Pagpapanatili ng Aktibidad para sa Kalusugan ng Kasu-kasuan Impormasyon

Ano ito

Ang pagpapanatili ng aktibidad para sa kalusugan ng kasu-kasuan ay nangangahulugang paggamit ng mga partikular na galaw upang mapanatili ang maayos na pag-andar ng iyong mga kasu-kasuan. Ang pamamaraang ito ay hindi lamang para sa mga may malubhang arthritis na dulot ng pagkasira. Kasama rito ang aerobic exercise, strength training, at mga rutinang pangkalastiko. Maaaring irekomenda ng iyong doktor ang mga gawaing ito upang matulungan ang pamamahala ng sakit at mapabuti ang iyong paggalaw.

Maaari mong simulan ang mga ehersisyong ito sa loob ng maikling panahon pagkatapos ng operasyon para sa pagpapalit ng kasu-kasuan. Kung magsisimula ka sa loob ng 12 linggo pagkatapos ng total knee replacement, malamang na makakakita ka ng mas mahusay na pang-araw-araw na pag-andar. Kung patuloy kang mag-eehersisyo ng higit sa 12 linggo, makakakuha ka ng mas malakas na kalamnan at mas maluwag na kasu-kasuan. Ang pagsisikap na ito sa pangmatagalan ay tumutulong sa paggaling ng iyong katawan at pagpapanatili ng lakas nito.

Gumagana ang ehersisyo sa pamamagitan ng pagpapabuti ng fitness ng iyong puso at baga. Tumatulong din ito upang mas maunawaan ng iyong utak ang mga signal ng sakit. Ang edukasyon sa siyensya ng sakit na ito ang pinakamabisang mag-isa kapag pinagsama sa pisikal na paggalaw, kaysa gamitin mag-isa. Bagama't hindi binabago ng mga wearable trackers ang iyong pakiramdam tungkol sa kalusugan ng iyong kasu-kasuan, ang paggalaw mismo ay may epekto. Para sa mga kondisyon tulad ng trigger finger o wrist arthritis, maaaring bawasan ng ehersisyo ang mga sintomas at maaari itong tumulong upang maiwasan ang operasyon sa paglipas ng panahon.

Gumagana ba ito?

Ang ehersisyo ay mahalagang bahagi ng iyong paggaling at pangmatagalang kalusugan ng kasu-kasuan. Kung naging kaalaman ka ng buong palitan ng tuhod, ang pagsisimula ng ehersisyo sa loob ng 12 linggo ay tumutulong upang mas mabuti ang iyong paggalaw. Ang paghintay ng higit sa 12 linggo bago magsimula ay maaari pa ring makatulong, ngunit maaaring kailanganin ng mas maraming oras upang mapalakas ang lakas ng kalamnan at flexibility.

Para sa osteoarthritis ng tuhod (arthritis na dulot ng pagkasuot), ang ehersisyo ay maaaring bawasan ang sakit at mapabuti ang function. Gayunpaman, hindi sapat ang ebidensya upang sabihin kung gaano ka kaiba ang iyong pakiramdam. Ang aerobic exercise ay nagpapabuti ng fitness ng puso at baga. Ang mga mind-body exercises tulad ng Pilates at Tai Chi ay maaaring magbigay ng pinakamainam na ginhawa para sa sakit at araw-araw na function. Maaari ring mapabuti ng Tai Chi ang iyong pangkalahatang kalidad ng buhay.

Ang pagdaragdag ng whole-body vibration sa iyong routine ng ehersisyo ay maaaring palakasin ang mga resulta para sa malubhang arthritis ng tuhod. Para sa mga isyu sa hinlalaki, ang paggamit ng mobile game para sa mga ehersisyo sa bahay ay maaaring tumulong upang mas mabuti kang sumunod sa iyong routine kumpara sa karaniwang mga tagubilin. Ang mga ehersisyo sa ankle pump ay kritikal pagkatapos ng surgery sa ibabang bahagi ng katawan upang maiwasan ang mga blood clot.

Nag-iiba ang mga resulta depende sa kondisyon. Para sa mga problema sa kamay, pulso, o siko, ang mga scapular (balikat) exercises ay madalas na hindi nagdudulot ng makikitang pagbabago sa function. Ang mga wearable activity trackers ay tila hindi nagpapabuti ng iyong pakiramdam o kalusugan ng kasu-kasuan. Para sa trigger finger, ang mga orthoses at ehersisyo ay tumutulong sa maikling panahon, ngunit hindi namin mapatutunang mas maganda ito kaysa sa ibang mga conservative treatments.

