Quality of Life and the time course of physical recovery of two rehabilitation protocols (Extension Rehabilitation versus Traditional Rehabilitation) in total knee arthroplasty for patients with preoperative fixed flexion deformity: A randomised controlled trial

Abstract

Introduction: This was the first study in Hong Kong Chinese population to evaluate the time course of recovery of impairments and function after unilateral total knee arthroplasty. Methods: This was a paired single-blind randomised controlled trial. Patients were randomised into intervention and control groups. The intervention group were treated with protocol of quadriceps strengthening in adjunct to usual rehabilitation. Patients were assessed preoperatively, postoperatively at 6 weeks, 3 months, and 6 months. Outcomes assessed included: pain at movement and walking, range of active and passive knee extension and flexion, and strength of knee extensors and flexors. Timed up-and-go test, 6-minute walk test, time of stairs management, Knee injury and Osteoarthritis Outcome Score, Knee Society Knee Score, and Knee Society Function Score were used. Results: Twenty patients (mean age, 77.1 ± 6.2 years) were included. Their baseline data were comparable. For pain, there was a significant reduction at 6 weeks in both groups. For physical capacity, early differences were detected in only the control group at active and passive knee ranges but both groups improved at 3 months. Knee extensor strength improved in the intervention group at 3 months but there was no improvement in the knee flexors strength for both groups. For ambulation, the intervention group improved at 3 months but both groups improved at 6 months. For quality of life, both groups improved at 3 months. Conclusion: The differences in recovery pattern of both groups may be related to multiple factors that need further evaluation.