The ability to kneel is an important function of the knee joint, as it is required for many daily activities, including religious practices, professional occupations and recreational pursuits. The inability to kneel following total knee arthroplasty (TKA) is frequently a source of disappointment. This work investigates patients' understanding of the term 'kneeling' and what proportion of patients can kneel before and after TKA, as well as identifying the factors that can affect the ability to kneel following TKA. The underlying hypothesis tested was: 'There are no differences between kneeling ability before and after TKA'. Kneeling ability after TKA may be affected by many factors, including patient-specific factors, the extent of wear on RPC (Retro patellar Cartilage), postoperative AKP (Anterior Knee Pain) and post-operative ROM (Range of Motion). Thus a consecutive series of TKA patients were assessed to test the afore-mentioned hypothesis. In particular, the thesis has examined: • Interpretation of kneeling and perceptions of kneeling ability after TKA. • The extent of wear on Retro Patellar Cartilage (RPC) and its correlation to kneeling ability. • Sensory changes in the knee after TKA. • Preoperative and Postoperative Anterior Knee Pain (AKP) assessment. • The reality of kneeling ability before and after TKA. • Postoperative ROM of the knee and its correlation to kneeling function. The advice offered by healthcare professionals may contribute to a low postoperative rate of kneeling. The patellofemoral joint plays an essential role in knee function and a person's kneeling ability, may be greatly affected by the performance of this joint. Firstly, this study analysed the responses of two samples of participants drawn from diverse cultural backgrounds (Christian and Muslim), it examined their primary interpretation of what kneeling constitutes, along with a subjective assessment of the importance of kneeling in their everyday lives. Secondly, it explored patients' perceptions of their kneeling ability after TKA, with a comparative analysis of their responses to the kneeling questionnaire specifically constructed by the author and also the question in relation to kneeling in the Oxford Knee Score (OKS). The third component investigated retro-patellar cartilage (RPC) morphology using intraoperative examination and standardised photography. Fourthly, a cohort of patients listed for TKAs was followed prospectively, in order to assess their kneeling ability prior to and following treatment, along with identifying the factors that could affect this function, i.e. knee pain, range of motion, sensory changes and sensitivity to pain on the anterior aspect of the knee as assessed with dolorimetry. Differences were detected in the subjective interpretation of the kneeling function, as well as its importance, for the two diverse cultures involved in this study. Pain, as opposed to poor range of movement, was identified as the main reason which led to kneeling difficulties. The majority of respondents reported that it was either extremely difficult or impossible to kneel on the operated knee. The high flexed position (required for prayer in certain cultures) was the most difficult position to achieve for most of the patients. Prior to surgery, 30 patients were seen during this period, 15 (50%) out of 30 consecutive patients were unable to kneel in any position whatsoever. Of those who could kneel to some degree, the most common posture that they could achieve was the upright kneeling position. Considerable variations were found to occur in patients' understanding of the term 'kneeling'. Consequently, this has significant implications for the design and interpretation of questions in relation to kneeling for diverse cultures, which are characterised by distinct lifestyles. The current patient-based selfV administered questionnaires, such as the OKS, although useful as a simple measure of overall knee function, were found to have limitations as an effective assessment tool in the measurement of kneeling function either before or after TKA and indicate that there is a need for a culturally appropriate questionnaire to assess kneeling function. Retro-patellar cartilage lesions were very prevalent in patients undergoing TKA. However, no significant correlation existed between the total amount of retro-patellar cartilage wear and the ability to kneel. Patients were more likely to be able to kneel if the cartilage of the superior facets of the patella were disease free (P=0.02). At the six months post-surgery stage, of the 14 consecutive patients, who could kneel pre-operatively 6 were able to kneel post-operatively. Of the 13 consecutive patients who were unable to kneel pre-operatively, all were unable to kneel post-operatively. Knee pain was the main reason attributed to this difficulty. However, no link was found to occur between sensory changes and kneeling function in the patients who participated in the study, after TKA performed via an anterior midline incision.

