{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:47:11Z","timestamp":1787161631573,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although joint arthroplasties are generally successful, many patients experience persistent impairments. It is unknown whether early outpatient physiotherapy can address these persistent impairments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether early outpatient physiotherapy, compared with delayed physiotherapy, improves pain, physical function and quality of life (QOL) in patients following lower limb arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis was conducted following the PRISMA guidelines. Searches were conducted across MEDLINE, Embase, CINAHL, Cochrane and PsycINFO. Eligible studies included randomised control trials (RCTs) comparing early and delayed physiotherapy in patients after lower limb arthroplasty. Data were pooled using a random\u2010effects model. Risk of bias assessment was completed using the Physiotherapy Evidence Database scale. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three RCTs involving 224 participants undergoing joint arthroplasty (lateral uni\u2010compartment knee replacement, total knee replacement and total hip replacement) were included. Meta\u2010analyses demonstrated no significant differences in pain, physical function or QOL between early and delayed physiotherapy in short, medium or long term follow\u2010ups. The certainty of evidence ranged from very low to low, with negligible to minimal effect sizes indicating minimal clinical relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The systematic review and meta\u2010analysis found low to very low quality evidence that early outpatient physiotherapy following knee or hip joint arthroplasty does not improve pain, physical function or QOL compared with delayed physiotherapy. Future research should aim to confirm modifiable risk factors contributing to poor outcomes post\u2010operatively and evaluate the effectiveness of early targeted physiotherapy in these high\u2010risk subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.70162","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T05:05:44Z","timestamp":1752555944000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Early Post\u2010Operative Outpatient Physiotherapy on Outcomes Following Lower Limb Arthroplasty: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4818-6339","authenticated-orcid":false,"given":"Sim\u1ee1ne","family":"LeBel","sequence":"first","affiliation":[{"name":"Physiotherapy Department Northern Health  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"King","sequence":"additional","affiliation":[{"name":"School of Allied Health, Human Services and Sport La Trobe University  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam I.","family":"Semciw","sequence":"additional","affiliation":[{"name":"School of Allied Health, Human Services and Sport La Trobe University  Victoria Australia"},{"name":"Northern Centre for Health Education and Research  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Snowdon","sequence":"additional","affiliation":[{"name":"School of Allied Health, Human Services and Sport La Trobe University  Victoria Australia"},{"name":"Academic Unit Peninsula Health  Victoria Australia"},{"name":"National Centre for Healthy Ageing  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5606\/tftrd.2020.6266"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000521"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.02.014"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102011\u2010000435"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20102909.112.1.155"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/PPR\u2010230802"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1836\u20109553(13)70198\u2010X"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0004\u20109514(09)70043\u20101"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2019.1639222"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S137892"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2023.11.011"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2007.04.011"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010017\u20105377\u20107"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010021\u201004600\u20102"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.02.061"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215516640035"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.09.017"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2025.12813"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/eahr.500147"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.05.007"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010018\u20103669\u20106"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215511427749"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.09.025"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2019.11.002"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2023.101134"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24894"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed\u20102017\u2010110883"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.4172\/2329\u20109096.S5\u2010002"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010023\u201007125\u2010y"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0000000000000347"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200307000\u201000014"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7203.185"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2010.03182.x"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2665\u20109913(23)00163\u20107"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S345496"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u2010135"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.08.044"},{"key":"e_1_2_12_42_1","unstructured":"World Health Organization.2001.International Classification of Functioning Disability and Health (ICF).https:\/\/www.who.int\/standards\/classifications\/international\u2010classification\u2010of\u2010functioning\u2010disability\u2010and\u2010health."},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010021\u201005023\u20103"}],"container-title":["Musculoskeletal Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:02:32Z","timestamp":1758880952000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/msc.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/msc.70162"],"URL":"https:\/\/doi.org\/10.1002\/msc.70162","archive":["Portico"],"relation":{},"ISSN":["1478-2189","1557-0681"],"issn-type":[{"value":"1478-2189","type":"print"},{"value":"1557-0681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,14]]},"assertion":[{"value":"2025-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70162"}}