Therapeutic efficacy of mobilization with movement in early postoperative rehabilitation after unicompartmental knee arthroplasty: a double-blind, randomized controlled trial

Abstract

Background: Early phase rehabilitation protocols are critical for optimizing functional outcomes following unicompartmental knee arthroplasty (UKA). Mobilization with movement (MWM), a manual therapy technique targeting joint kinematics and neuromuscular control, may synergize with rapid rehabilitation to address postoperative dysfunction. Purpose: To evaluate the adjunctive effects of MWM on early postoperative functional recovery, pain control, and knee joint stability in patients receiving a standardized rapid rehabilitation protocol for UKA. Materials and methods: This double-blind, randomized controlled trial enrolled 72 UKA patients (April 2022–October 2024). The participants were stratified into two cohorts: the control group (rapid rehabilitation intervention alone) and the observation group (rapid rehabilitation intervention + MWM). MWM: Therapist applies a rotational gliding force toward the tibia and an anteroposterior force (anterior or posterior) at the distal femur to stabilize the joint, coordinating with the patient’s active knee flexion-extension movements within a minimally painful range.The functional outcomes were quantitatively assessed via Passive range of motion (PROM), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Hospital for Special Surgery (HSS) score at five time points: preoperative, postoperative day 1, 2 weeks, 4 weeks, and 12 weeks. Results: Both groups demonstrated progressive improvement in PROM, WOMAC and HSS scores across all follow-up intervals compared with the scores of preoperative and postoperative day 1 (P < 0.01). Compared with the control group, the observation group presented superior functional recovery trajectories: PROM and HSS scoreswere significantly elevated at 2, 4 and 12 weeks (P < 0.01).WOMAC pain/stiffness subscales showed accelerated resolution in the observation group (P < 0.01). Conclusion: Integrating MWM protocols synergistically enhances early functional restoration post-UKA, as evidenced by validated outcome measures.