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Clinical relevance of active straight leg raising, standing up, and walking after total knee arthroplasty in a cross-sectional study

  • Original Article • KNEE - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Active straight leg raising (ASLR) is used to assess restoration of the quadriceps muscle immediately after total knee arthroplasty (TKA). This study aimed to (1) compare the times required to accomplish ASLR, standing up, and walking after TKA, and (2) evaluate the correlation between the time required to accomplish ASLR and perioperative patient-related factors.

Methods

This cross-sectional study included 271 patients (335 primary TKAs performed using the conventional medial parapatellar approach). Postoperative times required until each activity was accomplished were confirmed. Various factors that might impact ASLR, including prosthetic design, were also evaluated.

Results

Post-TKA, it took 1.5 ± 0.5 days to accomplish ASLR, 1.3 ± 0.6 days to accomplish standing up, and 1.4 ± 0.7 days to accomplish walking. There were no significant correlations between any factor and ASLR. Strong correlations were found between the times required to accomplish standing up and walking (p < 0.0001, r = 0.804). There were no significant correlations between the times required to accomplish ASLR and standing up/walking. A longer time was necessary for ASLR accomplishment than for standing up (p < 0.001) and walking (p < 0.001). Standing up was accomplished earlier than walking (p = 0.008).

Conclusions

There was no delay in post-TKA ASLR accomplishment compared with previous reports. No factors affecting ASLR during the perioperative period suggested that ASLR was controlled by factors other than knee joint-related factors. ASLR was not correlated with standing up/walking; hence, the clinical significance of ASLR immediately after TKA for early ambulation is unclear.

Level of evidence

Prognostic study, Level II.

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Authors and Affiliations

  1. Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan

    Yoshinori Ishii, Hideo Noguchi, Junko Sato, Takeshi Yamamoto & Tetsuya Sakurai

  2. Kouseiren Takaoka Hospital, 5-10 Eirakutyo, Takaoka, Toyama, 933-8555, Japan

    Hana Ishii

  3. Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori, Niigata, Niigata, 951-8520, Japan

    Shin-ichi Toyabe

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  1. Yoshinori Ishii
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Correspondence to Yoshinori Ishii.

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The author(s) declare that they have no competing interests.

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The local institutional review board approved this study. All patients provided informed consent.

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Ishii, Y., Noguchi, H., Sato, J. et al. Clinical relevance of active straight leg raising, standing up, and walking after total knee arthroplasty in a cross-sectional study. Eur J Orthop Surg Traumatol 28, 947–953 (2018). https://doi.org/10.1007/s00590-017-2100-z

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  • DOI: https://doi.org/10.1007/s00590-017-2100-z

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