Comparison of Early Versus Delayed Physiotherapy in Patients Undergoing Total Knee Replacement: An Observational Study
Bibliographic record
Abstract
Background: Total knee arthroplasty (TKA) is a standard treatment for advanced osteoarthritis, yet the timing of postoperative rehabilitation remains debated. Early physiotherapy, started within 24 hours, is proposed to enhance mobility, reduce pain, and shorten hospital stay, whereas delayed physiotherapy, initiated after 48 hours, focuses on wound healing and pain control. Prior studies also support early mobilization for improved outcomes. This study compared early versus delayed physiotherapy following TKA in a tertiary care center in Gujarat, India. Materials and Methods: A prospective randomized controlled trial was conducted for one year at a tertiary hospital in Gujarat. Patients aged 50–75 years with unilateral TKA for primary osteoarthritis were randomized (1:1) into early physiotherapy (EP; <24 hours post-surgery) or delayed physiotherapy (DP; >48 hours). Interventions included standardized quadriceps strengthening, knee flexion/extension, and gait training, performed three times daily for 30–45 minutes. Patients with uncontrolled comorbidities or prior knee surgery were excluded. Outcomes were assessed at baseline, day 3, week 2, and month 3 using the Visual Analog Scale (VAS), goniometer-measured range of motion (ROM), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and length of stay (LOS). Ethical approval and informed consent were obtained. Results: A total of 100 patients (mean age 62.4 ± 7.2 years; 62% female) completed the study. Groups were comparable at baseline. EP patients reported lower VAS pain scores on day 3 (3.2 vs. 5.1; p<0.001), greater ROM at week 2 (85° vs. 72°; p<0.01), and improved WOMAC scores at month 3 (28.5 vs. 35.7; p=0.002). LOS was shorter in EP (4.8 vs. 6.3 days; p<0.001). Complication rates were similar. Conclusion: Early physiotherapy after TKA improves pain, ROM, function, and reduces LOS without added risk. Adoption in tertiary centers could enannce recovery and resource efficiency.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".