Effect of Group-Based Outpatient Physical Therapy on Function After Total Knee Replacement: Results From a...

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Clinical Trials

Background:

• Total knee replacement (TKR) is a common procedure for osteoarthritis.
• Postoperative physical therapy (PT) is crucial for functional recovery.
• Optimizing PT protocols can enhance patient outcomes and satisfaction.

Purpose of the Study:

• To assess the long-term clinical effectiveness of a novel group-based outpatient physical therapy (PT) intervention following total knee replacement (TKR).
• To compare functional ability, knee symptoms, psychological well-being, and patient satisfaction between TKR patients receiving standard care versus TKR patients receiving standard care plus group PT.

Main Methods:

• A 2-center, unblinded, superiority randomized controlled trial involving 180 patients awaiting primary TKR for osteoarthritis.
• Patients were randomized to either a 6-session group-based outpatient PT intervention plus usual care (n=89) or usual care alone (n=91).
• The primary outcome was patient-reported functional ability (Lower Extremity Functional Scale) at 12 months postoperative, with secondary outcomes assessed at 3, 6, and 12 months.

Main Results:

• The intervention group showed a statistically significant improvement in function at 12 months (mean difference 4.47, P=0.04), favoring the PT group.
• Functional improvements were greater at 3 months (8.1 points) and 6 months (5.4 points) but decreased over time.
• No significant differences were found in secondary outcomes, though patient satisfaction with PT was higher in the intervention group.

Conclusions:

• Supplementing usual care with group-based outpatient PT after TKR demonstrated improvements in patient function at 12 months.
• The observed functional improvement magnitude was below the minimum clinically important difference.
• The intervention group reported higher patient satisfaction, suggesting potential benefits despite not reaching the primary clinical significance threshold.