Exercises and education prescribed as prehabilitation before total knee replacements (TKR) may not significantly improve the outcomes of the surgery, researchers say.
"This randomized clinical trial found no evidence that multidisciplinary prehabilitation before TKR for osteoarthritis improves short-term functional independence or reduces midterm activity limitations after surgery," write Christelle Nguyen, MD, PhD, Cochin Hospital, University Center, Paris, and colleagues in JAMA Network Open .
The finding contradicts previous research and the approach followed by many surgeons who assign weeks of regimens to improve their patients' health before operating on them.
But the limitations of the study make its significance hard to interpret, said Bert Mandelbaum, MD, in an interview with Medscape Medical News. Mandelbaum is professor of orthopedics at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, California, and team physician for the Los Angeles Galaxy professional soccer club, and was not involved in the study.
Previous research has shown that people fare better after total knee replacement if they start out in good health. And a few studies have suggested that physical therapy, exercise therapy, occupational therapy, and education, either alone or in combination, can improve outcomes and shorten hospital stay. But most of these studies have had small sample sizes.
In search of more definitive evidence, Nguyen et al.
