Researchers find one-to-one therapy not better than home-based or group therapy after TKA

The use of one-to-one therapy does not provide better short-term or long-term performance outcomes for patients after total knee arthroplasty when compared with group or home-based therapy, according to Australian researchers.

“This study provides very strong evidence that one-to-one therapy does not provide superior outcomes to group-based therapy or monitored home programs in the short and longer term after total knee arthroplasty. Thus, providers of one-to-one therapy in this context do so at greater cost without securing significantly better outcomes for their patients,” Victoria Ko, BappSc, and colleagues wrote in their study. “This revelation is particularly relevant in light of the growing numbers of total knee arthroplasties undertaken annually in the absence of enhanced rehabilitation resources.”

Ko and colleagues analyzed 249 total knee arthroplasty (TKA) patients who, at 2 weeks after surgery, went to a 6-week treatment program. Patients were randomly assigned to 12 one-to-one therapy sessions, 12 group-based therapy sessions or a monitored home program, according to the abstract.

At 10 weeks, the one-to-one therapy group had a median Oxford Knee score of 32 points compared with 36 points in the group-based therapy and 34 points in the home-based therapy groups. Ko and colleagues noted no significant differences across any of the therapy groups regarding secondary outcomes measures, such as the WOMAC and SF-12 scores, of the 233 patients available at 1-year follow-up.

Disclosure: Ko, Naylor, Mittal and Harris received grants paid to their institutions from the Fairfield Hospital grant. Ko received a grant paid to her institution from Whitlam Joint Replacement Centre.

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