Recovery Patterns After Total Knee ReplacementPhysical therapists are key members of the rehab team for patients receiving a total knee replacement (TKR). Helping patients improve quickly and recover function are the overall goals of therapy. Knowing what to expect helps patients judge their progress.
In this study, patterns of change in lower extremity function are measured after TKR. Previous studies have shown that most of the improvements in walking speed and distance occur in the first nine weeks after surgery. How long it takes to reach maximum function is unknown.
Therapists used two common tests of function to measure progress in 84 patients with TKRs. The tests included the Six-Minute Walk Test (6MWT) and the Lower Extremity Functional Scale (LEFS). The tests were given before and after surgery. Patients were followed for one year.
The results of this study showed that patients with higher test scores (meaning better function) before surgery had the best function afterward. The pattern of change was for maximal improvement in the first 12 weeks after TKA. Gradual improvement continued up to 26 weeks. Most of the recovery took place in the first six months.
The authors suggest that TKR patients need close follow-up during the first six weeks to six months after surgery. Any further improvements after six months are small and may not justify the expense of further rehab.
Physical therapists can use this information to help patients set realistic short-term goals. Using the 6MWT and LEFS tests can help identify patients' specific needs, guide treatment, and predict outcome.
Deborah M. Kennedy, BScPT, MSc, et al. Assessing Recovery and Establishing Prognosis Following Total Knee Arthroplasty. In Physical Therapy. January 2008. Vol. 88. No. 1. Pp. 22-32.
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