Early Physiotherapy in Acute Postoperative Phase After Total Knee Replacement: A Case Report

Abstract

Background: Knee osteoarthritis is a leading cause of pain and functional limitation in older adults. Total Knee Replacement (TKR) is commonly performed in advanced cases, but early postoperative pain, limited range of motion (ROM), and reduced mobility may delay recovery. Evidence on immediate clinical responses during the first few postoperative days remains limited.
Objective: To describe early physiotherapy management and changes in pain, ROM, and functional mobility during the first three postoperative days following TKR.
Methods: A case report was conducted on a 61-year-old female following TKR for advanced knee osteoarthritis. Physiotherapy was initiated on postoperative day one and provided once daily for three consecutive days. Interventions included breathing exercises, ankle pumping, muscle setting, ROM exercises, transfers, sit-to-stand, and gait training. Outcomes were assessed using the Numeric Rating Scale, goniometric ROM, and Modified Rivermead Mobility Index. Changes were analyzed descriptively.
Results: Pain at rest decreased from 7 to 3 and movement pain from 7 to 4. Knee flexion improved from 45° to 120°, extension from −10° to 0°, and MRMI from 7 to 34, indicating improvements in pain, ROM, and functional mobility.
Conclusion: Early physiotherapy within the first three postoperative days may contribute to short-term improvements in pain, ROM, and functional mobility following TKR. Findings should be interpreted cautiously due to the single-case design and short observation period.