Osteoarthritis of the knee: Does physical therapy intervention alone improve functional outcome scores of the timed up and go more than total knee arthroplasty?

Case study and literature review to answer the PICO question "For people with osteoarthritis of the knee, does physical therapy alone or a total knee arthroplasty improved timed up and go scores more?Background/Purpose: Osteoarthritis affects a large population of adults and is the leading cause of disability in America, but has few effective treatments. The purpose of this review was to evaluate the effectiveness of physical therapy intervention versus total knee replacement on the functional outcome of the timed up and go test. Case Description: Miss R, a 75-year-old female underwent a total knee arthroplasty to her left knee. She had physical therapy rehabilitation post-operatively at a skilled nursing facility for 26 days. Outcomes: Miss R was discharged home to continue rehabilitation in an outpatient setting. During her rehabilitation she had progressed her functional deficits enough to return to her home and live independently. She was ambulating with a cane over 1000 feet and was independent for all transfers, bed mobility, and activities of daily living. Discussion: A literary review revealed that overall timed up and go scores improved for patients with osteoarthritis that underwent a total knee arthroplasty or physical therapy interventions, however the improvements were often found to be not statistically significant or were not equivalent to healthy age-matched adult controls.Faculty advisor: Beth M Jones, PT, DPT, OC