Cargando…

Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review

Background and purpose — Essential for safe and timely hospital discharge, inpatient functional recovery following lower limb arthroplasty is also variable. A previous systematic review reported moderate and conflicting levels of evidence regarding patient-related predictors of inpatient recovery fo...

Descripción completa

Detalles Bibliográficos
Autores principales: Hewlett-Smith, Nicola, Pope, Rodney, Furness, James, Simas, Vini, Hing, Wayne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023898/
https://www.ncbi.nlm.nih.gov/pubmed/32237927
http://dx.doi.org/10.1080/17453674.2020.1744852
_version_ 1783675197221502976
author Hewlett-Smith, Nicola
Pope, Rodney
Furness, James
Simas, Vini
Hing, Wayne
author_facet Hewlett-Smith, Nicola
Pope, Rodney
Furness, James
Simas, Vini
Hing, Wayne
author_sort Hewlett-Smith, Nicola
collection PubMed
description Background and purpose — Essential for safe and timely hospital discharge, inpatient functional recovery following lower limb arthroplasty is also variable. A previous systematic review reported moderate and conflicting levels of evidence regarding patient-related predictors of inpatient recovery for primary total hip arthroplasty (THA). A systematic review of surgical prognostic factors for inpatient recovery following THA or total knee arthroplasty (TKA) is yet to be undertaken. We identified patient and surgical prognostic factors for inpatient functional recovery following THA and TKA; determined whether inpatient functional recovery varies between these procedures; and established whether validated outcome measures relevant to the patient’s functional requirements for hospital discharge are routinely assessed. Patients and methods — Critical Appraisal Skills Programme checklists assessed methodological quality, and a best-evidence synthesis approach determined the levels of evidence supporting individual prognostic factors. PubMed, CINAHL, Embase, Scopus, and PEDro databases were searched from inception to May 2019. Included studies examined patient or surgical prognostic factors and a validated measure of post-operative function within 2 weeks of primary, unilateral THA or TKA. Results — Comorbidity status and preoperative function are supported by a strong level of evidence for TKA. For THA, no strong level of evidence was found for patient-related prognostic factors, and no surgical factors were independently prognostic for either arthroplasty site. Limited evidence supports fast-track protocols in the TKA population. Interpretation — Preoperative screening and optimization is recommended. Assessment of Enhanced Recovery Pathways using validated outcome measures appropriate for the early postoperative period is warranted.
format Online
Article
Text
id pubmed-8023898
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-80238982021-04-22 Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review Hewlett-Smith, Nicola Pope, Rodney Furness, James Simas, Vini Hing, Wayne Acta Orthop Articles Background and purpose — Essential for safe and timely hospital discharge, inpatient functional recovery following lower limb arthroplasty is also variable. A previous systematic review reported moderate and conflicting levels of evidence regarding patient-related predictors of inpatient recovery for primary total hip arthroplasty (THA). A systematic review of surgical prognostic factors for inpatient recovery following THA or total knee arthroplasty (TKA) is yet to be undertaken. We identified patient and surgical prognostic factors for inpatient functional recovery following THA and TKA; determined whether inpatient functional recovery varies between these procedures; and established whether validated outcome measures relevant to the patient’s functional requirements for hospital discharge are routinely assessed. Patients and methods — Critical Appraisal Skills Programme checklists assessed methodological quality, and a best-evidence synthesis approach determined the levels of evidence supporting individual prognostic factors. PubMed, CINAHL, Embase, Scopus, and PEDro databases were searched from inception to May 2019. Included studies examined patient or surgical prognostic factors and a validated measure of post-operative function within 2 weeks of primary, unilateral THA or TKA. Results — Comorbidity status and preoperative function are supported by a strong level of evidence for TKA. For THA, no strong level of evidence was found for patient-related prognostic factors, and no surgical factors were independently prognostic for either arthroplasty site. Limited evidence supports fast-track protocols in the TKA population. Interpretation — Preoperative screening and optimization is recommended. Assessment of Enhanced Recovery Pathways using validated outcome measures appropriate for the early postoperative period is warranted. Taylor & Francis 2020-04-02 /pmc/articles/PMC8023898/ /pubmed/32237927 http://dx.doi.org/10.1080/17453674.2020.1744852 Text en © 2020 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/4.0/
spellingShingle Articles
Hewlett-Smith, Nicola
Pope, Rodney
Furness, James
Simas, Vini
Hing, Wayne
Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title_full Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title_fullStr Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title_full_unstemmed Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title_short Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
title_sort prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023898/
https://www.ncbi.nlm.nih.gov/pubmed/32237927
http://dx.doi.org/10.1080/17453674.2020.1744852
work_keys_str_mv AT hewlettsmithnicola prognosticfactorsforinpatientfunctionalrecoveryfollowingtotalhipandkneearthroplastyasystematicreview
AT poperodney prognosticfactorsforinpatientfunctionalrecoveryfollowingtotalhipandkneearthroplastyasystematicreview
AT furnessjames prognosticfactorsforinpatientfunctionalrecoveryfollowingtotalhipandkneearthroplastyasystematicreview
AT simasvini prognosticfactorsforinpatientfunctionalrecoveryfollowingtotalhipandkneearthroplastyasystematicreview
AT hingwayne prognosticfactorsforinpatientfunctionalrecoveryfollowingtotalhipandkneearthroplastyasystematicreview