Pre-habilitation for patients awaiting total knee replacement in the United Kingdom National Health Service:A review of publicly facing information


INTRODUCTION: Approximately 14,000 - 21,500 individuals per year are dissatisfied with the outcome of their Total Knee Replacement (TKR) in the UK National Health Service (NHS). National Institute of Clinical Excellence (NICE) guidelines recommend that future research should evaluate whether a 'full programme of pre-habilitation' can improve outcomes for patients awaiting TKR. The aim of this review was to describe current pre-habilitation practice for patients awaiting TKR in the UK NHS, to inform future research. METHODS: Two reviewers independently undertook electronic searches for publicly available information sheets (PIS) from websites of UK NHS Trusts that included detail about pre-habilitation for patients awaiting TKR. One reviewer extracted data, and a second reviewer verified this. RESULTS: Fifty PIS, nine information videos and one web page from 59 NHS Trusts were identified. NHS Trusts most commonly provide patients with advice on pre-operative rehabilitation via a single appointment, combined with a PIS (36/59; 61.0%). NHS Trusts use appointments, PIS and video to provide patients awaiting TKR with information regarding pain control (46/58; 79.3%), exercise therapy (46/58; 79.3%), what to expect on the day of surgery and in-patient stay (58/58; 100%), lifestyle interventions (27/58; 46.6%), and adverse events (44/58; 75.9%). CONCLUSION: NHS Trusts commonly provided patients awaiting TKR with 'advice on pre-operative rehabilitation', however no NHS Trust provided a comprehensive programme of pre-habilitation. The results of this study will inform the development of a comprehensive, multi-modal pre-habilitation programme, to be tested in a future high-quality randomised controlled trial.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences
Additional Information: The final publication is available at IOS Press through
Uncontrolled Keywords: Total knee replacement,pre-habiliation,Physical Therapy, Sports Therapy and Rehabilitation,Rehabilitation,Occupational Therapy
Publication ISSN: 2213-0691
Last Modified: 19 Mar 2024 18:06
Date Deposited: 29 Jul 2021 16:20
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Related URLs: https://content ... earch/ppr210548 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2021-12-10
Published Online Date: 2021-07-14
Accepted Date: 2021-06-28
Authors: Stephens, Gareth
Maarabouni, Ahmed
Mansell, Gemma (ORCID Profile 0000-0002-5479-2678)
Littlewood, Chris



Version: Accepted Version

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