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Review
. 2022 Mar 21;17(1):175.
doi: 10.1186/s13018-022-03066-9.

The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials

Wanying Su  1 , Yang Zhou  2 , Hailing Qiu  1 , Hui Wu  3
Affiliations
Review

The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials

Wanying Su et al. J Orthop Surg Res. .

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.

Keywords: Meta-analysis; Randomized controlled trials; Rehabilitation; Total knee arthroplasty.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the systematic literature
Fig. 2
Fig. 2
The risk of bias summary of the included studies
Fig. 3
Fig. 3
The risk of bias graph of the included studies
Fig. 4
Fig. 4
A forest plot diagram showing the VAS score
Fig. 5
Fig. 5
A forest plot diagram showing the ROM
Fig. 6
Fig. 6
A forest plot diagram showing the knee flexion
Fig. 7
Fig. 7
A forest plot diagram showing the knee extension
Fig. 8
Fig. 8
A forest plot diagram showing the time up and go
Fig. 9
Fig. 9
A forest plot diagram showing the 6-min walk
Fig. 10
Fig. 10
A forest plot diagram showing the KOOS symptoms
Fig. 11
Fig. 11
A forest plot diagram showing the KOOS pain
Fig. 12
Fig. 12
A forest plot diagram showing the KOOS function of daily living
Fig. 13
Fig. 13
A forest plot diagram showing the KOOS knee-related quality of life
Fig. 14
Fig. 14
A forest plot diagram showing the KOOS function in sport and recreation
Fig. 15
Fig. 15
A forest plot diagram showing the WOMAC pain
Fig. 16
Fig. 16
A forest plot diagram showing the WOMAC stiffness
Fig. 17
Fig. 17
A forest plot diagram showing the WOMAC function
Fig. 18
Fig. 18
A forest plot diagram showing the length of hospital stay
See this image and copyright information in PMC

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