Konings Marco J, De Vroey Henri, Weygers Ive, Claeys Kurt
Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Brugge, Belgium.
Department of Rehabilitation Sciences, KU Leuven, Leuven, Flanders, Belgium.
BMJ Open Sport Exerc Med. 2020 Jun 23;6(1):e000729. doi: 10.1136/bmjsem-2019-000729. eCollection 2020.
Desires and expectations of patients in regard to resume participation in sport activities after knee arthroplasty strongly increased in recent years. Therefore, this review systematically reviewed the available scientific literature on the effect of knee arthroplasty on sports participation and activity levels.
Systematic review and meta-analysis.
PubMed, Embase, SPORTDiscus and reference lists were searched in February 2019.
Inclusion of knee osteoarthritis patients who underwent total knee arthroplasty (TKA) and/or unicondylar knee arthroplasty. Studies had to include at least one preoperative and one postoperative measure (≥1 year post surgery) of an outcome variable of interest (ie, activity level: University of California, Los Angeles and/or Lower Extremity Activity Scale; sport participation: type of sport activity survey).
Nineteen studies were included, consisting data from 4074 patients. Knee arthroplasty has in general a positive effect on activity level and sport participation. Most patients who have stopped participating in sport activities in the year prior to surgery, however, do not seem to reinitiate their sport activities after surgery, in particular after a TKA. In contrast, patients who continue to participate in sport activities until surgery appear to become even more active in low-impact and medium-impact sports than before the onset of restricting symptoms.
Knee arthroplasty is an effective treatment in resuming sports participation and physical activity levels. However, to achieve the full benefits from knee arthroplasty, strategies and guidelines aimed to keep patients capable and motivated to participate in (low-impact or medium-impact) sport activities until close before surgery are warranted.
近年来，膝关节置换术后患者恢复参与体育活动的愿望和期望大幅增加。因此，本综述系统回顾了关于膝关节置换术对体育参与和活动水平影响的现有科学文献。
系统综述和荟萃分析。
2019年2月检索了PubMed、Embase、SPORTDiscus及参考文献列表。
纳入接受全膝关节置换术（TKA）和/或单髁膝关节置换术的膝骨关节炎患者。研究必须包括至少一项感兴趣的结局变量的术前和术后测量（术后≥1年）（即活动水平：加利福尼亚大学洛杉矶分校和/或下肢活动量表；体育参与：体育活动类型调查）。
纳入19项研究，包含4074例患者的数据。膝关节置换术总体上对活动水平和体育参与有积极影响。然而，大多数在手术前一年停止参加体育活动的患者，术后似乎并未重新开始体育活动，尤其是在接受TKA后。相比之下，术前持续参加体育活动的患者在低强度和中等强度运动中似乎比出现限制症状之前更加活跃。
膝关节置换术是恢复体育参与和身体活动水平的有效治疗方法。然而，为了从膝关节置换术中充分获益，有必要制定策略和指南，使患者在术前直至临近手术时都有能力且有动力参与（低强度或中等强度）体育活动。
