Recommendations
Preoperative
Design preoperative exercise programs for strength and flexibility
★★★★
Provide education to patients undergoing total knee arthroplasty (TKA)
★★★★
Do NOT use continuous passive motion devices (CPM)
★★★★
Postoperative
Encourage cryotherapy for pain management
★★★★
Teach importance of early mobility and appropriate progression of therapy
★★★★
Include motor function training
★★★★
Implement passive, active assistive, and active range of motion exercises
★★★★
Teach patients to position the operated knee in some degree of flexion (30 to
90 degrees), while resting to reduce blood loss and swelling in the first 7 days
★★★★
Use neuromuscular electrical stimulation (NMES)
★★★★
Design, implement and teach high-intensity strength training and exercise
programs within 7 days after surgery
★★★★
Provide supervised PT management, and determine the optimal setting by the
patients' safety, mobility, environmental, and personal factors
★★★★
Either group- or individual-based PT sessions
★★★★
Start PT management within 24 hours of surgery and prior to discharge
★★★★
Provide guidance to the care team and patient on safe and objective discharge
planning, patient functional status, assistance equipment, and services needed to
support a safe discharge from the acute care setting
★★★★
Outcomes Assessment
Collect the KOOS JR (Table 2) as a patient-reported outcome measure and both
the 30-Second Sit-to-Stand and Timed Up and Go tests to demonstrate the
effectiveness of care provided. These should be collected at a minimum at the first
visit and upon conclusion of care from each setting.
★★★★