Efficacy and safety of continuous nursing in improving functional recovery after total hip or knee arthroplasty in older adults: A systematic review.
Jing Sun, Yirong Xu, Juan Zhu and 2 others
PMID 38707686WHAT IT FOUND
Post-discharge nursing follow-up after hip or knee replacement was reported to improve joint function and pain.
It did not show a clear advantage in complications or readmission. The added care often included exercise, telehealth, or medication, so its separate effect is unclear.
Key findings
01The review included 15 studies, comprising nine randomized controlled trials and six cohort studies, involving 34,186 patients across the included studies.
02The included studies reported better hip function, daily living ability, quality of life, knee range of motion, knee function scores, and less knee pain during exercise.
03The review reports no significant advantage in postoperative complications or readmission after knee replacement.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The interventions were not uniform. They included telephone follow-up, home visits, internet platforms, home exercise, balance training, physical therapy, skilled nursing facility care, and calcitonin added to nursing care. The review cannot separate the effect of continuous nursing from the other components because many studies delivered them together. Most randomized trial sample sizes were not more than 200. Several randomized trials had unclear allocation concealment or blinding, which may introduce selection or measurement bias. The included studies used different outcome measures and follow-up times, and the review reports clinical heterogeneity among continuous nursing strategies. Economic effects were analyzed in only three studies, and their results were not unified. A small single-center WeChat study reported fewer complications, but the review says it was not representative. The review included only English-language studies, so non-English evidence was not considered.
Declared interests
The authors declare no conflicts of interest and report nothing to declare.
The easy way to misread this
Do not conclude that continuous nursing alone caused better joint function or less pain. The included care packages often also included exercise, physical therapy, telehealth platforms, home visits, or calcitonin, and the review did not separate those components.