Rééducation après arthroplastie totale du genou
BOURDILLON E. ET AL.
Kinésithér Scient 2007,480:21-27 - 10/09/2007
La rééducation après arthroplastie totale de genou est un acte kinési-thérapique fréquent, aussi bien à l'hôpital qu'en centre de rééduca-tion et en cabinet libéral. Malgré tout, aucun consensus n'existe surles techniques de rééducation.On distingue plusieurs types de PTG en fonction du nombre de liga-ments sacrifiés et des degrés de mobilité autorisés. Les modificationsliées à la pose de la néo-articulation sur le système musculaire, arti-culaire et proprioceptif sont essentielles à prendre en compte pourcibler les priorités rééducatives. Elles s'expriment en terme de déficitkinesthésique, d'une altération des capacités musculaires, liéenotamment à un déficit d'activation volontaire, et d'un enraidisse-ment articulaire plus ou moins prononcé.La rééduction doit permettre de pallier ces déficits, en tenant comptedes connaissances scientifiques sur la physiologie musculaire et arti-culaire, la reprogrammation sensitivo-motrice, et l'efficacité réelledes techniques kinésithérapiques. La lutte contre la douleur et larecherche précoce d'une amplitude optimale restent la priorité.
RE-EDUCATION AFTER TOTAL KNEE REPLACEMEN
Re-education after total knee replacement is common in physiothe-rapy, both in the hospital as well as in a centre of re-education or pri-vate practice. In spite of this, there is no consensus about the tech-niques for re-education.The different types of PTG can be distinguished according to the num-ber of ligaments sacrificed and the degrees of mobility allowed.Modifications related to the insertion of the neo-articulation on themuscular, articular and proprioceptive system necessarily have to betaken into account in order to target the re-education priorities. Theyexpress, in terms of physiotherapy deficiency, an alteration in themuscle capacities, in particular related to a deficiency in voluntaryactivation and a more or less pronounced joint stiffening.Re-education should make up for these deficiencies, by taking intoaccount scientific knowledge about muscular and joint physiology,sensory-motor reprogramming, and the real efficacy of physiotherapytechniques. The fight against pain and the early search for optimumamplitude remains the priority.
RE-EDUCATION AFTER TOTAL KNEE REPLACEMEN
Re-education after total knee replacement is common in physiothe-rapy, both in the hospital as well as in a centre of re-education or pri-vate practice. In spite of this, there is no consensus about the tech-niques for re-education.The different types of PTG can be distinguished according to the num-ber of ligaments sacrificed and the degrees of mobility allowed.Modifications related to the insertion of the neo-articulation on themuscular, articular and proprioceptive system necessarily have to betaken into account in order to target the re-education priorities. Theyexpress, in terms of physiotherapy deficiency, an alteration in themuscle capacities, in particular related to a deficiency in voluntaryactivation and a more or less pronounced joint stiffening.Re-education should make up for these deficiencies, by taking intoaccount scientific knowledge about muscular and joint physiology,sensory-motor reprogramming, and the real efficacy of physiotherapytechniques. The fight against pain and the early search for optimumamplitude remains the priority.
