The Role of Hydrotherapy in Enhancing Recovery After Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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6 randomized controlled trials (RCTs) involving 704 patients who underwent total knee arthroplasty (TKA) were included in this systematic review and meta-analysis comparing hydrotherapy with land-based rehabilitation or usual care. Pooled outcomes included postoperative pain measured using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, as well as lower-limb muscle strength. Hydrotherapy demonstrated significantly greater improvements in muscle strength, particularly knee extension and hip abduction, but did not significantly improve VAS or WOMAC pain scores compared with conventional rehabilitation. These findings suggested that hydrotherapy offered additional benefits for muscle strengthening following TKA without providing superior pain relief.