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knee rehabilitation

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21. Surgical Management of Osteoarthritis of the Knee

. POSTOPERATIVE MOBILIZATION: LENGTH OF STAY Strong evidence supports that rehabilitation started on the day of the total knee arthroplasty (TKA) reduces length of hospital stay. Strength of Recommendation: Strong Evidence Description: Evidence from two or more “High” strength studies with consistent findings for recommending for or against the intervention. POSTOPERATIVE MOBILIZATION: PAIN AND FUNCTION Moderate evidence supports that rehabilitation started on day of total knee arthroplasty (TKA) compared (...) to rehabilitation started on postop day 1 reduces pain and improves function. Strength of Recommendation: Moderate Evidence Description: Evidence from two or more “Moderate” strength studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention. 14 EARLY STAGE SUPERVISED EXERCISE PROGRAM: FUNCTION Moderate evidence supports that a supervised exercise program during the first two months after total knee arthroplasty (TKA) improves physical

2015 American Academy of Orthopaedic Surgeons

22. Treatment of Osteoarthritis of the Knee

Treatment of Osteoarthritis of the Knee TREATMENT OF OSTEOARTHRITIS OF THE KNEE EVIDENCE-BASED GUIDELINE 2 ND EDITION Adopted by the American Academy of Orthopaedic Surgeons Board of Directors May 18, 2013 i Disclaimer This clinical practice guideline was developed by an AAOS work group comprised of volunteer physicians and interdisciplinary clinicians as well as staff researchers with expertise in systematic reviews and statistical methods used to evaluate empirical evidence (...) (MID) Units 25 Peer Review 26 Public Comment 27 The AAOS Guideline Approval Process 28 Revision Plans 28 Guideline Dissemination Plans 28 AAOS Clinical Guideline on Treating Osteoarthritis of the Knee 31 Guideline Recommendations 31 Recommendation 1 31 Rationale 31 Supporting Evidence 32 Quality 32 Applicability 34 Final Strength of Evidence 35 Results 46 Evidence Tables and Figures 61 Quality and Applicability 61 Findings 98 Recommendation 2 138 Rationale 138 Supporting Evidence 138 Quality 138

2013 American Academy of Orthopaedic Surgeons

23. Guideline for the non-surgical management of hip and knee osteoarthritis

Guideline for the non-surgical management of hip and knee osteoarthritis Guideline for the non-surgical management of hip and knee osteoarthritis The Royal Australian College of General Practitioners, 1 Palmerston Crescent, South Melbourne, Vic 3205 Australia ACN 000 223 807, ABN 34 000 223 807 July 2009 Approved by NHMRC on 23 February 2009Guideline for the non-surgical management of hip and knee osteoarthritis The National Health and Medical Research Council (NHMRC) is Australia’s leading (...) Australian College of General Practitioners College House 1 Palmerston Crescent South Melbourne, Victoria 3205 Australia Tel 03 8699 0414 Fax 03 8699 0400 www.racgp.org.au ISBN 978-0-86906-299-9 Published July 2009 © The Royal Australian College of General Practitioners. All rights reserved.1 Guideline for the non-surgical management of hip and knee osteoarthritis July 2009 CONTENTS IntroductIon 3 The role of general practitioners 4 Endorsement and expiry date for the recommendations 4 Acknowledgments 5

2009 National Health and Medical Research Council

24. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions

. The authors of this guideline revision worked with the CPG Editors and medical librarians for methodological guidance. The research librarians were chosen for their expertise in systematic review rehabilitation literature search, and to perform systematic searches for concepts associated with meniscus and articular cartilage injuries of the knee in articles published from 2008 related to classification, examination, and intervention strategies consistent with previous guideline development methods related (...) team Description of Guideline Validation Identified reviewers who are experts in knee meniscus and articular cartilage injury management and rehabilitation reviewed this CPG content and methods for integrity, accuracy, and that it fully represents the condition. All comments, suggestions, or feedback from the expert reviewers were delivered to the authors and editors to consider and make appropriate revisions. These guidelines were also posted for public comment and review on the orthopt.org

2018 American Physical Therapy Association

25. Patients With Total Knee Arthroplasty in the Acute Post-Operative Phase

.0000000000000079 Original Studies Open Background: Despite seemingly routine use of physical therapy and its potential importance in reducing complications after total joint arthroplasty in the acute hospital setting, no agreed-upon approach to rehabilitation exists in this setting. In fact, rehabilitation practices and outcomes assessed are quite variable. Purpose: To determine the effects of physical therapy interventions in the acute care phase of total knee arthroplasty. Data Sources: Ovid Medline (...) community hospitals in North Carolina, the mean percentage of patients with both hip and knee TJA receiving physical therapy was 98%. Despite seemingly routine use of physical therapy and its potential importance in reducing complications after TJA in the acute hospital setting, no approach to rehabilitation in this setting appears to be standard. Rehabilitation practices and outcomes, in terms of functional measures as well as length of stay, are quite variable. , Therapists now have even less time

