Changes to rehabilitation after total knee replacement

Aust J Gen Pract. 2020 Sep;49(9):587-591. doi: 10.31128/AJGP-03-20-5297.

Abstract

Background: General practitioners play a vital and increasing part in the perioperative care of patients undergoing total knee replacement (TKR). Rising obesity rates, sports-related injuries and an ageing population are likely to result in a sharp increase in TKR procedures within the next decade, combined with higher cost concerns. Rehabilitation practices that show economic efficiency and produce superior patient outcomes are a major focus of current research.

Objective: The aim of this article is to provide an evidence-based summary of current rapid recovery protocols following TKR surgery.

Discussion: Rapid recovery protocols have been shown to be effective at reducing length of stay, postoperative pain and complications without compromising patient safety. These rapid recovery protocols include same-day mobilisation; blood preservation protocols; self-directed pedalling-based rehabilitation; and individualised targeted discharge to self-directed, outpatient therapist-directed or inpatient therapist-directed rehabilitation. Low-cost self-directed rehabilitation should be considered usual care, with inpatient rehabilitation reserved for the minority of at-risk patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Early Ambulation / methods
  • Early Ambulation / trends
  • Exercise Therapy / methods
  • Humans
  • Length of Stay / statistics & numerical data
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Rehabilitation / methods*
  • Treatment Outcome