Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial.

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.