Evidence map›Paper›PMID 26839013›Full record

SynthesisBMJ open2016

Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials.

Li Wang, Myeongjong Lee, Zhe Zhang, Jessica Moodie, Davy Cheng, Janet Martin

4 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 74 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 12 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03227120 nacompletednot on this mapstarted 2017, after this paper: background citation

The Effects of Prehabilitative Exercise on Functional Recovery Following Total Knee Arthroplasty

TypeinterventionalSponsorCarilion ClinicRan2017 to 2020Enrolled60ConditionsArthroplasty, Osteoarthritis, KneeArmsPrehabilitation exercise
NCT04153721 nacompletednot on this mapstarted 2020, after this paper: background citation

Evaluation of a Digital Perioperative Support Solution for Colorectal Surgery: Compliance and Impact on Patients

TypeinterventionalSponsorIHU StrasbourgRan2020 to 2023Enrolled22ConditionsColorectal CancerArmsName Digital Solution
NCT04814992 nacompletednot on this mapstarted 2020, after this paper: background citation

Pre-op CBT to Reduce the Risk for Development of Chronic Post-surgical Pain in Patients Undergoing Total Knee Arthroplasty

TypeinterventionalSponsorUniversity of PennsylvaniaRan2020 to 2023Enrolled54ConditionsChronic Post-Surgical PainArmsComputer-Assisted Preoperative CBT Intervention (PAINTrainer)
NCT07621666 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Prehab2Rehab: Digitally Supported Short-Term Prehabilitation Before Total Knee Replacement - A Randomized Controlled Feasibility Trial

TypeinterventionalSponsorLudwig Boltzmann Institute for Digital Health and PreventionRan2026 to 2027Enrolled60ConditionsKnee Osteoarthristis, Total Knee ReplacementArmsEXERCISE TRAINING WITH OR WITHOUT MEDICATION, Usual Care Group
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 12 syntheses or guidelines pooled it, 198 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Timed Stair-Climbing as a Surrogate Marker for Sarcopenia Measurements in Predicting Surgical Outcomes.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019
    Trial
  18. Article
  19. Article
  20. Article

14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Li WangCentre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI), University of Western Ontario, London, Ontario, Canada Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China Michael G DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
Myeongjong LeeDepartment of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Chungju, South Korea.
Zhe ZhangDepartment of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jessica MoodieCentre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI), University of Western Ontario, London, Ontario, Canada.
Davy ChengCentre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI), University of Western Ontario, London, Ontario, Canada Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, Ontario, Canada.
Janet MartinCentre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI), University of Western Ontario, London, Ontario, Canada Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, Ontario, Canada Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada.
Western University · CAImpact · CAKonkuk University · KRPeking Union Medical College Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe clinical impact of preoperative physiotherapy on recovery after joint replacement remains controversial. This systematic review aimed to assess the clinical impact of prehabilitation before joint replacement.

designWe searched PubMed, Embase and Cochrane CENTRAL up to November 2015 for randomised controlled trials comparing prehabilitation versus no prehabilitation before joint replacement surgery. Postoperative pain and function scores were converted to Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales (0-100, high scores indicate worse outcome). Random effects meta-analysis was performed to calculate weighted mean differences (WMD, 95% CI), subgrouped by hip and knee surgery. PRIMARY AND SECONDARY OUTCOMES: Postoperative pain and function scores, time to resume activities of daily living, quality of life, length of hospital stay, total cost, patient satisfaction, postoperative complications, any adverse events and discontinuations.

resultsOf 22 studies (1492 patients), 18 had high risk of bias. Prehabilitation slightly reduced pain scores within 4 weeks postoperatively (WMD -6.1 points, 95% CI -10.6 to -1.6 points, on a scale of 0-100), but differences did not remain beyond 4 weeks. Prehabilitation slightly improved WOMAC function score at 6-8 and 12 weeks (WMD -4.0, 95% CI -7.5 to -0.5), and time to climbing stairs (WMD -1.4 days, 95% CI -1.9 to -0.8 days), toilet use (-0.9 days, 95% CI -1.3 to -0.5 days) and chair use (WMD -1.2 days, 95% CI -1.7 to -0.8 days). Effects were similar for knee and hip surgery. Differences were not found for SF-36 scores, length of stay and total cost. Other outcomes of interest were inadequately reported.

conclusionsExisting evidence suggests that prehabilitation may slightly improve early postoperative pain and function among patients undergoing joint replacement; however, effects remain too small and short-term to be considered clinically-important, and did not affect key outcomes of interest (ie, length of stay, quality of life, costs).

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneePhysical Therapy ModalitiesActivities of Daily LivingHospital CostsHumansLength of StayOsteoarthritis, HipOsteoarthritis, KneePatient SatisfactionPostoperative ComplicationsPostoperative PainPreoperative CareQuality of LifeJOINT REPLACEMENTMETA-ANALYSISORTHOPAEDIC & TRAUMA SURGERYPAIN MANAGEMENTREHABILITATION MEDICINE

Identifiers

PMID26839013
PMCPMC4746481
OpenAlexW2310996805

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.