{
  "abstract": "Background\n\nNurse-led rehabilitation is increasingly embedded in postdischarge care after total hip or knee arthroplasty, but its effect on patient-reported recovery has not been quantified through meta-analysis.Objective\n\nThe aim of this study was to evaluate the effects of nurse-led rehabilitation versus usual care on functional recovery, self-efficacy, and quality of life after total hip or knee arthroplasty.Methods\n\nPubMed, Scopus, Web of Science, and ClinicalTrials.gov were searched (2010-2026; English only) for randomized controlled trials comparing nurse-led rehabilitation with usual care. Standardized mean differences (Hedges g) were pooled using random-effects models with Hartung-Knapp confidence intervals. Heterogeneity was assessed with I ² and prediction intervals, robustness with leave-one-out and subgroup analyses, and certainty with Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results\n\nEleven trials (1,107 participants) were included. Nurse-led rehabilitation improved functional recovery (10 trials; g = 1.11, 95% confidence interval 0.42-1.81; I ² = 94.5%), self-efficacy (five trials; g = 1.10, 0.00-2.20; I ² = 93.8%), and quality of life (four trials; g = 0.77, 0.08-1.46; I ² = 81.7%). The certainty of evidence (GRADE) was rated low for all three primary outcomes. Secondary outcomes were directionally favorable but imprecise. The functional recovery effect was robust to leave-one-out analysis, whereas self-efficacy was statistically fragile. Quality of life showed a homogeneous benefit after knee replacement (g = 1.12, I ² = 0%) but not hip (between-subgroup p = 0.032), and functional recovery differed by delivery model (p = 0.012, largest for digital). Heterogeneity was substantial throughout, all prediction intervals crossed the null, and funnel plot asymmetry suggested possible small-study effects.Conclusions\n\nNurse-led rehabilitation after hip or knee arthroplasty was associated with improved function, self-efficacy, and quality of life, consistently favoring nurse-led care in direction but with evidence of low certainty, substantial between-study heterogeneity, prediction intervals that crossed the null, and possible small-study effects. Therefore, the magnitude of benefit remains uncertain. Adequately powered, outcome-blinded trials are needed.Systematic review registration\n\nhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261425216, PROSPERO CRD420261425216.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Rehabilitation, Taixing People's Hospital, Taixing, Jiangsu, China."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ying Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuan Yin"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengxia Tang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qin Luo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1yz07mtywb11d.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1911533",
  "fulltext_url": "https://europepmc.org/articles/PMC13677350",
  "id": "1yz07mtywb11d",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898140",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Total Knee Arthroplasty Outcomes"
    ]
  ],
  "openalex": "W7219572231",
  "pdf_url": "https://europepmc.org/articles/PMC13677350?pdf=render",
  "pmcid": "PMC13677350",
  "pmid": "42898140",
  "published": "2026-10-05",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1yz07mtywb11d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898140",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898140"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Nurse-led rehabilitation after total hip or knee arthroplasty: a systematic review and meta-analysis of functional recovery, self-efficacy, and quality of life.",
  "title_text": "Nurse-led rehabilitation after total hip or knee arthroplasty: a systematic review and meta-analysis of functional recovery, self-efficacy, and quality of life.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/1yz07mtywb11d",
  "venue": "Frontiers in medicine",
  "versions": []
}