Evidence summary of the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement under enhanced recovery after surgery_West China Medical Journal

Authors：

XIE Yan , CHEN Jiali ,  NING Ning , ZHOU Zongke , LIAO Xia , LI Peifang , FU Zhongmin , LEI Lei , LI Ye , WANG Liqun

West China School of Nursing, Sichuan University / Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.com

Keywords：

Hip and knee osteoarthritis; joint replacement; prehabilitation; evidence summary

DOI：

10.7507/1002-0179.202206103

Video：

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Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.

Citation： XIE Yan, CHEN Jiali, NING Ning, ZHOU Zongke, LIAO Xia, LI Peifang, FU Zhongmin, LEI Lei, LI Ye, WANG Liqun. Evidence summary of the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement under enhanced recovery after surgery. West China Medical Journal, 2022, 37(10): 1517-1523. doi: 10.7507/1002-0179.202206103 Copy

1.	段丹, 寧寧, 周宗科, 等. 全髖、膝關節置換術后患者隨訪現狀的研究進展. 護士進修雜志, 2021, 36(18): 1664-1667.
2.	Wellsandt E, Golightly Y. Exercise in the management of knee and hip osteoarthritis. Curr Opin Rheumatol, 2018, 30(2): 151-159.
3.	李寅翠, 劉云. 全膝關節置換患者三聯預康復的研究進展. 護理與康復, 2020, 19(5): 28-31.
4.	王春燕, 付玲玲, 韓杰. 多維預康復干預在人工全膝關節置換術后患者中的應用及效果觀察. 護士進修雜志, 2020, 35(24): 2286-2289, 2296.
5.	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
6.	王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
7.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
8.	Kumar A, Taggarsi M. GRADEing quality of evidence and its importance in evidence-based practice. BMJ Evid Based Med, 2021, 26(5): 228-230.
9.	NICE. Joint replacement (primary): hip, knee and shoulder. NICE, 2020: 1-75.
10.	Anderson AM, Comer C, Smith TO, et al. Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study. BMC Musculoskelet Disord, 2021, 22(1): 352.
11.	Wainwright TW, Gill M, McDonald DA, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Acta Orthop, 2020, 91(1): 3-19.
12.	周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復—圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
13.	Cabilan CJ, Hines S, Munday J. The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. JBI Database System Rev Implement Rep, 2015, 13(1): 146-187.
14.	Johns WL, Layon D, Golladay GJ, et al. Preoperative risk factor screening protocols in total joint arthroplasty: a systematic review. J Arthroplasty, 2020, 35(11): 3353-3363.
15.	McDonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Re, 2014, 2014(5): CD003526.
16.	Calatayud J, Casa?a J, Ezzatvar Y, et al. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc, 2017, 25(9): 2864-2872.
17.	Gill SD, McBurney H, Schulz DL. Land-based versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial. Arch Phys Med Rehabil, 2009, 90(3): 388-394.
18.	Hermann A, Holsgaard-Larsen A, Zerahn B, et al. Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty-a randomized controlled trial. Osteoarthritis Cartilage, 2016, 24(1): 91-98.
19.	Nguyen C, Boutron I, Roren A, et al. Effect of prehabilitation before total knee replacement for knee osteoarthritis on functional outcomes: a randomized clinical trial. JAMA Netw Open, 2022, 5(3): e221462.
20.	Kohler JG, Holte AJ, Glass NA, et al. Dental screening in elective total joint arthroplasty: risk factors for failure. J Arthroplasty, 2021, 36(5): 1548-1550.
21.	Sharma R, Ardebili MA, Abdulla IN. Does Rehabilitation before total knee arthroplasty benefit postoperative recovery? a systematic review. Indian J Orthop, 2019, 53(1): 138-147.
