Abstract
BackgroundPhysiotherapy is a proven effective treatment strategy after total knee and hip arthroplasty (TKA/THA), however there is considerable practice variation regarding its timing, content and duration. This study aims to compare the (cost-) effectiveness of a standardized, treat-to-target postoperative physiotherapy strategy with usual postoperative care.MethodsUsing a cluster randomized study design, consecutive patients scheduled for a primary TKA/THA in 18 hospitals in the Netherlands will be assigned to the treat-to-target physio therapy strategy or usual postoperative care. With the treat-to-target strategy a standardized, individually tailored, exercise program is aimed at the attainment of specific functional milestones. Assessments are done at baseline, 6 weeks and 3, 6, 9 and 12 months follow up. The primary outcome will be the Knee injury / Hip disability and Osteoarthritis Outcome Score - Physical Function Short Form (KOOS-PS / HOOS-PS) at 3 months follow up. Secondary outcomes are the numeric rating scale for pain, the Oxford Knee and Hip Scores, performance-based test and the EuroQol 5D-5L for quality of life. Healthcare use, productivity and satisfaction with postoperative care are measured by means of questionnaires. In total, 624 patients will be needed of which 312 TKA and 312 THA patients.DiscussionThe study will provide evidence concerning the (cost-) effectiveness of the treat-to-target postoperative physiotherapy treatment compared to usual postoperative care. The results of this study will address an important evidence gap and will have a significant impact in daily practice of the physio therapist.Trial registrationRegistered in the Dutch Trial Registry on April 15, 2018. Registration number: NTR7129.
Highlights
Physiotherapy is a proven effective treatment strategy after total knee and hip arthroplasty (TKA/Total hip arthroplasty (THA)), there is considerable practice variation regarding its timing, content and duration
Trial objectives The aim of the present study is to evaluate the effectiveness of a standardized, treat-to-target postoperative physiotherapy (PPT) strategy in Total knee arthroplasty (TKA) and THA patients compared to usual PPT
The PATIO trial is, to our knowledge, the first study that analyses theeffectiveness of a standardized, personalized postoperative physiotherapy protocol compared to usual postoperative care in patients with OA receiving total knee and hip arthroplasty (TKA/THA)
Summary
Physiotherapy is a proven effective treatment strategy after total knee and hip arthroplasty (TKA/THA), there is considerable practice variation regarding its timing, content and duration. In patients undergoing total knee or hip arthroplasty (TKA/THA) for osteoarthritis (OA) postoperative physiotherapy (PPT) is a recommended treatment [1,2,3,4]. There is no consensus on the optimal composition of the treatment, timing (when to start and stop), and dosage (frequency). This has led to considerable practice variation, as demonstrated by a. More knowledge on optimized PPT strategies is necessary [16, 17]
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