Osteoarthritis is the commonest form of disability in older people. Total knee replacement surgery (knee arthroplasty) is a common procedure but even after surgery patients may still experience problems carrying out everyday tasks.
At present, it is not clear whether physiotherapy should be routinely provided after discharge from hospital. So researchers reviewed the evidence to determine the effectiveness of physiotherapy after elective surgery in people with osteoarthritis.
Six trials involving 614 patients were included overall in the review. Effectiveness was measured in terms of improving function, quality of life, walking, range of motion in the knee joint, and muscle strength.
The review showed a small to moderate effect of functional exercise on joint motion and quality of life at three to four months after surgery, but the effect was not sustained at one year.
The evidence is not conclusive but, given these results, it seems reasonable to refer patients for a short course of functional physiotherapy exercise after discharge to provide short term benefit, say the authors. These tentative findings also suggest that further research would be worthwhile to reduce the current level of uncertainty.
This review highlights the lack of high quality research into the effectiveness of physiotherapy exercise programmes after total knee replacement, says an accompanying editorial.