Use of a developed prehabilitation method in patients undergoing total knee arthroplasty

BACKGROUND: Knee osteoarthritis is a common degenerative–dystrophic disease of the musculoskeletal system, affecting 10%–20% of the global population, leading to incapacitation in 8%–21% of cases, and requiring a comprehensive treatment approach. In cases of ineffective conservative treatment or upon verification of terminal stages of osteoarthritis (Kellgren–Lawrence grades III and IV), total knee arthroplasty is recommended. Despite a high rate of favorable outcomes, 10%–30% of patients remain dissatisfied with the results of surgery. In this context, the use of a newly developed prehabilitation method in patients undergoing total knee arthroplasty may directly influence treatment outcomes by improving clinical and functional joint parameters and remarkably enhancing postoperative quality of life. AIM: The work aimed to evaluate the effectiveness of a new prehabilitation method in patients undergoing total knee arthroplasty. METHODS: A prospective, non-blinded, non-randomized, controlled, single-center interventional case–control study analyzed treatment outcomes in 64 patients with verified terminal-stage knee osteoarthritis who underwent total knee arthroplasty with the use of the developed prehabilitation method. Patients selected for participation in the study were allocated to two clinical groups: group 1 (control) and group 2 (main). Group 1 consisted of 33 patients, and group 2 included 31 patients. Comparative analysis and assessment of treatment effectiveness were performed 72 hours before surgery and subsequently 72 hours, 4 weeks, and 12 weeks after total knee arthroplasty using objective and subjective assessment methods. RESULTS: Comparative analysis of treatment outcomes demonstrated significant differences and positive trends in clinical and functional parameters associated with the use of the developed prehabilitation protocol in both groups at all follow-up time points. Changes in the Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analog Scale for pain, and the Two-Minute Walking Test 4 and 12 weeks postoperatively were more pronounced in the second group, with values of 24.0 and 15.0 points (p 0.001), 4.0 and 1.0 points (p 0.001), and 142.68 ± 15.91 m and 154.06 ± 11.73 m (p 0.001), respectively. CONCLUSION: The proposed prehabilitation method for total knee arthroplasty promotes complete clinical and functional recovery of the knee joint within 12 weeks after surgery and leads to an improvement in patients’ quality of life in both the short and long term.