The role of pain for early rehabilitation in fast track total knee arthroplasty

Abstract

Purpose. To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA).

Methods. One hundred consecutive patients operated with TKA in an orthopaedic unit at a University hospital were prospectively studied. Measurements of independence in transfer and ambulation (Cumulated Ambulation Score), pain intensity (Verbal Analog Scale (VAS)), range of knee motion, functional mobility (‘Timed Up & Go’ (TUG) test), and walking distance were recorded daily from the first postoperative day until discharge.

Results. On the first postoperative day, 90% of the patients were able to walk independently with median pain intensity of ≤5 on VAS. Of these, 78% walked > 70 m. All patients walked independently on postoperative Day 2 with pain intensity of ≤4. On the day of discharge, all patients walked with crutches with pain intensity of ≤3, walking distance > 70 m, median range of motion 10–80°, and median test time of the ‘TUG’ 19.2 s. The length of hospital stay was median 3 days.

Conclusion. Pain has a limited influence on the functional recovery beyond the first postoperative day after TKA, thereby allowing early physiotherapy.

Keywords:

• Knee
• arthroplasty
• early functional recovery
• pain

Acknowledgements

This project was funded by a grant from the IMK Almene Fond, Copenhagen, Denmark. We thank Dr. K. Otte and physiotherapist K. Juel Nielsen for their assistance related to this study.