{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:25:00Z","timestamp":1785198300787,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,5,3]],"date-time":"2005-05-03T00:00:00Z","timestamp":1115078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims and objectives\u2002<\/jats:bold> To assess the effectiveness of pre\u2010 and post\u2010operative physiotherapy at home for unilateral total knee replacement (TKR).<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> In this pragmatic randomized controlled trial set in participants\u2019 homes (four primary care trust areas) and physiotherapy outpatients in a South Yorkshire teaching hospital trust, 160 osteoarthritis patients waiting for unilateral TKR were randomly allocated to intervention (home) group (<jats:italic>n<\/jats:italic>\u2003=\u200380) or control (hospital outpatient) group (<jats:italic>n<\/jats:italic>\u2003=\u200380). The intervention group had pre\u2010 and post\u2010operative home visits for assessment and treatment by a community physiotherapist. Outcome measures were health\u2010related quality of life (HRQoL), measured by the Western Ontario McMaster Osteoarthritis index (WOMAC) and the Short Form 36 health survey (SF\u201036) pre\u2010operatively and at 12\u2003weeks post\u2010TKR operation; patient satisfaction; and \u200aNHS resource use.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> No significant differences were observed between the two treatment groups in the primary outcome measure, the WOMAC pain score, or any other HRQoL score. The home group had a significantly greater mean number of physiotherapy sessions than the hospital group [mean difference 5.2 sessions, 95% confidence interval (CI)\u2003=\u2003\u22126.3 to \u22124.1; <jats:italic>P<\/jats:italic>\u2003=\u20030.001]. There was no significant difference in the total NHS costs per patient between groups. However, home physiotherapy for TKR was significantly more expensive (mean difference \u2013\u00a3136.5, 95% CI\u2003=\u2003\u2013\u00a3160 to \u2013\u00a3113; <jats:italic>P<\/jats:italic>\u2003=\u20030.001). Patients were equally satisfied with physiotherapy at home or in hospital; however, more of the home group would choose their location for physiotherapy again.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Although home physiotherapy was as effective and as acceptable to patients as hospital outpatient physiotherapy for unilateral TKR, it was more expensive. Additional pre\u2010operative home physiotherapy did not improve patient\u2010perceived health outcomes.<\/jats:p>","DOI":"10.1111\/j.1365-2753.2005.00535.x","type":"journal-article","created":{"date-parts":[[2005,5,3]],"date-time":"2005-05-03T10:03:45Z","timestamp":1115114625000},"page":"283-292","source":"Crossref","is-referenced-by-count":86,"title":["Costs and effectiveness of pre\u2010 and post\u2010operative home physiotherapy for total knee replacement: randomized controlled trial"],"prefix":"10.1111","volume":"11","author":[{"given":"Caroline","family":"Mitchell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Walters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teena","family":"Binns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Mathers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,5,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199907)42:7<1361::AID-ANR9>3.0.CO;2-9"},{"issue":"12","key":"e_1_2_6_3_1","first-page":"1833","article-title":"Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee","volume":"15","author":"Bellamy N.","year":"1988","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6846.160"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.9.870"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199605000-00020"},{"key":"e_1_2_6_7_1","volume-title":"The NHS plan: A Plan for Investment. 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