Does The Use Of An Ortho-Glide Device Improve Patient Outcomes Following A Total Knee Replacement?

Abstract

Physiotherapy is routinely provided following Total Knee Replacement (TKR) surgery however, despite the rising prevalence of osteoarthritis and subsequent TKR rates, no formal guidelines outline the optimal modality of post-TKR exercise. This study aimed to evaluate the effectiveness of utilising an assistive device, known as the Ortho-Glide, for completing the prescribed Physiotherapy exercises following TKR.
The study design was a randomised controlled trial and a total of 31 participants were recruited and randomised into two groups. The Standard Physiotherapy group (n=16) were prescribed routine post-operative exercises, the Ortho-Glide group (n=15) undertook the same routine exercises but were issued with the Ortho-Glide assistive device to facilitate their completion. The primary outcome measure was the Knee Osteoarthritis Outcome Score (KOOS). Secondary outcome measures were the Numerical Pain Rating Scale (NPRS), with pain scores reported for both at rest and during exercise, and the Exercise Adherence Rating Scale (EARS). Outcome scores were collected at a pre-operative baseline, then at six weeks post-operatively, with the final data collected at 12-weeks following the TKR procedure.
A mixed methods analysis of variance was performed on the data. Mean scores for the KOOS and NPRS in both groups demonstrated statistical and clinically significant improvements from baseline to six weeks, and baseline to 12-weeks following TKR. No statistically significant difference was noted between groups at any time-point, however clinically significant differences were noted in a number of the KOOS subscales, favouring the Ortho-Glide group.
This study represents the first use of an Ortho-Glide device in clinical research. Despite economic and clinical motivations to optimise post-operative recovery, a lack of clarity exists regarding best practice in the prescription of Physiotherapy exercises post-TKR. The use of an Ortho-Glide appeared to offer greater clinically significant improvements in function compared to standard-care, although further research to investigate this is suggested.