Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review
Document Type
Article
Publication Date
1-2023
Publisher
Lippincott, Williams & Wilkins
Source Publication
American Journal of Physical Medicine & Rehabilitation
Source ISSN
0894-9115
Original Item ID
DOI: 10.1097/PHM.0000000000002006
Abstract
We sought to systematically review the evidence on the benefits and harms of prehabilitation interventions for patients who are scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021. We selected for inclusion randomized controlled trials and adequately adjusted nonrandomized comparative studies of prehabilitation programs reporting performance-based, patient-reported, or healthcare utilization outcomes. Three researchers extracted study data and assessed risk of bias, verified by an independent researcher. Experts in rehabilitation content and complex interventions independently coded rehabilitation interventions. The team assessed strength of evidence. While large heterogeneity across evaluated prehabilitation programs limited strong conclusions, evidence from 13 total knee arthroplasty randomized controlled trials suggest that prehabilitation may result in increased strength and reduced length of stay and may not lead to increased harms but may be comparable in terms of pain, range of motion, and activities of daily living (all low strength of evidence). There was no evidence or insufficient evidence for all other outcomes after total knee arthroplasty. Although there were six total hip arthroplasty randomized controlled trials, there was no evidence or insufficient evidence for all total hip arthroplasty outcomes.
Recommended Citation
Konnyu, Kristin J.; Thoma, Louise M.; Cao, Wangnan; Aaron, Roy K.; Panagiotou, Orestis A.; Bhuma, Monika Reddy; Adam, Gaelen P.; Pinto, Daniel; and Balk, Ethan M., "Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review" (2023). Physical Therapy Faculty Research and Publications. 221.
https://epublications.marquette.edu/phys_therapy_fac/221
Comments
American Journal of Physical Medicine & Rehabilitation, Vol. 102, No. 1 (January 2023): 1-10. DOI.