The Effects of a Preoperative Exercise Protocol on the Post-Operative Rehabilitation of a Total Knee Arthroplasty: A Four Patient Case Study

Total knee arthroplasty (TKA) is a frequent approach to resolve the process and symptoms of degenerative joint disease affecting the knee joints of older adults. Expectations of a TKA patient after surgery include decreased pain, increased range of motion, increased functional ability, and better quality of life. Though a high number of TKA surgeries are performed each year, within the field of rehabilitation there is not an established standard pre- or postoperative program for physical therapy treatment. Preoperative exercise and physical therapy can be a component of pain reduction, muscle strengthening, and a form of education for the surgical candidate. The purpose of this study was to determine if a preoperative exercise protocol implemented prior to a unilateral total knee arthroplasty surgery would have an effect on the speed of recovery, pain level, passive and active range of motion (PROM and AROM) and lower extremity muscle girth during post surgical rehabilitation. This study was a four patient case study, in which the subjects were assigned to two groups: those participating in preoperative exercise and those who had no preoperative exercise prior to unilateral TKA surgery. Both groups were measured on range of motion and girth of the affected extremity, and pain level prior to surgery and three and six weeks after surgery by a physical therapist. The evidence gathered in the study does not suggest that a four week pre-operative exercise protocol enhances range of motion at the knee joint at three or six weeks after the TKA surgery