Early recovery after fast-track Oxford unicompartmental knee arthroplasty. 35 patients with minimal invasive surgery.
OBJECTIVE
After total knee arthroplasty with conventional surgical approach, more than half of the quadriceps extension strength is lost in the first postoperative month. Unicompartmental knee arthroplasty (UKA) operated with minimally invasive surgery (MIS) results in less operative trauma. We investigated changes in leg-extension power (LEP) in the first month after MIS Oxford UKA and its relation to pain, knee motion, functional performance, and knee function.


METHODS
In 35 consecutive Oxford UKA patients, LEP was measured 1 week before and 1 month after surgery together with knee motion, knee swelling, the 30-second chair-stand test, and Oxford knee score. Assessment of knee pain at rest and walking was done using a visual analog scale.


RESULTS
30 patients were discharged on the day after surgery, and 5 on the second day after surgery. LEP and functional performance reached the preoperative level after 1 month. Only slight postoperative knee swelling was observed with rapid restoration of knee flexion and function. A high level of pain during the first postoperative night and day fell considerably thereafter. None of the patients needed physiotherapy supervision in the first month after discharge.


CONCLUSIONS
Fast-track MIS Oxford UKA with discharge on the day after surgery is safe and leads to early recovery of knee motion and strength even when no physiotherapy is used.
Department of Orthopaedics, Holstebro Regional Hospital, Denmark. stigmunk@rm.dk
Stig
S
Munk
Jesper
J
Dalsgaard
Karin
K
Bjerggaard
Ina
I
Andersen
Torben Baek
TB
Hansen
Henrik
H
Kehlet
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D010351:Patient Discharge; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D016138:Walking