Abstract
ObjectiveData on the utilisation of outpatient physiotherapy (PT) in patients following total knee arthroplasty (TKA) are scarce, and available studies have not been systematically synthesised. This study aims to summarise the existing literature on outpatient PT following TKA as well as to identify factors associated with its use.MethodsA systematic literature search in MEDLINE (via PubMed), CINAHL, Scopus and PEDro was conducted in July 2020 without language restrictions. Two authors independently selected studies, extracted data and assessed study quality. The primary outcome was the proportion being treated with at least one session of outpatient PT (land- or water-based treatments supervised/provided by a qualified physiotherapist) during any defined period within 12 months following TKA. Furthermore, predictors for the use of PT were assessed. Studies including only revision surgeries or bilateral TKA were excluded.ResultsAfter screening 1934 titles/abstracts and 56 full text articles, 5 studies were included. Proportions of PT utilisation ranged from 16.7 to 84.5%. There were large variations in the time periods after hospital discharge (4 weeks to 12 months) and in the reporting of PT definitions. Female sex was associated with higher PT utilisation, and compared to patients after total hip arthroplasty, utilisation was higher among those following TKA.ConclusionDespite using a broad search strategy, we found only 5 studies assessing the utilisation of PT after hospital discharge in patients with TKA. These studies showed large heterogeneity in PT utilisation, assessed time periods and PT definitions. Clearly, more studies from different countries with uniform PT definitions are needed to address this relevant public health question.
Highlights
Osteoarthritis (OA) is the most common joint disorder and a leading cause of disability in older adults [1, 2]
This study aims to summarise the existing literature regarding the proportion of patients receiving outpatient PT following total knee arthroplasty (TKA) as well as to identify factors associated with its use
Study selection and data extraction Results from the literature search were exported into an EndNote (Version X9, Clarivate, Philadelphia, PA, USA) library, and duplicates were removed
Summary
Osteoarthritis (OA) is the most common joint disorder and a leading cause of disability in older adults [1, 2]. It is a progressive condition associated with pain, movement restrictions and, as a result, diminished quality of life [3, 4]. TKAs are highly successful in restoring joint function and relieving pain, and they are associated with high patient satisfaction [15]. Jones et al observed 20% of patients with unfavourable pain outcomes at 6 months in a high-quality study in multiple centres with low loss to follow-up [17]. The exact percentage of patients with chronic pain and/or decreased function is unclear and varies across studies [16]
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