Rehabilitation after knee arthroplasty. An accelerated multidisciplinary approach

Fast-track knee arthroplasty is a multidisciplinary perioperative approach resulting in decreased convalescence, better patient satisfaction, and reduced hospital costs. However, considerable room for improvement had been recently identified in the postoperative portion of care. Which prognostic factors, in that phase, can improve the outcomes of rehabilitation, in terms of functional recovery and patient satisfaction, how, and for whom? Surgeons, physiatrists and physiotherapists from our high-volume hospital identified five postoperative issues as significantly prognostic to rehabilitation. An electronic research was performed to look for the associate keywords. 30 papers were included in the synthesis. Clinical, social, psychological and logistical prognostic factors are fundamental to improve patient education and compliance. Intensive and early physiotherapy when possible; standard exercise programs based on patient cluster of characteristics; discharge planning according to functional, psychological and social criteria; patient motivation; use of psychopharmacological treatment; substantial connection between institutions; are postoperative prognostic factors which play a major impact on the effectiveness of rehabilitation after fasttrack TKA. Future research should identify recovery curves to predict, track and understand specific outcomes to specific cohorts of patients, in order to refer them to the most suitable rehabilitative modality and setting.