Prevention of Quadriceps Inhibition is The Key to Achieve Movement of The Knee Joint After Total Knee Replacement and Lower End of Femur Surgery

Abstract

Background: Knee stiffness and weakness of quadriceps is common after surgeries around knee and even after total knee replacement. Swelling and inflammation in the early phases after surgery may contribute to stiffness and arthrogenic muscle inhibition. Aggressive physiotherapy to regain range of motion and early isometric and isotonic exercises are indicated for prevention of complications. Material and method: This were a descriptive, cross-sectional study which included hundred patients (without any limit of age range) attending the orthopaedic physical therapy outpatient department of Positron Hospital were selected for this study. The subjects were assessed for quadriceps inhibition and knee range of motion. The patients were assessed one week, six weeks and 12 weeks post surgery. The patients underwent supervised physiotherapy till 6 weeks and were put on home exercise program for next 6 weeks. Results: The quadriceps inhibition in initial phase was about 25% and quadriceps inhibition in recovery phase remained only 5%. There was zero flexion deficit in 30%, 59% and 76% of patients in first week, sixth week and twelfth week respectively. Mean of flexion deficit in hundred patients were 15% in first week, 6.5% flexion deficit remained in sixth week and only 2.9%flexion deficit left in twelfth week. Conclusion: Quadriceps inhibition was seen in 25% patients. Quadriceps inhibition was not associated with gender or age. There was moderate to strong correlation between flexion deficit and quadriceps inhibition