Is a combination of hands-on treatment & exercise better than just exercise in knee replacements?

“I’ve had a knee replacement and the physio is only doing exercise with me. Is the right?” It is very common for exercise only approaches after total knee arthroplasty, especially in the NHS, but in the private sector I have seen many patients that are struggling to get anywhere with their exercise only approach. In these cases, I need to add in some manual therapy techniques to help their pain, swelling and mobility. I have also commonly employed Neuromuscular electrical stimulation (NMES) to improve muscle function, as many of these patients are inhibited neuromuscularly. Now, I do this in real practice at our clinics, and it works very well, but what does the evidence say about it? So, is a combination of hands-on treatment and exercise better than just exercise in total knee replacement?

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The content in this video is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.

  • Karaborklu Argut, Sezen, Derya Celik, and Onder I. Kilicoglu. “The Combination of Exercise and Manual Therapy Versus Exercise Alone in Total Knee Arthroplasty Rehabilitation: A Randomized Controlled Clinical Trial.” PM & R (Online) (2020).

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Online Physiotherapy

Put simply this is Physio done via either telephone or video over the internet. Skype and facetime are examples of this.

Contrary to popular belief online physiotherapy can be very effective and it can help the same injuries that face to face physio can help. I have helped many people with injuries such as disc prolapses, tennis elbow, neck pain and much more).