Mahalaga ang prehabilitation (ehersisyo bago ang surgery). Ang isang supervised, personalized na programa bago ang anterior cruciate ligament reconstruction ay nagdudulot ng mas magandang function ng tuhod kumpara sa isang self-guided na plano. Pagkatapos ng wrist osteoarthritis, tumutulong ang ehersisyo sa pamamahala ng mga sintomas sa loob ng dalawang taon, na may kaunting mga pasyente na nangangailangan ng surgery.

May ilang mga natuklasan na mixed o limitado. Hindi pa namin alam kung ang total hip replacement ay dapat para lamang sa mga malubhang kaso. Kailangan ng mas maraming trials upang kumpirmihin ito. Habang ipinapakita ng mga pag-aaral sa hayop na ang moderate treadmill use ay tumutulong sa paggaling pagkatapos ng maikling pahinga, ang prolonged immobilization ay nakakasama sa paggaling.

Sa kabuuan, gumagana ang ehersisyo para sa maraming kondisyon, ngunit ang antas ng benepisyo ay nakadepende sa partikular na kasu-kasuan at uri ng aktibidad. Ang iyong doktor ang gabay sa iyo patungo sa angkop na programa.

Tama ba ito para sa iyo?

Maaari kang makatanggap ng benepisyo kung handa kang magsimulang gumalaw kaagad pagkatapos ng joint replacement. Ang pagsisimula ng ehersisyo sa loob ng 12 linggo pagkatapos ng total knee replacement ay tumutulong sa iyo na muling makuha ang iyong function. Kung magpapatuloy ka ng higit sa 12 linggo, makikita mo ang mas malaking pagtaas sa lakas ng kalamnan at flexibility ng kasu-kasuan. Ito ay nag-aaplay sa hip at knee replacements pareho.

Maaari ka ring makatanggap ng benepisyo kung may wear-and-tear arthritis ka sa iyong tuhod. Ang aerobic exercise ay nagpapabuti sa fitness ng iyong puso at baga. Para sa end-stage knee arthritis, ang pagdaragdag ng whole-body vibration sa iyong routine ay maaaring palakasin pa ang mga resulta. Ang ehersisyo ay maaari ring tumulong sa pamamahala ng mga sintomas sa wrist arthritis, na may kaunting mga pasyente na nangangailangan ng surgery sa loob ng 24 na buwan.

Gayunpaman, hindi ito para sa lahat. Ang paggamit ng wearable activity trackers upang subaybayan ang iyong galaw ay hindi nagpapabuti sa pakiramdam mo o sa iyong kalidad ng buhay. Ang ehersisyo ay maaaring hindi magbigay ng clinically important na pagpapagaan ng sakit para sa knee arthritis, kahit na tumutulong ito nang bahagya. Katulad nito, ang mga espesipikong ehersisyo para sa mga isyu sa kamay, wrist, o siko ay madalas na hindi nakarating sa threshold para sa makabuluhang pagpapabuti. Ang mga treatment para sa trigger finger ay nagpapakita ng short-term na mga pagtaas ngunit kulang sa ebidensya na mas mabuti ito kaysa sa ibang mga conservative na opsyon.

Ang recovery ay nag-iiba nang malaki sa pagitan ng mga pasyente. Ito ang dahilan kung bakit dapat i-customize ng iyong doktor ang plano para sa iyong mga partikular na pangangailangan. Huwag magpalagay na ang mga sintomas ng severe hip arthritis ay awtomatikong nangangailangan ng surgery agad-agad. Talakayin ang iyong mga layunin at limitasyon nang bukas. Ang shared decision-making ay tinitiyak na ang plano ay angkop sa iyong buhay at kalagayan sa kalusugan.

Ang pangunahing aral

Ang ehersisyo ay isang praktikal na paraan upang pamahalaan ang kalusugan ng kasu-kasuan at mapabuti ang pag-andar. Maaari kang magharap ng mas mahusay na lakas at flexibility kung mananatili kang aktibo sa loob ng higit sa 12 linggo pagkatapos ng operasyon sa palikpik. Ang aerobic na gawain ay nakakatulong din sa iyong puso at baga. Bagama’t madalas na binabawasan ng ehersisyo ang sakit, iba-iba ang eksaktong benepisyo para sa bawat tao. Maaaring irekomenda ng iyong doktor ang mga partikular na programa, tulad ng Pilates o Tai Chi, upang makaramdi ka ng pinakamahusay na pakiramdam.

