Department of Trauma and Orthopaedic Surgery, University College Hospital, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK.
Department of Orthopaedic Surgery, The Princess Grace Hospital, 42-52 Nottingham Pl, Marylebone, London, W1U 5NY, UK.
Arch Orthop Trauma Surg. 2022 Nov;142(11):3427-3436. doi: 10.1007/s00402-021-04180-9. Epub 2021 Sep 26.
The frequency of total knee arthroplasty (TKA) is increasing, particularly in younger and more active patients. In these patients, there may be greater functional demands, with an expectation to return to sporting activities (RTS) following TKA. There is a paucity of data on the time to RTS following TKA and the aim of this meta-analysis is to determine the time to RTS following TKA.
Using the PRISMA guidelines, an electronic search of PUBMED, MEDLINE, EMBASE, and the Cochrane Library for trails was performed on TKA and RTS in English language, published since the inception of the database to 31st October 2020. Data evaluating the time to RTS and functional outcomes were recorded by two authors independently that were included in the analysis. Pooled analysis using random effect model on overall proportions at the different time intervals and at the end of the follow-up was carried out for all studies.
In total, 1,611 studies were retrieved from literature search. Of these, nine studies met the inclusion criteria with 1,307 patients. Two studies with 148 patients demonstrated an overall pooled proportion of 18.7% (95% CI 8.2-32.3%) of patients RTS at 3 month post-TKA; Three studies reported RTS rate at 6 months 70.% (95% CI 48-88.4). Two studies with 123 patients demonstrated an overall pooled proportion of 84.0% (95% CI 77.1-89.9%) patients RTS at 12 months. 986 patients returned to sport from total of 1307, with an overall adjusted proportion return to sport of 87.9 (95% CI 80.5-93.8%) at the end of follow-up; mean 14 months (range 3-36 months).
Patients undergoing TKA were found to successfully RTS, pooled proportion analysis showed an increasing rate of RTS with time, at a mean of 14 months following TKA, where 87.9% of patients had returned to sports. The findings of this study will enable more informed discussions and rehabilitation planning between patients and clinicians on RTS following TKA.
全膝关节置换术（TKA）的频率正在增加，尤其是在年轻且更活跃的患者中。在这些患者中，功能需求可能更大，期望在 TKA 后能够恢复运动（RTS）。关于 TKA 后 RTS 的时间的数据很少，本荟萃分析的目的是确定 TKA 后 RTS 的时间。
使用 PRISMA 指南，对 PUBMED、MEDLINE、EMBASE 和 Cochrane 图书馆中以英语发表的关于 TKA 和 RTS 的试验进行了电子检索，检索时间自数据库创建以来至 2020 年 10 月 31 日。两名作者独立记录评估 RTS 时间和功能结果的数据，这些数据包含在分析中。对所有研究在不同时间间隔和随访结束时的总体比例进行了随机效应模型的汇总分析。
总共从文献检索中检索到 1611 项研究。其中，9 项研究符合纳入标准，共纳入 1307 例患者。2 项研究共 148 例患者的总体汇总比例为 18.7%（95%CI8.2-32.3%），即在 TKA 后 3 个月时恢复运动；3 项研究报告了 6 个月的 RTS 率为 70%（95%CI48-88.4%）。2 项研究共 123 例患者的总体汇总比例为 84.0%（95%CI77.1-89.9%），即 12 个月时患者恢复运动。在总共 1307 例患者中，有 986 例患者返回运动，在随访结束时，总体调整后运动恢复的比例为 87.9%（95%CI80.5-93.8%）；平均随访时间为 14 个月（范围 3-36 个月）。
接受 TKA 的患者被发现能够成功恢复运动，汇总比例分析显示随着时间的推移，RTS 的比例逐渐增加，平均在 TKA 后 14 个月，87.9%的患者已恢复运动。本研究的结果将使患者和临床医生能够就 TKA 后 RTS 进行更明智的讨论和康复计划。
