title: Range of motion after total knee arthroplasty: the effect of a preoperative home exercise program.
abstract: OBJECTIVE
  Preoperative range of motion (ROM) is the most important variable to determine final flexion after total knee arthroplasty (TKA). The purpose of this study was to determine whether a preoperative home exercise program could improve ROM in the arthritic knee and whether this influenced ROM and functional recovery following primary TKA.
  
  
  METHODS
  During the period between 2005 and 2006, one hundred and twenty-two patients with gonarthrosis were included in a prospective study and randomly allocated to either the control or the treatment group. The sixty-one subjects in the treatment group underwent a 6-week home-based exercise program before TKA surgery. All one hundred and twenty-two patients were assessed before and after this exercise intervention. Postoperative assessments were at 6 weeks, 6 months and 1 year. Each evaluation included knee ROM and the Knee Society Clinical Rating System. Length of hospital stay and postoperative duration before achieving 90° of knee flexion were also recorded.
  
  
  RESULTS
  Exercise program improves knee motion in the presence of gonarthrosis. After TKA, the patients in the exercise group achieved 90° of knee flexion faster and had a shorter hospital stay. There is no prolonged effect on knee motion or patient function between 6 weeks and 1 year postoperatively.
  
  
  CONCLUSIONS
  Preoperative exercise of the arthritic knee facilitates immediate postoperative recovery following primary TKA.
  
  
  METHODS
  Therapeutic study, Level I.
authors.affiliation: Orthopedic Clinic, University of Florence, Largo Palagi, 1, 50139, Florence, Italy, fabriziomatassi@gmail.com.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Matassi
authors.forename: Joris
authors.initials: J
authors.lastname: Duerinckx
authors.forename: Hilde
authors.initials: H
authors.lastname: Vandenneucker
authors.forename: Johan
authors.initials: J
authors.lastname: Bellemans
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery* / Q000628:therapy; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016037:Single-Blind Method; D016896:Treatment Outcome