Preoperative exercise in patients undergoing total knee arthroplasty: a pilot 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.
• Functional recovery and patient satisfaction after TKA are influenced by various factors.
• Preoperative interventions are being explored to optimize outcomes following TKA.

Purpose of the Study:

• To evaluate the impact of preoperative physiotherapy (PT) on functional, subjective, and socio-economic parameters in patients undergoing TKA.
• To compare outcomes between a control group and an intervention group receiving PT before TKA.

Main Methods:

• A randomized controlled trial involving 20 patients scheduled for TKA.
• The intervention group (IG) received 5-9 PT sessions, including PNF, endurance, and individualized exercises, 3-4 weeks pre-surgery.
• Outcome measures included the Stair Climbing Test (SCT), Lysholm Score (LS), Tegner Activity Scale (TAS), range of motion (ROM), pain levels, analgesic intake, and costs.

Main Results:

• The intervention group showed a significant increase in the Tegner Activity Scale (TAS) (p=0.002).
• The control group reported higher preoperative pain levels and consumed more analgesics post-surgery.
• The control group incurred 21.4% higher overall costs compared to the intervention group.

Conclusions:

• Preoperative physiotherapy significantly enhances the level of physical activity before and after total knee arthroplasty.
• PT intervention leads to a clinically relevant improvement in the Tegner Activity Scale (TAS).
• Preoperative physiotherapy may contribute to reduced pain, lower analgesic use, and decreased overall costs after TKA.