Using interactive technologies for rehabilitation following revision knee arthroplasty

A chronic periprosthetic infection after knee replacement typically requires two-stage treatment. However, the inter-stage rehabilitation protocol for patients with an articulating spacer has not been adequately developed. This study aimed to determine whether adding interactive biofeedback walking training on the Walker View treadmill enhances the effectiveness of a standard recovery program following the first stage of two-stage revision treatment. The prospective randomized controlled trial included 87 patients who had undergone removal of their endoprostheses and placement of articulating spacers. The treatment group (n = 43) had the standard 21-day rehabilitation program combined with Walker View sessions, while the control group (n = 44) only followed the program. We assessed knee joint movement volume, quadriceps EMG amplitude, stride length, walking speed, postural stability, and SF-36, WOMAC, and KSS scores. By the end of the rehabilitation course, the results registered in the treatment group were better than in the control group: flexion — 78 ± 6° versus 71 ± 7° (p = 0.01); EMG amplitude — 179 ± 16 versus 165 ± 16 μV (p = 0.01); step length — 54.2 ± 5.0 versus 49.5 ± 5.0 cm (p = 0.01); walking speed — 0.70 ± 0.05 versus 0.65 ± 0.05 m/s (p = 0.02); overall stability — 80 ± 8% versus 72 ± 7% (p = 0.01); physical component SF-36 — 51 ± 8 versus 47 ± 7 points (p = 0.01). The differences in WOMAC and KSS scores were insignificant (p = 0.06 and p = 0.07). The inclusion of Walker View sessions in the inter-stage rehabilitation program yields more pronounced improvements in mobility, neuromuscular function, walking, and balance restoration.