Background: Surgical techniques related to soft tissue management play critical roles in optimizing surgical outcomes and patient satisfaction in total knee arthroplasty (TKA). Despite the importance of wound closure and bleeding management approaches, no published guidelines/consensus are available. Methods: Twelve orthopedic surgeons participated in a modified Delphi panel consisting of 2 parts (each part comprising two rounds) from September–October 2018. Questionnaires were developed based on published evidence and guidelines on surgical techniques/materials. Questionnaires were administered via email (Round 1) or at a face-to-face meeting (subsequent rounds). Panelists ranked their agreement with each statement on a five-point Likert scale. Consensus was achieved if ≥70% of panelists selected 4/5, or 1/2. Statements not reaching consensus in Round 1 were discussed and repeated or modified in Round 2. Statements not reaching consensus in Round 2 were excluded from the final consensus framework. Results: Consensus was reached on 13 goals of wound management. Panelists agreed on 38 challenges and 71 strategies addressing surgical techniques or wound closure materials for each tissue layer, and management strategies for blood loss reduction or deep vein thrombosis prophylaxis in TKA. Statements on closure of capsular and skin layers, wound irrigation, dressings and drains required repeat voting or modification to reach consensus. Conclusion: Consensus from Asia-Pacific TKA experts highlights the importance of wound management in optimizing TKA outcomes. The consensus framework provides a basis for future research, guidance to reduce variability in patient outcomes, and can help inform recommendations for wound management in TKA.

The aim of the present study was to investigate the role of Isokinetic Training and Electromyography biofeedback training in improving strength of the quadriceps femoris in participants with Osteoarthritis of knee. Fifty four participants (male and female) in the age range of 50–63 years with knee Osteoarthritis of Grade II and III (Kellgren-Lawrence criteria) severity were recruited from the Department of Orthopedics, Hospital Universiti Sains Malaysia. The selected participants were taken to the Exercise and Sports science laboratory and the laboratory of School of Medical Sciences, Universiti Sains Malaysia for baseline assessment. Extent of muscle strength was assessed employing the isokinetic device BIODEX 4 System Pro. On completion of the baseline assessment the participants were randomly categorized into three groups (Gr.) (Viz. Gr. A, Gr. B, Gr. C and Gr. D) and thus each group consisted of 18 participants. Gr. A participants received Conventional Physiotherapy consisting of strengthening exercises; stretching exercises and range of motion exercises. Gr. B received Isokinetic Training at velocities of 90° and 150°/second. Gr. C participants received EMG Biofeedback training with Mega ME 6000 device. All the interventions were imparted for 25–30 minutes per session; 2 sessions per week for10 weeks (20 sessions). Mid intervention assessment was done after 5th week followed by the post intervention assessment after 10th week following baseline assessment protocol. After the post intervention assessment, the participants were instructed not to attend the training session for the next 8 weeks and not to get engaged in any sort of physical training, exercise or sport programme. The issue of sustainability was also verified by the post-follow-up assessments of the all of the variables following identical assessment protocols after 14th and 18th week of completion. Repeated measure of ANOVA revealed that, Isokinetic Training was beneficial in enhancing muscle-strength of quadriceps femoris (p<.05).