Patient Forgoes Knee Replacement Surgery by at Least 2 Years After Appropriate Nonsurgical Care Following Cardiac Rehabilitation: A Case Report

Abstract

Background Guidelines for knee osteoarthritis recommend that appropriate nonsurgical care, including education and exercise therapy, be offered prior to considering total knee replacement (TKR) surgery. Case Description A 66-year-old man with severe knee osteoarthritis was scheduled for TKR. Preoperative cardiac testing led to cardiac surgery and subsequent appropriate nonsurgical care for his knee osteoarthritis. This included aerobic exercise (cardiac rehabilitation) and a targeted exercise therapy and education program (Good Life with osteoArthritis in Denmark [GLA:D]®). Outcome and Follow-Up Following the 6-week cardiac rehabilitation program, the patient's walking distance improved by 130 m (39% improvement during the 6-minute walk test). Following the 6-week GLA:D® program, average knee pain reduced by 76% (6.5-cm reduction on a 10-cm visual analog scale) and joint-related quality of life improved by 72% (50 units using the Knee injury and Osteoarthritis Outcome Score [KOOS]). At 2-year follow-up, this patient had still not undergone a TKR. Discussion This case avoided a TKR for at least 2 years after accidentally receiving appropriate nonsurgical care. JOSPT Cases 2021;1(1):21–26. doi:10.2519/josptcases.2021.9943