2018 American Physical Therapy Association

26. Management of Venous Leg Ulcers: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum

Guideline 8.1: Primary Prevention—Clinical CEAP C3-4 Primary Venous Disease In patients with clinical CEAP C3-4 disease due to primary valvular reflux, we recommend compression, 20 to 30 mm Hg, knee or thigh high. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 8.2: Primary Prevention—Clinical CEAP C1-4 Post-thrombotic Venous Disease In patients with clinical CEAP C1-4 disease related to prior deep venous thrombosis (DVT), we recommend compression, 30 to 40 mm Hg, knee or thigh high. [GRADE - 1; LEVEL

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2014 American Venous Forum

27. Guidelines for the management of acute joint bleeds and chronic synovitis in haemophilia

of neovascularisation inthesynoviumispredispositiontomorebleedingsince thesenewvesselsarefriable.Thisleadstoaviciouscircle of bleeding, iron accumulation, synovial hypertrophy and hypervascularization leading to further bleeding and ultimately progressive joint damage. Interventions aimedatpreventingorbreakingthiscyclearekeystrate- giesforthepreservationofjointfunctioninpeoplewith haemophilia.Bleedingis particularly problematicinthe diarthrodial-hinged joints such as the knee, elbow and ankle. It is therefore (...) ). Physiotherapy Although consensus guidelines recommend physiother- apy following acute haemarthrosis [12], there is a very limited objective evidence base in relation to the opti- mal timing and types of rehabilitation strategies fol- lowing resolution of a joint bleed. Clinical physiotherapy intervention is aimed at symptom con- trol, prevention of bleed recurrence, prevention of joint damage and restoration of full function and activity. Early management strategies are often encap- sulated within

2017 United Kingdom Haemophilia Centre Doctors' Organisation

28. Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics?

health care settings including acute care, residential aged care, paediatric, neonatal and primary care and rehabilitation as well as the laboratory setting. All forms of use of chlorhexidine in humans and all different exposures (dosage form, duration, stratification of exposure) across different settings. 1. ‘Chlorhexidine Resistance’ (with definition / measures used) to chlorhexidine established. 2. A specific intervention identified as contributing to resistance to Chlorhexidine in a specific (...) Population and setting Intervention Outcome Types of studies Qu. 2 All patients (isolates) / participants (isolates) including children and adults in different health care settings including acute care, residential aged care, paediatric, neonatal and primary care and rehabilitation as well as the laboratory setting All forms of use of chlorhexidine in humans and all different exposures (dosage form, duration, stratification of exposure) across different settings. 1. ‘Resistance against antibiotics

2018 National Health and Medical Research Council

30. Hip strengthening for treatment of tibial stress fracture

[4a]). Further, these strength changes were correlated with statistically significant changes to the subjects’ running mechanics. Specifically, the runners demonstrated decreased rearfoot eversion range of motion, (p = 0.05), increased hip adduction range of motion (p = 0.05), and a trend of decreased hip internal rotation range of motion (p = 0.08). Rearfoot inversion moment (p = 0.02) and knee abduction moment (p = 0.05) decreased by 57% and 10%, respectively. Heinert measured hip abductor (...) strength on a heterogeneous group of active, recreational, female college students a priori using a hand-held dynamometer. A post-hoc analysis demonstrated that the subject group with weaker hip abductors demonstrated significantly increased knee abduction angle (p = .008) at initial contact, maximum angle, and toe-off as compared to the stronger subject (Heinert 2008 [3b]). There is limited evidence linking hip weakness with tibial stress fractures in runners. In a cross sectional study comparing

2011 Cincinnati Children's Hospital Medical Center

31. Acute Low Back Pain

Acute Low Back Pain 1 Quality Department Guidelines for Clinical Care Ambulatory Low Back Pain Guideline Team Team leader Anthony E. Chiodo, MD Physical Medicine & Rehabilitation Team members David J. Alvarez, DO Family Medicine Gregory P. Graziano, MD Orthopedic Surgery Andrew J. Haig, MD Physical Medicine & Rehabilitation R. Van Harrison, PhD Medical Education Paul Park, MD Neurosurgery Connie J. Standiford, MD General Internal Medicine Consultant Ronald A. Wasserman, MD Anesthesiology, Back (...) Location Muscle Strength Test Neurological Level Reflex Tests Spinal Level Toe Plantar flexion S-1 Achilles S-1 Dorsi flexion L-5 Medial Hamstring c L-5 Patella L-4 Ankle Plantar flexion S-1 a Dorsi flexion L-4, L-5 Babinski Tests upper motor neurons Knee Extension L-3,4 Flexion L-5, S-1 Hip Flexion L-2, 3 Abduction L-5, S-1 Internal Rotation L-5, S-1 b Adduction L-3, 4 a Ankle plantar flexion--rise up on the toes of one leg 5 times while standing. b Internal rotation--while seated patient keeps knees

