BACKGROUND: Length of stay and functional outcomes after total knee arthroplasty (TKA) are related to the timing and intensity of post-operative rehabilitation. OBJECTIVE: To determine the effectiveness of early and high-intensity rehabilitation after simultaneous bilateral TKA. METHODS: Prospective cohort data of 156 patients (11 men and 145 women; average age 72.0 ± 5.6 years) who underwent simultaneous bilateral primary TKA were analyzed. The intervention group (n= 82) underwent a high-intensity rehabilitation (phase II) after early postoperative standard rehabilitation (phase I) between June 2019 and May 2021. The control group (n= 74) underwent a lower-intensity rehabilitation (phase II) after phase I rehabilitation between July 2017 and May 2019. The timed up-and-go (TUG) test, timed stair climbing test (SCT), 6-minute walk test, isometric knee extensor and flexor strength of both knees, knee flexion and extension range of motion, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and functional levels, and the EuroQol five-dimension questionnaire were assessed preoperatively and 6 weeks after TKA. RESULTS: The average length of hospital stay was shortened by 5.7 days (p< 0.001). Phase II rehabilitation started earlier in the intervention group than in the control group (7.7 ± 1.3 vs 13.5 ± 2.0, p< 0.001). Compared with the control group, the intervention group showed significant improvements in the measures of mobility (WOMAC-function and SCT) and strength (isometric strength of both knee extensors and flexors) 6 weeks after TKA by statistically controlling for age and preoperative functional status. CONCLUSION: This study demonstrated that early and high-intensity rehabilitation could achieve functional improvement and shorten the length of hospital stay.

中文翻译：

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同时双侧全膝关节置换术后早期和高强度康复的功能结果和住院时间

背景：全膝关节置换术 (TKA) 后的住院时间和功能结果与术后康复的时间和强度有关。目的：确定同时双侧 TKA 后早期和高强度康复的有效性。方法：分析了 156 名同时接受双侧初次 TKA 患者（11 名男性和 145 名女性；平均年龄 72.0 ± 5.6 岁）的前瞻性队列数据。干预组（n=82）在 2019 年 6 月至 2021 年 5 月术后早期标准康复（I 期）后接受高强度康复（II 期）。对照组（n=74）接受低强度康复（Phase II）2017年7月至2019年5月I期康复后。计时起步（TUG）测试，计时爬楼梯测试（SCT），6分钟步行测试，术前和术后 6 周评估了双膝的等长伸膝屈肌力量、膝关节屈曲和伸展运动范围、关于疼痛、僵硬和功能水平的西安大略麦克马斯特大学骨关节炎指数 (WOMAC) 以及 EuroQol 五维问卷TKA。结果：平均住院时间缩短了 5.7 天 (p < 0.001)。干预组的 II 期康复开始时间早于对照组（7.7 ± 1.3 对比 13.5 ± 2.0，p < 0.001）。与对照组相比，通过对年龄和术前功能状态进行统计控制，干预组在 TKA 后 6 周的活动性（WOMAC 功能和 SCT）和力量（膝关节伸肌和屈肌的等距肌力）测量指标均有显着改善。结论：