Preoperative High-Intensity Strength Training and Outcomes After Total Knee Arthroplasty: A Systematic Review and Meta-analysis.

Study Summary

7 studies, including 6 randomized controlled trials and one prospective cohort study involving 419 patients undergoing total knee arthroplasty (TKA), were included in this systematic review and meta-analysis comparing preoperative high-intensity strength training with usual care or no structured preoperative training. Pooled outcomes included the Timed Up and Go (TUG) test, 6-Minute Walk Test (6MWT), stair test, knee flexion range of motion (ROM), Short Form-36 Health Survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score–Activities of Daily Living (KOOS-ADL). High-intensity strength training significantly improved 6MWT performance, knee flexion ROM, SF-36 scores, and WOMAC scores, with no significant differences in TUG, stair test, or KOOS-ADL outcomes. These findings suggested that preoperative high-intensity strength training may improve postoperative recovery, physical function, and quality of life following TKA.