Postoperative education for patients after hip/knee arthroplasty: a systematic review with meta-analysis of randomized controlled trials.

Abstract

Introduction: Guidelines often recommend patient education in the management of hip or knee replacement, despite evidence of its effectiveness is scarce. The aim of this study was to assess the effectiveness of postoperative patient education on pain, function, quality of life, and psychosocial issues.

Methods: We performed a systematic review and meta-analysis of RCTs investigating the effects of patient education (alone or in combination with other treatments) compared to usual care delivered after hip/knee replacement. Risk of bias was assessed using the Cochrane Risk of Bias 2.0. Certainty of evidence was established according to the GRADE approach.

Results: We included five trials. We found that patient education likely results in little to no effects compared to usual care in the medium-term on pain (SMD -0.09, 95% CI -0.41-0.22) and quality of life (MD 0.11, 95% CI 0.00-0.22). Similarly, it likely results in little to no effect on anxiety in both short- (MD 1.59, 95% CI -3.16 to -0.02) and medium-term (MD -1.51, 95% CI -3.07-0.05), as well as on depression in the short- (SMD -0.22, 95% CI -0.58-0.15) and medium-term (SMD -0.22, 95% CI -0.55-0.12). In contrast, usual care may improve long-term physical function (SMD 0.64, 95% CI -0.03-1.3).

Conclusion: Postoperative patient education provided no to small benefit on pain, physical function, quality of life or psychosocial issues compared to usual care. Its role may be more impactful when patient-tailored and integrated into multimodal rehabilitation strategies for people after hip/knee arthroplasty.