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Meta-Analysis
. 2021 Jun 2;53(6):jrm00200.
doi: 10.2340/16501977-2827.

Effectiveness of total knee arthroplasty rehabilitation programmes: A systematic review and meta-analysis

Waleed Alrawashdeh  1 , Jörg Eschweiler, Filippo Migliorini, Yasser El Mansy, Markus Tingart, Björn Rath
Affiliations
Meta-Analysis

Effectiveness of total knee arthroplasty rehabilitation programmes: A systematic review and meta-analysis

Waleed Alrawashdeh et al. J Rehabil Med. .

Abstract

Objective: To investigate the effectiveness of modified rehabilitation programmes in comparison with standard rehabilitation programmes after total knee arthroplasty through randomized controlled trials.

Data sources: A search was conducted in PubMed, PubMed Central (PMC) and Cochrane Library databases in December 2020.

Study selection: Randomized controlled trials were reviewed if they compared a physiotherapy exercise intervention with usual or standard physiotherapy care, or if they compared 2 types of exercise physiotherapy interventions meeting the review criteria, after total knee arthroplasty for osteoarthritis. A total of 18 randomized controlled trials were included at the end of the screening process.

Data extraction: Two authors independently screened the literature, extracted data, and assessed the quality of included studies. The outcomes were knee extension, knee flexion, pain visual analogue scale, overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 6-minute walking test, and Timed Up and Go test.

Data synthesis: There was no clear pattern regarding which combination of starting time-point and duration of the rehabilitation programme after total knee arthroplasty significantly improves the clinical outcome when comparing modified rehabilitation programmes with standard programmes. Moreover, no particular modification to the modified programmes could be solely attributed to the improved clinical outcome in the 2 studies that showed significant improvement.

Conclusion: Modified rehabilitation programmes do not result in systematic improvement in clinical outcome over one-size-fits-all-approaches after total knee arthroplasty.

Keywords: exercise; physical therapy; rehabilitation; total knee replacement.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow-chart of the literature search in Pubmed, PMC, and Cochrane. PMC: PubMed Central.
Fig. 2
Fig. 2
Forest plot of the knee extension comparison. SD: standard deviation; 95% CI: 95% confidence interval.
Fig. 3
Fig. 3
Forest plot of the knee flexion comparison. SD: standard deviation; 95% CI: 95% confidence interval.
Fig. 4
Fig. 4
Forest plot of the visual analogue scale (VAS) comparison. SD: standard deviation; 95% CI: 95% confidence interval.
Fig. 5
Fig. 5
Forest plot of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) comparison. SD: standard deviation; 95% CI: 95% confidence interval.
Fig. 6
Fig. 6
Forest plot of the 6-minute walking test (6MWT) comparison. SD: standard deviation; 95% CI: 95% confidence interval.
Fig. 7
Fig. 7
Forest plot of the Timed Up and Go (TUG) comparison. SD: standard deviation; 95% CI: 95% confidence interval.
See this image and copyright information in PMC

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