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Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial [with consumer summary] |
Labraca NS, Castro-Sanchez AM, Mataran-Penarrocha GA, Arroyo-Morales M, Sanchez-Joya MM, Moreno-Lorenzo C |
Clinical Rehabilitation 2011 Jun;25(6):557-556 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To compare the benefits of initiating rehabilitation treatment within 24 hours versus 48-72 hours after total knee arthroplasty for osteoarthritis. DESIGN: Experimental study with clinical trial design. SUBJECTS: Patients undergoing primary total knee arthroplasty for osteoarthritis were randomly assigned to experimental (n = 153) and control (n = 153) groups. INTERVENTIONS: Rehabilitation was started within 24 hours post surgery in the experimental group and between 48 hours and 72 hours post surgery in the controls. MAIN MEASURES: Measurement variables included joint range of motion, muscle strength, pain, autonomy, gait and balance. RESULTS: In comparison with the controls, the experimental group showed significantly shorter hospital stay (by (mean +/- standard deviation) 2.09 +/- 1.45 days; p < 0.001), fewer rehabilitation sessions until medical discharge (by 4.95 +/- 2.34; p < 0.001), lesser pain (by 2.36 +/- 2.47 points; p < 0.027), greater joint range of motion in flexion (by 16.29 +/- 11.39 degrees; p < 0.012) and extension (by 2.12 +/- 3.19; p < 0.035), improved strength in quadriceps (by 0.98 +/- 0.54; p < 0.042) and hamstring muscles (by 1.05 +/- 0.72; p < 0.041), and higher scores for gait (p < 0.047) and balance (p < 0.045). CONCLUSION: Initiation of rehabilitation within 24 hours after total knee arthroplasty reduces the mean hospital stay and number of sessions required to achieve autonomy and normal gait and balance.
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