22.	Knapp PW, Keller RA, Mabee KA, et al. Quantifying patient engagement in total joint arthroplasty using digital application-based technology. J Arthroplasty, 2021, 36(9): 3108-3117.
23.	Seward MW, Antonelli BJ, Giunta N, et al. Weight loss before total joint arthroplasty using a remote dietitian and mobile app: study protocol for a multicenter randomized, controlled trial. J Orthop Surg Res, 2020, 15(1): 531.
24.	An J, Ryu HK, Lyu SJ, et al. Effects of preoperative telerehabilitation on muscle strength, range of motion, and functional outcomes in candidates for total knee arthroplasty: a single-blind randomized controlled trial. Int J Environ Res Public Health, 2021, 18(11): 6071.
25.	Cooke M, Walker R, Aitken LM, et al. Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery:a pilot randomised controlled trial. Scand J Caring Sci, 2016, 30(1): 74-82.
26.	Gay C, Chabaud A, Guilley E, et al. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Ann Phys Rehabil Med, 2016, 59(3): 174-183.
27.	Lemay CA, Lewis CG, Singh JA, et al. Receipt of pain management information preoperatively is associated with improved functional gain after elective total joint arthroplasty. J Arthroplasty, 2017, 32(6): 1763-1768.
28.	Meredith SJ, Nadarajah V, Jauregui JJ, et al. Preoperative opioid use in knee surgery patients. J Knee Surg, 2019, 32(7): 630-636.
29.	Post ZD. CORR insights?: preoperative opioid misuse is associated with increased morbidity and mortality after elective orthopaedic surgery. Clin Orthop Relat Res, 2015, 473(7): 2413-2414.
30.	Shadbolt C, Gould D, Camacho X, et al. Preoperative opioid use and complications following total joint replacement: a protocol for a systematic review and meta-analysis. BMJ Open, 2020, 10(6): e035377.
31.	Schroer WC, LeMarr AR, Mills K, et al. 2019 Chitranjan S. Ranawat award: elective joint arthroplasty outcomes improve in malnourished patients with nutritional intervention: a prospective population analysis demonstrates a modifiable risk factor. Bone Joint J, 2019, 101-B (Suppl C): 17-21.
32.	Gu A, Malahias MA, Strigelli V, et al. Preoperative malnutrition negatively correlates with postoperative wound complications and infection after total joint arthroplasty: a systematic review and meta-analysis. J Arthroplasty, 2019, 34(5): 1013-1024.
33.	陳佳麗, 寧寧, 廖燈彬, 等. 術前高蛋白飲食提高全膝關節置換術患者的術前營養狀況. 成都醫學院學報, 2020, 15(5): 599-602.
34.	Bohl DD, Shen MR, Kayupov E, et al. Hypoalbuminemia independently predicts surgical site infection, pneumonia, length of stay, and readmission after total joint arthroplasty. J Arthroplasty, 2016, 31(1): 15-21.
35.	Spahn DR. Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology, 2010, 113(2): 482-495.
36.	Marchant MH Jr, Viens NA, Cook C, et al. The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. J Bone Joint Surg Am, 2009, 91(7): 1621-1629.
37.	Wallis JA, Taylor NF. Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery-a systematic review and meta-analysis. Osteoarthritis Cartilage, 2011, 19(12): 1381-1395.
38.	梁彩艷, 崔健, 楊旭, 等. 北京地區全膝關節置換術患者術前預康復實施現狀及影響因素分析: 多中心橫斷面調查研究. 中華骨與關節外科雜志, 2021, 14(11): 954-957.
39.	Kubo Y, Sugiyama S, Takachu R, et al. Effects of preoperative low-intensity training with slow movement on early quadriceps weakness after total knee arthroplasty in patients with knee osteoarthritis: a retrospective propensity score-matched study. BMC Sports Sci Med Rehabil, 2020, 12(1): 72.
40.	Vasta S, Papalia R, Torre G, et al. The influence of preoperative physical activity on postoperative outcomes of knee and hip arthroplasty surgery in the elderly: a systematic review. J Clin Med, 2020, 9(4): 969.