2011 University of Michigan Health System

33. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

for the prevention of venous thromboembolism in adults having elective total hip replacement surgery or elective total knee replacement surgery. [This text is from rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (NICE technology appraisal guidance 170).] [2018] [2018] 1.11.6 Consider one of the following if none of the options in recommendation 1.11.5 can be used: Apixaban [8] is recommended as an option for the prevention of venous thromboembolism (...) in adults after elective hip or knee replacement surgery. [This text is from apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults (NICE technology appraisal guidance 245).] Dabigatran etexilate [9] , within its marketing authorisation, is recommended as an option for the primary prevention of venous thromboembolic events in adults who have undergone elective total hip replacement surgery or elective total knee replacement surgery. [This text is from

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

34. Management of Anterior Cruciate Ligament Injuries

diagnostic tools for ACL injury. Strength of Recommendation: Strong Description: Evidence from two or more “High” strength studies with consistent findings for recommending for or against the intervention. ACL RADIOGRAPHS In the absence of reliable evidence, it is the opinion of the work group that in the initial evaluation of a person with a knee injury and associated symptoms [giving way, pain, locking, catching] and signs [effusion, inability to bear weight, bone tenderness, loss of motion (...) , and/or pathological laxity] that the practitioner obtain AP and lateral knee xrays to identify fractures or dislocations requiring emergent care. Strength of Recommendation: Consensus Description: There is no supporting evidence. In the absence of reliable evidence, the work group is making a recommendation based on their clinical opinion. Consensus recommendations can only be created when not establishing a recommendation could have catastrophic consequences. ACL MAGNETIC RESONANCE IMAGING (MRI) Strong evidence

2014 American Academy of Orthopaedic Surgeons

35. Management of Hip Fractures in the Elderly

and Harms of Implementing this Recommendation 195 Future Research 195 Unstable Intertrochanteric Fractures 196 Rationale 196 Risks and Harms of Implementing this Recommendation 196 12 Future Research 196 Results 198 VTE Prophylaxis 219 Rationale 219 Risks and Harms of Implementing this Recommendation 219 Future Research 219 Results 220 Transfusion Threshold 254 Rationale 254 Risks and Harms of Implementing this Recommendation 254 Future Research 254 Results 255 Rehabilitation 258 Sub-Recommendation

2014 American Academy of Orthopaedic Surgeons

36. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

problems, including psychological sequelae of trauma and cognitive impairment. These factors also make adherence to a treatment plan for chronic pain more difficult. Barriers to effective pain management for homeless people include poor understanding of pain management in the general medical community, mutual mistrust between homeless persons and medical providers, lack of access to appropriate pain specialty clinics and other opportunities for rehabilitation, and lack of clear treatment

2011 National Health Care for the Homeless Council

38. Joint Hypermobility - Identification and Management of

program, whereby sport specific training is provided in conjunction with continuation of the principles of earlier stages of gradual rehabilitation (Vaishya 2013 [4a], Simmonds 2007 [5a]). (See prior recommendations #12-#25). Note 1: Individuals have an increased risk of knee injury during sporting activities. o Increased knee injuries may occur during contact sport activities (Pacey 2010 [1a]) o JH is more prevalent in patients with anterior cruciate ligament (ACL) injury (4.46 odd ratio) (Vaishya (...) and lack core activation o Mini wall squat-poor midrange knee control, rely on genu recurvatum at end of cycle o Scapular activation-compensatory elevation, exaggerated lumbar extension (LocalConsensus 2014 [5]) Note 1: Assessment of motor competency through standardized protocols may not be sensitive enough to capture the full impact that JH has on the musculoskeletal function and quality of movement. Repetition of tasks often reveals deficits that may not be identified with one time trials (Remvig

2014 Cincinnati Children's Hospital Medical Center

40. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures

might consider discontinuing the practice of routinely prescribing prophylactic antibiotics for patients with hip and knee prosthetic joint implants undergoing dental procedures. Grade of Recommendation: Limited Description: Evidence from two or more “Low” strength studies with consistent findings, or evidence from a single Moderate quality study recommending for or against the intervention or diagnostic. A Limited recommendation means the quality of the supporting evidence that exists (...) & Congress of Neurological Surgeons Paul A. Anderson, MD Professor Department of Orthopedics & Rehabilitation University of Wisconsin K4/735 600 Highland Avenue Madison WI 53792 American Dental Association Elliot Abt, DDS 4709 Golf Road, Suite 1005 Skokie, IL 60076 American Dental Association Harry C. Futrell, DMD 330 W 23rd Street, Suite J Panama City, FL 32405 American Dental Association Stephen O. Glenn, DDS 5319 S Lewis Avenue, Suite 222 Tulsa, OK 74105-6543 American Dental Association John Hellstein

2012 American Academy of Orthopaedic Surgeons

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