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Meta-Analysis
. 2022 Mar 10:2022:4287555.
doi: 10.1155/2022/4287555. eCollection 2022.

A Systematic Review and Meta-Analysis on Randomized Control Trials for Preoperative Rehabilitation in Patients Planning for Joint Replacement Surgery for Better Outcomes

Haibo Yin  1 , Bin Chen  1 , Zhu Xu  1
Affiliations
Meta-Analysis

A Systematic Review and Meta-Analysis on Randomized Control Trials for Preoperative Rehabilitation in Patients Planning for Joint Replacement Surgery for Better Outcomes

Haibo Yin et al. J Healthc Eng. .

Abstract

Background: The clinical influence of the preoperative and postoperative therapies for recovery after the joint replacement surgery is still questionable. This study of systematic review and meta-analysis focuses on analyzing the clinical effects of preoperative rehabilitation among the patients who are planning to opt for joint replacement surgery for enhanced results.

Objective: Randomized clinical trials were selected where preoperative therapeutic exercises were performed by adults for preoperative rehabilitation in patients who were planning for replacement surgery for better outcomes and identified through databases and screening. Two reviewers were responsible for extracting appropriate studies, relevant data, assessing the risks, therapeutic validity, etc. Material and Methods. We performed random-effects meta-analysis for calculation of risk ratios and odds ratios, for knee and hip surgery cases. Analysis of length of hospital stay, short-term-based recovery period during hospital stay, total hip replacement functional recovery during hospital stay, short-term recovery of self-reported functioning, etc. was performed.

Results: Functional scores, postoperative pain, recovery time, length of hospital stay, and quality of life were studied. Of the seven studies included, the data of 614 patients were studied. The total number of participants in both exercise and control groups was analyzed to assess the bias of the study where the risk ratio was 0.96 and (0.74-1.25) was the 95% CI. Short-term-based recovery period during hospital stay for knee replacement was analyzed where 0.87 was the risk ratio and (0.61-1.23) was the 95% CI and for hip replacement where 0.99 was the risk ratio and (0.68-1.44) was the 95% CI. The RR for total hip replacement functional recovery during hospital stay was 0.80 with 95% CI (0.54-1.19). The RR for short-term recovery of self-reported functioning was 0.98 with 95% CI (0.76-1.26). Outcome analysis for pain and functionality evaluation was performed and assessed using WOMAC, HOOS, and HHS scores where the standardized mean difference was 0.38 and (0.20-0.57) was the 95% CI in hip surgery pain analysis and in knee surgery, 0.00 was the standardized mean difference and (-0.18-0.19) was the 95% CI.

Conclusion: Long-term outcomes were not affected by the preoperative rehabilitation. Though there was a slight improvement in early postoperative pain, this is not much of clinical significance.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA study over the study methods.
Figure 2
Figure 2
Forest plot for short-term-based recovery period during hospital stay for knee replacement.
Figure 3
Figure 3
Funnel plot for short-term-based recovery period during hospital stay for knee replacement.
Figure 4
Figure 4
Forest plot for short-term-based recovery period during hospital stay for hip replacement.
Figure 5
Figure 5
Funnel plot for short-term-based recovery period during hospital stay for hip replacement.
Figure 6
Figure 6
Forest plot for number of participants in exercise and control groups.
Figure 7
Figure 7
Funnel plot for number of participants in exercise and control groups.
Figure 8
Figure 8
Forest plot for total hip replacement functional recovery during hospital stay.
Figure 9
Figure 9
Funnel plot for total hip replacement functional recovery during hospital stay.
Figure 10
Figure 10
Forest plot for short-term recovery of self-reported functioning.
Figure 11
Figure 11
Funnel plot for short-term recovery of self-reported functioning.
Figure 12
Figure 12
Forest plot for outcome score for postoperative pain evaluation in hip surgery.
Figure 13
Figure 13
Forest plot for outcome score for postoperative pain evaluation in knee surgery.
Figure 14
Figure 14
Risk of bias and applicability concerns summary.
See this image and copyright information in PMC

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