Background/Purpose:

Physical therapy  shown to be effective after Total Hip and Knee Arthroplasty.  Less evidence is available for preoperative physical therapy  in Total Hip and Knee.  Little is known on what the actual characteristics, frequency and duration of physical therapy  after Total Hip and Knee  in daily practice are. The aim of the study was to describe the extent  and content of pre- and postoperative physical therapy before and after Total Hip and Total Knee surgery.

Methods:

To 1005 patients in 4 hospitals who received Total Hip and Knee in 2011 were sent a survey in 2012 regarding physical therapy (referral, setting, frequency, duration, content and satisfaction) before and after surgery, sociodemographic characteristics and health status.

Results:

522 patients (282 Total Hip en 240 Total Knee) responded (52%). 210 (40%) received preoperative physical therapy and 514 (98%) postoperative physical therapy (no differences between Total Hip en Total Knee). Total knee patients had significant higher average Body Mass Index, significant more co morbidity, and significant lower level of physical functioning compared with Total Hip patients.

More patients were referred by the orthopedic surgeon after surgery (77%) than before surgery (36%) and for Total Knee than for Total Hip. The most consistently reported exercise modalities (> 60% of patients) were preoperatively aerobic exercise and walking stairs, and postoperatively aerobic exercises, muscle strengthening exercises, range of motion exercises, walking stairs, rising/sitting and gait training.

Both before and after surgery significant more Total Knee patients reported receiving strengthening exercises (55% before, 65% after) and passive Range of Motion exercises (51% before, 60% after ) compared to Total Hip patients ( 32% before, 57% after and 36% before, 37% after , respectively). 

Total Hip and Knee patients who received physical therapy in secondary care before physical therapy in primary care were older and had a lower level of physical functioning compared to patients who only received physical therapy in primary care.

Total Hip and Knee patients were more satisfied with physical therapy after than before surgery.

Conclusion: A considerable number of patients received physical therapy before Total Hip and Knee surgery. There is a great variation of provided treatment modalities after, but particularly before surgery. Differences between hip and knee patients were reported by patients. These results indicates that more research into the potential benefits of physical therapy for specific groups of patients undergoing Total Hip or Knee surgery and into effective treatment modalities is needed. Distinction should be made between hip and knee patients.

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« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/pre-and-postoperative-physical-therapy-in-total-hip-and-knee-replacement-surgery-a-multi-center-study/