Formal vs. Home-Based Physical Therapy After Unicompartmental Knee Arthroplasty

Given that current practice trends are requiring treatments to be both clinically and cost
effective, research has begun to focus on evaluating the effect of specific interventions.
Many surgeon and patients have believed formal OPT is necessary to optimize functional
outcomes following orthopaedic procedures. However, the literature has begun to call into
question the need for OPT following total hip arthroplasty, total knee arthroplasty, total
shoulder arthroplasty, anterior cruciate ligament reconstruction, meniscectomy, and rotator
cuff repair.

A randomized controlled trial was done to compare face-to-face rehabilitation with in-home
telerehabilitation following total knee arthroplasty. Utilizing the Western Ontario and
McMaster Universities Osteoarthritis Index (WOMAC) as the primary outcome, the authors
demonstrated noninferiority of telerehabilitation compared to face-to-face rehabilitation.
Other secondary outcomes of Knee Injury and Osteoarthritis Outcome Score (KOOS), range of
motion, and isometric strength did not exhibit a difference between the treatment groups.
(see citation below)

Based on these findings, it appears that the high cost of formal OPT doesn't translate into a
meaningful improvement of functional outcome. Because patient's undergoing UKA have a higher
pre-operative functional status than patients having a TKA (Total Knee Arthroplasty), it is
reasonable to think that patients following a UKA are better equipped to succeed with HBPT.
As a result, the hypothesis of the current study is that HBPT will prove to be non-inferior
to formal OPT in the setting of UKA.

Inclusion Criteria:

- Scheduled for a unicompartmental knee arthroplasty

Exclusion Criteria:

- Require inpatient physical therapy beyond post-operative day one

- < 18 years old

- Decline to participate