Preoperative training in patients undergoing total knee arthroplasty. Systematic review

Authors

DOI:

https://doi.org/10.56294/saludcyt20251220

Keywords:

Preoperative Training, Prehabilitation, Balance training, Resistance training, Strength training, Total knee arthroplasty

Abstract

Introduction: total knee arthroplasty (TKA) is a surgical procedure widely used to treat pain, improve function and correct deformities in patients with various knee conditions Preoperative training or also known as “prehabilitation” emerges as a new approach to rehabilitation and refers to a set of interventions designed to optimize patient health prior to surgery through exercise programs and patient education. This article aims to determine the effects of preoperative training in patients undergoing RTA. 
Methods: a systematic review was carried out using the scientific databases: PubMed, Cochrane and Scopus, following the guidelines of the PRISMA model. We selected articles published within the last 5 years in English and Spanish with a population older than or equal to 50 years of age. Results: eleven RCTs were analyzed, these trials addressed different types of preoperative training within the intervention protocol in this way one trial of strength, another of balance, six of resistance, and three of strength combined with balance, in such a way it is determined to perform 4 weeks of training. 
Conclusions: it was determined that preoperative training in patients undergoing RTA improves muscle strength of the knee extensor muscles (quadriceps), functionality and physical activity status
l

References

1. Jette DU, Hunter SJ, Burkett L, Langham B, Logerstedt DS, Piuzzi NS, et al. Physical Therapist Management of Total Knee Arthroplasty. Phys Ther [Internet]. 31 de agosto de 2020;100(9):1603-31. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7462050/

2. Su W, Zhou Y, Qiu H, Wu H. The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials [Internet]. Vol. 17, Journal of Orthopaedic Surgery and Research. BioMed Central Ltd; 2022 [citado 30 de abril de 2024]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35313897/

3. García Fernández María, Arancha Pérez Bueno. Abordaje fisioterapéutico en la artroplastia total de rodilla. NPunto [Internet]. 2020 [citado 22 de septiembre de 2024];3(32). Disponible en: https://www.npunto.es/content/src/pdf-articulo/5fc4d6a9775cfart3.pdf

4. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. Journal of Bone and Joint Surgery [Internet]. 2007;89(4):780-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17403800/

5. de Andrade DC, Saaibi D, Sarría N, Vainstein N, Ruiz LC, Espinosa R. Assessing the burden of osteoarthritis in Latin America: a rapid evidence assessment. Clin Rheumatol [Internet]. 29 de mayo de 2022;41(5):1285-92. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9056472/

6. Hunter CW, Deer TR, Jones MR, Chiang Chien G, D’Souza RS, Davis T, et al. Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience. J Pain Res [Internet]. septiembre de 2022;Volume 15:2683-745. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9484571/

7. Chen X, Li X, Zhu Z, Wang H, Yu Z, Bai X. Effects of progressive resistance training for early postoperative fast-track total hip or knee arthroplasty: A systematic review and meta-analysis. Asian J Surg [Internet]. octubre de 2021;44(10):1245-53. Disponible en: https://www.sciencedirect.com/science/article/pii/S1015958421001019?via%3Dihub

8. Winther SB, Foss OA, Klaksvik J, Husby VS. Pain and load progression following an early maximal strength training program in total hip- and knee arthroplasty patients. Journal of Orthopaedic Surgery [Internet]. 1 de enero de 2020;28(2):230949902091639. Disponible en: https://journals.sagepub.com/doi/full/10.1177/2309499020916392?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org

9. McKinney B, Dbeis A, Lamb A, Frousiakis P, Sweet S. Virtual Reality Training in Unicompartmental Knee Arthroplasty: A Randomized, Blinded Trial. J Surg Educ [Internet]. noviembre de 2022;79(6):1526-35. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1931720422001532?via%3Dihub

10. Bade MJ, Christensen JC, Zeni JA, Christiansen CL, Dayton MR, Forster JE, et al. Movement pattern biofeedback training after total knee arthroplasty: Randomized clinical trial protocol. Contemp Clin Trials [Internet]. abril de 2020;91:105973. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7263966/

11. Sun J ning, Shan Y zhou, Wu L xia, Li N, Xu F hu, Kong X ru, et al. Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty. J Orthop Surg Res [Internet]. 15 de septiembre de 2023;18(1):692. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10504716/

12. Carli F, Ferreira V. Prehabilitation: a new area of integration between geriatricians, anesthesiologists, and exercise therapists. Aging Clin Exp Res [Internet]. 4 de marzo de 2018;30(3):241-4. Disponible en: https://link.springer.com/article/10.1007/s40520-017-0875-8

13. Franzoni S, Rossi SMP, Cassinadri A, Sangaletti R, Benazzo F. Perioperative Pain Management in Total Knee Arthroplasty: A Narrative Review of Current Multimodal Analgesia Protocols. Applied Sciences [Internet]. 16 de marzo de 2023;13(6):3798. Disponible en: https://www.mdpi.com/2076-3417/13/6/3798

14. Vasileiadis D, Drosos G, Charitoudis G, Dontas I, Vlamis J. Does preoperative physiotherapy improve outcomes in patients undergoing total knee arthroplasty? A systematic review. Musculoskeletal Care [Internet]. 4 de septiembre de 2022;20(3):487-502. Disponible en: https://onlinelibrary.wiley.com/doi/10.1002/msc.1616

