Impact of multimodal rehabilitation on functional recovery after complex orthopedic surgeries: A bibliographical review

Abstract

Introduction: Rehabilitation following complex orthopedic surgeries, such as total hip and knee arthroplasties and ligament reconstructions, is essential for restoring muscle function, joint mobility, balance, and patient quality of life. Functional deficits resulting from surgical trauma, prolonged immobilization, and postoperative pain can compromise recovery, making the implementation of multimodal protocols that integrate physical therapy, pain management, and medical strategies necessary. Objective: This bibliographic review aimed to evaluate the impact of multimodal rehabilitation, with an emphasis on structured physical therapy, on the functional recovery of patients undergoing complex orthopedic surgeries, considering muscle strength, joint range of motion, functional balance, and quality of life. Methods: This is a descriptive and analytical bibliographic review based on national and international publications available in the following databases: Virtual Health Library (BVS), which compiles scientific and technical health literature from Latin American and Caribbean countries; Latin American and Caribbean Health Sciences Literature (LILACS), which includes regional scientific production in health; United States National Library of Medicine (PubMed), an international reference database for biomedical sciences; and Scopus, a comprehensive multidisciplinary database of scientific articles and reviews. Articles published between 2019 and 2025 were included, totaling 14 studies, selected for their relevance to multimodal rehabilitation, physical therapy protocols, and functional outcomes following complex orthopedic surgery. Results: The literature demonstrated that multimodal rehabilitation programs, including structured physical therapy, significantly improve muscle strength, joint mobility, functional balance, and quality of life. Protocols combining resistance exercises, gait training, early mobilization, multimodal analgesia, and individualized monitoring reduced postoperative complications and accelerated functional recovery. Factors such as treatment adherence, family support, and comorbidities influenced the effectiveness of interventions, while the integration of educational strategies and supervised home programs enhanced the outcomes of these programs. Evidence indicates that functional recovery after complex orthopedic surgeries is multifactorial, depending on the interaction between intrinsic factors (muscle weakness, postural imbalances, biomechanical alterations) and extrinsic factors (adherence to the program, comorbidities, social support). Structured physical therapy and integrated multimodal rehabilitation emerge as central strategies, allowing individualized treatment, complication reduction, optimization of muscle and joint function, and improved quality of life. Standardized protocols, continuous monitoring, and patient education are fundamental to maximizing clinical outcomes. Conclusion: The study demonstrated that multimodal rehabilitation, with an emphasis on structured physical therapy, is essential for functional recovery following complex orthopedic surgeries. Individualized programs integrating pain management, therapeutic exercises, and continuous monitoring promote gains in strength, range of motion, balance, and quality of life, highlighting the importance of multifactorial approaches to optimize recovery and reduce postoperative complications.