The effect of pre-operative physiotherapy on the short-term functional outcome of primary totally knee arthroplasty

Introduction: Physiotherapy is an important part of rehabilitation following total knee arthroplasty (TKA). However, the significant impact of pre-operative physiotherapy on the functional outcomes of arthroplasty surgery is still debatable. This study evaluated the effect of pre-operative physiotherapy on the early functional outcome of primary TKA. Methodology: A randomized, controlled trial was performed involving 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA at a single tertiary centre. The physiotherapy group (n=24) performed physical therapy exercises for six weeks immediately prior to surgery. Twenty-six patients (n=26) in the non-physiotherapy group performed no pre-operative physiotherapy exercise. Post-operatively, all patients went through similar physiotherapy regime in the rehabilitation period. Assessment was done at three intervals; pre-operation, six weeks and three months post-operatively. The primary outcome measurement tool was the algo-functional Knee Injury and Osteoarthritis Outcome Score (KOOS). The difference of post-operative range of motion (ROM) of the operated knee was evaluated for both groups of patient. Results: Both groups showed significant difference for all KOOS subscales (p-value 0.05). The time-group interaction analysis showed significant difference only for Symptoms and Daily Living Activities between groups (p-value 0.05). The ROM difference was significant within both treatment groups (p-value 0.05). Time-group analysis also showed no significant difference of ROM between the two groups (p-value 0.928). Conclusion: A six-week pre-operative physiotherapy has no significant impact on the short-term functional outcomes and ROM of the knee following primary TKA.