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5 tips before your total knee replacement operation

  • National Institute for Health and Care Excellence (NICE). Joint replacement (primary): hip, knee and shoulder. NICE guideline [NG157]. Published June 4, 2020. Accessed [5th of Feb 2024]. https://www.nice.org.uk/guidance/ng157
  • Aggarwal A, Adie S, Harris IA, Naylor J. Cryotherapy following total knee replacement. Cochrane Database of Systematic Reviews 2023, Issue 9. Art. No.: CD007911. DOI: 10.1002/14651858.CD007911.pub3.
  • NHS. Preparing for a knee replacement. NHS. Published March 9, 2023. Accessed [15th of Jan 2024]. https://www.nhs.uk/conditions/knee-replacement/preparation/
  • NHS. Complications of a knee replacement. NHS. Published March 9, 2023. Accessed [15th of Jan 2024]. https://www.nhs.uk/conditions/knee-replacement/complications/
  • Wei B, Tang C, Li X, et al. Enhanced recovery after surgery protocols in total knee arthroplasty via midvastus approach: a randomized controlled trial. BMC Musculoskelet Disord. 2021;22(1):856. Published 2021 Oct 8. doi:10.1186/s12891-021-04731-6
  • Soffin EM, YaDeau JT. Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence. Br J Anaesth. 2016;117(suppl 3):iii62-iii72. doi:10.1093/bja/aew362
  • Seward MW, Chen AF. Obesity, preoperative weight loss, and telemedicine before total joint arthroplasty: a review. Arthroplasty. 2022;4(1):2. doi:10.1186/s42836-021-00102-7
  • Dowsey MM, Choong PF. Obesity is a major risk factor for prosthetic infection after primary hip arthroplasty. Clin Orthop Relat Res. 2008;466(1):153-158. doi:10.1007/s11999-007-0016-3
  • Liljensøe A, Laursen JO, Bliddal H, Søballe K, Mechlenburg I. Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial. Scand J Surg. 2021;110(1):3-12. doi:10.1177/1457496919883812
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Last Reviewed:

March 13, 2024

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Trochanteric bursitis

  • Pumarejo Gomez L, Li D, Childress JM. Greater Trochanteric Pain Syndrome (Greater Trochanteric Bursitis) [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557433/
  • Nurkovic J, Jovasevic L, Konicanin A, Bajin Z, Ilic KP, Grbovic V, Skevin AJ, Dolicanin Z. Treatment of trochanteric bursitis: our experience. J Phys Ther Sci. 2016 Jul;28(7):2078-81. doi: 10.1589/jpts.28.2078. Epub 2016 Jul 29. PMID: 27512268; PMCID: PMC4968510.
  • Rowand M, Chambliss ML, Mackler L. Clinical inquiries. How should you treat trochanteric bursitis? J Fam Pract. 2009 Sep;58(9):494-500. PMID: 19744419.
  • Lustenberger DP, Ng VY, Best TM, Ellis TJ. Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 2011 Sep;21(5):447-53. doi: 10.1097/JSM.0b013e318221299c. PMID: 21814140; PMCID: PMC3689218.
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Last Reviewed:

March 28, 2025

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Whiplash after concussion

  • Rebbeck T, Evans K, Elliott JM. Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management. J Orthop Sports Phys Ther. 2019 Nov;49(11):819-828. doi: 10.2519/jospt.2019.8946. Epub 2019 Oct 14. PMID: 31610758.
  • Walston L, Martin C, Walston Z, Yake D. An irritability-based approach to whiplash-associated concussion rehabilitation: a case series. Physiother Theory Pract. 2022 Nov;38(13):3136-3145. doi: 10.1080/09593985.2021.1938306. Epub 2021 Jun 25. PMID: 34167435.
  • Smith, Matthew A. MS, PhD*,†; McNinch, Neil L. MS, RN, PSTAT*; Chaney, Danielle MACPR, CCRP*; Shauver, Lisa MS*; Murray, Tamara APRN‡; Kline, Peyton BSPH, CCRP*; Lesak, Alexandria MPH*; Franco-MacKendrick, Lea MS§; Scott, Lora MD¶; Logan, Kelsey MD, MPH, FAAP, FACP¦; Ichesco, Ingrid K. MD**; Liebig, Christopher MD‡; Congeni, Joseph MD‡. Reduced Concussion Symptom Burden in Early Adolescent Athletes Using a Head–Neck Cooling Device. Clinical Journal of Sport Medicine 34(3):p 247-255, May 2024. | DOI: 10.1097/JSM.0000000000001198
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Last Reviewed:

April 4, 2025

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence:

Physical activity and pain

  • González-Iglesias, M.; Martínez-Benito, A.; López-Vidal, J.A.; Melis-Romeu, A.; Gómez-Rabadán, D.J.; Reina-Varona, Á.; Di-Bonaventura, S.; La Touche, R.; Fierro-Marrero, J. Understanding Exercise-Induced Hypoalgesia: An Umbrella Review of Scientific Evidence and Qualitative Content Analysis. Medicina2025, 61, 401. https://doi.org/10.3390/medicina61030401
  • Polaski AM, Phelps AL, Kostek MC, Szucs KA, Kolber BJ. Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain. PLoS One. 2019 Jan 9;14(1):e0210418. doi: 10.1371/journal.pone.0210418. PMID: 30625201; PMCID: PMC6326521.
  • Wewege MA, Jones MD. Exercise-Induced Hypoalgesia in Healthy Individuals and People With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. J Pain. 2021 Jan;22(1):21-31. doi: 10.1016/j.jpain.2020.04.003. Epub 2020 Jun 26. PMID: 32599154.
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Last Reviewed:

April 3, 2025

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Last Updated:

September 19, 2025

Level

Type of evidence

I

Large RCTs with clear cut results

II

Small RCTs with unclear results

III

Cohort and case-control studies

IV

Historical cohort or case-control studies

V

Case series, studies with no controls

Level of Evidence: