Knee replacement: group-based PT fails to improve long-term function

  • Lenguerrand E & al.
  • Arthritis Care Res (Hoboken)
  • 29.04.2019

  • von Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A novel group-based physical therapy (PT) improved function at 12 months after total knee arthroscopy (TKA), but the difference was not clinically relevant.

Why this matters

  • 20%-30% of TKA patients report long-term disability, and 20% report long-term chronic pain.
  • First study to examine the effect of group-based PT at 12 months postoperation.

Study design

  • Randomized controlled trial (RCT; n=180) of group-based PT+usual care vs usual care alone.
  • Group-based PT (the PT group) consisted of six 1-hour sessions of 12 exercise stations for increasing lower limb strength, balance, function, and confidence, using task-related activities.
  • Primary outcome was improvement in the validated 20-item Lower Extremity Functional Scale (LEFS) at 12 months by a minimal clinically important difference (MCID) of 9 points.
  • Funding: National Institute for Health Research, UK; others.

Key results

  • At 12 months postoperation, the PT group had higher LEFS by 4.47 points (P=.04), which was not enough for clinical significance.
  • The PT group at 3 months had a higher mean difference of 8.1 points (P<.001 and points at months.>
  • At 3, 6, and 12 months, the PT group had higher satisfaction with PT (all P values<.002 but no improvement on the knee injury and osteoarthritis outcome score or hospital anxiety depression scale.>

Limitations

  • Unblinded.