New Knees Love Aquatic Therapy

Aquatic therapy soon after total knee replacement surgery improves results

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Even though hip and knee replacement surgeries have become more common, it remains unclear how best to treat patients after surgery. Beginning aquatic therapy at the right time may be one way to improve quality of life.

Starting aquatic therapy six days after total knee replacement surgery may lead to better post-surgery results. Following total hip replacement surgery, patients may have better results if they start aquatic therapy after their wound has healed.

"Start aquatic therapy after joint replacement surgery."

Aquatic therapy has been shown to improve outcomes for patients after total hip and total knee replacement surgeries. A recent study by Thoralf R. Liebs, M.D., of the University of Schleswig-Holstein Medical Center, and colleagues shows that timing matters when it comes to post-surgery aquatic therapy.

The study's results show that patients who started aquatic therapy six days after total knee replacement surgery had better physical function, less pain, and less stiffness. After total hip replacement surgery, patients had improved physical function, pain, and stiffness if they waited for their wound to heal before starting aquatic therapy.

Typically, aquatic therapy is begun when the surgery wound heals around two weeks after surgery. According to Dr. Liebs, "This multicenter study demonstrates that the timing of physiotherapy measures, such as aquatic therapy, has clinically relevant effects after [total knee replacement surgery]."

"Our study is one of the few studies that demonstrates a clinically important effect on the health-related quality of life after [total knee replacement surgery] by a factor that can be influenced by the healthcare professional," Dr. Liebs notes.

In other words, this study shows that doctors have the power to improve the quality of life of their patients by encouraging them to start aquatic therapy. "The intervention is simple to administer, and requires limited extra input from the health care professional," he says.

The story is a little different for patients after total hip replacement surgery. Unlike knee replacement patients, hip replacement patients may still need to wait for their wound to heal before beginning aquatic therapy.

Dr. Liebs believes that hip replacement and knee replacement surgery patients may have different results from aquatic therapy because of differences in satisfaction after surgery. "[Total hip replacement surgery] has a high rate of patient satisfaction," he says, "and patients report an improved quality of life after the procedure."

Because they are already satisfied, hip replacement patients may not have much to gain from additional treatments like aquatic therapy.

In contrast, patients who have undergone total knee replacement surgery are less satisfied, so the addition of aquatic therapy has a bigger impact.

Dr. Liebs also explains that the effects of aquatic therapy may be more geared towards the knee joint than the hip joint.

For their study, the researchers randomly assigned patients who had undergone total hip and total knee replacement surgeries to receive aquatic therapy starting either six days or 14 days after surgery. Participants attended therapy sessions three times a week for 30 minutes.

The researchers measured physical function, pain, and stiffness at 3, 6, 12, and 24 months after surgery.

The findings are published in the Archives of Physical Medicine and Rehabilitation.

Reviewed by: 
Review Date: 
January 5, 2012
Last Updated:
January 12, 2012