Introduction : L’influence de l’Index de Masse Corporelle (IMC) sur la récupération des paramètres de la marche après prothèse totale de hanche (PTH) et de genou (PTG) est méconnue. Peu d' étude se sont intéressées à l'influence de l’IMC sur la récupération des amplitudes articulaires actives à la marche (AAA) ou de la vitesse de marche après PTH et PTG. Notre objectif était d’évaluer cet impact en préopératoire et en post-opératoire par une évaluation clinique et biomécanique. Notre hypothèse était que l’obésité (IMC>30kg/m2) serait un facteur péjoratif de récupération des paramètres de marche.Matériel et méthodes : Après avoir effectué une revue systématique de la littérature sur la récupération fonctionnelle après prothèses totales du membre inférieur (PTH et PTG) afin de nous assurer de l’originalité de notre travail et de sa pertinence nous avons réalisé 2 études prospectives indépendantes : en incluant 76 PTH chez des patients coxarthrosiques d’une part et 79 PTG chez des patients gonarthrosiques d’autre part. Tous les patients bénéficiaient d’une analyse quantifiée de la marche en préopératoire et en post-opératoire (à 6 mois pour les PTH et à un an pour les PTG). Un groupe de témoins sains appariés suivait le même protocole. La vitesse de la marche, l’AAA de hanche et de genou, ainsi que des scores fonctionnels et de qualité de vie étaient évalués, pour tous les paramètres le gain était calculé. Les patients étaient répartis en 2 groupes : patients non-obèses (G1) : IMC<30 et patients obèses (G2) : IMC≥30 dans chacune des cohortes. Des t-tests appariés étaient utilisés pour évaluer (1) les différences pré- et post-opératoires entre G1 et G2, puis les différences de gain entre G1 et G2. Enfin une régression linéaire uni- et multivariée recherchait les associations entre l’IMC, la vitesse de la marche et les AAA.Résultats Pour les 2 cohortes : en préopératoire, la vitesse de la marche et les AAA étaient significativement plus bas chez les obèses. En post-opératoire la vitesse de la marche et les AAA étaient significativement plus bas pour tous les patients opérés d’une PTG ou d’une PTH comparativement au groupe témoin. En pré-opératoire les obèses étaient plus symptomatiques. Une différence significative était retrouvée entre G1 et G2 concernant l’amélioration de la douleur en faveur des obèses (sur le gain de WOMAC douleur pour les PTG et d’EVA pour les PTH). Pour tous les autres paramètres les gains n’étaient pas différents entre G1 et G2. La régression uni- et multivariée ne montrait pas de relation significative entre la vitesse de la marche, les AAA et l’IMC.Conclusion : L’IMC n’a pas d’effet délétère direct sur la récupération des paramètres de marche après une PTH ou une PTG. En effet malgré une symptomatologie pré-opératoire plus forte les patients obèses présentent une amélioration comparable en termes de gain aux patients non-obèses. Cependant les paramètres de marche post-opératoire après une PTH ou une PTG demeurent significativement plus bas que ceux des témoins et ce quel que soit l’IMC des patients opérés, sans récupération ad integrum clinique ou biomécanique de leur fonction de la hanche ou du genou. Ainsi l’obésité semble présenter un effet similaire sur la récupération des paramètres de marche après une PTH ou une PTG. / Introduction : Body Mass Index (BMI) impact on gait recovery after total hip and total knee arthroplasty (THA and TKA) remains misunderstood. Few studies have analyzed the influence of BMI on the recovery of hip and knee range of motion (ROM) during gait or walking speed after THA and TKA. Our objective was to assess this impact preoperatively and post-operatively using both 3D gait analysis and clinical assessment. Our hypothesis was that obesity (BMI> 30kg /m2) would be a negative factor in the recovery of gait parameters.Material and methods: After conducting a systematic review of the literature on functional recovery after total prostheses of the lower limb (THA and TKA) to ensure the originality of this work and its relevance we conducted 2 independent prospective studies: including 76 THA in hip osteoarthritis patients on the one hand and 79 TKA in knee osteoarthritis patients on the other hand. All patients had a quantified gait analysis of preoperatively and postoperatively (at 6 months for THA and 1 year for TKA). A control group of matched healthy people followed the same protocol. The gait speed, ROM hip and knee, as well as functional and quality of life scores were evaluated, for all parameters the gain was calculated. Patients were divided into 2 groups in each cohort: non-obese patients (G1): BMI <30kg/m2 and obese patients (G2): BMI≥30kg/m2. Paired t-tests were used to evaluate the pre- and post-operative differences between G1 and G2, then the differences in gain between G1 and G2. Finally, a uni- and multivariate linear regression sought associations between BMI, gait speed, and ROM.Results: In both cohorts: preoperatively, gait speed and ROM were significantly lower in obese patients. Postoperatively, walking speed and ROM were significantly lower for all patients undergoing TKA or THA compared with the control group. Preoperatively obese patients were more symptomatic. A significant difference was found between G1 and G2 regarding pain improvement in favor of the obese (on the gain of WOMAC pain for TKA and analogic pain scale for THA). For all other parameters the gains were not different between G1 and G2. Uni- and multivariate regression showed no significant relationship between gait speed, ROM and BMI.Conclusion: BMI has no direct negative effect on recovery of walking parameters after THA or TKA. Indeed despite a higher preoperative symptomatology obese patients show a comparable improvement in terms of gain to non-obese patients clinically and biomechanically. However, postoperative gait parameters after THA or TKA remain significantly lower than those of controls, regardless of the BMI of patients without full clinical or biomechanical recovery. Though, obesity appears to have a similar effect on the gait parameters recovery after THA or TKA.

