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Background <p>There is currently limited evidence to support specific recommendations for long-term activity restrictions after knee replacement surgery. Consequently, physiotherapists´ guidance may vary, which could influence patients´ confidence, adherence to rehabilitation, overall recovery outcomes, and even contribute to the development of fear of movement. However, it is unclear to what extent such variation exists. This study aimed to explore and describe the recommendations given by physiotherapists regarding long-term activity restrictions following knee replacement.</p> Methods <p>An online survey was distributed to physiotherapy units in Swedish orthopedic specialist clinics and primary healthcare centers. For this study, responses to the question “Do you usually recommend any long-term restrictions? (For example, running, skiing, squatting, kneeling?) Please elaborate!” were analyzed using quantitative content analysis to systematically identify and quantify patterns.</p> Results <p>Of 233 physiotherapists who responded to the specific survey question, 66% (<i>n</i> = 151) reported that they provided specific recommendations regarding long-term activity restrictions following knee replacement. The most commonly non-recommended activities were running and jumping, followed by kneeling and squatting. However, the extent of these restrictions varied considerably, ranging from complete avoidance of certain activities to conditional approval based on intensity and frequency. Among those recommending long-term restrictions, 16% (<i>n</i> = 24) stated that the primary reason was to avoid compromising implant survival.</p> Conclusions <p>Considerable variability exists in physiotherapists´ recommendations regarding long-term activity restriction following knee replacement across both orthopedic clinics and primary healthcare settings. This variation reflects the current lack of evidence-based guidelines and highlights the need for consensus to support more consistent and confident communication with patients about long-term physical activity.</p>

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Major discrepancies in recommendations regarding long-term activity restrictions following knee replacement: a survey among Swedish physiotherapists

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  • 发表日期：

    2026年7月4日

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  • Kristin Gustafsson,
  • Thérése Jönsson,
  • Marcus Ljung,
  • Caroline Ståhl,
  • Elin Östlind

摘要

Background

There is currently limited evidence to support specific recommendations for long-term activity restrictions after knee replacement surgery. Consequently, physiotherapists´ guidance may vary, which could influence patients´ confidence, adherence to rehabilitation, overall recovery outcomes, and even contribute to the development of fear of movement. However, it is unclear to what extent such variation exists. This study aimed to explore and describe the recommendations given by physiotherapists regarding long-term activity restrictions following knee replacement.

Methods

An online survey was distributed to physiotherapy units in Swedish orthopedic specialist clinics and primary healthcare centers. For this study, responses to the question “Do you usually recommend any long-term restrictions? (For example, running, skiing, squatting, kneeling?) Please elaborate!” were analyzed using quantitative content analysis to systematically identify and quantify patterns.

Results

Of 233 physiotherapists who responded to the specific survey question, 66% (n = 151) reported that they provided specific recommendations regarding long-term activity restrictions following knee replacement. The most commonly non-recommended activities were running and jumping, followed by kneeling and squatting. However, the extent of these restrictions varied considerably, ranging from complete avoidance of certain activities to conditional approval based on intensity and frequency. Among those recommending long-term restrictions, 16% (n = 24) stated that the primary reason was to avoid compromising implant survival.

Conclusions

Considerable variability exists in physiotherapists´ recommendations regarding long-term activity restriction following knee replacement across both orthopedic clinics and primary healthcare settings. This variation reflects the current lack of evidence-based guidelines and highlights the need for consensus to support more consistent and confident communication with patients about long-term physical activity.