Inpatient Versus Outpatient Rehabilitation After TKA

Study Overview
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Brief Summary
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The purpose of this study is to compare the effectiveness of inpatient and outpatient rehabilitation following total knee arthroplasty. No studies exist that have evaluated these two rehabilitation programmes in a specific orthopaedic patient population with a focus on motor performance. We hypothesized that patients participating in outpatient care tend to be physically more active than patients in the rehabilitation clinic, leading to the assumption that outpatient rehabilitation has superior functional outcomes compared to the inpatient standard-of-care therapy.

Official Title
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Inpatient Versus Outpatient Rehabilitation Following Total Knee Arthroplasty

Conditions
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Total Knee Arthroplasty

Intervention / Treatment
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* Other: inpatient rehabilitation
* Other: outpatient rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with knee osteoarthritis and scheduled for primary TKA age: 50-80 Exclusion Criteria: BMI > 40 musculoskeletal and neurological disorders that limit physical function any planned further joint surgery within 6 months substantial pain or functional limitation which make the patients unable to perform study procedures

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: inpatient rehabilitation<br>After discharge, patients participate in daily physical therapy for 3 weeks in a rehabilitation hospital. | Other: inpatient rehabilitation<br> <br> |
| Experimental: outpatient rehabilitation<br>After discharge, patients participate in daily physical therapy for 3 weeks in an outpatient rehabilitation center. | Other: outpatient rehabilitation<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| physical activity (number of steps) | over a period of 7 days using activPAL activity recording system | during the first seven days of rehabilitation and 3 months post surgery (posttest) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| gait performance | spatio-temporal and temprophasic gait parameters | posttest (3 months after surgery) | 
| maximal active and passive knee joint range of motion | digital long-arm goniometer | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| stair climbing performance | stair climbing test | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| timed up and go performance | timed up and go test | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| joint position sense | The subjects' ability to actively reproduce a previously presented knee flexion angle (30° and 50° of knee Flexion) | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| knee pain | visual analogue scale | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| knee joint swelling | measurement of circumference | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 
| long-term Memory representation of the gait | structural dimensional analysis of mental representation (SDA-M) | change from baseline (9 days after surgery) to posttest (3 months after surgery) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rehabilitation, total knee arthroplasty