Knee arthritis is most effectively treated in its’ early stages with Physical Therapy including manual therapy and exercise interventions. These interventions have been shown to reduce pain and disability, as well as, prevent or post pone the need for future knee surgery. In later stages of disease progression, knee arthritis is most effectively treated with a total knee replacement. This major surgery involving the replacement of joint surfaces in the knee was first performed in the 1960s. Since this time it has become one of the most successful orthopedic surgeries due to its’ ability to improve pain and function among this end stage patient population. In our Boulder physical therapy practice, we often find patients who enter their orthopedic surgery with optimal range of motion, strength, and function have the best outcomes after surgery. A recent review article supports our clinical findings.
Authors in the journal Physical Therapy reviewed the available evidence on the use of pre operate Physical Therapy among patients electing for total knee replacement (Devasenapathy et al. 2019). They were interested in finding the importance of pre operative treatments on post operative function including gait speed, stair climbing, and function. Authors reviewed 12 studies and found an association between pre operative quadricep strength and post operative function. They noted pooling of information was limited in this meta analysis due to the different methodologies used in the available studies. They called for additional studies of higher methodological quality to improve predictor analysis.