1. 段丹, 寧寧, 周宗科, 等. 全髖、膝關節置換術后患者隨訪現狀的研究進展. 護士進修雜志, 2021, 36(18): 1664-1667.
2. Wellsandt E, Golightly Y. Exercise in the management of knee and hip osteoarthritis. Curr Opin Rheumatol, 2018, 30(2): 151-159.
3. 李寅翠, 劉云. 全膝關節置換患者三聯預康復的研究進展. 護理與康復, 2020, 19(5): 28-31.
4. 王春燕, 付玲玲, 韓杰. 多維預康復干預在人工全膝關節置換術后患者中的應用及效果觀察. 護士進修雜志, 2020, 35(24): 2286-2289, 2296.
5. Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
6. 王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
7. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
8. Kumar A, Taggarsi M. GRADEing quality of evidence and its importance in evidence-based practice. BMJ Evid Based Med, 2021, 26(5): 228-230.
9. NICE. Joint replacement (primary): hip, knee and shoulder. NICE, 2020: 1-75.
10. Anderson AM, Comer C, Smith TO, et al. Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study. BMC Musculoskelet Disord, 2021, 22(1): 352.
11. Wainwright TW, Gill M, McDonald DA, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Acta Orthop, 2020, 91(1): 3-19.
12. 周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復—圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
13. Cabilan CJ, Hines S, Munday J. The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. JBI Database System Rev Implement Rep, 2015, 13(1): 146-187.
14. Johns WL, Layon D, Golladay GJ, et al. Preoperative risk factor screening protocols in total joint arthroplasty: a systematic review. J Arthroplasty, 2020, 35(11): 3353-3363.
15. McDonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Re, 2014, 2014(5): CD003526.
16. Calatayud J, Casa?a J, Ezzatvar Y, et al. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc, 2017, 25(9): 2864-2872.
17. Gill SD, McBurney H, Schulz DL. Land-based versus pool-based exercise for people awaiting joint replacement surgery of the hip or knee: results of a randomized controlled trial. Arch Phys Med Rehabil, 2009, 90(3): 388-394.
18. Hermann A, Holsgaard-Larsen A, Zerahn B, et al. Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty-a randomized controlled trial. Osteoarthritis Cartilage, 2016, 24(1): 91-98.
19. Nguyen C, Boutron I, Roren A, et al. Effect of prehabilitation before total knee replacement for knee osteoarthritis on functional outcomes: a randomized clinical trial. JAMA Netw Open, 2022, 5(3): e221462.
20. Kohler JG, Holte AJ, Glass NA, et al. Dental screening in elective total joint arthroplasty: risk factors for failure. J Arthroplasty, 2021, 36(5): 1548-1550.
21. Sharma R, Ardebili MA, Abdulla IN. Does Rehabilitation before total knee arthroplasty benefit postoperative recovery? a systematic review. Indian J Orthop, 2019, 53(1): 138-147.
22. Knapp PW, Keller RA, Mabee KA, et al. Quantifying patient engagement in total joint arthroplasty using digital application-based technology. J Arthroplasty, 2021, 36(9): 3108-3117.
23. Seward MW, Antonelli BJ, Giunta N, et al. Weight loss before total joint arthroplasty using a remote dietitian and mobile app: study protocol for a multicenter randomized, controlled trial. J Orthop Surg Res, 2020, 15(1): 531.
24. An J, Ryu HK, Lyu SJ, et al. Effects of preoperative telerehabilitation on muscle strength, range of motion, and functional outcomes in candidates for total knee arthroplasty: a single-blind randomized controlled trial. Int J Environ Res Public Health, 2021, 18(11): 6071.
25. Cooke M, Walker R, Aitken LM, et al. Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery:a pilot randomised controlled trial. Scand J Caring Sci, 2016, 30(1): 74-82.
26. Gay C, Chabaud A, Guilley E, et al. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Ann Phys Rehabil Med, 2016, 59(3): 174-183.
27. Lemay CA, Lewis CG, Singh JA, et al. Receipt of pain management information preoperatively is associated with improved functional gain after elective total joint arthroplasty. J Arthroplasty, 2017, 32(6): 1763-1768.
28. Meredith SJ, Nadarajah V, Jauregui JJ, et al. Preoperative opioid use in knee surgery patients. J Knee Surg, 2019, 32(7): 630-636.
29. Post ZD. CORR insights?: preoperative opioid misuse is associated with increased morbidity and mortality after elective orthopaedic surgery. Clin Orthop Relat Res, 2015, 473(7): 2413-2414.
30. Shadbolt C, Gould D, Camacho X, et al. Preoperative opioid use and complications following total joint replacement: a protocol for a systematic review and meta-analysis. BMJ Open, 2020, 10(6): e035377.
31. Schroer WC, LeMarr AR, Mills K, et al. 2019 Chitranjan S. Ranawat award: elective joint arthroplasty outcomes improve in malnourished patients with nutritional intervention: a prospective population analysis demonstrates a modifiable risk factor. Bone Joint J, 2019, 101-B (Suppl C): 17-21.
32. Gu A, Malahias MA, Strigelli V, et al. Preoperative malnutrition negatively correlates with postoperative wound complications and infection after total joint arthroplasty: a systematic review and meta-analysis. J Arthroplasty, 2019, 34(5): 1013-1024.
33. 陳佳麗, 寧寧, 廖燈彬, 等. 術前高蛋白飲食提高全膝關節置換術患者的術前營養狀況. 成都醫學院學報, 2020, 15(5): 599-602.
34. Bohl DD, Shen MR, Kayupov E, et al. Hypoalbuminemia independently predicts surgical site infection, pneumonia, length of stay, and readmission after total joint arthroplasty. J Arthroplasty, 2016, 31(1): 15-21.
35. Spahn DR. Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology, 2010, 113(2): 482-495.
36. Marchant MH Jr, Viens NA, Cook C, et al. The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. J Bone Joint Surg Am, 2009, 91(7): 1621-1629.
37. Wallis JA, Taylor NF. Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery-a systematic review and meta-analysis. Osteoarthritis Cartilage, 2011, 19(12): 1381-1395.
38. 梁彩艷, 崔健, 楊旭, 等. 北京地區全膝關節置換術患者術前預康復實施現狀及影響因素分析: 多中心橫斷面調查研究. 中華骨與關節外科雜志, 2021, 14(11): 954-957.
39. Kubo Y, Sugiyama S, Takachu R, et al. Effects of preoperative low-intensity training with slow movement on early quadriceps weakness after total knee arthroplasty in patients with knee osteoarthritis: a retrospective propensity score-matched study. BMC Sports Sci Med Rehabil, 2020, 12(1): 72.
40. Vasta S, Papalia R, Torre G, et al. The influence of preoperative physical activity on postoperative outcomes of knee and hip arthroplasty surgery in the elderly: a systematic review. J Clin Med, 2020, 9(4): 969.

West China Medical Journal

Evidence summary of the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement under enhanced recovery after surgery

Abstract Full text Figures/Tables Video References Cited by

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