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Physical therapy lowers odds of chronic opioid use after total knee replacements

Knee osteoarthritis is the world’s most common form of arthritis, negatively affecting millions of people’s quality of life. For patients suffering from severe knee osteoarthritis, total knee replacement is the only option to help reduce their pain. Unfortunately, a substantial proportion of those patients end up becoming long-term opioid users.

Luckily, a new study out of Boston University has discovered a promising way to reduce patients’ risk of opioid addiction – completing physical therapy!

Physical therapy has long been associated with surgical recovery after total knee replacement. Completing PT after surgery helps patients regain their range of motion and strength, which are critical to regaining independence after surgery. Physical therapy after knee replacement surgery is also effective in reducing pain, but its effect on opioid use has gone unstudied.

The largest study of its kind, these researchers analyzed more than 67,000 patients who underwent total knee replacement between 2001 and 2016. What they discovered is eye-opening for many of our patients.

After reviewing all of these patients' outcomes, they found that even low levels of physical therapy were associated with a lower risk of chronic opioid use after total knee replacement. Even better results were seen in patients who started physical therapy earlier, as well as those who completed more sessions.

So what had the best results? Below are some of the key takeaways:

  • Number of PT rehab sessions – the more, the better Patients who completed six or more post-surgical PT sessions had a greater reduction in long-term opioid use compared to those who completed only 1-5 sessions. The greatest benefit was seen in those who completed 13 or more sessions of physical therapy after surgery.

  • Length of time between surgery and start of PT – sooner rather than later Researchers found that those who participated in physical therapy within 90 days of their surgery had a lower risk of chronic opioid use, with the greatest benefit coming from those who started their PT within the first 30 days post-surgery.

  • Completing prerehabilitation PT sessions – prehab for an easier rehab Patients who completed a few sessions of prehab (PT sessions before surgery) had lower odds of long-term opioid use. This adds to the long list of benefits seen from prehab, including lower post-operative pain, shorter lengths of stay at the hospital, and higher function after surgery.

While the exact reason why PT reduces the likelihood of opioid use is not yet clear, this study’s findings make it clear – physical therapy can reduce the odds that a patient will be a long-term opioid user in the future. This is just one more reason why physical therapy is integral to our patient’s recovery.

Whether you’re recovering from an injury or trying to improve your well-being, our team of physical therapists are here to help you succeed! Give our team a call at 703.433.2500 to schedule your first appointment with our award-winning team, or request an appointment online. To stay up-to-date on the latest news and tips from us, be sure to follow us on Facebook and Instagram, and sign up for our monthly newsletter!



  • Aoyagi K, Neogi T, Peloquin C. Association of physical therapy interventions with long-term opioid use after total knee replacement. JAMA Netw Open. 2021;4(10):e2131271. doi:10.1001/jamanetworkopen.2021.31271



Arthritis & Sports is the premier orthopaedics practice in Northern Virginia. Our team of specialty-trained physicians offers the latest treatment options for the full spectrum of orthopaedic sub-specialties - all under one roof.


From nonsurgical treatments like orthobiologics and physical therapy, to massage therapy and  nutrition counseling, we are dedicated to providing you with exceptional care from injury through rehabilitation.

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