Journal Of The Indonesian Medical Association · Oct 22, 2026

Effectiveness of Preoperative Physical Reconditioning Exercise in Patients with Grade IV Knee Osteoarthritis Undergoing Total Knee Arthroplasty: An Evidence-Based Case Report

By Daniel D, Laily I

Knee osteoarthritis (OA) is the most common degenerative joint disease and a leading cause of disability in the older population, often requiring total knee arthroplasty (TKA) as definitive treatment. Preoperative physical reconditioning exercise (prehabilitation) is thought to improve preoperative functional status and accelerate postoperative recovery, but clinical evidence remains variable. This evidence-based case report aims to evaluate the effectiveness of preoperative physical reconditioning exercise in patients with grade IV knee OA who will undergo TKA. A literature search was conducted in December 2024 using the PubMed, Scopus, Cochrane, and ScienceDirect databases to answer the clinical question. In the five selected systematic review studies, preoperative exercise programs consisting of lower extremity strengthening, flexibility, mobility, and balance training for 3-12 weeks were shown to shorten hospital stays, reduce postoperative pain (short term up to 3 months), and improve muscle strength, functional mobility, and overall knee function. Despite heterogeneity among studies, preoperative physical exercise for 4-12 weeks focusing on strengthening, flexibility, mobility, and balance is an effective strategy for improving preoperative functional status and accelerating recovery after TKA.

doi.org/10.47830/jinma-vol.76.3-2026-1995 Open access Interventions