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Gao JY, Duan YS, Zheng JQ, Wang QY, Li CL, Xu J. Perioperative position management of 46 cases with simultaneous bilateral auricle reconstruction: A summary of experience. Int J Pediatr Otorhinolaryngol 2024; 179:111905. [PMID: 38493660 DOI: 10.1016/j.ijporl.2024.111905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/01/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES The primary problem in simultaneous bilateral auricle reconstruction is the fragility of the reconstructed ear structure. Postoperative pressure is strictly prohibited to ensure the operation's effectiveness. The study aimed to summarize the experience of perioperative postural management in simultaneous bilateral auricular reconstruction. METHOD This study summarizes the experience of perioperative postural management, providing preoperative sleeping posture adaptability training, neck movement training, standardization of the head position angles and the head suspension time in surgery, using protective headrests, paying attention to the transfer and handover procedures, and using specially designed pillows. RESULTS The comprehensive nursing approach in simultaneous bilateral auricular reconstruction significantly reduced complications, improved patient comfort, and optimized postoperative adaptation. Preoperative posture training, standardized intraoperative head positions, and vigilant postoperative care played pivotal roles, demonstrating positive outcomes in 46 cases. DISCUSSION Perioperative position management can reduce the risk of complications and pressure injuries, improving patients' postoperative comfort, emotional state, tolerance, and adaptability. CONCLUSION All ears were viable and in good shape after long-term follow-up. The experiences discussed in this study can be broadly applied to technically mature ear reconstruction teams.
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Affiliation(s)
- Jia-Ying Gao
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Ya-Shan Duan
- ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, China; Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jie-Qing Zheng
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Qian-Ying Wang
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Chen-Long Li
- ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, China; Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.
| | - Jing Xu
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China.
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Rhim HC, Schon JM, Xu R, Nolan D, Ahn J, Short K, Schon LC. Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241255136. [PMID: 38812567 PMCID: PMC11135079 DOI: 10.1177/24730114241255136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Jason M. Schon
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Raylin Xu
- Harvard Medical School, Boston, MA, USA
| | - David Nolan
- Department of Physical Therapy, Movement, and Rehabilitation Science, Northeastern University, Boston, MA, USA
- Sports Physical Therapy Service, Massachusetts General Hospital, Boston, MA, USA
| | - Jiyong Ahn
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kelly Short
- Center for Restorative Therapies, Mercy Medical Center, Baltimore, MD, USA
| | - Lew C. Schon
- Director of Orthopaedic Innovation, Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
- Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, New York University Langone Health, NY, USA
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Jiao S, Feng Z, Dai T, Huang J, Liu R, Meng Q. High-Intensity Progressive Rehabilitation Versus Routine Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2024; 39:665-671.e2. [PMID: 37634879 DOI: 10.1016/j.arth.2023.08.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND This study aimed to compare the effectiveness of high-intensity progressive rehabilitation training with routine training in the early treatment of patients undergoing total knee arthroplasty. METHODS There were 78 patients who underwent total knee arthroplasty and were randomized into high-intensity progressive training and routine rehabilitation training groups (RRT). The primary outcome measures were the American Hospital for Special Surgery Knee Score (HSS), with secondary outcomes including patient satisfaction, visual analog pain score, first time of standing after surgery, 6-minute walk test, 36-Item Short Form Survey (SF-36), and length of hospital stay. The incidence of postoperative complications were recorded. RESULTS The HSS scores were higher in the intervention group at 2 weeks, 3 months, and 12 months postoperatively (P < .001). The RRT group had higher visual analog pain scores than the intervention group at 24 hours, 3 days, and 2 weeks after surgery (P < .001). The intervention group had an earlier the first time of standing after surgery and a longer 6-minute walk test distance (P < .001, P = .028, P < .001, P < .001). Patient satisfaction was higher in the intervention group, with a higher quality of life rating at 3 months postoperatively (P < .001). However, 1 year after surgery, the 2 groups had no significant differences in mental component summaries. The length of hospital stay was shorter in the intervention group than in the RRT group. CONCLUSION Compared to routine training, high-intensity progressive rehabilitation training is more effective. It reduces postoperative patient pain, accelerates recovery of joint function, increases patient satisfaction, improves quality of life, shortens hospital stays, and promotes rapid recovery.
