Abstract
Objective: Physical therapy following total knee arthroplasty (TKA) typically follows a time-based protocol (TB), which progresses according to a time schedule but does not adequately reflect individual patient differences. Therefore, we aimed to develop a criteria-based protocol (CB) that considers tissue healing and patient goals and to investigate whether CB leads to different outcomes postoperatively.
Methods: The participants were divided into two groups: 25 followed the TB protocol, and 34 followed the CB protocol. TB followed a time schedule for mobilization, whereas CB was structured into four stages with specific subcategories. The primary outcome was the length of hospital stay. The secondary outcomes included satisfaction, activity level, and timed up and go (TUG) test results, assessed preoperatively and at 12 weeks postoperatively. Additionally, factors influencing hospital stay and the secondary outcomes were identified through multiple regression analysis.
Results: The length of hospital stay was significantly shorter in the CB group. The CB group showed improvement in all parameters at 12 weeks postoperatively compared to preoperative values. In the TB group, satisfaction and activity levels improved at 12 weeks postoperatively, but no changes were observed in TUG. There was no difference between the groups at 12 weeks postoperatively. Furthermore, multiple regression analysis identified CB as a significant variable for all outcomes.
Conclusion: CB may reduce the length of hospital stay and positively influence postoperative satisfaction, activity level, and physical function.
