Objective: This study investigated the association between reduced preoperative muscle mass and postoperative motor function in patients undergoing total knee arthroplasty (TKA) using the Criteria-Based Protocol (CB) for early mobilization.

Methods: Fifty-one patients who underwent TKA were included. Based on preoperative adjusted skeletal muscle mass, patients were classified into a low muscle mass group (L group) and a high muscle mass group (H group). All patients followed the CB protocol for postoperative rehabilitation.Age, body mass index (BMI), and functional outcomes preoperatively and at 12 weeks postoperatively were compared between groups.

Results: The L group was older (76.5±5.5 vs 72.3±6.1 years) and had a lower BMI (23.2±3.2 vs 27.8±3.7) than the H group (p＜0.05). Preoperative comparisons showed significant differences in flexion range of motion (129.0±13.0 vs 118.3±21.6) and activity (37.9±17.3 vs 50.1±17.0) (p＜0.05), whereas no significant differences were observed in postoperative motor function.

Conclusion: When the CB protocol was used, patients with lower preoperative muscle mass showed no difference in short-term functional outcomes compared with those with higher preoperative muscle mass.

Background: Mycoplasma-associated bilateral striatal necrosis (BSN) is a rare neurological disease presenting with a wide variety of symptoms, including extrapyramidal signs like parkinsonism and dystonia. While its long-term course and the effect of rehabilitation intervention are poorly understood, this case report highlights the significant contribution of rehabilitation to a favorable outcome.

Case Presentation: An 11-year-old girl presented with status epilepticus and loss of consciousness following a Mycoplasma pneumoniae infection. She was diagnosed with BSN based on head MRI findings. The patient exhibited diverse symptoms, including chorea-like movements, dysphagia, dysarthria, disinhibited and impulsive behaviors, inattention, and severe fatigability, which significantly impaired her activities of daily living.

Methods & Results: She immediately began immunomodulatory therapy and early intensive rehabilitation, including physical, occupational, and speech therapy. Through this intensive, multidisciplinary approach, she achieved a remarkable neurological recovery. Her cognition, including attention and concentration improved, and her academic performance returned to premorbid levels. She was able to successfully return to school and society without significant long-term sequelae.

Conclusion: This case suggests that early and intensive rehabilitation, in conjunction with immunomodulatory therapy, can lead to a significant recovery even in rare neurological conditions like Mycoplasma-associated BSN. The findings underscore the critical role of a multidisciplinary approach in not only restoring motor function but also facilitating a full return to cognitive and social activities. They also emphasize the need for robust collaboration among medical, educational, and family support systems to ensure a successful return to school for children with acquired brain injury.