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Affiliation(s)
- Songsong Jiao
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Zhencheng Feng
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Tianming Dai
- Guangzhou Institute of Traumatic Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Jian Huang
- Department of Traumatic Orthopaedics, The Central Hospital of Xiaogan, Hubei, China
| | - Ruijia Liu
- Department of Orthopedics, Foshan Fosun Chancheng Hospital, Foshan, China
| | - Qingqi Meng
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
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Jiao S, Feng Z, Huang J, Dai T, Liu R, Meng Q. Enhanced recovery after surgery combined with quantitative rehabilitation training in early rehabilitation after total knee replacement: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:74-83. [PMID: 37934189 PMCID: PMC10938034 DOI: 10.23736/s1973-9087.23.07899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/22/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The number of patients undergoing total knee replacement (TKR) is increasing yearly; however, there is still a relative lack of specific, individualized, and standardized protocols for functional exercise after TKR. Quantitative rehabilitation training was developed to improve the recovery of postoperative joint function, increase patient satisfaction, shorten the length of the hospital stay, improve the quality of life, and promote rapid patient recovery. AIM We aimed to compare the effectiveness of quantitative rehabilitation training based on the enhanced recovery after surgery (ERAS) concept with conventional rehabilitation training in the early rehabilitation of patients with TKR. DESIGN This was a single-centre, prospective, randomized controlled trial. SETTING Inpatient department. POPULATION Participants were patients who underwent unilateral total knee replacement. METHODS Based on the ERAS concept, a quantitative rehabilitation training program was developed for the quantitative group, and the control group underwent conventional rehabilitation training. Seventy-eight patients undergoing TKR were randomly divided into two blinded groups: the quantitative rehabilitation group and the conventional rehabilitation group. The analysis was performed according to per-protocol practice. The primary outcome metric was the Hospital for Special Surgery Knee Score (HSS Score), and secondary outcomes included patient satisfaction, Visual Analog Pain Score (VAS), time to get out of bed for the first time after surgery, 6-minute-walk test (6MWT), quality-of-life score (SF-36), and number of days in the hospital. The incidence of postoperative complications was also recorded. RESULTS There was no significant difference in HSS scores between the two groups before surgery (P=0.967), but the quantitative rehabilitation training group had significantly higher scores at two weeks (P=0.031), 3 months (P<0.01), and 12 months (P<0.01) after surgery than did the conventional rehabilitation training group, and both groups had higher HSS scores than before surgery. The quantitative training group had significantly higher VAS scores at 24 hours and three days postoperatively than the conventional training group (P<0.01), while there was no statistical significance at any other time points. The quantitative rehabilitation group had an earlier time to get out of bed for the first time after surgery (P<0.01), a longer 6MWT distance (P=0.028), and higher patient satisfaction and quality of life scores (SF-36) (P<0.01) that did the control group. The number of days in the hospital was lower in the quantitative training group than in the control group (P<0.001). There was no significant difference in the incidence of postoperative complications between the two groups. CONCLUSIONS Compared with conventional rehabilitation training, quantitative rehabilitation training based on the ERAS concept was found to be safe and effective and can accelerate the recovery of joint function after surgery, shorten hospitalization time, improve patient satisfaction, and promote rapid recovery. CLINICAL REHABILITATION IMPACT The quantitative rehabilitation training based on the ERAS concept provides a new program for rehabilitation exercises after total knee arthroplasty, which is safe and reliable, accelerates the recovery of joint function, and should be considered for clinical promotion.
