2023, Vol. 27 ›› Issue (9): 1383-1389

Effect of tendon manipulation with equal emphasis on muscles and bones on accelerating the functional rehabilitation of quadriceps femoris after total knee arthroplasty

Zhang Lichuang1, 2, Gao Huali1, Wang Jingchao1, Lin Huijun1, Wu Chonggui1, Ma Yinghui1, Huang Yunfei1, Fang Xue2, Zhai Weitao1, 2, 3   

Abstract: BACKGROUND: After total knee arthroplasty, the quadriceps femoris muscle strength of patients has a certain decline. If the injured quadriceps femoris cannot be effectively rehabilitated for a long time, it may cause a continuous decline in quadriceps femoris muscle strength and even lower limb muscle atrophy.
OBJECTIVE: To explore the effect of tendon manipulation with equal emphasis on muscles and bones on the accelerated rehabilitation of quadriceps femoris after total knee arthroplasty.
METHODS: Totally 80 patients undergoing total knee arthroplasty in the Guanghua Hospital, Shanghai University of Traditional Chinese Medicine were randomly divided into control group and treatment group (n=40 per group). The control group was given routine rehabilitation after total knee arthroplasty, including ankle pump training and quadriceps isometric contraction training. Rehabilitation training was conducted on the 1st to 14th days after operation. The treatment group was given routine rehabilitation combined with tendon manipulation with equal emphasis on muscles and bones to enhance the precise exercise of quadriceps femoris. Rehabilitation training was conducted on the 1st to 14th days after operation. The surface electromyography index, visual analogus scale score, tenderness threshold, hospital for special surgery knee score, the scores of Osteoarthritis Index questionnaire of Western Ontario and McMaster University, and hospital anxiety and depression scale were compared between the two groups.
RESULTS AND CONCLUSION: (1) After 7 and 14 days of manipulation intervention, the median frequency of surface electromyography of lateral femoral muscle, hospital for special surgery knee score, and knee tenderness threshold were higher in the treatment group than those in the control group (P < 0.05). Visual analogus scale score, Osteoarthritis Index questionnaire of Western Ontario and McMaster University, and hospital anxiety and depression scale were lower in the treatment group than those in the control group (P < 0.05). (2) There were no adverse events caused by manipulation or no surgical complications during manual rehabilitation. (3) The results show that the tendon manipulation with equal emphasis on muscles and bones can accelerate the functional rehabilitation of quadriceps femoris after total knee arthroplasty, which is safe and effective.
Key words: total knee arthroplasty, quadriceps femoris, accelerated rehabilitation, knee function, electromyogram, muscle weakness, postoperative rehabilitation