Evidence & references

Overview

Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
Total hip arthroplasty outcomes should not be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
Self-monitoring physical activity with wearable activity trackers does not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
Scapular exercise programs for hand, wrist, or elbow disorders result in functional outcome differences that most often do not reach the minimum threshold to be considered clinically important [8].
Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
Neuromuscular exercise therapy contributes to symptom management in wrist osteoarthritis over time, with few participants requiring surgical conversion at 24 months [10].

How It Works

Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty [5].
It is uncertain whether the improvements in pain and function from exercise for knee osteoarthritis are clinically important [5].
The addition of wearable activity tracker use did not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
Most differences in functional outcomes from scapular exercise programs for hand, wrist, or elbow disorders did not reach the minimum threshold to be considered clinically important [8].
Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management [9].
Few participants in either group required surgery at 24 months in a trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may optimize the benefits of exercise therapy [12].
Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction [13].
Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction [13].
Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis [14].
Pain science education is less successful when delivered standalone compared to when it is part of an exercise intervention [14].
There is heterogeneity in functional recovery among joint arthroplasty patients, highlighting the importance of a personalised, data-driven approach to post-operative care [15].

What the Evidence Shows

Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
Findings question whether total hip arthroplasty should be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
The addition of wearable activity tracker use did not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
Most differences in functional outcomes for patients with hand, wrist, or elbow disorders following a scapular exercise program did not reach the minimum threshold to be considered clinically important [8].
Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
The document for Fu’s subcutaneous needling versus bracing combined with exercise therapy is a study protocol and does not report results or conclusions [11].
The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize exercise benefits [12].
Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction in a murine model [13].
Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction in a murine model [13].
Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis, and is less successful when delivered standalone [14].
An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program before anterior cruciate ligament reconstruction [16].
Both combined mode kinetic chain exercises with core strengthening and combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved overall quality of life in patients with knee osteoarthritis [17].
Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy resulted in statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline [18].
Mobile game-based home exercise programs may be a potentially effective option for thumb rehabilitation, with significantly higher adherence observed compared to standard home exercise programs [19].
Ankle pump exercises significantly reduce the incidence of deep vein thrombosis and increase venous haemodynamic parameters—specifically maximum venous outflow and maximum venous capacity—in patients undergoing lower limb orthopaedic surgery [20].
There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis [21].
Tai Chi may be the best mind–body exercise for improving quality of life in knee osteoarthritis [21].

Practical Considerations

Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
Total hip arthroplasty should not necessarily be prioritized only for patients with severe hip osteoarthritis symptoms, although this requires confirmation in a trial [2].
Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
Self-monitoring physical activity with wearable activity trackers does not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
Most differences in functional outcomes from scapular exercise programs for hand, wrist, or elbow disorders did not reach the minimum threshold to be considered clinically important [8].
Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to symptom management over time [10].
The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize the benefits of exercise therapy [12].
Heterogeneity in functional recovery among joint arthroplasty patients underscores the importance of a personalized, data-driven approach to post-operative care to optimize long-term outcomes [15].

