Multidisciplinary rehabilitation after primary total knee arthroplasty: a randomized controlled study of its effects on functional capacity and quality of life

Abstract

Objective: To examine whether a multidisciplinary rehabilitation programme can improve functional recovery and quality of life and reduce the use of rehabilitation services compared with conventional care one year after total knee arthroplasty. Design: Prospective, randomized, non-blinded, controlled trial. Setting: An outpatient centre-based setting. Subjects: Eighty-six patients who were scheduled for primary total knee arthroplasty due to osteoarthritis of the knee. Interventions: A ten-day multidisciplinary rehabilitation programme, which was focused on enhancing functional capacity, was organized 2—4 months after surgery. In both groups, a standard amount of physiotherapy was included in conventional care. Main measures: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 15D, 15-m walk test, stair test, isometric strength measurement of the knee. Use of rehabilitation services was asked about with a questionnaire. Outcomes were assessed preoperatively and at 2-, 6- and 12-month follow-ups. Results: In both groups, functional capacity and quality of life improved significantly. The mean absolute change in the WOMAC function score was —32.4 mm (SD 26.4) in the rehabilitation group and —32.8 mm (SD 20.1) in the control group (P-time*group = 0.40). No difference was found between groups in any outcome measure or in the use of rehabilitation services during the study period. Conclusions: This study indicates that for knee osteoarthritis patients treated with primary total knee arthroplasty, a 10-day multidisciplinary outpatient rehabilitation programme 2—4 months after surgery does not yield faster attainment of functional recovery or improvement in quality of life than can be achieved with conventional care.