Vasylenko Ye. O., Tsizh L. М.

EFFECTIVENESS OF PHYSICAL THERAPY IN THE PREOPERATIVE PERIOD IN TOTAL KNEE ARTHROPLASTY IN PATIENTS WITH BILATERAL GONARTHROSIS

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About the author:

Vasylenko Ye. O., Tsizh L. М.

Heading:

THERAPY AND REHABILITATION

Type of article:

Scientific article

Annotation:

Total knee arthroplasty (TKA) has become one of the most frequently performed orthopedic interventions in response to progressive functional insufficiency and pain associated with osteoarthritis. According to the Center for Medical Statistics of the Ministry of Health of Ukraine, more than 12–15 thousand large joint arthroplasty are performed in the country annually, among which the knee joint accounts for approximately 35–45%. Patients with bilateral gonarthrosis who undergo TKA face special challenges in the postoperative period, as the non-operated joint often remains functionally limited and cannot compensate for the load from the operated limb. The preserved gait asymmetry after unilateral TKA is an important predictor of the need for further contralateral arthroplasty, which emphasizes the importance of considering the non-operated knee during postoperative rehabilitation. Most studies focus on unilateral TKA, where the main focus is on restoring function in the operated limb without considering the impact of the non-operated limb on the overall outcome. The lack of studies that comprehensively analyze the rehabilitation of patients with bilateral gonarthrosis, especially in terms of physical therapy, creates a significant gap in science and justifies the need for further research to optimize rehabilitation strategies in such patients. The aim of the study is to increase the effectiveness of physical therapy for patients with bilateral gonarthrosis by developing and substantiating a program of therapeutic exercises in the preoperative period. During 2023–2025, 82 patients with bilateral gonarthrosis of stage II–IV, who were scheduled for primary unilateral total knee arthroplasty, were consecutively included in the study. After applying the inclusion/exclusion criteria, 80 patients aged 33 to 82 years (mean age was 64.6±9.5 years) continued to participate in the study, of whom 58 were women (72.5%) and 22 were men (27.5%). All participants were offered to undergo a prehabilitation program. Depending on their voluntary consent to participate in the program, patients were divided into the main group (OG), where the prehabilitation intervention program was performed, and the control group (CG, without prehabilitation). In OG patients, already during the 2nd visit, 1-2 days before the operation, the level of general endurance, strength and speed-power indicators were better than in CG representatives, which led to the preservation of this difference on the 5th day after the operation (p<0.05). Functional positive changes were the basis for the better ability of OG representatives to perform daily activities, which led to a decrease in the manifestations of limitation of vital activities and positive dynamics of quality of life indicators (p<0.05). The proposed program of therapeutic exercises, which was applied in the preoperative period in patients with bilateral gonarthrosis, is an effective means for restoring walking speed, speed-power physical qualities and endurance, which leads to an increase in the ability to perform daily activities, a decrease in the manifestations of limitation of vital activities and, most importantly, an improvement in the quality of life.

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 491-497 pages, index UDC 616.728.3-002.77-089.844:615.825

DOI:

10.29254/2077-4214-2026-3-182-491-497