No description available.

High quality health services are often difficult to access in rural and remote areas of Australia. This is due to a shortage of health care professionals and specialists, inadequate and poorly distributed resources, and the tyranny of distance. The result is a reduced level of health and a higher mortality rate than seen in urban communities. Telemedicine, which is the use of various technologies to deliver a range of health care services over a distance, has the potential to increase equity and access to health care in rural and remote areas. To date there has been a poor uptake of telemedicine technology within the profession of physiotherapy. This undoubtedly stems from the perceived, and indeed, real difficulty of performing what is traditionally ‘hands on’ therapy, via an electronic medium. Added to this is a paucity of rigorous clinical outcome studies to demonstrate the efficacy of performing successful treatment via this delivery method. The aim of this thesis was to establish the efficacy of telemedicine as a clinical tool for physiotherapists. To achieve this, the first major undertaking was the development of a telemedicine system to meet the unique needs of clinical physiotherapists and their patients. A series of studies was then performed to calibrate the system and establish its validity and reliability as a clinical assessment tool. Finally, a randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The telemedicine system was constructed using a human systems development approach, with close consultation with senior clinical physiotherapists and potential users of the system. The personal computer-based system was designed to connect patients in their home with physiotherapists in the hospital, via low-speed and low-cost communications. The system incorporated real-time videoconferencing and physical measurement tools to enable the remote assessment of patients. The validity and reliability of the telemedicine physical measurement tools were established through a series of five studies. The results demonstrated these measurements to be accurate and reliable, under various measurement conditions, when compared to reference instruments. A prospective randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The research model chosen for this study was the rehabilitation of subjects who had undergone total knee replacement surgery. Block randomisation was used to assign 65 participants to either a traditional face-to-face therapy group or a telemedicine rehabilitation group. Participants in both groups received treatment over a six week period. Data analysis focussed on comparing physical and functional rehabilitation outcomes achieved in each treatment group. The results of this study demonstrated that the rehabilitation outcomes produced via the telemedicine system were similar to those achieved in the traditional manner. Additionally, the telemedicine therapy was found to produce greater improvements in a number of functional outcome measurements. A high level of satisfaction was expressed by participants who received treatment via the telemedicine method. This thesis provides evidence of the efficacy of telemedicine as a clinical tool for physiotherapists. Furthermore, the work detailed in this thesis represents one of the first randomised control trials in telerehabilitation and makes a significant contribution towards the knowledge of low-bandwidth telemedicine in general. This thesis provides a framework upon which further research and telemedicine applications may be developed, with the ultimate goal of improving equity and access to high quality health services in rural and remote areas.

