Effects of pre- or postoperative therapeutic exercise on the quality of life, before and after total knee arthroplasty for osteoarthritis

Objective: To investigate the effects of a preoperative or postoperative rehabilitation program on health related quality of life. for patients affected by final-stage idiopathic knee osteoarthritis, before and after primary total knee arthroplasty. Design: 53 successive patients (aged 68.76 +/- 5.64 years) were randomly assigned to receive a general strengthening exercise program for 3 weeks preoperatively (PROR,n = 18) or a specific strengthening rehabilitation program for 8 weeks postoperatively (POP, n = 15). The control group followed standard preoperative and postoperative care (CON, n = 20). Measurements: Health status (Short Form-36), functional ability (Iowa Level of Assistance Scale), active range of motion (AROM). Results: PROP group showed improvement in their mental health dimensions preoperatively and better functional readiness at hospital discharge. POP group achieved higher level of functional ability (p < 0.05) after the exercise intervention and realized a substantial increment of AROM (p < 0.05). Conclusions: A preoperative general strengthening exercise program is feasible, seems to be beneficial to patients' mental health affected by final-stage idiopathic knee osteoarthritis and assists in the early return of basic functional abilities during the in-patient rehabilitation period. A Postoperative specific strengthening exercise intervention is effective in increasing the active range of motion and restoring rapidly the functional autonomy throughout the out-patient intermediate reliabilitation phase.