Efficacy of Sling Exercise Training Compared to Standard Physiotherapy to Improve Muscle Strength, Joint Range of Motion and Functional Outcomes Following Total Knee Arthroplasty: A Pilot Randomized Controlled Trial

Background Recovery following total knee arthroplasty (TKA) is frequently incomplete, highlighting the need for more effective rehabilitation approaches. Methods This single‐blind pilot randomized controlled trial allocated 40 women undergoing unilateral total knee arthroplasty (TKA) to either Sling Training (ST) or Standard Physiotherapy Training (SPT) (1:1). Both groups completed supervised outpatient rehabilitation three times weekly for 8 weeks, beginning 1‐week post‐surgery. Outcomes included quadriceps and hamstring isometric strength, knee range of motion, and WOMAC total score, assessed at baseline and week 8 by a blinded assessor. Results Both groups improved significantly; however, ST produced larger gains in quadriceps strength (+60% vs. +30%), hamstring strength, knee flexion ROM (+19.2° vs. +12.2°), and WOMAC reduction (−41.9 vs. −35.7; p = 0.003). Approximately 90% of ST participants versus 75% of SPT participants exceeded the ≥ 12‐point MCID threshold. Conclusion Sling‐based exercise training may offer superior early functional and strength recovery compared with standard physiotherapy after TKA, supporting its potential role as an adjunct to early rehabilitation. Larger, multi‐centre trials are needed to confirm effectiveness and generalizability.