High quality health services are often difficult to access in rural and remote areas of Australia. This is due to a shortage of health care professionals and specialists, inadequate and poorly distributed resources, and the tyranny of distance. The result is a reduced level of health and a higher mortality rate than seen in urban communities. Telemedicine, which is the use of various technologies to deliver a range of health care services over a distance, has the potential to increase equity and access to health care in rural and remote areas. To date there has been a poor uptake of telemedicine technology within the profession of physiotherapy. This undoubtedly stems from the perceived, and indeed, real difficulty of performing what is traditionally ‘hands on’ therapy, via an electronic medium. Added to this is a paucity of rigorous clinical outcome studies to demonstrate the efficacy of performing successful treatment via this delivery method. The aim of this thesis was to establish the efficacy of telemedicine as a clinical tool for physiotherapists. To achieve this, the first major undertaking was the development of a telemedicine system to meet the unique needs of clinical physiotherapists and their patients. A series of studies was then performed to calibrate the system and establish its validity and reliability as a clinical assessment tool. Finally, a randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The telemedicine system was constructed using a human systems development approach, with close consultation with senior clinical physiotherapists and potential users of the system. The personal computer-based system was designed to connect patients in their home with physiotherapists in the hospital, via low-speed and low-cost communications. The system incorporated real-time videoconferencing and physical measurement tools to enable the remote assessment of patients. The validity and reliability of the telemedicine physical measurement tools were established through a series of five studies. The results demonstrated these measurements to be accurate and reliable, under various measurement conditions, when compared to reference instruments. A prospective randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The research model chosen for this study was the rehabilitation of subjects who had undergone total knee replacement surgery. Block randomisation was used to assign 65 participants to either a traditional face-to-face therapy group or a telemedicine rehabilitation group. Participants in both groups received treatment over a six week period. Data analysis focussed on comparing physical and functional rehabilitation outcomes achieved in each treatment group. The results of this study demonstrated that the rehabilitation outcomes produced via the telemedicine system were similar to those achieved in the traditional manner. Additionally, the telemedicine therapy was found to produce greater improvements in a number of functional outcome measurements. A high level of satisfaction was expressed by participants who received treatment via the telemedicine method. This thesis provides evidence of the efficacy of telemedicine as a clinical tool for physiotherapists. Furthermore, the work detailed in this thesis represents one of the first randomised control trials in telerehabilitation and makes a significant contribution towards the knowledge of low-bandwidth telemedicine in general. This thesis provides a framework upon which further research and telemedicine applications may be developed, with the ultimate goal of improving equity and access to high quality health services in rural and remote areas.

High quality health services are often difficult to access in rural and remote areas of Australia. This is due to a shortage of health care professionals and specialists, inadequate and poorly distributed resources, and the tyranny of distance. The result is a reduced level of health and a higher mortality rate than seen in urban communities. Telemedicine, which is the use of various technologies to deliver a range of health care services over a distance, has the potential to increase equity and access to health care in rural and remote areas. To date there has been a poor uptake of telemedicine technology within the profession of physiotherapy. This undoubtedly stems from the perceived, and indeed, real difficulty of performing what is traditionally ‘hands on’ therapy, via an electronic medium. Added to this is a paucity of rigorous clinical outcome studies to demonstrate the efficacy of performing successful treatment via this delivery method. The aim of this thesis was to establish the efficacy of telemedicine as a clinical tool for physiotherapists. To achieve this, the first major undertaking was the development of a telemedicine system to meet the unique needs of clinical physiotherapists and their patients. A series of studies was then performed to calibrate the system and establish its validity and reliability as a clinical assessment tool. Finally, a randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The telemedicine system was constructed using a human systems development approach, with close consultation with senior clinical physiotherapists and potential users of the system. The personal computer-based system was designed to connect patients in their home with physiotherapists in the hospital, via low-speed and low-cost communications. The system incorporated real-time videoconferencing and physical measurement tools to enable the remote assessment of patients. The validity and reliability of the telemedicine physical measurement tools were established through a series of five studies. The results demonstrated these measurements to be accurate and reliable, under various measurement conditions, when compared to reference instruments. A prospective randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The research model chosen for this study was the rehabilitation of subjects who had undergone total knee replacement surgery. Block randomisation was used to assign 65 participants to either a traditional face-to-face therapy group or a telemedicine rehabilitation group. Participants in both groups received treatment over a six week period. Data analysis focussed on comparing physical and functional rehabilitation outcomes achieved in each treatment group. The results of this study demonstrated that the rehabilitation outcomes produced via the telemedicine system were similar to those achieved in the traditional manner. Additionally, the telemedicine therapy was found to produce greater improvements in a number of functional outcome measurements. A high level of satisfaction was expressed by participants who received treatment via the telemedicine method. This thesis provides evidence of the efficacy of telemedicine as a clinical tool for physiotherapists. Furthermore, the work detailed in this thesis represents one of the first randomised control trials in telerehabilitation and makes a significant contribution towards the knowledge of low-bandwidth telemedicine in general. This thesis provides a framework upon which further research and telemedicine applications may be developed, with the ultimate goal of improving equity and access to high quality health services in rural and remote areas.

