Perioperative management of elderly patients with osteoarthritis requiring total knee arthroplasty.
Jiang An Lim, Azeem Thahir
PMID 33745384WHAT IT FOUND
Preoperative education, pain drugs, strength exercises, blood management and early mobilisation are discussed for older patients having total knee replacement.
This is a narrative review, so these are reported recommendations, not tested outcomes.
Key findings
01Preoperative celecoxib was reported to reduce patient-controlled analgesia use and pain scores and improve knee flexion at 72 hours compared with starting it after surgery.
02Prehabilitation before surgery was reported to shorten hospital stay and improve knee range of motion, sit-to-stand performance and postural control after knee replacement.
03Mobilisation within 24 hours of surgery was reported to shorten hospital stay, reduce pain scores and improve function compared with starting physiotherapy a day later.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This is a narrative review without a described search method, so it does not show how studies were chosen or whether negative evidence was missed. It reports findings from cited studies rather than testing interventions in a new group of patients. The review describes many perioperative components together, especially enhanced recovery after surgery, so it cannot show which single component caused any reported effect. It focuses on elderly patients undergoing total knee replacement for osteoarthritis, so it does not tell how to apply these points to younger patients or to other knee surgery populations. It gives no detailed dosing, timing or contraindications for the interventions, so the recommendations cannot be used as a complete care plan.
Declared interests
The supplied text states that the research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. No author conflict of interest list is supplied.
The easy way to misread this
Do not treat these points as evidence that any single intervention will help your patient. The paper is a narrative review without methods or new results, and it reports findings from cited studies rather than testing the interventions.