15. Wang Y, Qu G, Yang J. Impact of Preoperative Balance Training on Postoperative Functional Recovery of Patients after Total Knee Arthroplasty: A Systematic Review and Meta-Analysis [Internet]. 2024 ene. Disponible en: https://inplasy.com/inplasy-2024-1-0122/

16. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews [Internet]. Vol. 372, The BMJ. BMJ Publishing Group; 2021. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8005924/

17. Albanese E, Bütikofer L, Armijo-Olivo S, Ha C, Egger M. Construct validity of the Physiotherapy Evidence Database (PEDro) quality scale for randomized trials: Item response theory and factor analyses. Res Synth Methods [Internet]. 1 de marzo de 2020 [citado 2 de junio de 2024];11(2):227-36. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079093/

18. Blasco JM, Acosta-Ballester Y, Martínez-Garrido I, García-Molina P, Igual-Camacho C, Roig-Casasús S. The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial. Clin Rehabil [Internet]. 1 de febrero de 2020 [citado 2 de junio de 2024];34(2):182-93. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31608677/

19. Gränicher P, Stöggl T, Fucentese SF, Adelsberger R, Swanenburg J. Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial. Arch Physiother [Internet]. 1 de diciembre de 2020 [citado 2 de junio de 2024];10(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/32774889/

20. Skoffer B, Maribo T, Mechlenburg I, Korsgaard CG, Søballe K, Dalgas U. Efficacy of preoperative progressive resistance training in patients undergoing total knee arthroplasty: 12-month follow-up data from a randomized controlled trial. Clin Rehabil [Internet]. 1 de enero de 2020 [citado 2 de junio de 2024];34(1):82-90. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31663369/

21. Rittharomya J, Malathum P, Orathai P, Belza B, Kawinwonggowit V, Aree-Ue S. The Effectiveness of Preoperative Quadriceps Exercise and Diet Control Program for Older Adults Waiting for Total Knee Arthroplasty: A Randomized Controlled Trial [Internet]. Vol. 24, Pacific Rim Int J Nurs Res. 2020 [citado 6 de octubre de 2024]. Disponible en: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/228023

22. Domínguez-Navarro F, Silvestre-Muñoz A, Igual-Camacho C, Díaz-Díaz B, Torrella JV, Rodrigo J, et al. A randomized controlled trial assessing the effects of preoperative strengthening plus balance training on balance and functional outcome up to 1 year following total knee replacement. Knee Surgery, Sports Traumatology, Arthroscopy [Internet]. 1 de marzo de 2021 [citado 2 de junio de 2024];29(3):838-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32342139/

23. Kim S, Hsu FC, Groban L, Williamson J, Messier S. A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty – short term outcome. BMC Musculoskelet Disord [Internet]. 1 de diciembre de 2021 [citado 2 de junio de 2024];22(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/33902505/

24. An JA, Ryu HK, Lyu SJ, Yi HJ, Lee BH. Effects of preoperative telerehabilitation on muscle strength, range of motion, and functional outcomes in candidates for total knee arthroplasty: A single-blind randomized controlled trial. Int J Environ Res Public Health [Internet]. 1 de junio de 2021 [citado 6 de octubre de 2024];18(11). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200128/

25. Nguyen C, Boutron I, Roren A, Anract P, Beaudreuil J, Biau D, et al. Effect of Prehabilitation before Total Knee Replacement for Knee Osteoarthritis on Functional Outcomes: A Randomized Clinical Trial. JAMA Netw Open [Internet]. 9 de marzo de 2022 [citado 6 de octubre de 2024];5(3). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908069/

26. Sun J ning, Shan Y zhou, Wu L xia, Li N, Xu F hu, Kong X ru, et al. Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty. J Orthop Surg Res [Internet]. 1 de diciembre de 2023 [citado 2 de junio de 2024];18(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/37715204/

27. Gränicher P, Mulder L, Lenssen T, Fucentese SF, Swanenburg J, DE BIE R, et al. Exercise- and education-based prehabilitation before total knee arthroplasty: a pilot study. J Rehabil Med [Internet]. 2024 [citado 2 de junio de 2024];56. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859968/

28. Kubo Y, Fujita D, Sugiyama S, Takachu R, Sugiura T, Sawada M, et al. Safety and Effects of a Four-Week Preoperative Low-Load Resistance Training With Blood Flow Restriction on Pre- and Postoperative Quadriceps Strength in Patients Undergoing Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial. Cureus [Internet]. 13 de julio de 2024 [citado 6 de octubre de 2024]; Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328827/

29. Song K, Qi L, Mu Z, Sun H, Zhai S, Liu D, et al. Health-related quality of life after total knee arthroplasty and unicompartmental knee arthroplasty for unicompartmental osteoarthritis: A systematic review and meta-analysis. Journal of Orthopaedic Surgery [Internet]. 1 de mayo de 2024;32(2). Disponible en: https://journals.sagepub.com/doi/full/10.1177/10225536241256245?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org

Downloads

Published

2025-01-01

Issue

Section

Systematic reviews or meta-analyses

How to Cite

1.
Arevalo Navas BP, Cantuña Vallejo PF. Preoperative training in patients undergoing total knee arthroplasty. Systematic review. Salud, Ciencia y Tecnología [Internet]. 2025 Jan. 1 [cited 2025 Jan. 2];5:1220. Available from: https://sct.ageditor.ar/index.php/sct/article/view/1220