Abstract
Background
Unicompartmental Knee Replacement (UKR) is an established treatment for end stage arthritis affecting one compartment of the knee. UKR lends itself to rapid recovery and early discharge. The content, type, timing and dose of early post-operative physiotherapy treatment has yet to be reviewed.
Objective
To review the content of early physiotherapy in the first eight weeks following unilateral UKR.
Data sources
A literature search of Medline, CINAHL, AMED and PubMed and the Physiotherapy Evidence Database (PEDRo) plus citation searching.
Eligibility criteria
Randomised controlled trials (RCTs) and observational studies reporting a physiotherapy intervention for UKR involving a form of post-operative exercise/education/advice delivered within the first eight weeks of surgery and commencing as an in-patient. Two reviewers independently performed screening, data extraction and risk of bias assessment.
Data synthesis
Narrative syntheses were undertaken due to the heterogeneity of the primary outcomes.
Results
Eleven studies were included (n = 1293 participants), three RCTs and eight observational studies. The dose and content of post-operative physiotherapy was highly variable with a move in recent years to rapid recovery and same day discharge with more self-directed rehabilitation. No studies had a low risk of bias.
Limitations
Small sample sizes and high heterogeneity limit our findings
Conclusions
This review highlights the range of post-operative physiotherapy provision following UKR with a recent move to minimal physiotherapy input. Further research is required to identify those patients who may need additional physiotherapy above that now routinely provided, along with the most effective timing, type, and dosage of the intervention.
Systematic review registration number
PROSPERO CRD42021243238.
Contribution of the Paper
- Early physiotherapy to regain knee ROM should be performed within a comfortable range to reduce pain and facilitate rapid mobilisation.
- Regaining flexion is rarely problematic following UKR.
- Enhanced recovery and same day discharge after UKR is now commonplace.
- A recent move to self-directed physiotherapy has been successful.