appointments before going on holiday to Jamaica for a week. I did take a wheel chair with me and of course my crutches. I returned for another months physiotherapy (twice a week) and was doing so well I was discharged. The first week in May I went on a trip to Hong Kong, China and Thailand. This required quite a lot of walking and climbing stairs which I managed with no difficuilty.
Other than a few small things it is not wise im my mind to do the Oxford knee together with my surgeon was the best thing that happened to me as I had been almost unable to walk for the previous couple of years.
I am now 61 and am looking after my 20 month old granddaughter on a daily basis with no problems.
I hope this is of some help to anyone about to have this surgery. I realize that it is professionals that you expect on this site but I felt my experience could be of some help.
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