Quadriceps muscle group function and after total knee arthroplasty—asystematic narrative update
I. Morelli, Nicola Maffulli, Lorenzo Brambilla, M Agnoletto, Giuseppe M. Peretti, Laura Mangiavini
Abstract
BACKGROUND: This article systematically summarizes the present evidences, published in the last 20 years, regarding the pre- and post-operative factors, which may influence recovery of the function of the quadriceps muscle group following total knee arthroplasty (TKA). We following the PRISMA methodology, including meta-analyses and high-level evidence studies (prospective trials, and, when unavailable, retrospective studies). SOURCES OF DATA: Pubmed and Cochrane databases: 582 articles were identified and 54 of them were selected. AREAS OF AGREEMENT: Tourniquets inflated at high pressure exert a detrimental effect on the quadriceps muscle group. Faster quadriceps recovery takes place using mini-invasive approaches, an eight-week rehabilitation period including balance training and the use of nutraceuticals. AREAS OF DISAGREEMENT: Pre-habilitation and pre-operative factors, analgesic methods and different TKA implants. GROWING POINTS AND AREAS TIMELY FOR DEVELOPING RESEARCH: Telerehabilitation seems a cost-effective tool for rehabilitation after TKA. Patients' optimization protocols before TKA should include standardized nutraceuticals intake.