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Range of motion after total knee arthroplasty: the effect of a preoperative home exercise program
Fabrizio Matassi1, Joris Duerinckx, Hilde Vandenneucker
1Orthopedic Clinic, University of Florence, Largo Palagi, 1, 50139, Florence, Italy, fabriziomatassi@gmail.com.
Purpose:
Preoperative range of motion (ROM) is the most important variable to determine final flexion after total knee arthroplasty (TKA). The purpose of this study was to determine whether a preoperative home exercise program could improve ROM in the arthritic knee and whether this influenced ROM and functional recovery following primary TKA.
Methods:
During the period between 2005 and 2006, one hundred and twenty-two patients with gonarthrosis were included in a prospective study and randomly allocated to either the control or the treatment group. The sixty-one subjects in the treatment group underwent a 6-week home-based exercise program before TKA surgery. All one hundred and twenty-two patients were assessed before and after this exercise intervention. Postoperative assessments were at 6 weeks, 6 months and 1 year. Each evaluation included knee ROM and the Knee Society Clinical Rating System. Length of hospital stay and postoperative duration before achieving 90° of knee flexion were also recorded.
Results:
Exercise program improves knee motion in the presence of gonarthrosis. After TKA, the patients in the exercise group achieved 90° of knee flexion faster and had a shorter hospital stay. There is no prolonged effect on knee motion or patient function between 6 weeks and 1 year postoperatively.
Conclusion:
Preoperative exercise of the arthritic knee facilitates immediate postoperative recovery following primary TKA.
Levels Of Evidence:
Therapeutic study, Level I.