Vasta Sebastiano, Papalia Rocco, Torre Guglielmo, Vorini Ferruccio, Papalia Giuseppe, Zampogna Biagio, Fossati Chiara, Bravi Marco, Campi Stefano, Denaro Vincenzo
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00100 Rome, Italy.
J Clin Med. 2020 Mar 31;9(4):969. doi: 10.3390/jcm9040969.
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) represent two of the most common procedures in orthopedic surgery. The growing need to avoid physical impairment in elderly patients undergoing this kind of surgery puts the focus on the possibility to undertake a preoperative physical activity program to improve their fit and physical health at the time of surgery. A systematic review has been carried out with online databases including PubMed-Medline, Cochrane Central and Google Scholar. The aim was to retrieve available evidence concerning preoperative physical activity and exercise, before total knee or total hip arthroplasty in patients older than 65 years, and to clarify the role of this practice in improving postoperative outcomes. Results of the present systematic analysis showed that, for TKA, most of the studies demonstrated a comparable trend of postoperative improvement of Visual Analogue Scale (VAS), range of movement (ROM) and functional scores, and those of quality of life. There is insufficient evidence in the literature to draw final conclusions on the topic. Prehabilitation for patients undergoing TKA leads to shorter length of stay but not to an enhanced postoperative recovery. Concerning THA, although currently available data showed better outcomes in patients who underwent prehabilitation programs, there is a lack of robust evidence with appropriate methodology.
全髋关节置换术（THA）和全膝关节置换术（TKA）是骨科手术中最常见的两种手术。对于接受此类手术的老年患者，避免身体功能受损的需求日益增加，这使得人们将重点放在术前开展体育活动计划以改善他们在手术时的身体状况和身体健康上。我们使用包括PubMed-Medline、Cochrane Central和谷歌学术在内的在线数据库进行了一项系统综述。目的是检索有关65岁以上患者在全膝关节置换术或全髋关节置换术前进行体育活动和锻炼的现有证据，并阐明这种做法在改善术后结果中的作用。本次系统分析的结果表明，对于TKA，大多数研究表明视觉模拟量表（VAS）、活动范围（ROM）和功能评分以及生活质量的术后改善趋势具有可比性。文献中没有足够的证据就该主题得出最终结论。接受TKA的患者进行术前康复可缩短住院时间，但不会增强术后恢复。关于THA，尽管目前可得的数据显示接受术前康复计划的患者有更好的结果，但缺乏采用适当方法的有力证据。
