Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: ALiterature Review and Unanswered Questions

This review focuses on the validity and the effectiveness of rehabilitation techniques and physical therapies before and after total knee arthroplasty (TKA). The intent is to drive surgeons and rehabilitation specialists in the choice of the strategies for the treatment after TKA. The Data sources were MEDLINE, PubMed, CINAHL, EMBASE, and PsychINFO databases using the selected key words. Three authors independently selected studies for review using as criteria English, adults, any clinical population, and intervention for. Among several published studies of rehabilitation after TKA, only a few were based on scientific evidence. Moreover, many studies were heterogeneous and included different outcomes and evaluations. There is consensus that a complete and specific rehabilitation post-operative programme is effective in reducing the length of hospitalisation and the incidence of early complications. However, it is not clear what “complete and specific rehabilitation” may mean: the real efficacy of every specific treatment (continuous passive motion, cryotherapy, magneto therapy, neuro muscular electrical stimulation, whole body vibration, hydrotherapy, pre-operative physiotherapy) is still questionable, and often related to the experience of the authors. In conclusion, patients undergoing physiotherapy obtain a better and faster outcome achievement than non-treated patients; however, evidence-based treatments, protocols and clinical trials are recommended.

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