Home-Based Compared with Hospital-Based Rehabilitation Program for Patients Undergoing Total Knee Arthroplasty for Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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Abstract

Objective

The aim of this study was to compare the effects of home-based with those of hospital-based rehabilitation on patients undergoing total knee arthroplasty (TKA).

Design

PubMed, Web of Science, EMBASE, and Cochrane Library were systematically searched for randomized controlled trials; the studies were assessed with the modified Jadad scale. Ten trials involving 1240 patients were eligible for meta-analysis.

Results

The results revealed that home-based rehabilitation is not inferior to hospital-based rehabilitation according to the total Western Ontario and McMaster Universities Osteoarthritis index score, physical function, stiffness, walk test, and Oxford Knee Score at 12 or 52 weeks after TKA (P > 0.05). Neither pain nor knee flexion range of motion differed between the groups in the first 12 weeks. Unexpectedly, the pain score in the hospital-based group was better than that in the home-based group (P < 0.05), whereas the knee flexion range of motion in the home-based group was superior to that in the hospital-based group (P < 0.05) at 52 weeks. The meta-analysis revealed that the 2 rehabilitation programs have similar costs (P > 0.05).

Conclusion

Home-based rehabilitation after primary TKA was comparable to hospital-based rehabilitation and thus is a significant alternative for patients.

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