Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Sports Medicine

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
• Postoperative rehabilitation is crucial for restoring function and patient satisfaction.
• Optimizing rehabilitation protocols can enhance recovery and long-term outcomes.

Purpose of the Study:

• To compare the safety and efficacy of a high-intensity (HI) progressive rehabilitation protocol with a low-intensity (LI) protocol after TKA.
• To evaluate the impact of early, intensive rehabilitation on functional recovery and strength.
• To assess potential limitations of early high-intensity rehabilitation, such as arthrogenic muscle inhibition.

Main Methods:

• 162 participants undergoing TKA were randomized into HI or LI rehabilitation groups.
• The HI protocol involved progressive resistance and rapid weight-bearing exercises.
• Rehabilitation occurred in an outpatient setting over 11 weeks, with outcomes assessed up to 12 months postoperatively.

Main Results:

• No significant differences were observed between HI and LI groups in primary outcomes (stair climbing test) or secondary outcomes at 3 and 12 months.
• Both groups demonstrated significant improvements in strength, function, and pain scores compared to baseline by 12 months.
• Adverse event rates were similar between the HI and LI rehabilitation groups.

Conclusions:

• Both high-intensity and low-intensity rehabilitation protocols are effective for improving strength and function following TKA.
• High-intensity progressive rehabilitation is a safe option for patients after TKA.
• Early postoperative arthrogenic muscular inhibition may limit the effectiveness of high-intensity rehabilitation in the initial stages.