In recent years there has been growing interest in the possibility to prepare patients for surgery through a “pre-habilitation” program, composed of strengthening and stretching exercises in the immediate preoperative period. Preoperative strengthening showed a positive effect on perioperative outcomes in several of the included studies.

 

With total hip arthroplasty (THA) and total knee arthroplasty (TKA) representing the two most common procedures in orthopedic surgery, it is important to give thought on how to optimize outcomes and minimize cost. A recent study found in the Journal of Clinical Medicine confirms the value of an exercise program started prior to surgery.

In general the findings showed that the exercises begin about 6 weeks prior to surgery in order to maximize results. The supervision of any program by a trainer or a physical therapist ensures that the proper exercises are being completed, safe modifications are incorporated as needed, and that compliance improves due to the accountability factor.

 

The healthcare-related economic burden is extensive for these surgeries, especially concerning postoperative hospitalization, leading in recent years to the development of several fast-track strategies aimed to improve results and decrease hospital stay expenses. It is useful to know that in small cohorts preoperative physical training shortens the length of stay in the hospital, which is a remarkable result in an era of increased attention to healthcare expenses. With outpatient prehab even with a physical therapist being such a low, it would be a worthwhile suggestion to offer anyone undergoing total joint arthroplasty. Think of it as “sharpening the saw” when the time in prior to surgery offers a far more streamlined and positive experience afterwards!