The role of pain for early rehabilitation in fast track total knee arthroplasty

Bente Holm; Morten Tange Kristensen; Lis Myhrmann; Henrik Husted; Lasse Østergaard Andersen; Billy Kristensen; Henrik Kehlet

doi:10.3109/09638280903095965

The role of pain for early rehabilitation in fast track total knee arthroplasty

Bente Holm, Morten Tange Kristensen, Lis Myhrmann, Henrik Husted, Lasse Østergaard Andersen, Billy Kristensen, Henrik Kehlet

61 Citations (Scopus)

Abstract

Purpose. To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA). Methods. One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility ('Timed Up and Go' (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge. Results. On the first postoperative day, 90 of the patients were able to walk independently with median pain intensity of ≤5 on VAS. Of these, 78% walked > 70m. All patients walked independently on postoperative Day 2 with pain intensity of ≤4. On the day of discharge, all patients walked with crutches with pain intensity of ≤3, walking distance > 70m, median range of motion 10-80°, and median test time of the 'TUG' 19.2 s. The length of hospital stay was median 3 days. Conclusion. Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.

Original language	English
Journal	Disability and Rehabilitation
Volume	32
Issue number	4
Pages (from-to)	300-6
Number of pages	7
ISSN	0963-8288
DOIs	https://doi.org/10.3109/09638280903095965
Publication status	Published - 1 Jan 2010

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title = "The role of pain for early rehabilitation in fast track total knee arthroplasty",

abstract = "Purpose. To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA). Methods. One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility ('Timed Up and Go' (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge. Results. On the first postoperative day, 90 of the patients were able to walk independently with median pain intensity of ≤5 on VAS. Of these, 78% walked > 70m. All patients walked independently on postoperative Day 2 with pain intensity of ≤4. On the day of discharge, all patients walked with crutches with pain intensity of ≤3, walking distance > 70m, median range of motion 10-80°, and median test time of the 'TUG' 19.2 s. The length of hospital stay was median 3 days. Conclusion. Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.",

author = "Bente Holm and Kristensen, {Morten Tange} and Lis Myhrmann and Henrik Husted and Andersen, {Lasse {\O}stergaard} and Billy Kristensen and Henrik Kehlet",

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doi = "10.3109/09638280903095965",

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T1 - The role of pain for early rehabilitation in fast track total knee arthroplasty

AU - Holm, Bente

AU - Kristensen, Morten Tange

AU - Myhrmann, Lis

AU - Husted, Henrik

AU - Andersen, Lasse Østergaard

AU - Kristensen, Billy

AU - Kehlet, Henrik

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Purpose. To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA). Methods. One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility ('Timed Up and Go' (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge. Results. On the first postoperative day, 90 of the patients were able to walk independently with median pain intensity of ≤5 on VAS. Of these, 78% walked > 70m. All patients walked independently on postoperative Day 2 with pain intensity of ≤4. On the day of discharge, all patients walked with crutches with pain intensity of ≤3, walking distance > 70m, median range of motion 10-80°, and median test time of the 'TUG' 19.2 s. The length of hospital stay was median 3 days. Conclusion. Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.

AB - Purpose. To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA). Methods. One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility ('Timed Up and Go' (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge. Results. On the first postoperative day, 90 of the patients were able to walk independently with median pain intensity of ≤5 on VAS. Of these, 78% walked > 70m. All patients walked independently on postoperative Day 2 with pain intensity of ≤4. On the day of discharge, all patients walked with crutches with pain intensity of ≤3, walking distance > 70m, median range of motion 10-80°, and median test time of the 'TUG' 19.2 s. The length of hospital stay was median 3 days. Conclusion. Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.

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DO - 10.3109/09638280903095965

M3 - Journal article

SN - 0963-8288

VL - 32

SP - 300

EP - 306

JO - Disability and Rehabilitation

JF - Disability and Rehabilitation

IS - 4

ER -

The role of pain for early rehabilitation in fast track total knee arthroplasty

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