No clinician consensus on physical activity after TKA

During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.

“We just have [our] gut instinct as to what is best for the implant and what is not,” Richard Iorio, MD, told Orthopedics Today. “In general, if it feels comfortable with the patient, if they are educated and trained well in the activity and they can do it without pain or discomfort and it is good for their cardiovascular fitness, we will encourage participation.”

A literature review by Michael R. Bloomfield, MD, and his colleagues showed total joint procedures “are increasingly being performed in more active patients,” with 19% of patients returning to athletic activities after knee replacement. However, other research has shown there is limited peer-reviewed information to help orthopedic surgeons advise their patients on the appropriate athletic activity after knee replacement.

“There has always been a philosophy that the patient and the surgeon want the joint replacement to last as long as possible — hopefully, for the duration of the patient’s life,” Thomas P. Schmalzried, MD, told Orthopedics Today. “But that is in contrast to the philosophy about patients having joint replacement surgery to enjoy a better quality of life and there are certain physical activities that increase their quality of life. There is a big controversy about advisability as compared with capability.”

Click here to read the full Cover Story in the November issue of Orthopedics Today.