Assessment of Rehabilitation Protocol After Primary Unilateral Total Knee Arthroplasty With Kinematic Alignment
Keywords:
Total knee arthroplasty; kinematic alignment; rehabilitation; physiotherapy; knee function; muscle strength; range of motion; quality of life.Abstract
Background: Total knee arthroplasty (TKA) is an established surgical treatment for advanced knee osteoarthritis. However, postoperative pain, muscle weakness, restricted range of motion, gait impairment, and reduced functional independence may delay recovery. Kinematic alignment (KA) aims to restore patient-specific knee anatomy, while structured rehabilitation seeks to translate surgical correction into meaningful functional improvement.
Aim: To assess outcomes following a structured rehabilitation protocol after primary unilateral TKA performed using kinematic alignment.
Methods: An observational longitudinal study was conducted at the Department of Physiotherapy, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow. The cohort of 240 patients who underwent primary unilateral TKA using KA. Rehabilitation comprised three phases: acute inpatient rehabilitation during postoperative days 0–2, transitional home-based rehabilitation during days 3–14, and progressive strengthening during weeks 3–6. Outcomes included Visual Analogue Scale (VAS) pain scores, Oxford Knee Score (OKS), knee range of motion (ROM), muscle strength, quality-of-life scores. Pre- and post-rehabilitation outcomes were compared using the Wilcoxon signed-rank test.
Results: Mean VAS pain score decreased from 7.55 ± 1.08 to 2.94 ± 1.53. Mean OKS increased from 22.49 ± 4.49 to 38.63 ± 5.31, while mean ROM improved from 89.15 ± 10.30° to 116.30 ± 11.22°. Mean muscle strength grade increased from 1.71 ± 0.79 to 4.03 ± 0.81, and the mean quality-of-life score increased from 47.32 ± 7.56 to 77.04 ± 9.59. All five outcome measures demonstrated statistically significant pre–post differences (p < 0.0001).
Conclusion: Significant improvements in pain, knee function, ROM, muscle strength, and quality-of-life scores were observed following the structured rehabilitation programme. These findings support the clinical relevance of organised, progressive rehabilitation after KA TKA.
