The postoperative status of total knee arthroplasty (TKA) patients on discharge from an acute setting in Johannesburg hospitals, South Africa

摘要

IntroductionudThere is little known about the acute status of TKA patients, as many studiesudhave focused on the long-term outcomes (Aarons et al., 1996). Knowing theudacute status can aid physiotherapists in planning postoperative treatmentudprotocols and help with discharge planning.udThis research examines the postoperative status of total knee arthroplasty (TKA)udpatients on discharge from an acute setting. The objectives of the study were toudestablish pain, ROM of the operated knee, functional level, socio-demographicudfactors, clinical data and the relationship between identified factors andudpostoperative functional status of TKA patients in the acute setting.udMaterials and MethodsudThis study is classified as a quantitative, cross-sectional design.udSociodemographic and clinical data, pain, range of movement (ROM) andudfunction of TKA patients were collected on day three post operation. A selfdesigneduddata capture sheet, the goniometer, VAS (Visual Analogue Scale) andudILOA (Iowa Level of Assistance) were used to measure data.udResultsudForty-four patients were assessed. There were 41% males and 59% females.udThe average age was 67 years and BMI was 30kg/m2. All patients haduddecreased ROM and 82% had poor quadriceps strength. Pain on walking wasud5.8 on the VAS and correlated with the ILOA score. Pain on rest was 3.3 andudwhen climbing stairs was 2.4. Sixty-one percent of subjects performed supine toudsit, 59% performed sit to stand and 43% performed ambulation independently.udMen performed better with an ILOA score of 24. Females had an ILOA score ofud31. Length of stay (LOS) was 5.7 days. Females, older subjects and those withudno medical conditions were more likely to stay in hospital for longer.udConclusionudKnowledge of these factors will help to give patients a likely prognosis following audTKA and target future rehabilitation. Patients should receive adequate painudcontrol to improve their functional ability. More attention should be given toudfemale patients as they perform worse than men. Patients in this populationudshould be referred for outpatient physiotherapy post-discharge, as their status onudday three post operation reflected poor ROM, quadriceps muscle strength andudfunction which may affect their rehabilitation outcome.