Impact of upper-limb aerobic exercise on the prevention of chronic postsurgical pain after total knee arthroplasty: a randomized controlled trial

OBJECTIVE: To investigate whether adding early upper-limb aerobic exercise to usual postoperative rehabilitation reduces the incidence of chronic postsurgical pain (CPSP) at 6 months after total knee arthroplasty (TKA). RESULTS: Eighty patients undergoing primary unilateral TKA were randomized to the intervention or control groups. Both groups received usual postoperative rehabilitation, and the intervention group additionally performed upper-limb ergometer exercise on postoperative days 2-14. The primary outcome, CPSP at 6 months, occurred at very low rates in both the intervention (2.6%) and control (2.4%) groups. The estimated risk difference was 0.1% (95% confidence interval: -12.1% to 12.8%). No significant between-group differences were observed in secondary outcomes. The effect of adding upper-limb aerobic exercise to usual rehabilitation remains inconclusive, given the extremely low event rate and wide confidence intervals. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000046684), registered 20 January 2022.