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Publication
The outcomes of empowering individuals after total knee arthroplasty: a randomized controlled trial
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Advisor(s)
Abstract(s)
Background: The rehabilitation of individuals after total knee arthroplasty is essential to optimize outcomes. The number of surgeries has been increasing significantly worldwide, overburdening healthcare systems with rising associated costs. Purpose: This study aims to demonstrate the effectiveness and cost-effectiveness of a rehabilitation plan consisting of two weekly physiotherapy sessions, supplemented by a home exercise program, in individuals over 65 years of age undergoing primary Total Knee Arthroplasty, compared to conventional rehabilitation with three weekly sessions. Methods: A single-centre randomized experimental study with intervention evaluated the efficiency and cost of two rehabilitation plans for individuals aged 65 and over who underwent primary Total Knee Arthroplasty and were referred for outpatient physiotherapy in the period from September 27 to December 31, 2022. Twenty-four Individuals were randomly assigned to two groups: the experimental group (15 individuals), which received face-to-face physiotherapy twice per week, supplemented by a home exercise program, and the control group (9 individuals), which received face-to-face physiotherapy three times per week without additional exercises. Both groups received treatment for 5 weeks and were assessed at the beginning and the end of the 5-week treatment period. The effectiveness of the interventions was measured through the assessment of pain and functionality using the Oxford Knee Score (scored from 12 to 60 points), active range of movement measured in degrees with a goniometer, and muscle strength evaluated by the number of repetitions in the 30-second chair stand test. The economic evaluation was conducted from the hospital’s perspective, using cost-effectiveness analysis, with the incremental cost-effectiveness ratio calculated to compare the costs of the two rehabilitation plans. Results: There were no significant differences between the groups in the initial assessment. After the 5-week treatment, both groups demonstrated improvements in all effectiveness indicators, with the experimental group achieving better outcomes. However, no statistical significance was found in the comparisons between the two groups (p > 0.05 for all indicators). The resulting incremental cost-effectiveness ratio of -3.71€/effectiveness unit was favorable to the experimental group. Conclusion(s): The rehabilitation plan of the experimental group emerged as the cost-effective alternative compared to the control group, highlighting a potential strategy for optimizing health resources in the hospital department where the study was conducted. No participant expressed any concerns about the home treatment. Implications: The empowerment of individuals through the teaching of home exercises is a useful tool for individuals following total knee arthroplasty, providing the same health benefits at a lower cost to the hospital. It also reduces the need for hospital visits, resulting in economic savings for individuals and families, as well as a reduction in environmental footprint.
Description
Keywords
Physiotherapy Rehabilitation Total knee arthroplasty Home-based exercises Cost-effectiveness analysis
Citation
Gomes A, Correia AD, Eiras M, Cunha G. The outcomes of empowering individuals after total knee arthroplasty: a randomized controlled trial. In: World Physiotherapy Congress 2025, Tokyo (Japan), May 29-31, 2025.