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Affiliation(s)
- Songsong Jiao
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Zhencheng Feng
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jian Huang
- Department of Traumatic Orthopedics, The Central Hospital of Xiaogan, Hubei, China
| | - Tianming Dai
- Guangzhou Institute of Traumatic Surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Ruijia Liu
- Department of Orthopedics, Fosun Chancheng Hospital of Foshan, Foshan, China
| | - Qingqi Meng
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China -
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Chan PK, Chan TCW, Mak CYH, Chan THM, Chan SHW, Wong SSC, Fu H, Cheung A, Chan VWK, Cheung MH, Cheung CW, Chiu KY. Pain Relief After Total Knee Arthroplasty with Intravenous and Periarticular Corticosteroid: A Randomized Controlled Trial. J Bone Joint Surg Am 2023; Publish Ahead of Print:00004623-990000000-00809. [PMID: 37220180 DOI: 10.2106/jbjs.22.01218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is a cost-effective procedure, but it is also associated with substantial postoperative pain. The present study aimed to compare pain relief and functional recovery after TKA among groups that received intravenous corticosteroids, periarticular corticosteroids, or a combination of both. METHODS This randomized, double-blinded clinical trial in a local institution in Hong Kong recruited 178 patients who underwent primary unilateral TKA. Six of these patients were excluded because of changes in surgical technique; 4, because of their hepatitis B status; 2, because of a history of peptic ulcer; and 2, because they declined to participate in the study. Patients were randomized 1:1:1:1 to receive placebo (P), intravenous corticosteroids (IVS), periarticular corticosteroids (PAS), or a combination of intravenous and periarticular corticosteroids (IVSPAS). RESULTS The pain scores at rest were significantly lower in the IVSPAS group than in the P group over the first 48 hours (p = 0.034) and 72 hours (p = 0.043) postoperatively. The pain scores during movement were also significantly lower in the IVS and IVSPAS groups than in the P group over the first 24, 48, and 72 hours (p ≤ 0.023 for all). The flexion range of the operatively treated knee was significantly better in the IVSPAS group than in the P group on postoperative day 3 (p = 0.027). Quadriceps power was also greater in the IVSPAS group than in the P group on postoperative days 2 (p = 0.005) and 3 (p = 0.007). Patients in the IVSPAS group were able to walk significantly further than patients in the P group in the first 3 postoperative days (p ≤ 0.003). Patients in the IVSPAS group also had a higher score on the Elderly Mobility Scale than those in the P group (p = 0.036). CONCLUSIONS IVS and IVSPAS yielded similar pain relief, but IVSPAS yielded a larger number of rehabilitation parameters that were significantly better than those in the P group. This study provides new insights into pain management and postoperative rehabilitation following TKA. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- P K Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - T C W Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - C Y H Mak
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - T H M Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - S H W Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - S S C Wong
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong SAR
| | - H Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - A Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR
| | - V W K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR
| | - M H Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - C W Cheung
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong SAR
| | - K Y Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
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Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for Patients Undergoing Orthopedic Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e238050. [PMID: 37052919 PMCID: PMC10102876 DOI: 10.1001/jamanetworkopen.2023.8050] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Importance Prehabilitation programs for patients undergoing orthopedic surgery have been gaining popularity in recent years. However, the current literature has produced varying results. Objective To evaluate whether prehabilitation is associated with improved preoperative and postoperative outcomes compared with usual care for patients undergoing orthopedic surgery. Data Sources Bibliographic databases (MEDLINE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], AMED [Allied and Complementary Medicine], Embase, PEDRO [Physiotherapy Evidence Database], and Cochrane Central Register of Controlled Trials) were searched for published trials, and the Institute for Scientific Information Web of Science, System for Information on Grey Literature in Europe, and European clinical trials registry were searched for unpublished trials from January 1, 2000, to June 30, 2022. Study Selection Randomized clinical trials (RCTs) comparing prehabilitation with standard care for any orthopedic surgical procedure were included. Data Extraction and Synthesis Two independent reviewers screened trials. Data were pooled using a random-effects model. Recommendations were determined using the Grading of Recommendations Assessment, Development and Evaluation system and the study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Main Outcomes and Measures Pain, function, muscle strength, and health-related quality of life (HRQOL). Results Forty-eight unique trials involving 3570 unique participants (2196 women [61.5%]; mean [SD] age, 64.1 [9.1] years) were analyzed. Preoperatively, moderate-certainty evidence favoring prehabilitation was reported for patients undergoing total knee replacement (TKR) for function (standardized mean difference [SMD], -0.70 [95% CI, -1.08 to -0.32]) and muscle strength and flexion (SMD, 1.00 [95% CI, 0.23-1.77]) and for patients undergoing total hip replacement (THR) for HRQOL on the 36-item Short Form Health Survey (weighted mean difference [WMD], 7.35 [95% CI, 3.15-11.54]) and muscle strength and abduction (SMD, 1.03 [95% CI, 0.03-2.02]). High-certainty evidence was reported for patients undergoing lumbar surgery for back pain (WMD, -8.20 [95% CI, -8.85 to -7.55]) and moderate-certainty evidence for HRQOL (SMD, 0.46 [95% CI, 0.13-0.78]). Postoperatively, moderate-certainty evidence favoring prehabilitation was reported for function at 6 weeks in patients undergoing TKR (SMD, -0.51 [95% CI, -0.85 to -0.17]) and at 6 months in those undergoing lumbar surgery (SMD, -2.35 [95% CI, -3.92 to -0.79]). Other differences in outcomes favoring prehabilitation were of low to very low quality of evidence. Conclusions and Relevance In this systematic review and meta-analysis of RCTs, moderate-certainty evidence supported prehabilitation over usual care in improving preoperative function and strength in TKR and HRQOL and muscle strength in THR, high-certainty evidence in reducing back pain, and moderate-certainty evidence in improving HRQOL in lumbar surgery. Postoperatively, moderate-certainty evidence supported prehabilitation for function following TKR at 6 weeks and lumbar surgery at 6 months. Prehabilitation showed promising results for other outcomes, although high risk of bias and heterogeneity affected overall quality of evidence. Additional RCTs with a low risk of bias investigating preoperative and postoperative outcomes for all orthopedic surgical procedures are required.
