title: Prehabilitation versus usual care before total knee arthroplasty: A case report comparing outcomes within the same individual.
abstract: This case report compared pre- and postoperative functional ability, knee strength, and pain of a female who underwent two separate total knee arthroplasty (TKA) procedures. The female patient was part of a larger research study. The first surgery on the right knee was preceded with usual care and the second surgery on the left knee was preceded by prehabilitation. Functional ability was assessed by a 6-minute walk, chair raises, and the time required to ascend and descend stairs. Knee extension and flexion isokinetic strength was assessed using the KinCom Isokinetic Dynamometer. Pain was assessed using the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC). Functional abilities, knee strength, and pain were assessed at baseline measurements 4 weeks before surgery, 1 week before surgery, and at 1 and 3 months post surgery during each TKA procedure. Results indicate that the prehabilitation intervention had a favorable impact on improving functional ability up to 30%, increasing knee strength by 50% and decreasing pain prior to the left knee TKA. For this patient, prehabilitation increased functional ability and strength prior to surgery. Gains in strength were maintained in the nonsurgical knee after surgery. These findings indicate that prehabilitation may be effective at facilitating the rehabilitation following a TKA.
authors.affiliation: Exercise Physiology Laboratory, Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky 40292, USA. kent.brown@louisville.edu
authors.forename: Kent
authors.initials: K
authors.lastname: Brown
authors.forename: Ann M
authors.initials: AM
authors.lastname: Swank
authors.forename: Peter M
authors.initials: PM
authors.lastname: Quesada
authors.forename: John
authors.initials: J
authors.lastname: Nyland
authors.forename: Arthur
authors.initials: A
authors.lastname: Malkani
authors.forename: Robert
authors.initials: R
authors.lastname: Topp
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011300:Preoperative Care; D020127:Recovery of Function; D055070:Resistance Training; D013997:Time Factors; D016896:Treatment Outcome