Effects of transitional care in improving joint function recovery after total hip replacement in elderly patients: a Meta-analysis

Abstract

Objective To evaluate the effects of transitional care in improving joint function after total hip replacement in elderly patients. Methods Randomized controlled trials on the effects of transitional care on the recovery of joint function after total hip arthroplasty in elderly patients were collected by searching databases such as The Cochrane Library, Web of Science, PubMed, Embase, EBSCO, CBM, CNKI, VIP and WanFang Data. The time limit for retrieval was from the beginning of the database to August 31st, 2017. Meta-analysis was conducted by using RavMan 5.3 to do the statistical process. Results A total of 12 RCTs were included. The results of Meta-analysis showed that transitional care significantly improved muscle strength of hip flexor [SMD=1.64, 95%CI (1.26, 2.01) , P<0.01], hip extensor [SMD=1.01, 95%CI (0.67, 1.36) , P<0.01]and hip abductor [SMD=1.33, 95%CI (0.97, 1.69) , P<0.01]within 3 months. The hip functional scores showed a good result within and beyond 3 months [SMD=0.67, 95%CI (0.53, 0.81) , P<0.01]. There was no difference in the recovery of hip activity between the two groups with 3 months [SMD=0.81, 95%CI (-0.28, 1.89) , P=0.14], but the result became better when beyond 3 months [SMD=1.07, 95%CI (0.93, 1.21) , P<0.01]. Conclusions Transitional care can effectively promote hip joint function recovery after total hip replacement in elderly, and it is recommended to be popularized in clinical practice. Key words: Aged; Arthroplasty, replacement, hip; Meta-analysis; Transitional care