Effects of knee extension exercise starting within 4 h after total knee arthroplasty

Eur J Orthop Surg Traumatol. 2021 Jun 17. doi: 10.1007/s00590-021-03042-9. Online ahead of print.


Purpose: To determine the beneficial effects of knee extension exercise applied from 4 h after TKA.

Methods: Patients undergoing TKA for osteoarthritis were assigned to early rehabilitation (n = 41) and control rehabilitation (n = 39) groups. Rehabilitation of knee extension exercise was started within 4 h postoperative in the early group and 2 days after surgery in the control group. Joint range of motion and pain were assessed before surgery and at 3 days to 12 months after surgery. Muscle strength and gait parameters were assessed before and 3 weeks after surgery.

Results: Extension range of motion was significantly increased in the early group than the control at 3 days, 3 weeks and 6 months after surgery. In gait parameters, peak knee flexion and extension angles during stance phase were significantly improved in the early group than the control group at 3 weeks after surgery. Flexion range of motion was increased in the early group than the control at 12 months after surgery.

Conclusion: Starting knee extension exercise within 4 h after TKA reduced the early loss of extension range of motion and improved gait pattern and seemed to contribute to be better functional outcome one year after surgery.

Keywords: Gait analysis; Knee extension exercise; Muscle strength; Pain; Range of motion; Total knee replacement.