A Pilates program specifically designed for patients undergoing knee and hip replacements during the pre/postoperative phases may speed recovery.

Two reconstructive physicians and two certified Pilates professionals have recommended that patients undergoing total hip or knee arthroplasty follow a protocol of Pilates exercises. The protocol, published in the Bulletin of the NYU Hospital for Joint Diseases (2007; 65 (2), 120-25), is based on anecdotal evidence of success with several arthroplasty patients seen by these healthcare practitioners.

As joint arthroplasty procedures become minimally invasive and insurance regulations limit the availability of physical therapy, health professionals are seeking alternative methods of rehabilitation. Pilates is a viable choice because it is readily practiced in the pre/postoperative phases and because it promotes a whole-body approach to rehabilitation, argue those proposing the Pilates protocol. They support preoperative training to establish muscle memory; to improve strength, mobility and range of motion of the joints; and to develop a trainer-client relationship that will facilitate training after the operation. For the postoperative period they endorse a progressive Pilates practice with exercises that strengthen the core, increase range of motion at the joint and strengthen surrounding muscles.

Randomized clinical trials are needed to analyze the efficacy of Pilates training protocols for joint replacement patients. Until more research studies are conducted, medical personnel should work with certified Pilates professionals to develop ap­propriate training programs.