Papalia Rocco, Campi Stefano, Vorini Ferruccio, Zampogna Biagio, Vasta Sebastiano, Papalia Giuseppe, Fossati Chiara, Torre Guglielmo, 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", 00135 Rome, Italy.
J Clin Med. 2020 May 9;9(5):1401. doi: 10.3390/jcm9051401.
Hip and knee replacement is an effective treatment for symptomatic, end-stage hip and knee osteoarthritis, aiming to relieve pain and restore joint function. Several postoperative rehabilitation protocols and physical activities are proposed in routine clinical practice. However, their effect on clinical outcome and implant revision in patients undergoing joint replacement is still unclear. A systematic review of the literature was performed through a comprehensive search on online databases including Pubmed-Medline, Cochrane central, and Google scholar. We included all the available studies on postoperative physical activity and rehabilitation protocols after total knee and total hip arthroplasty in patients older than 65 years. The primary endpoint was to evaluate the effect of physical activity and rehabilitation on clinical outcome; the secondary outcome was to determine the effect on patients' quality of life (QoL) and implant survival. Although the heterogeneity of the rehabilitation protocols and outcome measures did not allow to draw definitive conclusions, most studies suggested that aquatic therapy, ergometer cycling, and fast-track protocols have a beneficial effect on muscle strength, gait speed, and main clinical scores after total hip arthroplasty. Similarly, enhanced rehabilitation protocols produced an improvement in primary and secondary outcomes after total knee arthroplasty.
髋关节和膝关节置换术是治疗有症状的终末期髋膝关节骨关节炎的有效方法，旨在缓解疼痛并恢复关节功能。在常规临床实践中提出了几种术后康复方案和体育活动。然而，它们对接受关节置换术患者的临床结局和植入物翻修的影响仍不明确。通过对包括PubMed-Medline、Cochrane中心和谷歌学术在内的在线数据库进行全面检索，对文献进行了系统综述。我们纳入了所有关于65岁以上患者全膝关节置换术和全髋关节置换术后体育活动和康复方案的现有研究。主要终点是评估体育活动和康复对临床结局的影响；次要结局是确定对患者生活质量（QoL）和植入物存活的影响。尽管康复方案和结局指标的异质性不允许得出明确结论，但大多数研究表明，水疗、测力计骑行和快速康复方案对全髋关节置换术后的肌肉力量、步态速度和主要临床评分有有益影响。同样，强化康复方案在全膝关节置换术后的主要和次要结局方面产生了改善。
