Pre-surgery exercise and post-operative physical function of people undergoing knee replacement surgery

The objective of this study was to summarize the evidence regarding the effectiveness and dose-response characteristics of pre-operative exercise programmes on post-operative physical function following total knee arthroplasty, through a systematic review.

Twelve candidate studies were identified, but only 3 papers satisfied all inclusion criteria: 2 studies evaluated the effect of resistance training and 1 trial investigated proprioceptive training. The latter study elicited significantly enhanced post-operative gains in function for indices of standing balance (overall stability index: Hedges’ g = -1; anteroposterior stability index: Hedges’ g = -1.15; 6 weeks post-surgery). Results of meta-analysis based on the findings of 2 studies showed that, compared with controls, prehabilitative exercise involving resistance training offered no additional gains in isometric quadriceps muscle strength at 6 and 12 weeks post-operatively.

Despite a potential for efficacy of exercise-based conditioning, this review highlights the scarcity of robust dose-response evidence to guide the formulation of total knee arthroplasty prehabilitation effectively.

Knee crepitus

Knee Crepitus

Join Claire Robertson in this short online course to explore knee crepitus, what it is, what are the implications for symptoms and treatment and how we should help our patients…