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DOES AN OUTPATIENT PHYSIOTHERAPY REGIME IMPROVE THE RANGE OF KNEE MOTION AFTER TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE STUDY.



Abstract

Objective: To determine if a standard course of outpatient physiotherapy improves the range of knee motion following primary total knee arthroplasty.

Design: One hundred and fifty patients undergoing primary total knee arthroplasty were recruited and randomly assigned into two groups. Group 1 received a course of physiotherapy with a standard protocol over a six week period within 4 weeks of hospital discharge. Group 2 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 and Bartlet patellar) were collected. An SF12 health questionnaire was used as a generic outcome measure.

Results: Both groups were equally matched by age and sex. Although patients in Group 1 achieved greater range of knee motion than those in Group 2 this was not statistically significant. No difference was also noted in any of the outcome measures used.

Conclusion: We conclude that in patients undergoing primary total knee arthroplasty, inpatient physiotherapy with good instructions and a well-structured home exercise regime can dispense with the need for outpatient physiotherapy.

Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN