Department of Nursing, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China.
Department of Supervision Office, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, 28 Changsheng West Road, Hengyang, 421001, Hunan Province, China.
J Orthop Surg Res. 2023 Sep 19;18(1):704. doi: 10.1186/s13018-023-04160-2.
Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and safety of outpatient versus home-based rehabilitation persists.
A thorough literature review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across four databases. Two researchers independently identified eligible studies centering on knee arthroplasty patients undergoing either outpatient or home-based rehabilitation. Study quality was assessed using the Cochrane Collaboration's risk of bias tool, while continuous outcomes were subject to meta-analyses using Stata 17 software.
Our analysis identified no significant differences in primary outcomes, including Range of Motion, Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, and the Knee Society Score, between home-based and outpatient rehabilitation across different follow-up points. Adverse reactions, readmission rates, the need for manipulation under anesthesia, reoperation rate, and post-surgery complications were also similar between both groups. Home-based rehabilitation demonstrated cost-effectiveness, resulting in substantial annual savings. Furthermore, quality of life and patient satisfaction were found to be comparable in both rehabilitation methods.
Home-based rehabilitation post-knee arthroplasty appears as an effective, safe, and cost-efficient alternative to outpatient rehabilitation. Despite these findings, further multicenter, long-term randomized controlled trials are required to validate these findings and provide robust evidence to inform early rehabilitation choices post-knee arthroplasty.
膝关节置换术后康复对于恢复膝关节功能和确保患者整体健康至关重要。关于门诊与家庭康复相对有效性和安全性的争论仍在继续。
我们按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，在四个数据库中进行了全面的文献回顾。两名研究人员独立确定了以接受门诊或家庭康复的膝关节置换患者为中心的合格研究。使用 Cochrane 协作风险偏倚工具评估研究质量，而使用 Stata 17 软件对连续结果进行荟萃分析。
我们的分析表明，在不同随访点，家庭康复与门诊康复在主要结局方面（包括活动范围、西安大略和麦克马斯特大学关节炎指数、膝关节损伤和骨关节炎结局评分、牛津膝关节评分和膝关节协会评分）没有显著差异。两组之间的不良反应、再入院率、需要在麻醉下进行手法复位、再次手术率和术后并发症也相似。家庭康复具有成本效益，可实现大量年度节省。此外，两种康复方法的生活质量和患者满意度相当。
膝关节置换术后家庭康复似乎是门诊康复的有效、安全且具有成本效益的替代方法。尽管有这些发现，但仍需要进一步的多中心、长期随机对照试验来验证这些发现，并提供强有力的证据，为膝关节置换术后的早期康复选择提供信息。
