The Effect of Preoperative Quadriceps Exercise on Functional Outcome after Total Knee Arthroplasty
Yodpiti Tungtrongjit MD*, Pattira Weingkum BSc (Nursing and Midwifery)*, Piyarat Saunkool BSc (Physical therapy)**
Affiliation : * Department of Orthopaedic Surgery, Phrae Hospital, Phrae, Thailand ** Department of Rehabilitation, Phrae Hospital, Phrae, Thailand
Objective : To compare the level of pain scores, range of motion, quadriceps strength and quality of life after TKA patients
between preoperative quadriceps exercise group and usual care group.
Study design : A randomized controlled trial study.
Material and Method: From January 2011-January 2012, 60 patients undergoing primary TKA were included. The patients
were randomized into two groups with the use of blocking letter in 30 patients for each. The patients assigned to the
preoperative quadriceps exercise group were asked to participate in three weeks home quadriceps strengthening exercise
program until their TKA. The patients assigned to the usual care group were asked to continue their normal activities until
their TKA. Preoperative data were collected within three weeks prior to the TKA. Should be 4 data collection included visual
analog scale (VAS), quadriceps strength, knee range of motion and Modified WOMAC score. Both groups were evaluated
four times: three weeks before surgery, 1 month, 3 months and 6 months after surgery.
Results : 60 patients was divided into 2 groups, the preoperative quadriceps exercise group and the usual care group. Most
patients were female, older than 60 years, primary school educated, housekeeper occupation. Body mass index, duration of
knee pain, Paracetamal and NSAIDs use were not statistically significant different. The quadriceps exercise group had
statistically significant decreased pain in the postoperative 3 months (p = 0.003). The quadriceps exercise group had
statistically significant decreased mean Modified WOMAC score in the postoperative 1, 3 months (p < 0.001, 0.001) and
quadriceps strength better than the usual care group during the follow-up in the postoperative 3 months.
Conclusion : Preoperative quadriceps exercise at least three weeks prior total knee replacement result in short term benefit
such as decreased pain, improved quadriceps strength and improved quality of life after elective TKA
Keywords : Total knee arthroplasty (TKA), Quadriceps strength, WOMAC score, Visual analog scale