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Affiliation(s)
- Anuj Punnoose
- Young Adult Hip Service, Physiotherapy Department, Addenbrooke's-Cambridge University Hospitals NHS (National Health Service) Trust, Cambridge, United Kingdom
- School of Allied Health, Anglia Ruskin University, Chelmsford and Cambridge, United Kingdom
| | | | - Ori Weiss
- Department of Orthopedics, Meir Medical Centre, Kfar-Saba, Israel
| | - Jufen Zhang
- School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Alison Rushton
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopedics, Addenbrooke's-Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
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Vervullens S, Meert L, Baert I, Smeets RJEM, Verdonk P, Rahusen F, Meeus M. Prehabilitation before total knee arthroplasty: A systematic review on the use and efficacy of stratified care. Ann Phys Rehabil Med 2022; 66:101705. [PMID: 36115573 DOI: 10.1016/j.rehab.2022.101705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Preoperative rehabilitation (hereafter called "prehabilitation") has been proposed as a potentially effective treatment to target preoperative risk factors to prevent insufficient outcome after total knee arthroplasty (TKA). PURPOSE We aimed to assess whether previous clinical trials of non-surgical, non-pharmacological prehabilitation in individuals with knee osteoarthritis (KOA) awaiting TKA focused on specific clinical phenotypes or specific individual characteristics and whether the content of the prehabilitation was stratified accordingly. Second, we aimed to summarize and compare the long-term effects of stratified and non-stratified care on pain, satisfaction, function and quality of life. METHODS A systematic literature search of PubMed, Web of Science, Scopus and Embase was performed. All relevant articles published up to April 19, 2021 reporting "(randomized controlled) clinical trials or prospective cohort studies" (S) related to the key words "total knee arthroplasty" (P), "preoperative conservative interventions" (I), "pain, function, quality of life and/or satisfaction" (O) were included. RESULTS After screening 3498 potentially eligible records, 18 studies were assessed for risk of bias. Twelve studies had low, 2 moderate, 3 serious, and one high risk of bias. The latter study was excluded, resulting in 17 included studies. Five studies investigated a"stratified prehabilitation care" and 12 "non-stratified prehabilitation care". Stratified prehabilitation in 4 studies meant that the study sample was chosen considering a predefined intervention, and in the fifth study, the prehabilitation was stratified to individuals' needs. No direct comparison between the 2 approaches was possible. We found weak evidence for a positive effect of biopsychosocial prehabilitation compared to no prehabilitation on function (stratified studies) and pain neuroscience education prehabilitation compared to biomedical education on satisfaction (non-stratified studies) at 6 months post-TKA. We found strong evidence for positive effects of exercise prehabilitation compared to no prehabilitation on pain at 6 months and on function at 12 months post-TKA (non-stratified studies). CONCLUSION More research is needed of stratified prehabilitation care focusing on individual characteristics in people with KOA awaiting TKA. REGISTRATION NUMBER This systematic review was prospectively registered at PROSPERO on March 22, 2021 (no. CRD42021221098).
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Affiliation(s)
- Sophie Vervullens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Pain in Motion International Research Group (PiM), www.paininmotion.be, the Netherlands
| | - Lotte Meert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; Pain in Motion International Research Group (PiM), www.paininmotion.be, the Netherlands
| | - Isabel Baert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group (PiM), www.paininmotion.be, the Netherlands
| | - Rob J E M Smeets
- Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands; CIR Revalidatie, location Eindhoven, the Netherlands; Pain in Motion International Research Group (PiM), www.paininmotion.be, the Netherlands
| | - Peter Verdonk
- ORTHOCA, Antwerp, Belgium and ASTARC department, Antwerp University, Belgium
| | - Frank Rahusen
- Department of Orthopaedics, St Jans Gasthuis Weert, the Netherlands
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium; Pain in Motion International Research Group (PiM), www.paininmotion.be, the Netherlands.
