By Jocelyn K. Lindsay
When an individual has arthritis, physical therapy is often thought of as the conservative treatment option before considering having a joint replaced. But in the case of an already-scheduled joint replacement, could PT help with the recovery after?
More and more, patients are coming into physical therapy with a prescription to cover both before and after their joint replacement surgery. This is a growing trend we are seeing in clinical practice, in which surgeons and orthopedic physicians want their patients to have 2-3 therapy sessions prior to a scheduled joint replacement. This then opens the door to wonder the effect any physical therapy sessions will have on the recovery process, especially when it comes to functionality.
According to a randomized control trial done by Joaquin Calatayud and his colleagues in 20171, PT prior to surgery did prove useful in patients that had just received a knee replacement. In this study, it was shown that an 8-week high-intensity strengthening program prior to surgery helped patients improve their pain levels, knee range of motion & strength, and functionality after surgery when compared to their counterparts in the study that received no PT before surgery. On the other hand, according to a meta-analysis done by Jian-Xiong Ma and his colleagues2, various studies found that undergoing PT prior to surgery did not prove to be any more effective in improving recovery than not having PT.
Despite the somewhat conflicting statistical evidence and data, having PT before surgery can have so many benefits. For one, you can build a connection with the therapist that will be treating you after your procedure. PT can come to be part of your routine. You will be introduced to exercises and important mobility information prior to entering the hospital for the operation. Finally, it can give you peace of mind to know that a dedicated movement professional will know your goals and how best you work.
- Calatayud, J., Casaña, J., Ezzatvar, Y. et al. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 25, 2864–2872 (2017). https://doi.org/10.1007/s00167-016-3985-5
- Ma J, Zhang L, Kuang M, et al. The effect of preoperative training on functional recovery in patients undergoing total knee arthroplasty: A systematic review and meta-analysis. International Journal of Surgery. 2018;51:205-212. https://www.sciencedirect.com/science/article/pii/S174391911830493X. doi: https://doi.org/10.1016/j.ijsu.2018.01.015.