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Limiting Clinic Visits after Total Knee Replacement

It's true that exercise after knee replacement surgery is important. But can you do these exercises on your own or do you need a clinic-based program? A group of researchers in Canada studied this question.

They divided 160 patients into two groups. They were all knee patients who had the meniscus removed or an anterior cruciate ligament (ACL) repair. One group had a clinic-based rehab program. The other group followed a home-based exercise program. The home group was monitored by telephone calls from a physical therapist. All patients had a total knee replacement and did the same exercises.

There weren't any differences between the two groups. Results were the same at 12 weeks and at one year after surgery. Researchers looked at pain levels, walking ability, range of motion, and number of stairs climbed in 30 seconds. The same findings have been reported for other patients.

Not everyone needs physical therapy after a total knee replacement. Home exercise programs may be a good plan. A physical therapist can set up the program and follow the patient by phone. This gives the patient a level of care after the operation, but it limits the number of visits to a clinic.

Studies are needed to show which patients need a clinic-based rehab program from the start. The authors think certain psychosocial or other factors may help point out patients who need more supervision during rehab.

References: John F. Kramer, PhD, et al. Comparison of Clinic- and Home-Based Rehabilitation Programs after Total Knee Arthroplasty. In Clinical Orthopaedics and Related Research. May 2003. Vol. 410. Pp. 225-234.

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