Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary.
Orthotics and Prosthetics Department, Rehabilitation Sciences School, University of Jordan, Amman, Jordan.
BMC Musculoskelet Disord. 2022 Jun 15;23(1):576. doi: 10.1186/s12891-022-05531-2.
The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question.
A systematic review and meta-analysis were conducted to evaluate the benefit of KR surgery alone to enhance physical activity recommendations based on high validity accelerometer. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined.
Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m body mass index. The results found that the number of steps was significantly improved up to 36.35 and 45.5% after 6-months and 1-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients' health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after 6-months and 1-year follow-ups. Heterogeneity among studies was low to moderate (0-63%).
Knee replacement surgery is an effective treatment for improving patients' quality of life with severe knee injuries. However, various factors impact the success of surgical and achieving maximum benefit of the surgery. One factor, sedentary time, can be reduced by implementing pre-and post-surgery exercise or physical activity recommendations. Further studies are needed to understand the benefit of surgery with or without rehabilitation assessed using high validity monitors.
膝关节置换 (KR) 手术旨在恢复活动水平并降低残疾风险。该手术的结果主要通过主观工具或低有效性客观工具进行评估。然而，使用高有效性客观加速度计评估手术对活动水平的影响仍存在争议。
进行了系统评价和荟萃分析，以评估 KR 手术单独增强基于高有效性加速度计的体力活动建议的益处。两名独立审查员评估了五个电子数据库（Cochrane 中央对照试验注册处、EMBASE、PubMed、Web of Science 和 Scopus），以查找 2000 年 1 月至 2021 年 10 月期间的相关研究。进行了质量评估和风险偏倚评估。
纳入了三篇文章，共有 202 名参与者（86 名男性，116 名女性），平均年龄为 64 岁，平均体重指数为 32kg/m²。结果发现，手术后 6 个月和 1 年，步数分别显著增加了 36.35%和 45.5%。然而，这些变化没有达到推荐的活动水平指南，可能与患者的健康状况和手术前的活动水平有关。手术后 6 个月和 1 年的随访中，久坐时间、站立时间和直立时间没有显著变化。研究之间的异质性为低至中度（0-63%）。
膝关节置换术是治疗严重膝关节损伤患者提高生活质量的有效方法。然而，各种因素会影响手术的成功和手术的最大获益。一个因素，即久坐时间，可以通过实施手术前后的锻炼或体力活动建议来减少。需要进一步的研究来了解手术的益处，以及是否结合康复治疗，使用高有效性监测器进行评估。
