Evidence map›Paper›PMID 35264223›Full record

SynthesisJournal of orthopaedic surgery and research2022

The active knee extension after extensor mechanism reconstruction using allograft is not influenced by "early mobilization": a systematic review and meta-analysis.

Cristiano De Franco, Vincenzo de Matteo, Marco Lenzi, Ernesto Marano, Enrico Festa, Alessio Bernasconi, Francesco Smeraglia, Giovanni Balato

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 15% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
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

8 authors at 1 institution in 1 country.

Cristiano De FrancoDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Vincenzo de MatteoDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Marco LenziDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Ernesto MaranoDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Enrico FestaDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Alessio BernasconiDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Francesco SmeragliaDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy.
Giovanni BalatoDepartment of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5 80130, Naples, Italy. giovanni.balato@unina.it.
Federico II University Hospital · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative rehabilitation after extensor mechanism reconstruction (EMR) with allograft following total knee arthroplasty (TKA) is not standardized. This meta-analysis aimed to evaluate the effectiveness of early and late knee mobilization after EMR. The range of motion (ROM) and extensor lag in both groups were also assessed as the secondary endpoint.

methodsFollowing the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed, including studies dealing with the use of allograft for EMR following TKA. Failure was defined as the persistence of extensor lag > 20°. Coleman Methodology Score and Methodological Index for Non-Randomized Studies (MINORS) score were used to assess the quality of studies included. The failure rate was set as the primary outcome in early (4 weeks) and late (8 weeks) mobilization groups after EMR with allograft. Secondary outcomes were postoperative extensor lag and ROM.

resultsTwelve articles (129 knees) were finally selected for this meta-analysis. Late and early knee mobilization was described in five and seven studies, respectively. No difference was noted between both groups' failure rates (11/84 vs. 4/38, respectively; p = 0.69). The mean extensor lag at last follow-up was 9.1° ± 8.6 in the early mobilization group, and 6.5° ± 6.1 in the late mobilization group is not significantly different (p > 0.05). The mean postoperative knee flexion was 107.6° ± 6.5 and 104.8° ± 7 in the early and late mobilization group, respectively.

conclusionWhile immobilization after EMR in TKA is mandatory to allow tissue healing, early knee mobilization after four weeks can be recommended with no additional risk of failure and increased extensor lag compared to a late mobilization protocol. LEVEL OF EVIDENCE: IV, therapeutic study. Registration PROSPERO (International Prospective Register of Systematic Reviews): CRD42019141574.

Indexed as

AllograftsArthroplasty, Replacement, KneeEarly AmbulationHumansKnee JointRange of Motion, ArticularTreatment OutcomeAllograftExtensor mechanismMobilizationRehabilitationTKA

Identifiers

PMID35264223
PMCPMC8905813
OpenAlexW4220742841

What OpenQuestion holds

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Registered trials

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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.