Effectiveness of Preoperative Reconditioning Exercise in Grade IV Knee Osteoarthritis Patients Undergoing Total Knee Arthroplasty: An Evidence-Based Case Report

Abstract

Knee osteoarthritis (OA) is the most common degenerative joint disease and a leading cause of disability among older adults, frequently requiring total knee arthroplasty (TKA) as a definitive treatment. Preoperative reconditioning exercise (prehabilitation) is thought to enhance preoperative functional status and accelerate postoperative recovery, although clinical evidence remains varied. This evidence- based case report aims to evaluate the effectiveness of preoperative reconditioning exercise in a patient with grade IV knee OA scheduled for TKA. A literature search was conducted in December 2024 across PubMed, Scopus, Cochrane, and ScienceDirect databases to address the clinical question. Across the five selected systematic reviews, preoperative exercise programs consisting of lower-extremity strengthening, flexibility, mobility, and balance training delivered over 3-12 weeks were shown to shorten hospital stay, reduce postoperative pain in the short term (up to 3 months), and improve muscle strength, functional mobility, and overall knee function. Despite heterogeneity across studies, implementing preoperative exercise for 4-12 weeks focusing on lower-extremity strengthening, flexibility, mobility, and balance training is an effective strategy to optimize preoperative functional status and accelerate postoperative recovery following TKA.