The effect of pre-operative physiotherapy on the early functional outcome of primary total knee arthroplasty

Introduction: Physiotherapy is an important part of rehabilitation following total knee arthroplasty (TKA). However, the significant impact of pre-operative physiotherapy on the functional outcomes of arthroplasty surgery is still debatable. This study evaluated the effect of pre-operative physiot...

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Bibliographic Details
Main Authors: Ismail, Mohd Shukry, Sharifudin, Mohd Ariff, Ahmad Shokri, Amran
Format: Conference or Workshop Item
Language:English
English
Published: 2013
Subjects:
Online Access:http://irep.iium.edu.my/32604/
http://irep.iium.edu.my/32604/
http://irep.iium.edu.my/32604/1/Kelantan_Research_Day_2013_-_Rehab_TKA_%28Poster%29.pdf
http://irep.iium.edu.my/32604/14/Kelantan_Research_Day_2013_%28PP-13%29.pdf
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Summary:Introduction: Physiotherapy is an important part of rehabilitation following total knee arthroplasty (TKA). However, the significant impact of pre-operative physiotherapy on the functional outcomes of arthroplasty surgery is still debatable. This study evaluated the effect of pre-operative physiotherapy on the early functional outcome of primary TKA. Methodology: A randomized, controlled trial was performed involving 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA at a single tertiary centre. The physiotherapy group (n=24) performed physical therapy exercises for six weeks immediately prior to surgery. Twenty-six patients (n=26) in the non-physiotherapy group performed no pre-operative physiotherapy exercise. Post-operatively, all patients went through similar physiotherapy regime in the rehabilitation period. Assessment was done at three intervals; pre-operation, six weeks and three months post-operatively. The primary outcome measurement tool was the algo-functional Knee Injury and Osteoarthritis Outcome Score (KOOS). The difference of post-operative range of motion (ROM) of the operated knee was evaluated for both groups of patient. Results: Both groups showed significant difference for all KOOS subscales (p-value <0.001). The mean score difference at six weeks and three months was not significant in Sports and Recreational Activities subscale for both groups (p-value >0.05). The time-group interaction analysis showed significant difference only for Symptoms and Daily Living Activities between groups (p-value <0.05). There was no significant difference with regards to time in Pain, Sport and Recreational Activities and Quality of life between groups (p-value >0.05). The ROM difference was significant within both treatment groups (p-value <0.001). The pre-operative and three months ROM showed no significant difference in both treatment groups (p-value >0.05). Time-group analysis also showed no significant difference of ROM between the two groups (p-value 0.928). Conclusion: A six-week pre-operative physiotherapy has no significant impact on the short-term functional outcomes and ROM of the knee following primary TKA.