Abstract
Objective: It is unknown whether routine physiotherapy is of benefit following total knee arthroplasty. Referrals are usually made by the inpatient physiotherapist or by the General Practitioners concerned about the patients range of knee motion. There have been no prospective, randomized, controlled studies in this area.
Design: One hundred and fifty patients undergoing primary total knee arthroplasty were recruited and randomly assigned into two groups. Ethical approval was given by the local ethics committee. Group 1 (n=55) received nine sessions of physiotherapy over a six-week period within 3 weeks of hospital discharge. Group 2 (n=76) received no outpatient physiotherapy. All patients received inpatient physiotherapy for the length of their hospital stay. Range of knee motion was measured using a goniometer by members of the outcome team blinded to the randomisation. Validated knee scores, Oxford knee, American knee society, and Bartlet patellar score were also collected. An SF-12 health questionnaire was used as a generic outcome measure.
Results: Both groups were equally matched in age, sex, diagnosis, and magnitude of deformity. Patients in Group 1 achieved an average loss in active range of motion of 2 degrees, whereas those in Group 2 achieved an average increase of 5 degrees. There is a significant difference in active range of motion between group 1 and group 2 (P=0.049). No difference in passive range of motion.
Conclusion: We concluded that the use of outpatient physiotherapy improves the range of knee motion to patients after total knee replacement at three months.
The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
