Effectiveness of Passive and Active ROM Exercises Following TKA

Effectiveness of New Interventional Approaches to Improve Physical Function Following Total Knee Arthroplasty

The purpose of the study is to determine the effectiveness of new interventional approaches in the early postoperative phase following total knee arthroplasty (TKA). It is assumed that active training programs are more effective in improving physical function than the passive standard-of-care therapy.

The major objectives of rehabilitation after TKA are the early regain of range of motion (ROM) and mobilization of the patient. Continuous passive motion (CPM) is frequently used as part of the postoperative care regime following TKA with the aim to increase knee joint mobility and improve postoperative recovery despite little conclusive scientific evidence. Conflicting research findings have generated an ongoing debate on its usage. As the greatest loss of function occurs in the first month following TKA, it is surprising that the ROM therapy during hospital stay is still carried out passively. A passive mobilization of the knee joint with CPM does not encourage the patients to actively participate in their rehabilitation. Research on the effectiveness of active ROM exercises added to standard physiotherapy during the short in-hospital period is lacking so far.The objective of this study is to compare the passive clinical standard therapy (CPM) with different active training programs (controlled active motion, CAM). It was hypothesised that the CAM therapies are more effective in improving physical function than the CPM therapy.

Inclusion Criteria:

• patients with knee osteoarthritis and scheduled for primary TKA
• age: 50-80

Exclusion Criteria:

• BMI > 40
• musculoskeletal and neurological disorders that limit physical function
• any planned further joint surgery within 6 months
• substantial pain or functional limitation which make the patients unable to perform study procedures