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Quadriceps Strength is One Key to Recovery after Knee Replacement

Forty patients at the University of Delaware are helping physical therapists find ways to improve the results of total knee replacement (TKR). Research has shown that many adults lose overall function after TKR. Their pain is better but they walk slower. It takes twice as long to go up and down stairs. Many stop doing their favorite leisure activities such as gardening.

Patients in this study did the usual rehab program after TKR. Four weeks after the surgery they started part two of rehab. The program was six-weeks of exercises and activities. The goal was to increase motion and strength. Training to improve function was also included.

Everyone was tested for pain, motion, and strength. Testing was done two weeks before surgery and again two weeks after surgery. Follow-up tests were done at one, two, three, and six months post-operatively. As expected from the results of other studies, patients showed a decrease in motion, strength, and function one month after surgery. Everything improved after that.

The biggest problem was quadriceps muscle weakness. The researchers found that patients had more function as the quadriceps got stronger. This finding is important as many patients gradually decline in function in the years after TKR.

The authors suggest a more rigorous exercise program may be needed after TKR to regain maximal function. Quadriceps strength is more important than joint pain or motion for recovery.

References: Ryan L. Mizner, MPT, PhD, et al. Quadriceps Strength and the Time Course of Functional Recovery After Total Knee Arthroplasty. In Journal of Orthopaedic and Sports Physical Therapy. July 2005. Vol. 35. No. 7. Pp. 424-436.

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