Development of reference charts for monitoring quadriceps strength with handheld dynamometry after total knee arthroplasty.
Jeremy Graber, Elizabeth Juarez-Colunga, Charles Thigpen and 4 others
PMID 34751608WHAT IT FOUND
New reference charts let therapists compare a patient's quadriceps strength after knee replacement to typical recovery curves.
This helps identify who is recovering poorly and needs more attention, though even top performers often remain weaker than healthy peers.
Key findings
01Reference charts were developed to describe normative quadriceps strength recovery for the first 180 days following total knee arthroplasty.
02The charts allow clinicians to identify patients with suboptimal recovery, such as those whose strength declines or remains in the bottom centiles, enabling quicker intervention.
03Even patients in the 90th centile for post-surgery recovery may still have quadriceps strength significantly lower than healthy population norms.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The data came from a limited number of sites, which may affect generalizability. Handheld dynamometry can underestimate force in strong patients or when the tester is weak. The charts reflect average recovery but do not account for individual patient factors like pain or comorbidities. Preoperative strength was not included, so comparisons are only against post-surgery norms.
Declared interests
The authors report no relevant competing interests.
The easy way to misread this
Do not assume a patient is fully recovered if they score well on these charts. The reference charts compare patients to other post-surgery patients, not to healthy individuals. A patient in the top centile may still have significant strength deficits relative to the general population.