Despite seemingly routine use of physical therapy and its potential importance in reducing complications after total joint arthroplasty in the acute hospital setting, no agreed-upon approach to rehabilitation exists in this setting. In fact, rehabilitation practices and outcomes assessed are quite variable.Purpose:
To determine the effects of physical therapy interventions in the acute care phase of total knee arthroplasty.Data Sources:
Ovid Medline, Cochrane Database of Systematic Reviews, CINAHL.Review Selection Criteria:
Peer-reviewed research from January 1996 to October 2016 of adults with primary total knee arthroplasty receiving any physical therapy intervention related to body systems/function impairments or activity/participation limitations measured within 7 days of surgery. All studies included a comparison group.Data Extraction:
Two reviewers extracted data and determined study quality.Data Synthesis:
Qualitative summary considering studies' risk of bias and number favoring interventions for outcomes.Results:
Thirty-nine studies were included. Interventions included extra therapy, accelerated therapy, cryotherapy, Chinese medicine, lymphatic drainage, mechanical and manual passive motion, active-assistive motion, biofeedback, and electrical stimulation. Most studies included undefined “standard care.” Outcomes varied, with pain and knee motion commonly reported.Conclusions:
Evidence supports cryotherapy for reducing pain and accelerated therapy for improving range of motion and walking, but quality is low. High-quality studies in these areas are needed.