Meta-Analysis of Knee Joint Function Recovery after Anterior Cruciate Ligament Reconstruction by Accelerated Rehabilitation Surgery

Long-term effects of non-weight bearing and immobilization after anterior cruciate ligament reconstruction on joint contracture formation in rats

PURPOSE

Non-weight bearing improves and immobilization worsens contracture induced by anterior cruciate ligament reconstruction (ACLR), but effect persistence after reloading and remobilization remains unclear, and the combined effects of these factors on ACLR-induced contracture are unknown. We aimed to determine 1) whether the effects of short-term (2-week) non-weight bearing or immobilization after ACLR on contracture would be sustained by reloading or remobilization during a 10-week observation period, and 2) how the combination of both interventions compared to the outcome of either alone.

METHODS

We divided 88 ACL-reconstructed male rats into four groups: non-intervention, non-weight bearing, joint immobilization, and both interventions. Interventions were performed for 2 weeks, followed by rearing without intervention. Twelve untreated rats were used as controls. At 2, 4, and 12 weeks post-surgery, we assessed range of motion (ROM) and histological changes.

RESULTS

ACLR resulted in persistent loss of ROM, accompanied by synovial shortening, capsule thickening, and osteophyte formation. Two weeks of non-weight bearing increased ROM and reduced osteophyte size, but the beneficial effects disappeared within 10 weeks after reloading. Two-week immobilization decreased ROM and facilitated synovial shortening. After remobilization, ROM partially recovered but remained below non-intervention levels at 12 weeks. When both interventions were combined, ROM was similar to immobilization alone.

CONCLUSIONS

The beneficial effects of 2-week non-weight bearing on contracture diminished within 10 weeks after reloading. The adverse effects of 2-week immobilization on contracture persisted after 10 weeks of remobilization. The effects of the combined use of both interventions on contracture were primarily determined by immobilization.

Application of enhanced recovery after surgery in perioperative nursing care of elderly patients with hip and knee arthroplasty: A systematic review and meta-analysis

BACKGROUND

To collect data from randomized controlled trials (RCTs) to evaluate the effects of enhanced recovery after surgery on postoperative recovery of elderly patients who underwent hip or knee arthroplasty.

METHODS

The search was limited to studies published prior to January 1, 2023, in the electronic databases of Cochrane, Embase, Ovid Medline, Proquest, PubMed, Scopus, Web of Science, and Chinese databases, including China National Knowledge Internet (CNKI) and SinoMed. All relevant data were collected from the studies that met the inclusion criteria. The outcome variables were recovery of joint function and incidence of complications. STATA software (version 14.0) was used for the meta-analysis.

RESULTS

A total of 44 published studies met the inclusion criteria. The cumulative data included 2203 cases receiving enhanced recovery after surgery (ERAS), and 2173 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that the VAS score was significantly lower in the ERAS group than in the non-ERAS group (P < .01), and there were fewer incidences of complications in the ERAS group than in the control group (P < .01).

CONCLUSIONS

ERAS significantly reduced pain and the incidence of complications in elderly patients who had undergone joint replacement surgery.

Retracted: Meta-Analysis of Knee Joint Function Recovery after Anterior Cruciate Ligament Reconstruction by Accelerated Rehabilitation Surgery

[This retracts the article DOI: 10.1155/2022/5085143.].

Analysis of the Efficacy of Acupuncture Combined with Rehabilitation Training in the Treatment of Upper Limb Spasm after Stroke: A Systematic Review and Meta-Analysis

Objective

Systematic evaluation of the efficacy of acupuncture combined with cognitive rehabilitation training in the treatment of upper limb spasm after cerebral apoplexy.

Methods

The data of CNKI, CBM, CQVIP, Wanfang, and the libraries of Pubmed and Cochrane were searched by computer, and the related literatures about acupuncture combined with cognitive rehabilitation training in the treatment of cognitive dysfunction after stroke were searched. The search time is from January 1, 1995 to January 1, 2022. All data segments were independently analyzed and extracted by two evaluators. After evaluating the quality of the methodology, meta-analysis was carried out by using the RevMan5.4 software.

Results

Finally, 11 studies were included, with a total of 789 subjects. The results of meta-analysis indicated that acupuncture combined with cognitive rehabilitation training was superior to simple cognitive rehabilitation training or drugs in the following aspects, the difference exhibited statistically significant, the total effective rate (RR = 1.58, 95% CI), latency of P300 (MD = -18.46, 95% CI), amplitude of P300 (MD = 1.23, 95% CI (0.82), P < 0.00001, 95% CI (0.31)), and activity of daily living (ADL), respectively, were significantly higher compared to the control group (P < 0.00001), and the difference was statistically significant (P < 0.05). Based on the results of systematic evaluation, the GRADE system recommendation classification method is used to evaluate the quality of evidence. The results show that the level of evidence is low and the intensity of recommendation is weak.

Conclusion

The results of this meta-analysis suggest that the curative effect of acupuncture combined with cognitive rehabilitation training is better compared to simple cognitive rehabilitation training or drugs. However, due to the low quality of the original literature, it needs to be confirmed by multicenter, high-quality, large-sample randomized blind controlled trials in the future.