Multidisciplinary rehabilitation after primary total knee arthroplasty: a randomized controlled study of its effects on functional capacity and quality of life.
OBJECTIVE
To examine whether a multidisciplinary rehabilitation programme can improve functional recovery and quality of life and reduce the use of rehabilitation services compared with conventional care one year after total knee arthroplasty.


METHODS
Prospective, randomized, non-blinded, controlled trial.


METHODS
An outpatient centre-based setting.


METHODS
Eighty-six patients who were scheduled for primary total knee arthroplasty due to osteoarthritis of the knee.


METHODS
A ten-day multidisciplinary rehabilitation programme, which was focused on enhancing functional capacity, was organized 2-4 months after surgery. In both groups, a standard amount of physiotherapy was included in conventional care.


METHODS
The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 15D, 15-m walk test, stair test, isometric strength measurement of the knee. Use of rehabilitation services was asked about with a questionnaire. Outcomes were assessed preoperatively and at 2-, 6- and 12-month follow-ups.


RESULTS
In both groups, functional capacity and quality of life improved significantly. The mean absolute change in the WOMAC function score was -32.4 mm (SD 26.4) in the rehabilitation group and -32.8 mm (SD 20.1) in the control group (P-time*group = 0.40). No difference was found between groups in any outcome measure or in the use of rehabilitation services during the study period.


CONCLUSIONS
This study indicates that for knee osteoarthritis patients treated with primary total knee arthroplasty, a 10-day multidisciplinary outpatient rehabilitation programme 2-4 months after surgery does not yield faster attainment of functional recovery or improvement in quality of life than can be achieved with conventional care.
Kauppila
Anna-Maija
AM
Department of Physical Medicine and Rehabilitation, Oulu University Hospital, Oulu, Finland. anna-maija.kauppila@oulu.fi
Kyllönen
Eero
E
Ohtonen
Pasi
P
Hämäläinen
Martti
M
Mikkonen
Paula
P
Laine
Vesa
V
Siira
Pertti
P
Mäki-Heikkilä
Paula
P
Sintonen
Harri
H
Leppilahti
Juhana
J
Arokoski
Jari P A
JP
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D010349:Patient Compliance; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function