Efficacy and safety of knee flexion enhanced standardized home exercise program comparing supervised physiotherapy to improve mobility and quality of life after Total knee arthroplasty

Background: In the present study, we introduced a knee flexion enhanced standardized home exercise program assisted by a low stool and evaluate efficiency of this method in the management of rehabilitation after TKA.Methods: Patients were recruited from July 2014 and December 2015, and randomized into two groups, a knee flexion enhanced standardized home exercise program group (group KFEH) and commonly-used supervised physiotherapy group (group SPT). Outcomes were evaluated by observing the joint function with the Knee Society score (KSS), Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and ROM assessment at selected time points (pre-operation and 1 week, 1 month, 3 month, 6 month and 1 year following post-operation). Results: At last, we observed pain and functional improvements in both groups. Noninferiority was shown 12 months postoperatively for clinical outcomes except group KFEH had better ROM range at 1 month (P<0.01). The absolute value of WOMAC and KSS were slight better in group KFEH without significant difference, and there was no difference about VAS between two groups as well as complication incidence rate. Additionally, home program would save patients’ times and decrease economic burden. Patents would save 14 times postoperative rehabilitation in outhospital service, and cut down at least 782 RMB in total. Conclusion: Taking the rehabilitation and economical efficiency, we recommend knee flexion enhanced home exercise program for TKA rehabilitation management.