The benefits of ambulatory physiotherapy after total knee replacement. Clinical practice recommendations.

ABSTRACT

AIMS: To develop clinical practice guidelines for ambulatory physiotherapy for patients able to leave the surgery department directly for home just after total knee replacement (TKR). METHOD: We used the SOFMER (French Society of Physical and Rehabilitation Medicine) methodology, which associates a systematic revue of the literature, collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. Main outcomes considered in the recommendations were impairment, disability, medico-economic implications and postoperative complications. RESULTS: The literature review did not allow for recommending systematic prescription of ambulatory physiotherapy for patients able to leave the surgery department directly for home just after TKR. However, this prescription could improve muscle strength and function but not mobility. When patients can return home directly after surgery, we recommend ambulatory physiotherapy as suggested by French clinical practice to increase function. CONCLUSION: Good methodological trials must be developed to define the criteria for prescribing ambulatory physiotherapy for patients able to return home just after total knee replacement (TKR) and to evaluate the content of the optimal program.