Total Knee Replacement (TKA) and the Importance of Physical Therapy by Nick Rinard
At Nick Rinard Physical Therapy a lot of patients come to see us with knee pain and/or knee arthritis, both before and after various knee surgeries, including total knee replacement surgeries.
Since 2010, knee replacements have been the most performed surgery on people over 45 years of age. Knee replacements are performed at the rate of 700,000 per year. Because of this increasing rate, the efficacy of pain relief and improvement of function should be investigated.
100 patients with knee arthritis
A researcher, Soren Thorgaard Skou, has done just that. In his study, he looked at 100 patients with knee arthritis and assigned them to a surgical group or non-surgical group (which received physical therapy, medication and diet education). After one year, 85% percent of the surgical group had significant improvements in pain vs 68% of the physical therapy group. The surgical group and larger gains in their ability to climb stairs and walk. However, the study also showed that the surgical group is at greater risk for complications that the physical therapy group is not. The surgical group is more likely to have blood clots or a manipulation (another procedure performed by the surgeon to increase range of motion). The surgical group had more adverse side effects vs the physical therapy group (24 vs. 6).
Physical therapy is effective
Physical therapy is effective and should be considered a viable option before jumping to surgery. If the first knee replacement can be delayed, this can decrease the necessity for a second surgery (current replacements last 10-15 years). We urge our patients to remember that we are always here for you before or after surgery. Nick Rinard Physical Therapy is a phone call away 503-244-6232 !
1/3rd of knee replacements are unnecessary
This, taken into consideration with the study that came out last summer that found nearly 1/3rd of knee replacements are unnecessary, should be considered when deciding to have a knee replacement or a trial of physical therapy to determine effectiveness.
Dr. Skou’s report (N Engl J Med. 2015 373;17:1668-9)