Introduction
Methods
Inclusion criteria
Exclusion criteria
Information sources
Search strategy
Selection process
Data collection process
Data items
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General information (number of participants, patient characteristics, study characteristics).
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Outcomes (strength measurements, muscle mass measurements, muscle activation, wellbeing, range of motion and performance measurements).
Study risk of Bias assessment
Effect measures
Synthesis method
Main analyses
Multilevel meta-regression
Sensitivity analysis
Reporting Bias assessment
Certainty assessment
Results
Study selection
Study characteristics
Subject data | Measurement variable | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Authors | Participants (female/male) | Preoperative age | Preoperative BMI (kg/m2) | Measurement points | Strength operated leg | Strength non-operated leg | Preoperative contralateral strength difference (%) (mean strength operated leg/mean strength non-operated leg*100) | Force measurement (unit) | Force measuring device | Data extraction | Country |
Bascuas et al. [3] | 44 (32/12) | 71.4 ± 7.12 | 32.65 ± 5.02 | Preoperative One year postoperative | 21,28 ± 8,22 23,00 ± 7,61 | 21,57 ± 7,67 25,83 ± 10,72 | 98,66 | Max. isometric muscle strength (kg) | Isometric dynamometry | Median = mean; IQR in SD | Spain |
Gapeyeva et al. [14] | 10 (10/0) | 63 ± 5.5 | 29 ± 4 | Preoperative Six months postoperative | 159,45 ± 47,91 173,16 ± 38,80 | 233,04 ± 57,05 252,53 ± 52,49 | 68,42 | Max. isometric voluntary contraction (N) | Chair fixed dynamometer | WebPlotDigizier, SE in SD | Estonia |
Hashimoto et al. [17] | 83 (83/0) | 75.6 ± 7.2 | 25.4 | Preoperative One year postoperative | 0,29 ± 0,11 0,37 ± 0,11 | 0,33 ± 0,11 0,38 ± 0,12 | 87,88 | Max. isometric contraction (kgf/kg) | Handheld dynamometer mTas F1 | SE in SD | Japan |
Huber et al. [20] | 23 (10/13) | 71.9 ± 8.1 | 30.8 ± 4.9 | Preoperative Three months postoperative | 247,60 ± 100,50 204,10 | 315,40 ± 123,1 279,10 | 78,50 | Isometric muscle strength (N) | Handheld pull gauge | Mean derived from change of first measurement | Swizerland |
Husby et al. [22] | 20 (12/8) | 63 | 28.6 ± 5.1 | Preoperative One year postoperative | 18,20 ± 8,50 20,57 | 22,50 ± 9,4 30,15 | 80,89 | 1 RM (kg) | Leg extensor press | Mean derived from change of first measurement | Norway |
Lowe et al. [30] | 51 (30/21) | 70.76 ± 9.45 | 29.27 ± 5.82 | Preoperative Three months postoperative One year postoperative | 0,34 ± 0,42 0,72 ± 0,50 0,87 ± 0,79 | 0,57 ± 0,50 0,88 ± 0,64 0,83 ± 0,76 | 59,65 | Leg extensor Power (W/kg) | Leg extensor press | Median = mean; IQR in SD | United Kingdom |
Merk et al. [29] | 53 (43/10) | 64.68 ± 8.56 | 28.57 ± 2.09 | Preoperative three months Postoperative Five-seven months postoperative | 39,00 ± 21,73 42,70 ± 22,09 55,20 ± 29,34 | 76,3 ± 39,87 81,3 ± 40,8 83,9 ± 41,03 | 51,11 | Max. isokinetic muscle strength (60°/sec.) (Nm) | Isokinetic MessSystem Cybex 340 | Median = mean; confidence interval in SD | Germany |
