Enhanced recovery

Enhanced recovery after total knee replacement surgery

Project reference number: HLSLTC0015


Total knee replacement (TKR) surgery is a common operation for patients with osteoarthritis. There is considerable variation in the results of the surgery between patients: many improve considerably, while other do not fully recover or keep reporting high levels of pain and disability. A recent systematic review by our group on pre-operative physiotherapy for TKR concluded that there is some evidence that these interventions are effective in improving outcome of TKR however, the intervention protocols were generally not developed from a solid evidence base, did not utilise stakeholder involvement nor target specific subgroups of patients at risk of poor outcome.


The aim of this PhD is to develop an evidence-based and stakeholder-informed protocol for enhanced recovery from TKR for patients with KOA at risk of poor outcome following TKR, including identification of optimal clinical management as well as identification of the right target patient groups.

Relevance and importance of this research

TKR is a common procedure with considerable consequences for patients undergoing the procedure as well as for the financial viability of the NHS. With an ageing population and increased prevalence of obesity the number of TKR procedures and associated costs are set to rise significantly in the coming years, thus it is importance to optimise the effectiveness and cost-effectiveness of TKR. Enhanced recovery protocols are a key instrument for the NHS to minimise post-operative length of hospital stay and consistently return patients to a good level of physical function within a shorter time frame, in particular those patients who would be at high risk of poor outcome.

Application deadline

The application deadline for October intake is 1st of July.

Research supervisors

Candidates are encouraged to contact the following researchers for further details:

Modes of study

This project is available as a:

  • PhD: 3 years full-time or 4.5 years part-time.


Applicants will normally hold a UK honours degree 2:1 (or equivalent); or a Masters degree in a subject relevant to the research project. Equivalent professional qualifications and any appropriate research experience may be considered. A minimum English language level of IELTS score of 6.5 (or equivalent) with no element below 6.0 is required. Some research disciplines may require higher levels.

Specific requirements of the project

The successful applicant will be a qualified Chartered Physiotherapist holding the minimum of a first degree (2:1 or above). Previous experience of stakeholder involvement and quantitative research methodology is desirable.