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.

ACKNOWLEDGMENTS

This case report is part of a larger case study examining the effects of 4 weeks of prehabilitation before TKA. Research was conducted at the University of Louisville, Exercise Physiology Laboratory, and the University of Louisville School of Nursing. This project was supported by National Institute of Nursing Research grant R01 NR 008135-01A2 (R. Topp, Principal Investigator) and the Hygenic Corporation (Akron, Ohio).

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.