Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients
Objective: To examine a novel application of exercise-based prehabilitation in severe knee osteoarthritis—termed “pre-evaluation exercise''—focused on supporting surgical decision-making and adherence to clinical guidelines, rather than attempting to enhance post-operative recovery. Design...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Osteoarthritis and Cartilage Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913125000378 |
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| author | Thomas Bandholm Rasmus Skov Husted Anders Troelsen Kristian Thorborg |
| author_facet | Thomas Bandholm Rasmus Skov Husted Anders Troelsen Kristian Thorborg |
| author_sort | Thomas Bandholm |
| collection | DOAJ |
| description | Objective: To examine a novel application of exercise-based prehabilitation in severe knee osteoarthritis—termed “pre-evaluation exercise''—focused on supporting surgical decision-making and adherence to clinical guidelines, rather than attempting to enhance post-operative recovery. Design: This narrative review discusses the usage of exercise in the clinical decision process for total knee arthroplasty (TKA). It synthesizes data from studies on exercise-based prehabilitation, covering patient selection, implementation, and its effects on surgical choices. Emphasis is placed on multi-disciplinary coordination within an Enhanced Recovery After Surgery (ERAS) framework. Results: Evidence suggests that pre-evaluation exercise can improve symptom management and may lead to delayed or reduced surgical intervention. This approach shows significant potential in reducing the rate of TKA surgeries among patients with severe knee osteoarthritis by improving physical conditioning, addressing symptom variability, and enhancing informed, patient-centered surgical decisions. Conclusions: Pre-evaluation exercise in knee osteoarthritis is a viable strategy that complements existing ERAS initiatives by facilitating guideline-conformant surgical decision-making. Incorporating this into pre-surgical care pathways can foster improved patient-related outcomes and healthcare resource optimization. |
| format | Article |
| id | doaj-art-d8027d4ed2b44fad8e2dfcaf4ce3bcba |
| institution | Kabale University |
| issn | 2665-9131 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj-art-d8027d4ed2b44fad8e2dfcaf4ce3bcba2025-08-20T03:47:41ZengElsevierOsteoarthritis and Cartilage Open2665-91312025-06-017210060110.1016/j.ocarto.2025.100601Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patientsThomas Bandholm0Rasmus Skov Husted1Anders Troelsen2Kristian Thorborg3Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Clinical Research, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Corresponding author.Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Clinical Research, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, DenmarkDepartment of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkPhysical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Sports Orthopaedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, DenmarkObjective: To examine a novel application of exercise-based prehabilitation in severe knee osteoarthritis—termed “pre-evaluation exercise''—focused on supporting surgical decision-making and adherence to clinical guidelines, rather than attempting to enhance post-operative recovery. Design: This narrative review discusses the usage of exercise in the clinical decision process for total knee arthroplasty (TKA). It synthesizes data from studies on exercise-based prehabilitation, covering patient selection, implementation, and its effects on surgical choices. Emphasis is placed on multi-disciplinary coordination within an Enhanced Recovery After Surgery (ERAS) framework. Results: Evidence suggests that pre-evaluation exercise can improve symptom management and may lead to delayed or reduced surgical intervention. This approach shows significant potential in reducing the rate of TKA surgeries among patients with severe knee osteoarthritis by improving physical conditioning, addressing symptom variability, and enhancing informed, patient-centered surgical decisions. Conclusions: Pre-evaluation exercise in knee osteoarthritis is a viable strategy that complements existing ERAS initiatives by facilitating guideline-conformant surgical decision-making. Incorporating this into pre-surgical care pathways can foster improved patient-related outcomes and healthcare resource optimization.http://www.sciencedirect.com/science/article/pii/S2665913125000378OsteoarthritisTotal knee replacementPrehabilitationExercise therapy |
| spellingShingle | Thomas Bandholm Rasmus Skov Husted Anders Troelsen Kristian Thorborg Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients Osteoarthritis and Cartilage Open Osteoarthritis Total knee replacement Prehabilitation Exercise therapy |
| title | Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| title_full | Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| title_fullStr | Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| title_full_unstemmed | Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| title_short | Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| title_sort | changing the narrative for exercise based prehabilitation evidence informed and shared decision making when discussing the need for a total knee arthroplasty with patients |
| topic | Osteoarthritis Total knee replacement Prehabilitation Exercise therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2665913125000378 |
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