title: Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty.
abstract: BACKGROUND
  Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).
  
  
  METHODS
  50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.
  
  
  RESULTS
  Both groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).
  
  
  CONCLUSIONS
  Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.
authors.affiliation: Department of Orthopedics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.|Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Mohd Shukry
authors.initials: MS
authors.lastname: Mat Eil Ismail
authors.affiliation: Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.|Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia, Pahang, Malaysia.
authors.forename: Mohd Ariff
authors.initials: MA
authors.lastname: Sharifudin
authors.affiliation: Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Amran Ahmed
authors.initials: AA
authors.lastname: Shokri
authors.affiliation: Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Shaifuzain
authors.initials: S
authors.lastname: Ab Rahman
mesh_terms: D000203:Activities of Daily Living; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D026741:Physical Therapy Modalities; D011300:Preoperative Care / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: algofunctional Knee Injury and Osteoarthritis Outcome Score; functional outcome; prehabilitation; preoperative physiotherapy; total knee arthroplasty