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COmmunity-based Rehabilitation after Knee Arthroplasty (CORKA): study protocol for a randomised controlled trial
Karen L Barker1,2, David Beard3, Andrew Price3
1NIHR - BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK. Karen.barker@ouh.nhs.uk.
Trials
|October 15, 2016
Summary
This study investigates a tailored community rehabilitation program for knee replacement patients at risk of poor outcomes. The goal is to improve function and cost-effectiveness compared to usual care.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Services Research
Background:
- Increasing rates of knee arthroplasty surgeries necessitate efficient rehabilitation strategies.
- A significant percentage of patients do not achieve satisfactory outcomes with current post-operative care.
- Limited physiotherapy resources and an aging patient population highlight the need for targeted interventions.
Purpose of the Study:
- To evaluate the clinical and cost-effectiveness of a community-based multidisciplinary rehabilitation intervention for knee arthroplasty patients.
- To identify patients at risk of poor outcomes using a predictive algorithm for targeted rehabilitation.
- To compare a tailored rehabilitation package against usual care in improving patient function and quality of life.
Main Methods:
- A prospective, single-blind, two-arm randomized controlled trial (RCT) involving 620 patients undergoing knee arthroplasty.
- Patients identified as high-risk via a predictive algorithm will be randomized to either usual care or a tailored community-based rehabilitation package.
- Primary outcome measured by the Late Life Function and Disability Instrument at 1-year post-surgery, with secondary outcomes including various functional and quality-of-life scores.
Main Results:
- The study aims to determine if the tailored rehabilitation package leads to better functional outcomes and is cost-effective.
- Secondary outcome analysis will include Oxford Knee Score, quality of life, physical activity levels, and performance-based tests.
- A nested qualitative study will explore patient experiences and perceptions of the rehabilitation interventions.
Conclusions:
- There is a need for optimized, individualized rehabilitation strategies following knee arthroplasty.
- This trial will provide evidence on the effectiveness and cost-effectiveness of a targeted, community-based approach for at-risk patients.
- Findings will inform resource allocation for physiotherapy services to benefit the elderly and frail population undergoing knee replacement.
