Clinical Benefits of Prehabilitation Before THA and TKA Procedures

Emerging evidence supports the role of structured prehabilitation in improving postoperative outcomes for hip and knee replacements. The 2025 JOSPT overview by Keogh et al. examines systematic reviews and meta-analyses from RCTs - let's unpack the data.

Overview of the Evidence Base

The study includes 3 systematic reviews and 21 meta-analyses covering:

• THA: 19 RCTs, 1,110 patients

• TKA: 46 RCTs, 3,362 patients

Evidence quality ranged from critically low to moderate.

Outcome Improvements with Prehabilitation

Structured prehab (resistance training alone or multimodal with RT) demonstrated favorable outcomes for both THA and TKA:

• Reduced complication rates

• Enhanced patient strength
• Improved objective functional outcomes
• Better quality of life
• Higher self-reported functional scores

These positive effects were mostly confined to the first six months post-op, with attenuation beyond that period.

Clinical Implications

• Recommend prehab for eligible arthroplasty patients to reduce complications and enhance early postoperative function.

• Tailor RT protocols based on patient tolerance, as increasing volume alone may not yield proportional benefits.
• Monitor outcomes up to 6 months, where benefits are most evident, and plan for transitions into post-operative rehabilitation.

Implement these interventions seamlessly with support from Gaylord's clinical teams. Please see our Orthopedic Rehabilitation Services for more information.

Study Source: Keogh et al., 2025, The Effects of Structured Prehabilitation on PostoperativeOutcomes Following Total Hip and Total Knee Arthroplasty (J Orthop SportsPhys Ther)

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