title: Comparison of postdischarge physiotherapy versus usual care following primary total knee arthroplasty for osteoarthritis: an exploratory pilot randomized clinical trial.
abstract: OBJECTIVE
  To evaluate a pilot trial of a postdischarge physiotherapy intervention to improve patient function versus usual physiotherapy in patients undergoing total knee arthroplasty aiming to assess: recruitment rate, feasibility and acceptability of the intervention and control, suitability of outcomes, retention and adverse events and to inform sample size calculation for a definitive trial.
  
  
  METHODS
  Exploratory pilot randomized controlled trial using independent assessment.
  
  
  METHODS
  Mixed urban and rural, UK.
  
  
  METHODS
  Patients undergoing primary, elective unilateral knee arthroplasty for osteoarthritis.
  
  
  METHODS
  Two additional home physiotherapy visits of functional weight-bearing exercises, functional task-specific training versus treatment as usual.
  
  
  RESULTS
  Oxford Knee Score at 12 months.
  
  
  RESULTS
  completion rates, adverse events, Knee Injury and Osteoarthritis Outcome Score, leg extensor power, timed 10-m walk, timed sit-to-stand, resource use diaries. Assessments completed at baseline (pre-operatively), 3, 6 and 12 months.
  
  
  RESULTS
  Of 181 eligible participants 107 (59.1%) were randomized over 13 months, one participant withdrew, no adverse events. Intervention group n = 56 (mean age 67.8), control group n = 51 (mean age 70.8). The difference in mean change of Oxford Knee Scores between groups (intervention--control) at 12 months was 0.2 (95% confidence interval (CI) -3.8, 4.2), P = 0.94. Patient diaries revealed non-trial additional physiotherapy requires improved measurement.
  
  
  CONCLUSIONS
  Successful recruitment and retention rates were achieved. The intervention appeared feasible and acceptable but may be suboptimal in intensity given recent research. A sample size of 1271 participants would be required for a fully powered randomized controlled trial using the main outcome. However new outcomes, potentially of greater validity and responsiveness, require consideration.
authors.affiliation: Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospital NHS Trust, Oxford, UK. catherine.minnslowe@noc.nhs.uk
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Minns Lowe
authors.forename: Karen L
authors.initials: KL
authors.lastname: Barker
authors.forename: Roger
authors.initials: R
authors.lastname: Holder
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Sackley
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006792:House Calls; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000534:rehabilitation* / Q000601:surgery; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D016037:Single-Blind Method; D006113:United Kingdom; D016474:Weight-Bearing