Catherine J Minns Lowe , Karen L Barker, Michael Dewey, Catherine M Sackley,
The objective of this study was to evaluate the effectiveness of physiotherapy exercise after elective primary total knee arthroplasty in patients with osteoarthritis. Randomised controlled trials were reviewed if they included a physiotherapy exercise intervention compared with usual or standard physiotherapy care, or compared two types of exercise physiotherapy interventions meeting the review criteria, after discharge from hospital after elective primary total knee arthroplasty for osteoarthritis. Six trials were identified, five of which were suitable for inclusion in meta-analyses. There was a small to moderate standardised effect size in favour of functional exercise for function three to four months postoperatively. There were also small to moderate weighted mean differences for range of joint motion and for quality of life in favour of functional exercise three to four months postoperatively. Benefits of treatment were no longer evident at one year. The authors conclude that interventions including physiotherapy functional exercises after discharge result in short term benefit after elective primary total knee arthroplasty. Effect sizes are small to moderate, with no long term benefit.
BMJ, 2007, doi:10.1136/bmj.39311