High quality health services are often difficult to access in rural and remote areas of Australia. This is due to a shortage of health care professionals and specialists, inadequate and poorly distributed resources, and the tyranny of distance. The result is a reduced level of health and a higher mortality rate than seen in urban communities. Telemedicine, which is the use of various technologies to deliver a range of health care services over a distance, has the potential to increase equity and access to health care in rural and remote areas. To date there has been a poor uptake of telemedicine technology within the profession of physiotherapy. This undoubtedly stems from the perceived, and indeed, real difficulty of performing what is traditionally ‘hands on’ therapy, via an electronic medium. Added to this is a paucity of rigorous clinical outcome studies to demonstrate the efficacy of performing successful treatment via this delivery method. The aim of this thesis was to establish the efficacy of telemedicine as a clinical tool for physiotherapists. To achieve this, the first major undertaking was the development of a telemedicine system to meet the unique needs of clinical physiotherapists and their patients. A series of studies was then performed to calibrate the system and establish its validity and reliability as a clinical assessment tool. Finally, a randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The telemedicine system was constructed using a human systems development approach, with close consultation with senior clinical physiotherapists and potential users of the system. The personal computer-based system was designed to connect patients in their home with physiotherapists in the hospital, via low-speed and low-cost communications. The system incorporated real-time videoconferencing and physical measurement tools to enable the remote assessment of patients. The validity and reliability of the telemedicine physical measurement tools were established through a series of five studies. The results demonstrated these measurements to be accurate and reliable, under various measurement conditions, when compared to reference instruments. A prospective randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The research model chosen for this study was the rehabilitation of subjects who had undergone total knee replacement surgery. Block randomisation was used to assign 65 participants to either a traditional face-to-face therapy group or a telemedicine rehabilitation group. Participants in both groups received treatment over a six week period. Data analysis focussed on comparing physical and functional rehabilitation outcomes achieved in each treatment group. The results of this study demonstrated that the rehabilitation outcomes produced via the telemedicine system were similar to those achieved in the traditional manner. Additionally, the telemedicine therapy was found to produce greater improvements in a number of functional outcome measurements. A high level of satisfaction was expressed by participants who received treatment via the telemedicine method. This thesis provides evidence of the efficacy of telemedicine as a clinical tool for physiotherapists. Furthermore, the work detailed in this thesis represents one of the first randomised control trials in telerehabilitation and makes a significant contribution towards the knowledge of low-bandwidth telemedicine in general. This thesis provides a framework upon which further research and telemedicine applications may be developed, with the ultimate goal of improving equity and access to high quality health services in rural and remote areas.

High quality health services are often difficult to access in rural and remote areas of Australia. This is due to a shortage of health care professionals and specialists, inadequate and poorly distributed resources, and the tyranny of distance. The result is a reduced level of health and a higher mortality rate than seen in urban communities. Telemedicine, which is the use of various technologies to deliver a range of health care services over a distance, has the potential to increase equity and access to health care in rural and remote areas. To date there has been a poor uptake of telemedicine technology within the profession of physiotherapy. This undoubtedly stems from the perceived, and indeed, real difficulty of performing what is traditionally ‘hands on’ therapy, via an electronic medium. Added to this is a paucity of rigorous clinical outcome studies to demonstrate the efficacy of performing successful treatment via this delivery method. The aim of this thesis was to establish the efficacy of telemedicine as a clinical tool for physiotherapists. To achieve this, the first major undertaking was the development of a telemedicine system to meet the unique needs of clinical physiotherapists and their patients. A series of studies was then performed to calibrate the system and establish its validity and reliability as a clinical assessment tool. Finally, a randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The telemedicine system was constructed using a human systems development approach, with close consultation with senior clinical physiotherapists and potential users of the system. The personal computer-based system was designed to connect patients in their home with physiotherapists in the hospital, via low-speed and low-cost communications. The system incorporated real-time videoconferencing and physical measurement tools to enable the remote assessment of patients. The validity and reliability of the telemedicine physical measurement tools were established through a series of five studies. The results demonstrated these measurements to be accurate and reliable, under various measurement conditions, when compared to reference instruments. A prospective randomised controlled trial was conducted to assess the treatment efficacy of the telemedicine system. The research model chosen for this study was the rehabilitation of subjects who had undergone total knee replacement surgery. Block randomisation was used to assign 65 participants to either a traditional face-to-face therapy group or a telemedicine rehabilitation group. Participants in both groups received treatment over a six week period. Data analysis focussed on comparing physical and functional rehabilitation outcomes achieved in each treatment group. The results of this study demonstrated that the rehabilitation outcomes produced via the telemedicine system were similar to those achieved in the traditional manner. Additionally, the telemedicine therapy was found to produce greater improvements in a number of functional outcome measurements. A high level of satisfaction was expressed by participants who received treatment via the telemedicine method. This thesis provides evidence of the efficacy of telemedicine as a clinical tool for physiotherapists. Furthermore, the work detailed in this thesis represents one of the first randomised control trials in telerehabilitation and makes a significant contribution towards the knowledge of low-bandwidth telemedicine in general. This thesis provides a framework upon which further research and telemedicine applications may be developed, with the ultimate goal of improving equity and access to high quality health services in rural and remote areas.

