Abstract
Total knee arthroplasty (TKA) is a very common surgical treatment approach for severe osteoarthritis. Complications of TKA include loss of range of motion and prolonged analgesic requirement for pain control. Osteopathic manipulative techniques (OMT) have been utilized to address localized muscular stiffness to improve range of motion; however, limited studies directly correlate OMT and TKA recovery. This review highlights the therapeutic benefits OMT can have in the postoperative management of arthroplasty with respect to range of motion, edema, pain perception, and ability to perform activities of daily living. This review revealed the use of OMT would positively influence range of motion by manipulation of localized musculature and can result in decreased demand for analgesics. This can, in turn, shorten hospital stay and return the ability of patients to perform activities of daily living earlier than without OMT. Increased research is needed to strengthen these findings on the benefits of OMT in the postoperative management of arthroplasty.
Highlights
BackgroundOsteoarthritis (OA) is the most common cause of chronic disability and pain for those aged 65 or older in the United States (US) [1]
This review aims to explore the current literature on osteoarthritic pain management and how Osteopathic manipulative techniques (OMT) can play a role in postoperative care
A search was conducted of the National Library of Medicine's MEDLINE/PubMed databases in addition to the Journal of American Osteopathic Association with the intent of finding all relevant articles published in English with keywords “post-operative”, “knee arthroplasty”, “total knee replacement”, and “osteopathic medicine”
Summary
Osteoarthritis (OA) is the most common cause of chronic disability and pain for those aged 65 or older in the United States (US) [1]. A degenerative joint disease that is caused by the breakdown of cartilage and bone, OA causes the greatest debilitation in large joints-shoulders, elbows, hips, and knees. Knee OA is prevalent with the ongoing obesity epidemic as mechanical stress associated with truncal weight results in hyaline cartilage degradation of the tibiofemoral and patellofemoral joints, followed by bony remodeling and narrowing of the joint space [2]. Inflammation of the synovium and cartilage can accompany this process, leading to the hallmark symptoms of pain on ambulation and joint stiffness [4]. Treatment is often centered on symptom management, ranging from conservative measures such as lifestyle modifications and non-steroidal antiinflammatory drugs (NSAIDs) to more invasive procedures such as corticosteroid injections and surgery [5]
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