The role of pain for early rehabilitation in fast track total knee arthroplasty.
OBJECTIVE
To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA).


METHODS
One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility ('Timed Up & Go' (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge.


RESULTS
On the first postoperative day, 90% of the patients were able to walk independently with median pain intensity of < or =5 on VAS. Of these, 78% walked > 70 m. All patients walked independently on postoperative Day 2 with pain intensity of < or =4. On the day of discharge, all patients walked with crutches with pain intensity of < or =3, walking distance > 70 m, median range of motion 10-80 degrees , and median test time of the 'TUG' 19.2 s. The length of hospital stay was median 3 days.


CONCLUSIONS
Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.
Holm
Bente
B
Department of Physiotherapy, Copenhagen University Hospital at Hvidovre, Hvidovre, Denmark. bente.holm@hvh.regionh.dk
Kristensen
Morten Tange
MT
Myhrmann
Lis
L
Husted
Henrik
H
Andersen
Lasse Østergaard
LØ
Kristensen
Billy
B
Kehlet
Henrik
H
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D018709:Statistics, Nonparametric; D013997:Time Factors; D016138:Walking / Q000502:physiology