A retrospective analysis of postrehabilitation outcomes following total knee arthroplasty

Total knee arthroplasty (TKA) is one of the most frequently performed orthopaedic procedures in Canada. Despite the frequency at which TKAs are performed, few studies have examined the association between postoperative outcomes and long-term functional outcomes following group-based rehabilitation in Canada. The primary objective of the present study was to examine changes in flexion and extension from intake to discharge from rehabilitation in patients in Saskatchewan, Canada. A secondary objective was to explore the demographic and medical predictors of range of motion in TKA patients, and treatment duration.

A retrospective chart review from an outpatient rehabilitation clinical database was conducted between September 2014 and December 2016, and assessed demographic and medical variables.

A total of 672 patient charts were included in the study. Significant improvements (p < 0.001) were noted from intake to discharge from rehabilitation for flexion and extension. Right-side TKA, flexion at intake and the length of treatment predicted flexion at discharge from rehabilitation (R²  = 0.23). Gender, right side TKA, extension at intake and the length of treatment predicted extension at discharge from rehabilitation (R²  = 0.23). Lastly, age, flexion at intake and extension at intake predicted length of treatment in the rehabilitation programme (R²  = 0.21).

Patients who participated in rehabilitation following TKA experienced improvements in flexion and extension. Those with decreased flexion and extension after TKA may be less likely to experience a desirable range of motion, indicating a need for more intensive targeted rehabilitation in this group, and adjustments in hospital and community care.