BMC musculoskeletal disorders
Mid-term clinical outcomes and isokinetic performance after primary total knee arthroplasty within a modified ERAS protocol: a single-blinded randomized controlled trial
By Schiegl J, Greimel F, Zeman F and 3 others.
Abstract
Background
Persistent muscular deficits are a major contributor to functional limitations following total knee arthroplasty (TKA). While Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted to improve postoperative outcomes, their influence on mid-term objective muscle strength recovery remains insufficiently defined. This study aimed first, to determine whether a modified ERAS protocol enhances mid-term recovery of knee muscle strength after primary TKA and second, compare associated clinical outcomes using validated functional and patient-reported measures.
Methods
The study received ethical approval from the Ethics Committee of the University of Regensburg, Germany (Reference No. 19-1470-101 on 31 July 2019) and was conducted in accordance with the principles of the Declaration of Helsinki. In this prospective, single-blinded randomized controlled trial, 58 patients undergoing primary TKA were assigned to either a modified ERAS protocol (n = 31) or conventional perioperative care (n = 27). Assessments were conducted at 5 days, 4 weeks, 3 months, 6 months, and 12 months postoperatively. Isokinetic muscle strength - including peak torque (Nm), total work (J), and power (W) - was measured using the Biodex® System 3 Dynamometer. Clinical outcomes were evaluated using the Numeric Rating Scale (NRS) for pain, Patient-Reported Outcome Measures (PROMs), and the Knee injury and Osteoarthritis Outcome Score (KOOS).