Early post-operative physiotherapy rehabilitation after primary unilateral unicompartmental knee replacement: a systematic review

Background Unicompartmental Knee Replacement (UKR) is an established treatment for end stage arthritis affecting one compartment of the knee. UKR lends itself to rapid recovery and early discharge. The content, type, timing and dose of early post-operative physiotherapy treatment has yet to be reviewed. Objective To review the content of early physiotherapy in the first eight weeks following unilateral UKR. Data sources A literature search of Medline, CINAHL, AMED and PubMed and the Physiotherapy Evidence Database (PEDRo) plus citation searching. Eligibility criteria Randomised controlled trials (RCTs) and observational studies reporting a physiotherapy intervention for UKR in-volving a form of post-operative exercise/education/advice delivered within the first eight weeks of surgery and commencing as an in-patient. Two reviewers independently performed screening, data extraction and risk of bias assessment. Data synthesis Narrative syntheses were undertaken due to the heterogeneity of the primary outcomes. Results Eleven studies were included (n = 1293 participants), three RCTs and eight observational studies. The dose and content of post-operative physiotherapy was highly variable with a move in recent years to rapid recovery and same day discharge with more self-directed rehabilitation. No studies had a low risk of bias. Limitations Small sample sizes and high heterogeneity limit our findings Conclusions This review highlights the range of post-operative physiotherapy provision following UKR with a recent move to minimal physiotherapy input. Further research is required to identify those patients who may need additional physiotherapy above that now routinely provided, along with the most effective timing, type, and dosage of the intervention. (c) 2022 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.