The Second Affiliated Hospital, Jiaxing University, Jiaxing, China.
J Healthc Eng. 2022 Mar 10;2022:4287555. doi: 10.1155/2022/4287555. eCollection 2022.
The clinical influence of the preoperative and postoperative therapies for recovery after the joint replacement surgery is still questionable. This study of systematic review and meta-analysis focuses on analyzing the clinical effects of preoperative rehabilitation among the patients who are planning to opt for joint replacement surgery for enhanced results.
Randomized clinical trials were selected where preoperative therapeutic exercises were performed by adults for preoperative rehabilitation in patients who were planning for replacement surgery for better outcomes and identified through databases and screening. Two reviewers were responsible for extracting appropriate studies, relevant data, assessing the risks, therapeutic validity, etc. . We performed random-effects meta-analysis for calculation of risk ratios and odds ratios, for knee and hip surgery cases. Analysis of length of hospital stay, short-term-based recovery period during hospital stay, total hip replacement functional recovery during hospital stay, short-term recovery of self-reported functioning, etc. was performed.
Functional scores, postoperative pain, recovery time, length of hospital stay, and quality of life were studied. Of the seven studies included, the data of 614 patients were studied. The total number of participants in both exercise and control groups was analyzed to assess the bias of the study where the risk ratio was 0.96 and (0.74-1.25) was the 95% CI. Short-term-based recovery period during hospital stay for knee replacement was analyzed where 0.87 was the risk ratio and (0.61-1.23) was the 95% CI and for hip replacement where 0.99 was the risk ratio and (0.68-1.44) was the 95% CI. The RR for total hip replacement functional recovery during hospital stay was 0.80 with 95% CI (0.54-1.19). The RR for short-term recovery of self-reported functioning was 0.98 with 95% CI (0.76-1.26). Outcome analysis for pain and functionality evaluation was performed and assessed using WOMAC, HOOS, and HHS scores where the standardized mean difference was 0.38 and (0.20-0.57) was the 95% CI in hip surgery pain analysis and in knee surgery, 0.00 was the standardized mean difference and (-0.18-0.19) was the 95% CI.
Long-term outcomes were not affected by the preoperative rehabilitation. Though there was a slight improvement in early postoperative pain, this is not much of clinical significance.
关节置换手术后的术前和术后治疗对恢复的临床影响仍存在争议。本系统评价和荟萃分析研究重点分析了计划接受关节置换手术的患者进行术前康复治疗的临床效果，以获得更好的结果。
通过数据库和筛选，选择对计划接受关节置换手术以获得更好结果的成年人进行术前治疗性锻炼的随机临床试验，以进行术前康复。两名审查员负责提取适当的研究、相关数据、评估风险、治疗有效性等。我们对膝关节和髋关节手术进行了随机效应荟萃分析，以计算风险比和优势比。还分析了住院时间、住院期间短期恢复期间、住院期间全髋关节置换功能恢复、短期自我报告功能恢复等。
研究了功能评分、术后疼痛、恢复时间、住院时间和生活质量。在纳入的 7 项研究中，共研究了 614 名患者的数据。对实验组和对照组的总人数进行了分析，以评估研究的偏倚，风险比为 0.96，95%CI 为（0.74-1.25）。对膝关节置换术住院期间短期恢复期间进行了分析，风险比为 0.87，95%CI 为（0.61-1.23），髋关节置换术的风险比为 0.99，95%CI 为（0.68-1.44）。住院期间全髋关节置换功能恢复的 RR 为 0.80，95%CI 为（0.54-1.19）。短期自我报告功能恢复的 RR 为 0.98，95%CI 为（0.76-1.26）。进行了疼痛和功能评估的结果分析，并使用 WOMAC、HOOS 和 HHS 评分进行了评估，髋关节手术疼痛分析的标准化均数差为 0.38，95%CI 为（0.20-0.57），膝关节手术的标准化均数差为 0.00，95%CI 为（-0.18-0.19）。
术前康复不会影响长期结果。尽管术后早期疼痛略有改善，但这并没有太大的临床意义。
