ReviewOsteoarthritis and cartilage open2026
Efficacy of prehabilitation modalities in total knee arthroplasty:
Review in Osteoarthritis and cartilage open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Up to 30% of patients with osteoarthritis experience suboptimal recovery after total knee arthroplasty (TKA), increasing interest in prehabilitation as a potential strategy to improve postoperative outcomes. This study compared the efficacy of individual prehabilitation modalities versus standard care for physical function, quadriceps strength, pain, and health-related quality of life (HR-QoL) at 3 months after TKA, with additional analyses at 4-8 weeks. Design: We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) following PRISMA guidelines. Eligible studies included adults undergoing TKA for osteoarthritis who received preoperative prehabilitation targeting physical, educational, nutritional, or behavioral domains. Comparators were standard care or alternative prehabilitation interventions. Confidence in the evidence was assessed using the CINeMA framework. Results: 20 RCTs (1095 patients) comparing eight prehabilitation modalities were included. At 3 months after TKA, no prehabilitation modality demonstrated statistically significant improvements in physical function, quadriceps strength, pain, or HR-QoL compared with standard care. Similar findings were observed at 4-8 weeks after TKA, except that lower-extremity strength training significantly improved quadriceps strength compared with standard care. Confidence in the evidence was predominantly low to very low, primarily because of imprecision, although three treatment comparisons were supported by moderate confidence. Conclusion: Current evidence does not support recommending one prehabilitation modality over another before TKA. Although lower-extremity strength training improved short-term quadriceps strength, this finding was supported by low-confidence evidence. Larger, adequately powered head-to-head trials are needed to determine whether specific prehabilitation modalities provide clinically meaningful postoperative benefits. Registration: PROSPERO (CRD42024490615).
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