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Study Review: the power of prehabilitation when undergoing joint replacement

Total hip arthroplasty (THA) and total knee arthroplasty (TKA), also known as hip/ knee replacements, are surgical procedures in which parts of the joint are replaced with artificial material to restore function and ultimately reduce pain. As an arthritis patient, if other forms of treatment have not improved the joint’s ability to function or been able to prevent additional damage, your rheumatologist may recommend arthroplasty.

A recent study conducted by a team of Canadian Physiotherapists at The University of Western Ontario has discovered valuable information regarding the impact of prehabilitative care prior to arthroplasty. The team wanted to see if education and exercises for patients before surgery (prehabilitation) impacts pain, function, strength, anxiety and length of hospital stay after surgery (post-operative outcomes).

The team used a specific research method known as a systematic review and meta- analysis. This means that they carefully selected a number of existing studies on the topic and then combined and analyzed the results. This technique provides a more complete and powerful picture regarding the impact of prehabilitative care.

Thirty-five studies, with a total of 2,956 patients, were included in the analysis. After a comprehensive evaluation, the researchers concluded the following:

  • Total knee arthroplasty (TKA): Patients who received education and exercise before surgery experienced significantly greater improvements in function and muscle strength and were able to stay in hospital for fewer days.
  • Total hip arthroplasty (THA): Patients who received education and exercise before surgery experienced the same improvements as TKA patients, as well as significantly less pain.

The researchers recognize that there are inconsistencies between the studies used in the analysis which could have affected the results. For example, there were different methods used to measure post-operative outcomes. There were also differences in the quality of prehabilitative care provided to patients.

Although there are certain limitations to this study (as there are to all studies), it provides arthritis patients and healthcare providers with valuable information regarding the impact of prehabilitation for TKA and THA.

This study also illustrates the power of education and exercise, which can provide us with great benefits not only for surgical outcomes but in all circumstances. For example, using up-to-date, credible resources, we as patients can develop the skills and knowledge to better manage our disease. As for exercise, making physical activity a daily habit is shown to reduce fatigue, strengthen bones and muscles as well as increase stamina and flexibility.

For more information regarding exercise and arthritis, have a look at the following resources:

Podcast: the benefits of exercise and arthritis 

JointHealth™ Insight: exercise, arthritis and osteoporosis 

Find patient exercise classes happening in British Columbia through the ArthritisBC+Me events calendar