Physiotherapy-supervised Mobilization and Exercise Following Total Knee Arthroplasty Surgery: a Questionnaire Survey

Background: Limited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following total knee arthroplasty. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following total knee arthroplasty.

Methods: A prospective survey was carried out among physiotherapists treating total knee arthroplasty patients. A total population sample was identified and postal questionnaires were sent to the 33 physiotherapists currently working at the departments of orthopedics. In total, 29 physiotherapists (response rate 88%) from eight hospitals completed the survey.

Results: The majority (90%) of the physiotherapists offered preoperative information. The main rationale of physiotherapy treatment after total knee arthroplasty was to prevent and treat postoperative complications, improve range of motion and promote physical activity. In general, one to three treatment sessions were given by a physiotherapist on postoperative day-1 and one to two treatment sessions were given during postoperative days 2 and 3. During weekends, physiotherapy was given to a lesser degree (59% on Saturdays and 31% on Sundays to patients on postoperative day-1. The routine use of early mobilization and knee range of motion exercises was common during the first postoperative days, but the choice of exercises and duration of treatment varied. There were great variations of instructions to the patients concerning weight bearing and exercises involving the quadriceps. All respondents considered physiotherapy necessary after total knee arthroplasty, but only half of them considered the physiotherapy treatment offered as optimal.

Conclusions: The results of this survey show that there are small variations in physiotherapysupervised mobilization and exercise following total knee arthroplasty. Comparison with surveys in other remaining centers in India is warranted to improve the physiotherapy management and postoperative recovery of the total knee arthroplasty patients.