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Blasco JM, Pérez-Maletzki J, Díaz-Díaz B, Silvestre-Muñoz A, Martínez-Garrido I, Roig-Casasús S. Fall classification, incidence and circumstances in patients undergoing total knee replacement. Sci Rep 2022; 12:19839. [PMID: 36400816 PMCID: PMC9674575 DOI: 10.1038/s41598-022-23258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
To propose a fall-classification framework for patients undergoing total knee replacement (TKR). In addition, we reinforced the available evidence on fall incidence and circumstances and compared the characteristics of fallers versus. nonfallers. Retrospective and prospective data were collected from 253 subjects with severe knee osteoarthritis who were waiting for primary TKR. Falls were classified considering the location of the destabilizing force, source of destabilization and fall precipitating factor. Fall incidence and circumstances were described; the characteristics of fallers and nonfallers in terms of functional and balance performance were compared with F-tests (95% CI). The fall incidence before surgery was 40.3% (95% CI 34.2% to 46.6%). This figure decreased to 13.1% (95% CI 9.2% to 18.0%) and to 23.4% (95% CI 17.8% to 29.6%) at 6 and 12 months after surgery, respectively. Most falls were caused by destabilizations in the base of support (n = 102, 72%) and were due to extrinsic factors (n = 78, 76%) and trip patterns. Significant differences between fallers and nonfallers were found in knee extensor strength and monopodal stability in the surgical limb (p < 0.05). Falls are prevalent in patients with severe knee osteoarthritis. Symptoms and functional performance improve after surgery, and fall incidence is reduced. Most fall events originate from disruptions in the base of support and are precipitated by extrinsic factors, generally trips during walking activities.
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Affiliation(s)
- José-María Blasco
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.476458.c0000 0004 0427 8560IRIMED Joint Research Unit, IIS La Fe - UV, Valencia, Spain
| | - José Pérez-Maletzki
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain
| | - Beatriz Díaz-Díaz
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.106023.60000 0004 1770 977XHospital Clínic i Universitari de València, Valencia, Spain
| | | | | | - Sergio Roig-Casasús
- grid.5338.d0000 0001 2173 938XGroup in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de Valéncia (Spain), Calle Gascó Oliag nº5, 46010 Valencia, Valencia Spain ,grid.84393.350000 0001 0360 9602Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2022; 52:709-725. [PMID: 36125444 DOI: 10.2519/jospt.2022.11160] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE: To assess whether prehabilitation influenced knee functioning before and within the first year after total knee arthroplasty (TKA) surgery. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: The authors searched the MEDLINE/PubMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database, Web of Science, and Scopus databases from their inception until March 2022. STUDY SELECTION CITERIA: The authors included peer-reviewed articles comparing preoperative, short-, mid- or long-term effects of exercise-based physical therapy before primary unilateral TKA with TKA without prehabilitation. DATA SYNTHESIS: We assessed bias using the Cochrane Risk-of-Bias tool (ROB 2.0) and therapeutic validity using the i-CONTENT tool. Standardized mean differences (Hedges' g) and 95% confidence intervals (CIs) were calculated for knee functioning. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Sixteen trials (968 participants) were included; 14 qualified for meta-analysis. Low to very low certainty of evidence favored prehabilitation over no intervention for improving knee functioning before (g = 1.23; 95% CI: 0.49, 1.97) and up to 3 months after TKA (short-term: 1 day to 1 month, g = 0.90; 95% CI: 0.18, 1.61; mid-term: 6 weeks to 3 months, g = 0.45; 95% CI: 0.06, 0.84). There were no significant between-group differences at long-term follow-up (6-12 months, g = 0.07; 95% CI: -0.17, 0.30). CONCLUSION: There was low to very low certainty of evidence that prehabilitation promotes superior knee functioning before and up to 3 months after TKA, compared to TKA alone. The long-term postoperative effects were inconclusive. J Orthop Sports Phys Ther 2022;52(11):709-725 Epub: 20 September 2022. doi:10.2519/jospt.2022.11160.
