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Rehabilitation for Total Knee Replacement at University of Colorado Hospital

Studies to improve outcomes currently recruiting participants

For more information on the studies,
contact the Muscle Performance
Lab at (303) 724-9590 or email
Jennifer Stevens-Lapsley, PhD,

Patients who have undergone total knee replacement surgery may soon have improved outcomes, thanks to research studies developed by investigators at the University of Colorado Denver's Physical Therapy Program and conducted at University of Colorado Hospital.

  • Two of the studies will compare the effectiveness of relatively new rehabilitation protocols with established standards.
  • Another will investigate outcomes in patients who undergo minimally invasive knee replacement procedures as an alternative to traditional surgery.

Two rehab studies, one goal: countering post-op muscle weakness

According to Jennifer Stevens-Lapsley, PT, MPT, PhD, assistant professor of Physical Medicine and Rehabilitation at UCD's School of Medicine, patients who have undergone total knee replacement surgery frequently suffer long-term muscle weakness.

The NMES unit sends electrical signals to
electrodes positioned on the quadriceps,
which causes the muscle to contract.

A high-intensity regimen. With this in mind, one of the studies — which plans to recruit patients through 2013 — includes high-intensity exercises and weight lifting to strengthen muscles that help control stair descent. Patients receive home and outpatient physical therapy for 11 weeks, all the while steadily increasing the amount of activity.

Electrical stimulation. Another study aims to determine the effectiveness of neuromuscular electrical stimulation (NMES) to strengthen the quadriceps, the large muscle group on the front of the thigh.

The NMES unit makes the quadriceps contract — and therefore "exercise" — by firing bursts of electrical signals to the muscles via a transmitter, wires and electrodes placed on the area.

Donald Eckhoff, MD, lead physician for the study, has been using NMES on patients for about a year. He reports generally positive results, but needs more data to determine optimal treatment.

Forty patients have enrolled in the NMES study as of February 2009; investigators hope to attract another 30 by the end of the year.

Smaller incisions, smaller problems?

In another study that is enrolling new participants, researchers are examining long-term outcomes for patients who undergo minimally invasive total knee replacement, a relatively new technique that requires a much smaller incision than traditional surgery and avoids inflicting trauma to the quadriceps.

Researchers hope to determine if this technique decreases post-operative pain and muscle loss.


This page is adapted from a story that appeared in the UCH Insider, the hospital's candid, biweekly newsletter (archives and free email subscription information). Tyler Smith is managing editor of the Insider.