Evidence summary of exercise in patients after total knee arthroplasty

QIN Zhuzhu; YE Xinxin; ZOU Xiaoling; ZHENG Xutong; CHEN Danfeng; ZHAN Chenju

doi:10.12104/j.issn.1674-4748.2025.16.003

Abstract：Objective:To systematically retrieve,evaluate and integrate the evidence of exercise in patients after total knee arthroplasty,and to provide reference for clinical practice.Methods:According to the"6S"evidence resource pyramid model,clinical decisions,guidelines,expert consensus,evidence summary,recommended practice,systematic review,meta-analysis and randomized controlled trials related to functional exercise of patients after total knee arthroplasty were searched by computer in domestic and foreign guidelines,official websites of professional associations and Chinese and English databases.The search period was from January 1,2013 to December 31,2023.Two researchers who had participated in evidence-based methodology training independently evaluated the quality of the included literature and extracted evidence.Finally,the evidence was discussed and integrated by the research group.Results:A total of 17 articles were included,including 1 clinical decision,3 guidelines,4 evidence summaries,4 systematic reviews,2 randomized controlled trials and 3 expert consensus.Twenty-five pieces of best evidence were integrated,covering five aspects of organization and management,preliminary safeguards,functional exercise program,health education,and discharge follow-up.Conclusion:This study summarizes the best evidence of exercise in patients after total knee replacement,and suggests that more high-quality studies on total exercise volume and FITT factor management(including exercise frequency,intensity,time and type)should be conducted in the future,with a multidisciplinary team,patients and families working together to develop the optimal rehabilitation exercise program.