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Anderson AM, Drew BT, Antcliff D, Redmond AC, Comer C, Smith TO, McHugh GA. Content and delivery of pre-operative interventions for patients undergoing total knee replacement: a rapid review. Syst Rev 2022; 11:184. [PMID: 36050795 PMCID: PMC9436722 DOI: 10.1186/s13643-022-02019-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/07/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Total knee replacement (TKR) is a common operation typically performed for end-stage knee osteoarthritis. Patients awaiting TKR often have poor health-related quality of life. Approximately 20% of patients experience persistent pain post-TKR. Pre-operative TKR interventions could improve pre- and post-operative outcomes, but future research is required to inform their design. This review aimed to identify and synthesize recent literature on the content and delivery of pre-operative TKR interventions to help guide future research and clinical practice. METHODS This rapid review included randomized trials of pre-operative TKR interventions ("outcomes studies") and primary studies exploring patients' and/or health professionals' views of pre-operative TKR interventions ("views studies"). Medline, Embase, PsycINFO, CINAHL and the Cochrane Central Register of Controlled Trials were searched for English language studies published between January 2009 and December 2020. Eligible studies' reference lists were screened. Studies were appraised using the Mixed Methods Appraisal Tool. The findings were narratively synthesized using a convergent segregated approach. RESULTS From 3263 records identified, 52 studies were included (29 outcomes studies, 21 views studies, two outcomes/views studies). The studies' methodological quality varied but was generally highest in qualitative studies. The outcomes studies investigated education (n=5), exercise (n=20), psychological (n=2), lifestyle (n=1), and/or other interventions (n=5). The views studies addressed education (n=20), exercise (n=3), psychological (n=1), lifestyle (n=4), and/or other interventions (n=1). Only three outcomes studies (two randomized controlled trials (RCTs) and a pilot study) compared the effectiveness of intervention components/delivery approaches. The two RCTs' results suggest that pre-operative TKR exercise interventions are equally effective regardless of whether they include strength or strength plus balance training and whether they are hospital- or home-based. Personal tailoring and using more than one delivery format were associated with improved outcomes and/or perceived as beneficial for multiple intervention types. CONCLUSIONS Definitive evidence on the optimal design of pre-operative TKR interventions is lacking. Personal tailoring and employing multiple delivery formats appear to be valuable design elements. Preliminary evidence suggests that including balance training and hospital versus home delivery may not be critical design elements for pre-operative TKR exercise interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019143248 FUNDER: National Institute for Health and Care Research (ICA-CDRF-2018-04-ST2-006).
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Affiliation(s)
- Anna M Anderson
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. .,NIHR Leeds Biomedical Research Centre, Leeds, UK.
| | - Benjamin T Drew
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Deborah Antcliff
- School of Healthcare, University of Leeds, Leeds, UK.,Physiotherapy Department, Bury Care Organisation, Northern Care Alliance NHS Group, Bury, UK.,School of Medicine, Keele University, Keele, UK
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Christine Comer
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,Leeds Community Healthcare NHS Trust Musculoskeletal and Rehabilitation Services, Leeds, UK
| | - Toby O Smith
- School of Health Sciences, University of East Anglia, Norwich, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Wu Z, Wang Y, Li C, Li J, Chen W, Ye Z, Zeng Z, Hong K, Zhu Y, Jiang T, Lu Y, Liu W, Xu X. Preoperative Strength Training for Clinical Outcomes Before and After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. Front Surg 2022; 9:879593. [PMID: 35937597 PMCID: PMC9349363 DOI: 10.3389/fsurg.2022.879593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background There is an increasing interest in preoperative strength training for promoting post-operative rehabilitation, but the effectiveness of preoperative strength training for clinical outcomes after total knee arthroplasty (TKA) remains controversial. Objective This study aims to systematically evaluate the effect of preoperative strength training on clinical outcomes before and after TKA. Methods We systematically searched PubMed, Cochrane Library, Web of Science, and EMBASE databases from the inception to November 17, 2021. The meta-analysis was performed to evaluate the effects of preoperative strength training on clinical outcomes before and after TKA. Results Seven randomized controlled trials (RCTs) were included (n = 306). Immediately before TKA, the pooled results showed significant improvements in pain, knee function, functional ability, stiffness, and physical function in the strength training group compared with the control group, but not in strength (quadriceps), ROM, and WOMAC (total). Compared with the control group, the results indicated strength training had a statistically significant improvement in post-operative knee function, ROM, and functional ability at less than 1 month and 3 months, and had a statistically significant improvement in post-operative strength (quadriceps), stiffness, and WOMAC (total) at 3 months, and had a statistically significant improvement in post-operative pain at 6 months. However, the results indicated strength training had no statistically significant improvement in post-operative strength (quadriceps) at less than 1 month, 6, and 12 months, had no statistically significant improvement in post-operative pain at less than 1 month, 3, and 12 months, had no statistically significant improvement in post-operative knee function at 6 and 12 months, and had no statistically significant improvement in post-operative physical function at 3 months. Conclusions Preoperative strength training may be beneficial to early rehabilitation after TKA, but the long-term efficacy needs to be further determined. At the same time, more caution should be exercised when interpreting the clinical efficacy of preoperative strength training for TKA.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ziquan Zeng
