Department of Health Services Research, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany.
University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany.
BMC Musculoskelet Disord. 2021 Aug 18;22(1):711. doi: 10.1186/s12891-021-04600-2.
Data on the utilisation of outpatient physiotherapy (PT) in patients following total knee arthroplasty (TKA) are scarce, and available studies have not been systematically synthesised. This study aims to summarise the existing literature on outpatient PT following TKA as well as to identify factors associated with its use.
A systematic literature search in MEDLINE (via PubMed), CINAHL, Scopus and PEDro was conducted in July 2020 without language restrictions. Two authors independently selected studies, extracted data and assessed study quality. The primary outcome was the proportion being treated with at least one session of outpatient PT (land- or water-based treatments supervised/provided by a qualified physiotherapist) during any defined period within 12 months following TKA. Furthermore, predictors for the use of PT were assessed. Studies including only revision surgeries or bilateral TKA were excluded.
After screening 1934 titles/abstracts and 56 full text articles, 5 studies were included. Proportions of PT utilisation ranged from 16.7 to 84.5%. There were large variations in the time periods after hospital discharge (4 weeks to 12 months) and in the reporting of PT definitions. Female sex was associated with higher PT utilisation, and compared to patients after total hip arthroplasty, utilisation was higher among those following TKA.
Despite using a broad search strategy, we found only 5 studies assessing the utilisation of PT after hospital discharge in patients with TKA. These studies showed large heterogeneity in PT utilisation, assessed time periods and PT definitions. Clearly, more studies from different countries with uniform PT definitions are needed to address this relevant public health question.
全膝关节置换术（TKA）后门诊物理治疗（PT）的利用数据很少，现有的研究也没有进行系统的综合分析。本研究旨在总结 TKA 后门诊 PT 的现有文献，并确定与使用相关的因素。
2020 年 7 月，我们在 MEDLINE（通过 PubMed）、CINAHL、Scopus 和 PEDro 中进行了系统的文献检索，无语言限制。两名作者独立选择研究、提取数据和评估研究质量。主要结局是在 TKA 后 12 个月内的任何规定时间内，至少接受一次门诊 PT（由合格的物理治疗师监督/提供的陆地或水上治疗）治疗的比例。此外，还评估了 PT 使用的预测因素。不包括仅 Revision 手术或双侧 TKA 的研究。
经过筛选 1934 篇标题/摘要和 56 篇全文文章，有 5 项研究被纳入。PT 使用率的比例从 16.7%到 84.5%不等。出院后时间（4 周至 12 个月）和 PT 定义报告方面存在较大差异。女性性别与较高的 PT 使用率相关，与全髋关节置换术患者相比，TKA 后患者的 PT 使用率更高。
尽管使用了广泛的搜索策略，但我们仅发现 5 项研究评估了 TKA 患者出院后接受 PT 的情况。这些研究显示 PT 使用率、评估时间和 PT 定义方面存在很大的异质性。显然，需要更多来自不同国家的具有统一 PT 定义的研究来解决这一相关的公共卫生问题。
