Pre- and Post-Operative Rehabilitation Interventions in Patients at Risk of Poor Outcomes Following Knee or Hip Arthroplasty: Protocol for Two Systematic Reviews.
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引用次数: 0
Abstract
Objective: Total knee (TKA) and hip arthroplasty (THA) are successful procedures in treating end-stage osteoarthritis when nonoperative treatments fail. However, a growing body of literature has been reporting suboptimal outcomes following TKA and THA. While pre- and post-operative rehabilitation is imperative to recovery, little is known about their effectiveness for patients at risk of poor outcomes. In the 2 systematic reviews with identical methodology, we aim to evaluate the effectiveness of (a) pre-operative and (b) post-operative rehabilitation interventions for patients at risk of poor outcomes following TKA and THA.
Methods: The 2 systematic reviews will follow the principles and recommendations outlined in the Cochrane Handbook. Only randomized controlled trials (RCTs) and pilot RCTs will be searched in 6 databases: CINAHL, MEDLINE, Embase, Web of Science, Pedro, and OTseeker. Eligible studies including patients at risk of poor outcomes and evaluating rehabilitation interventions following and preceding arthroplasty will be considered for inclusion. Primary outcomes will include performance-based tests and functional patient-reported outcome measures, and secondary outcomes will include health-related quality of life and pain. The quality of eligible RCTs will be evaluated using the Cochrane's risk of bias tool, and the strength of evidence will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).
Discussion: These reviews will synthesize the evidence regarding the effectiveness of pre-and post-operative rehabilitation interventions for patients at risk of poor outcomes, which in turn may inform practitioners and patients in planning and implementing the most optimal rehabilitation programs to achieve the best outcomes after arthroplasty.
目的:当非手术治疗失败时，全膝关节(TKA)和髋关节置换术(THA)是治疗终末期骨关节炎的成功方法。然而，越来越多的文献报道TKA和THA后的次优结果。虽然术前和术后康复对恢复是必不可少的，但对于有不良预后风险的患者，他们的有效性知之甚少。在两篇采用相同方法的系统综述中，我们旨在评估(a)术前和(b)术后康复干预对TKA和THA术后预后不良风险患者的有效性。方法:这两篇系统综述将遵循Cochrane手册中概述的原则和建议。只有随机对照试验(rct)和试点rct将在6个数据库中检索:CINAHL, MEDLINE, Embase, Web of Science, Pedro和OTseeker。符合条件的研究包括有不良预后风险的患者，以及评估关节置换术前后的康复干预措施。主要结果将包括基于性能的测试和患者报告的功能结果测量，次要结果将包括与健康相关的生活质量和疼痛。采用Cochrane偏倚风险工具评价符合条件的随机对照试验的质量，采用推荐、评估、发展和评价等级(GRADE)评价证据的强度。讨论:这些综述将综合有关有不良预后风险的患者术前和术后康复干预有效性的证据，这反过来可能会告诉从业者和患者计划和实施最优的康复方案，以实现关节置换术后的最佳结果。系统评价注册:PROSPERO CRD42022355574。
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