Exploring the physical therapist routine rehabilitation after total knee arthroplasty in tertiary care hospitals of Peshawar; a cross-sectional study

Abstract

Background: Total knee arthroplasty is a surgical replacement of a knee joint. Evidence-based physiotherapy protocol plays a major role in the rehabilitation after replacement surgery to perform daily life and sports activities without pain, discomfort, and limited knee function.

Objectives: To explore the physical therapist routine rehabilitation after total knee arthroplasty and physiotherapist’s advice for returning to sports after total knee arthroplasty.

Methods: A cross-sectional study was conducted on 97 physical therapists working in tertiary care hospitals in Peshawar from December 2020 to May 2021. Both male and female physiotherapists with age ranging from 24 to 45 years, having at least one year of orthopedic rehabilitation experience, and working in private and government tertiary hospitals were recruited via census sampling technique. Those having no experience in orthopedic rehabilitation were excluded from the study. The data was collected via a structured questionnaire. The data was analyzed using SPSS version 25

Results: Most of the participant’s age were n=77 (79.4%), ranging from 25-29 years. About (85.6%) physical therapists had an experience of 1-5 years. 93% of physical therapists recommended the RICE protocol to reduce swelling. About 53% recommended cooling (for pain relief), 70% recommended CPM (for mobility) while 71% recommended open chain exercise for muscle strength. 84.7% physical therapists recommended sports to the patient after knee arthroplasty. There was a non-significant association in variation of protocols between Government and Private Hospitals.

Conclusion: The study concluded that most physical therapists use RICE principles (Rest, Ice, Compression, Elevation), cryotherapy, and passive exercise therapy, such as Continuous Passive Motion (CPM), along with various walking exercises, closed chain exercises, and bridging exercises for rehabilitating patients after total knee replacement surgery. Interestingly, the recommendations for sports activities post-total knee arthroplasty were up to date across individual athletes. Additionally, there was no significant difference observed in the protocols for total knee replacement between government and private hospitals.