Quadriceps muscle group function and after total knee arthroplasty-asystematic narrative update

Background: This article systematically summarizes the present evidences, published in the last 20 years, regarding the pre- and post-operative factors, which may influence recovery of the function of the quadriceps muscle group following total knee arthroplasty (TKA). We following the PRISMA methodology, including meta-analyses and high-level evidence studies (prospective trials, and, when unavailable, retrospective studies). Sources of data: Pubmed and Cochrane databases: 582 articles were identified and 54 of them were selected. Areas of agreement: Tourniquets inflated at high pressure exert a detrimental effect on the quadriceps muscle group. Faster quadriceps recovery takes place using mini-invasive approaches, an eight-week rehabilitation period including balance training and the use of nutraceuticals. Areas of disagreement: Pre-habilitation and pre-operative factors, analgesic methods and different TKA implants. Growing points and areas timely for developing research: Telerehabilitation seems a cost-effective tool for rehabilitation after TKA. Patients’ optimization protocols before TKA should include standardized nutraceuticals intake.