Preoperative Exercise in Patients Undergoing Total Knee Arthroplasty: a Pilot Randomized Controlled Trial

Overview

Journal Arch Physiother

Specialty Rehabilitation Medicine

Date 2020 Aug 11

PMID 32774889

Citations 16

Authors

Pascale Granicher

Thomas Stoggl

Sandro F Fucentese

Rolf Adelsberger

Jaap Swanenburg

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to assess the effect of preoperative physiotherapy (PT) on functional, subjective and socio-economic parameters after total knee arthroplasty (TKA).

Methods: 20 patients (mean ± SD: age 67 ± 7 years) scheduled for TKA at Balgrist University Hospital between July 2016 and March 2017 were randomly assigned to a control (CG) or intervention (IG) group. 3 to 4 weeks prior to surgery the IG completed 5 to 9 sessions of PT containing proprioceptive neuromuscular facilitation (PNF) techniques, endurance training and individually indicated interventions. Measurements were executed at baseline, preoperative and 3 months after TKA. The primary outcome measure was the Stair Climbing Test (SCT), secondary outcome measures were the knee range of motion (ROM) and the level of physical activity using Lysholm Score (LS) and Tegner Activity Scale (TAS). The subjective and socio-economic parameters were the Patients' Global Impression of Change (PGIC) scale, inpatient rehabilitation time, preoperative pain levels and metabolic equivalent (MET), postoperative intake of analgesics and overall costs.

Results: No difference between IG and CG was found for SCT (F (2/36) = 0.016, = 0.984, η2 = 0.004). An interaction between group and time was shown for TAS (F (18/1) = 13.890) with an increase in the IG ( = 0.002, η2 = 0.536). The sub-item "pain" within the LS presented a higher pain-level in CG (F (18/1) = 4.490, = 0.048, η2 = 0.974), while IG showed a higher preoperative MET compared to CG ( = 0.035). There were no other significant changes. The CG produced 21.4% higher overall costs, took more analgesics and showed higher preoperative pain levels than the IG.

Conclusions: Findings show that preoperative therapy improved the level of physical activity before and after TKA and resulted in a clinically relevant gain in TAS.

Trial Registration: ClinicalTrials.gov Identifier; NCT03160534. Registered 19 May 2017.

Citing Articles

Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement.

Choi K, Chau W, Li L, Ng S, Lo B, Ong M Arthroplasty. 2025; 7(1):16.

PMID: 40059198 PMC: 11892224. DOI: 10.1186/s42836-025-00301-6.

A Comparison Between Intensive and Conventional Therapies: A Systematic Review and Meta-Analysis Regarding the Pre-operative Outcomes After Total Knee Replacement.

Zahed M, Alesawy A, Zahed Z, Mohamed A, Samir R, Eleisawy M Cureus. 2025; 16(12):e75141.

PMID: 39759729 PMC: 11699589. DOI: 10.7759/cureus.75141.

Optimizing the Preoperative Preparation of Sarcopenic Older People: The Role of Prehabilitation and Nutritional Supplementation before Knee Arthroplasty.

Pegreffi F, Chiaramonte R, Donati Zeppa S, Lauretani F, Salvi M, Zucchini I Nutrients. 2024; 16(20).

PMID: 39458460 PMC: 11510523. DOI: 10.3390/nu16203462.

Feasibility of prehabilitation for patients awaiting total knee arthroplasty; a pilot study.

Mulder L, Berghmans D, Feczko P, de Bie R, Lenssen A J Orthop. 2024; 59:51-56.

PMID: 39351267 PMC: 11439548. DOI: 10.1016/j.jor.2024.07.019.

Towards a common definition of surgical prehabilitation: a scoping review of randomised trials.

Fleurent-Gregoire C, Burgess N, McIsaac D, Chevalier S, Fiore Jr J, Carli F Br J Anaesth. 2024; 133(2):305-315.

PMID: 38677949 PMC: 11282475. DOI: 10.1016/j.bja.2024.02.035.

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