Proprioceptive Neuromuscular Facilitation in Postoperative Recovery after Total Hip Arthroplasty and Total Knee Arthroplasty: A Narrative Synthesis

Abstract

Lower limb arthroplasties, including total hip arthroplasty (THA) and total knee arthroplasty (TKA), are established surgical interventions for advanced degenerative joint diseases; however, patients frequently encounter persistent postoperative challenges such as pain, muscle weakness, restricted range of motion (ROM), impaired balance, and altered gait patterns. Proprioceptive neuromuscular facilitation (PNF) is increasingly utilised in orthopaedic rehabilitation to address these neuromuscular deficits, extending beyond its conventional neurological scope. This narrative review evaluates and consolidates evidence on the efficacy of PNF-integrated rehabilitation regarding pain management, functional recovery, muscular strength, joint ROM, balance, and gait performance in adult patients undergoing THA and TKA. We conducted a comprehensive literature search across multiple electronic databases up to June 2026, screening studies that evaluated preoperative or postoperative PNF interventions against standard care, conventional physiotherapy, or no intervention. We synthesised ten studies, including randomised controlled trials, non-randomised comparative trials, and case reports. The pooled evidence indicates that incorporating PNF into lower limb arthroplasty rehabilitation accelerates functional recovery, enhances muscular strength, facilitates early improvements in active and passive joint ROM, sharpens static and dynamic balance, mitigates fall risk, and optimises spatiotemporal gait parameters compared with standard protocols alone. In conclusion, PNF represents a clinically valuable modality in post-arthroplasty musculoskeletal care, and clinicians should consider embedding individualised, supervised PNF protocols early into rehabilitation pathways to optimise functional independence and long-term quality of life.