#Dissemination2024

PhD course Dissemination of Clinical Research: Papers, Preprints, and Social Media, Hvidovre Hospital, March 22-23, 2023

Changing the narrative for exercise-based prehabilitation: evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients

“The better you go into surgery – the better you leave surgery”. That is the narrative often used to argue the importance of prehabilitation exercise in total knee arthroplasty (TKA) to enhance postoperative recovery. Although the narrative makes sense intuitively, it has been very difficult to show clinically relevant superiority of prehabilitation exercise on postoperative muscle strength and function outcomes after TKA compared to no prehabilitation. In this narrative review, we present a clinical use case for prehabilitation exercise in severe knee osteoarthritis where the focus is more on enhancing surgical decision making and guideline adherence than on enhancing post-operative recovery. We call this “pre-evaluation exercise”. A simple pre-evaluation exercise program performed at home twice a week (after initial instruction)—seems to provide a basis for enhanced surgical decision making in severe knee OA. If combined with education about the importance of being physically active daily, using a type of activity that makes sense for the individual patient, metabolic fitness and cardiovascular health could also be targeted

Tourniquet versus no tourniquet on knee-extension strength early after fast-track total knee arthroplasty; a randomized controlled trial

Thigh tourniquet is commonly used in total knee arthroplasty (TKA) but may contribute to pain and muscle damage. Consequently, the reduction in knee-extension strength after TKA may be caused by quadriceps muscle ischaemia underneath the cuff