Effect of Neuromuscular Electrical Stimulation After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Peng L, Wang K, Zeng Y, Wu Y, Si H, Shen B · Frontiers in Medicine

Quadriceps strength was higher with stimulation within one month (SMD 0.81, 95% CI 0.51 to 1.11), at one to two months (0.55, 0.13 to 0.97), three to four months (0.42, 0.18 to 0.66) and twelve to thirteen months (0.46, 0.18 to 0.74). Pain fell at one to two months (MD -0.62, 95% CI -1.04 to -0.19) and three to six months (-0.44, -0.74 to -0.14), and the WOMAC at three to four months (-0.43, -0.82 to -0.05). Timed-up-and-go, three-minute walk and SF-36 mental component also moved. The authors state that many outcomes did not reach statistical significance or the minimal clinically important difference and that the clinical benefit remains to be confirmed.

Population

691 patients across nine randomised trials of neuromuscular electrical stimulation after total knee replacement, ten databases searched to June 2021

Intervention

Postoperative neuromuscular electrical stimulation of the quadriceps as a supplement to usual rehabilitation

Comparator

Usual rehabilitation without stimulation

Limitations

The population has had the joint replaced, so nothing here bears on cartilage: the endpoints are muscle, pain and function around a prosthesis. Pooled pain and WOMAC effects are small enough that the authors themselves flag the minimal clinically important difference. Registered as CRD42021265609. Funded by the National Natural Science Foundation of China (81974347) and a West China Hospital clinical research project; no commercial relationships declared.