Key Evidence

[L1] The interventions implemented at ≤12 weeks primarily improved the functional performance, whereas those lasting >12 weeks resulted in greater gains in the muscle strength and joint flexibility. [1] (10.1186/s13018-025-06430-7)
[L3] These findings question whether THA should be prioritized only for those patients who have severe hip OA symptoms, but require confirmation in a trial. [2] (10.1016/j.arth.2025.04.032)
[L1] These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. [3] (10.1186/s12891-025-08746-1)
[L1] Exercise may improve pain and function with low to moderate certainty, but it is uncertain whether differences are clinically important. [5] (10.1097/corr.0000000000003476)
[L1] The addition of WAT-use did not have any effect on perceived joint function or HRQoL. [7] (10.1186/s12891-024-08238-8)
[L1] However, most of these differences did not reach the minimum threshold to be considered clinically important. [8] (10.1016/j.jht.2024.07.006)
[L4] Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments. [9] (10.1016/j.jhsg.2026.101038)
[L1] Nevertheless, few participants in either group required surgery at 24 months, indicating that both exercise programs may contribute to symptom management over time. [10] (10.1186/s12891-025-09463-5)
[Paper] This document is a study protocol outlining the design of a randomized controlled trial to compare Fu's subcutaneous needling with bracing combined with exercise therapy; it does not report results or conclusions. [11] (10.1186/s13018-026-06719-1)
[L3] The addition of WBV to exercise therapy led to greater improvements in several outcomes, suggesting that WBV may be a valuable adjunct to optimize the benefits of exercise therapy. [12] (10.1186/s42836-025-00301-6)
[L5] Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing, whereas prolonged immobilization has a detrimental effect on physical recovery. [13] (10.1177/2325967125s00320)
[L1] PSE may act as a mechanism of action for exercise interventions, and is less successful delivered standalone. [14] (10.1186/s12891-025-09313-4)
[L3] The findings highlight heterogeneity in functional recovery and underscore the importance of a personalised, data-driven approach to post-operative care to optimise long-term outcomes. [15] (10.1186/s42836-025-00339-6)
[L1] An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program. [16] (10.1177/2325967126s00041)
[L2] The study concluded that both the experimental group receiving core strengthening exercises with combined mode kinetic chain exercises and the control group receiving combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved the overall quality of life of patients with knee Osteoarthritis. [17] (10.1186/s12891-026-09531-4)
[L2] The intervention group showed statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline. [18] (10.1016/j.jisako.2026.101105)
[L2] Mobile game-based home exercise programs may be considered a potentially effective option in thumb rehabilitation and, at the very least, not inferior to standard home exercise programs, with significantly higher adherence to home exercises observed in the mobile game group. [19] (10.1177/17589983251387079)
[L1] This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters—specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)—in patients undergoing lower limb orthopaedic surgery. [20] (10.1186/s13018-025-06236-7)
[L1] There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. [21] (10.1186/s13018-025-05682-7)

References

[1] Changes in knee outcome measures following later-stage exercise interventions implemented ≤ 12 weeks vs. > 12 weeks after total knee arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06430-7 [2] Total Hip Arthroplasty versus Education and Exercise: A Secondary Analysis of Propensity Matched Data Comparing Outcomes Across Hip Osteoarthritis Symptom Severity. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.032 [3] Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08746-1 [5] Cochrane in CORR®: Exercise for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003476 [7] Effects of self-monitoring physical activity with wearable activity trackers on perceived joint function and health-related quality of life in people with hip and knee osteoarthritis: a secondary analysis of a cluster-randomised clinical trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08238-8 [8] Effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders: A comprehensive systematic review with meta-analysis. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2024.07.006 [9] Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101038 [10] Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09463-5 [11] Fu’s subcutaneous needling versus bracing combined with exercise therapy in the treatment of postacute lateral ankle sprain and the prevention of chronic ankle instability: a randomized controlled trial protocol. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06719-1 [12] Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00301-6 [13] Poster 234: Improvement of Tendon-Bone Interface Healing by Moderate Treadmill Exercise Combined with Knee Brace Immobilization Following an Anterior Cruciate Ligament Reconstruction in a Murine Model. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00320 [14] Pain science education and exercise interventions for people with knee or hip osteoarthritis: a systematic review, content and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09313-4 [15] Unsupervised machine learning models reveal two distinct post-operative physical activity profiles among joint arthroplasty patients: a United Kingdom biobank cohort study. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00339-6 [16] Effectiveness of Exercise Prehabilitation Before Anterior Cruciate Ligament Reconstruction on Functional Outcomes – A Single-Blinded Randomized Controlled Trial: Prevention, Prehab and Rehab. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00041 [17] Combined mode-kinetic chain exercise with and without core stability exercises on patients with knee osteoarthritis. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09531-4 [18] Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy improves postural control, quadriceps strength, and pain: A randomized clinical trial. Journal of ISAKOS. 2026. DOI: 10.1016/j.jisako.2026.101105 [19] Effects of home exercise-based mobile games on thumb rehabilitation outcomes. Hand Therapy. 2025. DOI: 10.1177/17589983251387079 [20] Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis and venous hemodynamics following lower limb orthopedic surgery: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06236-7 [21] Comparative efficacy of mind–body exercise for pain, function, quality of life in knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05682-7