Does Rehab Help Before Joint Replacement?

Total knee arthroplasty outcomes not improved through preoperative rehabilitation

(RxWiki News) Before going through knee replacement surgery, patients often do some rehab for their aching joint. That is, they try to improve pain and function before surgery. But does this pre-surgery rehab improve outcomes?

According to recent research, pre-surgery rehabilitation seemed to do little to improve pain, function and motion after knee replacement surgery.

This study indicates your pre-surgery rehabilitation does not change post-surgery recovery.

"Ask your doctor how to prepare for surgery."

Patients are often encouraged to get as fit and strong as possible before undergoing total knee replacement surgery. Strengthening the muscles around your knee is thought to make recovery faster.

University of Kentucky researchers Carrie Silkman Baker, PhD, ATC, and Jennifer Medina McKeon, PhD, ATC, found pre-surgery rehabilitation may not help so much.

Through their review of past studies, the researchers found pre-surgery rehabilitation did not lead to improved pain, stiffness and function after knee replacement surgery.

Pre-surgery rehabilitation did not improve range of motion either.

In addition, patients' length of stay in the hospital was not shortened through pre-surgery rehabilitation, which suggests that rehabilitation did not speed up their recovery.

For their study, Drs. Baker and McKeon used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to measure pain, stiffness and physical function. WOMAC is a 24 item scale that asks patients if they feel pain during certain activities, if they feel stiff at certain points in the day and whether they can do certain daily activities.

The study's results showed that pre-surgery rehabilitation likely had no effect on participants' WOMAC scores after surgery.

These findings should not immediately sway patients from doing rehabilitation before total knee replacement surgery for a couple reasons.

First, the study was small. Only seven studies were included in the review.

Second, the researchers did not find pre-surgery rehabilitation led to poorer outcomes after surgery.

More research is needed to better understand how pre-surgery rehabilitation affects outcomes for patients undergoing total knee replacement.

The study was published in October in PM&R, a journal of the American Academy of Physical Medicine and Rehabilitation.

Review Date: 
October 30, 2012