Tag Archives: non-steroidal anti-inflammatory drugs (NSAIDs)

Unlocking the Secrets of Post-Surgical Flexion: The Vital Role of Rehabilitation in Total Knee Arthroplasty Recovery

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By Gelu Murvai, Simona Cavalu et al.

This article delves into the critical aspect of postoperative flexion, particularly in the context of total knee arthroplasty (TKA), commonly known as total knee replacement. Postoperative flexion serves as a pivotal metric for assessing the success of the procedure and a patient’s ability to regain functional knee movement. The exploration encompasses the desired range of post-surgery flexion, the surgical factors influencing it, and the indispensable role of rehabilitation in facilitating patients in achieving functional flexion. The study tracks the progress of 713 patients who underwent total knee arthroplasty utilizing the cemented technique, categorizing them based on whether they received non-steroidal anti-inflammatory drugs for postoperative treatment. The monitoring of prosthetic and knee complications, along with the evaluation of the Knee Association Score (KSS) for functional assessment, revealed postoperative complications in approximately 18.23% of the patient cohort. These complications were predominantly associated with a restricted range of motion (ROM < 90°) and patellar clunk syndrome. Significantly, the KSS scale exhibited notable enhancements in the quality of life at 12 months post-surgery compared to preoperative and 6-month assessments. The majority of patients achieved scores classified as good or excellent, underlining the positive impact of the surgical approach and postoperative management on functional outcomes and overall patient well-being. Copyright Gelu Murvai, Simona Cavalu et al.

Prosthetic Complications

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It is evident that there is a 6.1% higher incidence of patients experiencing complications related to normal range of motion in the NSAIDs group, with statistically significant differences (χ2 = 106.511, p = 0.001). Additionally, regarding patellar clunk syndrome, 6.9% more patients were observed in the NSAID group, also showing a statistically significant difference (χ2= 113.230, p = 0.001). Copyright G. Murvai, Simona Cavalu et al.

Knee Complications

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Knee complications, including redness, clunk, rigidity, mechanical issues, septic complications, and fractures, were monitored. Copyright G. Murvai, Simona Cavalu et al.
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A total of 275 patients experienced all six problems, 28 individuals had five different problems, 136 patients were affected by four different types of problems, 84 people had three, and 108 patients had two different types of problems. Additionally, 27 patients had only one of the six problems, while 54 had none of the six types of problems. Copyright G. Murvai,Simona Cavalu et al.

Knee Society Score (KSS)

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Graphical representation of mean KSS scale scores at the study’s commencement and conclusion in preoperative stage (A) and after 6 months (B). Copyright G. Murvai,
Simona Cavalu et al.
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Average values of the KSS scale at the three evaluation time points. Copyright G. Murvai, Simona Cavalu et al.

A comprehensive statistical analysis revealed a noteworthy disparity between the two research groups. The calculated F-statistic (ANOVA) of 4640 yielded a p-value of 0.032, indicating statistical significance. Importantly, the group receiving non-steroidal anti-inflammatory drugs (NSAIDs), denoted as the “N-group”, exhibited significantly superior results in comparison to the counterpart group. The observed statistical difference underscores the impact of NSAIDs on the evolution of KSS, implying a meaningful influence on the functional outcomes measured by this scoring system. These findings suggest a potential association between the use of NSAIDs and enhanced postoperative knee function, providing valuable insights into the factors contributing to the divergent results within the studied patient cohorts. Further investigation into the specific mechanisms and implications of NSAID administration in the context of total knee arthroplasty may illuminate pathways for optimizing patient outcomes and guiding clinical decision making. Copyright G. Murvai, Simona Cavalu et al.

Conclusions

Postoperative complications affected approximately 18.23% of the patient cohort, primarily concerning normal range of motion (ROM < 90°) and patellar clunk syndrome.Inadequate healing, such as excessive scar tissue formation or adhesions around the joint, can limit movement and may necessitate additional surgery.Misalignment of the prosthesis can result in restrictions in the normal movement of the joint, often requiring surgical revision.The group of patients who experienced complications related to normal range of motion recorded a significantly higher percentage (6.1%) when NSAIDs were administered, and in terms of patellar clunk syndrome, the percentage was 6.9% higher in this group.The KSS scale showed a significant increase in the 6-month quality-of-life assessments, with the majority of patients achieving scores considered good or excellent. The mean values of the KSS scale exhibited statistically significant improvements at the two evaluation points, reflecting an enhancement in the patients’ quality of life.Limitations noted include small sample sizes, which could affect the overall results. We did not perform a range of motion analysis due to limited data availability, and the existence of a risk of bias in the articles may influence our results. Short-term follow-up may underestimate side effects. Additionally, clinical heterogeneity could not be completely eliminated, requiring more randomized controlled trials for subgroup analysis. Copyright G. Murvai, Simona Cavalu et al.

Full text available at https://www.mdpi.com/2673-1592/5/4/93