skip to main content

OA Prehabilitation — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOsteoarthritisOA PrehabilitationSCE Rheumatology

A 65-year-old woman with severe bilateral knee osteoarthritis has been listed for primary elective right knee replacement after appropriate non-surgical treatment. According to NICE, which measure should be offered when she is listed for surgery?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Preoperative rehabilitation advice covering exercise, lifestyle and functional independence

NICE recommends that people having hip or knee replacement receive preoperative rehabilitation advice when listed for surgery. This should cover exercises to undertake before and after surgery, relevant lifestyle measures such as weight management, diet and smoking cessation, and ways to maximise functional independence and quality of life. NICE considers this preparation helpful for engagement with postoperative rehabilitation and reports evidence of reduced hospital stay, although it does not mandate a particular supervised physiotherapy programme. Routine CT or MRI is not the recommended prehabilitation intervention and should not be performed solely because osteoarthritis is present. Deferring all rehabilitation until after surgery contradicts NICE guidance. Arthroscopic lavage or debridement should not be offered as treatment for osteoarthritis and is not an appropriate preliminary procedure before replacement.

Reference: National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157, recommendation 1.2.1: Preoperative rehabilitation. 2020; last reviewed 2024. https://www.nice.org.uk/guidance/ng157/chapter/Recommendations