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Kunhao Hong
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yue Zhu
- Baishui Health Center, Qujing, China
| | - Tao Jiang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yanyan Lu
- Luoyang Orthopedic Hospital Of Henan Province (Orthopedic Hospital of Henan Province), Zhengzhou, China
- Correspondence: Xuemeng Xu Yanyan LuWengang Liu
| | - Wengang Liu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- Correspondence: Xuemeng Xu Yanyan LuWengang Liu
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- Correspondence: Xuemeng Xu Yanyan LuWengang Liu
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Effect of Oral Tranexamic Acid on the Blood Transfusion Rate and the Incidence of Deep Vein Thromboembolism in Patients after TKA. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6041827. [PMID: 35845590 PMCID: PMC9286974 DOI: 10.1155/2022/6041827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
Abstract
Purpose To explore the effect of oral tranexamic acid treatment on the blood transfusion rate and the incidence of deep vein thromboembolism after total knee arthroplasty (TKA). Methods 90 patients undergoing TKA admitted to First People's Hospital of Changshu City from January 2019 to January 2020 were selected and randomized into the control group and the experimental group accordingly (45 cases in each group). The control group intravenously received 20 mL/kg tranexamic acid before the incision was closed. The experimental group was given 1 g of tranexamic acid orally before anesthesia, 6 h and 12 h after the operation. Results The experimental group witnessed better perioperative indexes in relation to the control group. The experimental group displayed better postoperative coagulation function indexes as compared to the control group (P < 0.05). Remarkably lower postoperative vascular endothelial function indexes in the experimental group than in the control group were observed. The experimental group experienced a markedly lower incidence of deep vein thromboembolism in comparison with the control group (P < 0.05). The postoperative knee society score (KSS) score of the experimental group was significantly higher than that of the control group. A significantly higher postoperative modified rivermead mobility index (MRMI) score was yielded in the experimental group in contrast to the control group (P < 0.05). The experimental group obtained lower numerical rating scale (NRS) scores at T2 and T3 as compared to the control group. Conclusion Oral tranexamic acid is a suitable alternative for patients undergoing TKA in terms of reducing the blood transfusion rate, relieving pain, and accelerating the recovery of the patient's limbs.
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Jørgensen SL, Kierkegaard S, Bohn MB, Aagaard P, Mechlenburg I. Effects of Resistance Training Prior to Total Hip or Knee Replacement on Post-operative Recovery in Functional Performance: A Systematic Review and Meta-Analysis. Front Sports Act Living 2022; 4:924307. [PMID: 35911376 PMCID: PMC9329591 DOI: 10.3389/fspor.2022.924307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the effectiveness of pre-operative resistance training in patients allocated to TJR surgery on selected post-operative outcomes, via a meta-analysis of studies using exercise modalities and loading intensities objectively known to promote gains in muscle size and strength in adults of young-to-old age. Design A systematic review and meta-analysis. Literature Search Cochrane Central, MEDLINE, EMBASE, and PEDro were searched on August 4th 2021. Study Selection Randomized Controlled Trials (RCTs) were included if (i) they compared pre-operative lower-limb-exercises before elective TJR with standard care, (ii) explicitly reported the exercise intensity, and (iii) reported data on functional performance. Data Synthesis This systematic review and meta-analysis is reported in accordance with the PRISMA reporting guidelines. A random effects model with an adjustment to the confidence interval was performed for pooling the data. Results One thousand studies were identified. After applying exclusion criteria, five RCTs were located including 256 participants (mean age ranged from 61 to 72 years, 54% women). Moderate-to-large improvements in functional performance and maximal knee extensor strength were observed at 3 months after surgery along with small-to-moderate effects 12 months post-operatively. For patient-reported outcomes, small-to-moderate improvements were observed at 3 months post-operatively with no-to-small improvements at 12 months. Conclusion Prehabilitation efforts involving progressive resistance training provides an effective means to improve post-operative outcomes related to functional performance, knee extensor strength and patient-reported outcome in patients undergoing TJR. Due to large methodological diversity between studies, an optimal loading intensity remains unknown. Systematic Review Registration Prospero ID: CRD42021264796.
