Effect of 3-week preoperative rehabilitation on pain and daily physical activities in patients with severe osteoarthritis undergoing total knee arthroplasty

Chigusa Ohno; Takahiro Ogawa; Takaya Taniguchi; Tokio Kinoshita; Yasuhisa Fujita; Yukihide Nishimura; Hiroshi Yamada; Fumihiro Tajima

doi:10.1177/20494637221084190

Effect of 3-week preoperative rehabilitation on pain and daily physical activities in patients with severe osteoarthritis undergoing total knee arthroplasty

Br J Pain. 2022 Oct;16(5):472-480. doi: 10.1177/20494637221084190. Epub 2022 Apr 19.

Authors

Chigusa Ohno¹, Takahiro Ogawa^{2

3}, Takaya Taniguchi⁴, Tokio Kinoshita², Yasuhisa Fujita², Yukihide Nishimura⁵, Hiroshi Yamada⁴, Fumihiro Tajima²

Affiliations

¹ Department of Rehabilitation Medicine, Gifu Municipal Hospital, Gifu, Japan.
² Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.
³ Chuzan Hospital Clinical Education and Research Center, Okinawa, Japan.
⁴ Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
⁵ Department of Rehabilitation Medicine, Iwate Medical University, Morioka, Japan.

Abstract

Background: We hypothesized that 3 weeks of preoperative rehabilitation could improve postoperative pain in patients undergoing total knee arthroplasty (TKA). Aim: This study aimed to evaluate the effects of 3 weeks of preoperative rehabilitation on postoperative pain after TKA.

Methods: This prospective cohort study included 29 subjects (41 knees) divided into two groups: the preoperative rehabilitation group included 14 subjects (20 knees) and the control group included 15 subjects (21 knees). All subjects were scheduled for unilateral or bilateral TKA. The preoperative rehabilitation group completed a 90-min rehabilitation program 3 days per week for 3 weeks before their TKA. The rehabilitation included body weight exercise, resistance exercise, and cycle ergometer exercise. The control group did not undergo any rehabilitation prior to TKA. We assessed the patients using Western Ontario and McMaster Universities' Osteoarthritis Index (WOMAC) and recorded their physical activity of walking, standing, sitting, and lying down at study entry and/or before TKA and 1 month after TKA.

Results: The WOMAC total and WOMAC pain scores were significantly lower after 3-weeks of rehabilitation, but before TKA and 1 month after surgery were significantly lower in the preoperative rehabilitation group than in the control group. The time spent walking, standing, sitting, and lying down for 12 h did not change after TKA in the preoperative rehabilitation group. In contrast, in the control group, the time spent in walking and standing positions decreased and the time in the sitting position increased after TKA (p < 0.05). Conclusion: We found that 3-week preoperative training reduced knee pain and helped maintain physical activity after surgery in patients with severe osteoarthritis who underwent TKA.

Keywords: Osteoarthritis; Western Ontario and McMaster universities osteoarthritis index pain; physical activity; preoperative rehabilitation; total knee arthroplasty.