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The effect of immediate post-operative knee range of motion photographs on post-operative range of motion after total knee arthroplasty

An assessor-blinded randomized controlled clinical trial in sixty patients

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Abstract

Purpose

We attempted to determine the effect of immediate post-operative knee range of motion (ROM) photographs on improving ROM after total knee arthroplasty (TKA).

Methods

Sixty patients, scheduled for unilateral primary TKA, were randomized into two groups. The photo group (n = 30) were immediately shown post-TKA knee ROM photographs as motivation for rehabilitation. The non-photo group (n = 30) received identical post-operative pain control and rehabilitation programs. Post-operative knee ROM and Knee Society Scores (KSS) at day three, six weeks, three months, six months, one year, and two years were evaluated. Outcome assessors were blinded to the groups during the study.

Results

Patients in the photo group had better knee flexion on day three (99.9° ± 15.3°, 95% confidence interval (CI) 94.1-105.7° vs. 92.3° ± 11.4°, 95% CI 87.9-96.8°; p = 0.038) and at six weeks (120.9° ± 13.4°, 95% CI 115.7-126.0° vs. 112.5° ± 13.6°, 95% CI 107.2-117.8°; p = 0.023); however, there were no differences in range of flexion beyond six weeks post-operatively. Knee extension did not significantly differ throughout. Clinical KSS was significantly higher in the photo group at six weeks (90.7° ± 6.2° vs. 86.6° ± 6.4°, p = 0.017). Functional KSS showed no differences between groups during follow-up.

Conclusion

Showing knee ROM photographs seemed to result in significant improvement of knee flexion and clinical KSS in the first 6 weeks post-TKA and may be recommended as part of post-TKA rehabilitation.

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Acknowledgments

We thank D Kim Liwiski for reviewing the article and helping with the language. We also thank all participants for providing the data used in this study.

Funding

Our institution provided all funding for this study.

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Authors and Affiliations

  1. Department of Orthopedics, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand

    Piya Pinsornsak & Supakit Kanitnate

  2. Department of Orthopedics, Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani, 12120, Thailand

    Krit Boontanapibul

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  1. Piya Pinsornsak
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Correspondence to Piya Pinsornsak.

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Pinsornsak, P., Kanitnate, S. & Boontanapibul, K. The effect of immediate post-operative knee range of motion photographs on post-operative range of motion after total knee arthroplasty. International Orthopaedics (SICOT) 45, 101–107 (2021). https://doi.org/10.1007/s00264-020-04877-3

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