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Affiliation(s)
- Stian Langgård Jørgensen
- Department of Occupational and Physical Therapy, Horsens Regional Hospital, Horsens, Denmark
- Horsens Research Centre - Hip Training & Preservation Surgery (H-HIP), Department of Occupational and Physical Therapy, Horsens Regional Hospital, Horsens, Denmark
- Department of Orthopedic Surgery, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- *Correspondence: Stian Langgård Jørgensen
| | - Signe Kierkegaard
- Horsens Research Centre - Hip Training & Preservation Surgery (H-HIP), Department of Occupational and Physical Therapy, Horsens Regional Hospital, Horsens, Denmark
- Department of Orthopedic Surgery, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marie Bagger Bohn
- Horsens Research Centre - Hip Training & Preservation Surgery (H-HIP), Department of Occupational and Physical Therapy, Horsens Regional Hospital, Horsens, Denmark
- Department of Orthopedic Surgery, Horsens Regional Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Inger Mechlenburg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Su W, Zhou Y, Qiu H, Wu H. The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2022; 17:175. [PMID: 35313897 PMCID: PMC8935773 DOI: 10.1186/s13018-022-03066-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There have been controversial findings for the effectiveness of rehabilitation before operation after total knee arthroplasty (TKA). This study aimed to conduct an updated, comprehensive systematic review. On that basis, the review was to be combined with meta-analysis to measure the effects of rehabilitation before operation on functions and pain after TKA.
Methods
Articles were searched by using Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, Cochrane, Pubmed, CNKI, Wanfang, Weipu and the Chinese Biomedical Database from the beginning to December 10, 2021. The major outcomes included pain, knee flexion and extension, as well as knee range of motion (ROM). Secondary outcomes included timed-up-and-go (TUG), 6-min walk, and patient-reported functional outcome (the Knee Injury and Osteoarthritis Outcome Score (KOOS) or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)). Third outcomes included the length of hospital stay.
Results
Nineteen studies recruiting 1008 patients satisfied with the inclusion criteria. Significant difference was identified in knee flexion, TUG, KOOS (knee-associated life quality and functions in sports and recreation), as well as the length of hospital stay (P < 0.05). Insignificant statistical difference was identified in pain, 6-min walk, ROM, knee extension, KOOS (pain, symptoms and function of daily living) after TKA between the two groups. No difference was found between the groups in WOMAC.
Conclusions
Preoperative rehabilitation could significantly shorten hospital stay, whereas there is not any conclusive evidence of the improvement of postoperative functions. Accordingly, in-depth high-quality studies should be conducted to confirm the effectiveness of preoperative rehabilitation in patients having received TKA.
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Preoperative Aerobic Exercise Therapy Prior to Abdominal Surgery: What Is the Evidence? What Dose? CURRENT ANESTHESIOLOGY REPORTS 2021. [DOI: 10.1007/s40140-021-00488-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Chen X, Li X, Zhu Z, Wang H, Yu Z, Bai X. Effects of progressive resistance training for early postoperative fast-track total hip or knee arthroplasty: A systematic review and meta-analysis. Asian J Surg 2021; 44:1245-1253. [PMID: 33715964 DOI: 10.1016/j.asjsur.2021.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/17/2020] [Accepted: 02/22/2021] [Indexed: 11/29/2022] Open
Abstract
Progressive resistance training (PRT) is one of the most commonly used exercise methods after joint replacement, while its effectiveness and safety are still controversial. Therefore, it's vital to investigate the effect of PRT on muscle strength and functional capacity early postoperative total hip arthroplasty (THA) or total knee arthroplasty (TKA). Relevant studies were identified via a search of Medline, Web of science and Cochrane Library from 2002 to 12 May 2020. Fifteen of 704 studies which comprised 6 THAs and 8 TKAs, involving 1021 adult patients were eligible for inclusion in the meta-analysis. There were no significant differences between the two groups after TKA in the 6-min walk test (6-WMT) within 1 month (95% CI = -0.41, 1.53), within 3 months (95% CI = -0.27, 0.76), within 12 months (95% CI = -0.29, 0.66); climb performance in seconds (s) (SCP), leg extension power, timed up and go test in seconds (s) (TUG) within 1 month (95% CI = -1.75, 0.77), within 3 months (95% CI = -0.48, 0.33), within 12 months (95% CI = -0.44, 0.35), sit to stand, number of repetitions in 30s (ST). There was no difference in the incidence of adverse events (95% CI = -0.01, 0.10). Similarly, two groups were also no obvious distinction after THA in the 6-WMT, SCP, Leg extension power, ST. PRT early after THA or TKA did not differ significantly from SR in terms of functional capacity, muscle strength recovery and incidence of adverse events. PRT is one of the options for rapid rehabilitation after joint replacement.
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Affiliation(s)
- Xing Chen
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China
| | - Xi Li
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China
| | - Zhiyong Zhu
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China
| | - Huisheng Wang
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China
| | - Zhongshen Yu
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China
| | - Xizhuang Bai
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China.
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WITHDRAWN: Effects of progressive resistance training for early postoperative fast-track total hip or knee arthroplasty: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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