Knä- och höftplastik är bland de vanligaste kirurgiska ingreppen och har en stor positiv inverkan för den enskilda individens livskvalitet. Det har utarbetats flera vårdmodeller för patientkategorin som genomgår en knä- eller höftplastik, dels för att minska vårdkostnader men även för att förbättra vården. Det behövs emellertid mera kunskap om patientens upplevelse eftersom vården är i ständig utveckling. Studiens syfte var att beskriva patientens upplevelse av hemgång från en specialiserad elektiv enhet, den första postoperativa dagen efter knä- eller höftplastik, och första tiden efteråt. Telefonintervjuer utfördes med 12 patienter, och analyserades enligt kvalitativ innehållsanalys, med en induktiv ansats. Resultatet utmynnade i fem huvudkategorier med respektive underkategorier. Huvudkategorierna som framkom var; Den betydelsefulla hemmiljön, Information från sjukhuset, Oundvikligt hjälpbehov, Återhämtningens utmaningar och Hälsofrämjande kontakt. Informanterna delade en positiv upplevelse av hemgång den första postoperativa dagen och kunde hantera eventuella svårigheter på ett adekvat sätt, på egen hand eller med stöd av medskickad dokumentation, anhöriga eller kontakt med sjukhuset. Hemgång dagen efter knä- eller höftplastik upplevs som tryggt. / Knee and hip arthroplasty are among the most common surgeries available today and have a great impact on the quality of life of the individual. Several care models have been developed for patients having had knee or hip arthroplasty, not only to address the cost of healthcare, but also to improve the quality of the care itself. However, more knowledge about a patients experience following surgery is required as the care is continually progressing. The purpose of this study was to document the experience of a patient following a knee or hip arthroplasty. We aim to document their experiences returning home from a specialized elective unit, their first day post operation, as well as the initial period of recovery. Phone call interviews were carried out with 12 patients, and analyzed according to qualitative content analysis with inductive approach. The results were divided into five main categories, each with their own sub-categories. The main categories were; the importance of the home environment, information from the hospital, the necessity of help, challenges of recovery and health promotion contact. The participants reported a positive experience returning home after the first postoperative day and were able to handle potential issues in an adequate manner; on their own, with support from informative documentation, with help from relatives or through contact with the hospital. The experience of returning home the first day post operation, after a knee or hip arthroplasty is considered comfortable.

Bakgrund: Personer som drabbas av knäledsartros där inte medicinsk behandling fungerat blir aktuella för total knäartroplastik (TKA). Under en persons livstid är risken att få knäledsartros 40-45%. TKA förknippas med måttlig till svår smärta efter det kirurgiska ingreppet. Smärtlindringsmetoder har utvecklats och blivit effektivare för att patienten ska få bättre smärtlindring postoperativt. Tidigare studier har visat att god postoperativ smärtlindring förbättrar återhämtningen och minskar postoperativa komplikationer för patienten. Syftet: Syftet med vår kvantitativa enkätstudie var att undersöka patientens skattning av smärta postoperativt efter TKA. Metod: I studien deltog 29 kvinnor och män mellan 53-84 år. Deltagarna fick skatta sin smärta vid två tillfällen, 0-1 timme och mellan 2-4 timmar postoperativt med visuell analog skala (VAS). Data analyserades i SPSS version 24.0. Resultatet: Resultatet visade att efter 0-1 timme postoperativt hade 89.7% VAS ≤ 3 och vid 2-4 timmar postoperativt hade 75.8% VAS ≤ 3. Majoriteten av deltagarna 72.4% skattade sin smärta VAS ≤ 3 vid båda tillfällena. Det fanns en skillnad mellan de deltagare som erhållit spinalanestesi och generell anestesi. Vid första skattningen postoperativt var det ingen som erhållit spinalanestesi som skattade smärta, de som skattade VAS &gt; 3 hade erhållit generell anestesi. Konklusion: Slutsatsen är att patienter som genomgår TKA är väl smärtlindrade men att en större studie med fler antal deltagare skulle behövas göras för att utveckla bättre omvårdnadsrutiner för att möta personers behov av smärtlindringen när spinalanestesins effekter avtagit.