Total knee replacement prehab: Does it work?

Delayed knee replacement surgery? Don’t panic – evidence suggests that it’s a blessing in disguise…

‘Prehab’ is becoming an increasingly popular approach for preparing patients for their post-operative rehabilitation stages. Knee replacement surgery is no exception!

A family member of mine is preparing for a postponed knee replacement surgery in the new year, so took a look into the research. I was pleased to find that research evidence from a number of studies has been shown to improve measures of strength and function before and after total knee replacement surgery. Here are some key points from just one study by Dr Robert Topp and his colleagues that was published in Physical Medicine and Rehabilitation in 2009:

  1. STRUCTURE: prehab group vs. normal care group (randomised controlled study)
  2. PREHAB PROGRAMME: resistance training, flexibility, and step training performed three times each week prior to surgery
  3. KEY RESULTS: Prehab group experienced improved functional activities (ability to transition from seated to standing), reduced pain before surgery, with greater improvements in function and quadriceps strength symmetry 3-months post-surgery.
    Here’s a link to the article:

This is just one study, and there are many others with a range of findings – both positive and negative. For example the findings from a more recent study by Carly MacKay et al. (2012) published in the same journal reported no significant functional or strength benefits in the months following surgery. However, this was not a randomised controlled trial, and had a smaller sample of participants. I wouldn’t discount this information, but I feel that the randomised controlled trial is a more reliable source of information.

If you have had a recommendation for total knee replacement, or even had this surgery,  I would like to know what you have experienced. Were you prescribed pre-surgical exercise? What do you think – does prehab work? Do you have any success stories?
Please feel welcome to comment below.

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