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.0000000000002008
Abstract
We sought to determine the comparative benefit and harm of rehabilitation interventions for patients who have undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021. We included randomized controlled trials and adequately adjusted nonrandomized comparative studies of rehabilitation 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. The team assessed strength of evidence. Evidence from 53 studies randomized controlled trials suggests that various rehabilitation programs after total knee arthroplasty may lead to comparable improvements in pain, range of motion, and activities of daily living. Rehabilitation in the acute phase may lead to increased strength but result in similar strength when delivered in the postacute phase. No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period after total knee arthroplasty; risk of harms among various postacute rehabilitation programs seems comparable. All findings were of low strength of evidence. Evaluation of rehabilitation after total knee arthroplasty needs a systematic overhaul to sufficiently guide future practice or research including the use of standardized intervention components and core outcomes.
Recommended Citation
Konnyu, Kristin J.; Thoma, Louise M.; Cao, Wangnan; Aaron, Roy K.; Panagiotou, Orestis A.; Bhuma, Monika Reddy; Adam, Gaelen P.; Balk, Ethan M.; and Pinto, Daniel, "Rehabilitation for Total Knee Arthroplasty: A Systematic Review" (2023). Physical Therapy Faculty Research and Publications. 223.
https://epublications.marquette.edu/phys_therapy_fac/223
Comments
Accepted version. American Journal of Physical Medicine & Rehabilitation, Vol. 102, No. 1 (January 2023): 19-33. DOI. © Lippincott Williams & Wilkins, Inc. Used with permission.