Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
Surgery following neoadjuvant therapy has become the standard treatment for middle- and late-stage resectable esophageal cancer. However, treatment modalities such as radiotherapy, chemotherapy, and surgery cause physical and psychological harm to patients, reducing their quality of life. Prehabilitation, as an emerging preoperative management strategy, integrates various measures, including exercise training, nutritional support, and psychological support. Its aim is to enhance patients’ physiological and psychological reserves prior to surgery, bolster their tolerance to surgical stress, and thus accelerate the postoperative recovery process. This approach is a key manifestation of the Enhanced Recovery After Surgery (ERAS) concept. This article reviews prehabilitation during neoadjuvant therapy for esophageal cancer patients from 3 aspects: intervention timing, intervention content, and barriers, with the aim of providing a reference for promoting early recovery in patients undergoing esophageal cancer surgery.