40 (18/22) | 64 ± 9 | 31.4 ± 3.7 | Preoperative Three months postoperative Six months postoperative | 18, 00 ± 8,00 15,00 ± 6,00 18,00 ± 8,00 | 23,00 ± 10,00 23,00 ± 10,00 23,00 ± 10,00 | 78,26 | Max. isometric muscle strength (N/BMI) | Electromechanical dynamometer | Everything was given as needed | United States | |
Moutzouri et al. [36] | 25 | 72.3 ± 5.6 | Preoperative 14 weeks postoperative | 41,80 ± 17,80 55,40 ± 23,50 | 57,20 ± 16,30 69,10 ± 24,40 | 73,08 | Isokinetik knee extensors’ peak force (N) | Isokinetic dynamometer | Everything was given as needed | Greece | |
Thomas et al. [48] | 10 (6/4) | 64.7 ± 7.9 | 29.15 ± 2.5 | Preoperative Six months postoperative | 1,07 ± 1,45 1,28 ± 0,95 | 1,53 ± 1,26 1,50 ± 1,52 | 69,93 | Max. isometric strength (Nm/kg) | Electromechanical dynamometer | WebPlotDigizier, SE in SD | United States |
Topp et al. [49] | 28 (18/8) | 63.5 ± 6.68 | 32 ± 6.09 | Preoperative Three months postoperative | 54,02 ± 31,43 60,74 ± 25,45 | 82,74 ± 46,04 94,73 ± 46,62 | 65,29 | Max. isokinetic muscle strength (torque/body weight) | Biodex System 3 Version 3.30 dynamometer | SE in SD | United States |
Tsukada et al. [50] | 27 (27/0) | 74.1 ± 8.6 | 27.2 ± 4.6 | Preoperative Three months postoperative | 157,50 ± 57,75 156,62 ± 64,75 | 161,00 ± 42,88 186,38 ± 51,63 | 97,83 | Isometric knee extension strength (N) | Microfet 2 Load Cell Dynamometer | WebPlotDigizier | Japan |
Vahtrik et al. [52] | 14 (14/0) | 60.2 ± 7.6 | 34.7 ± 4.6 | Preoperative Three months postoperative Six months postoperative | 8,40 ± 3,37 7,10 ± 2,62 8,70 ± 4,49 | 11,10 ± 4,49 11,30 ± 4,86 13,70 ± 5,99 | 75,68 | Maximal voluntary contraction (isometric):body mass | Custommade dynamometer | SE in SD | Estonia |
Vahtrik et al. [52] | 12 (12/0) | 61 ± 6.8 | 33 ± 4.6 | Preoperative Three months postoperative Six months postoperative | 258,73 ± 60,48 150,00 ± 27,5 187,30 ± 52,24 | 322,20 ± 74,20 294,44 ± 71,46 317,46 ± 54,98 | 80,30 | Max. isometric voluntary contraction (N) | Dynanometric chair equipment | WebPlotDigizier, SE in SD | Estonia |
Vuorenmaa et al. [55] | 43 (37/6) | 70 ± 5 | 31 ± 5 | Preoperative Three months postoperative | 181 ± 35,71 138 ± 58,43 | 232 ± 29,22 236 ± 61,68 | 78,02 | Max. Isometric knee strength (N) | David-200 dynamometer | Mean derived from change of first measurement; confidence interval in SD | Finland |
Wada et al. [56] | 20 (10/10) | 70.8 ± 7.2 | 27.6 ± 2.2 | Preoperative Six months postoperative One year postoperative | 1,03 ± 0,44 1,15 ± 0,39 1,24 ± 0,34 | 1,35 ± 0,41 1,35 ± 0,41 1,29 ± 0,41 | 76,30 | Peak isometric knee extionsion torque (Nm/kg) | Handhelt dynamometer | Everything was given as needed | Japan |
Hopkins et al. [19] | 19 (19/0) | 66.1 ± 6.9 | 32.2 ± 7.1 | Preoperative Six months postoperative One year postoperative | 6398 ± 878 6173 ± 933 6138 ± 1148 | 6461 ± 888 6135 ± 768 6056 ± 858 | 99,02 | Leg lean tissue mass (g) | Dual-energy X-ray absorptiometry (DXA) (GE Lunar Prodigy, Bedford MA) | Everything was given as needed | United Kingdom |
Takamura et al. [46] | 47 (39/8) | 75.6 ± 7.7 | 27 ± 5.2 | Preoperative Three months postoperative Six months postoperative | 0,81 ± 0,31 0,66 ± 0,23 0,76 ± 0,2 | 1,01 ± 0,34 0,94 ± 0,29 0,94 ± 0,29 | 80,20 | Nm/kg | Hand-held dynamometer (HHD; Anima, Tokyo, Japan) | Everything was given as needed | Japan |
Ho et al. [18] | 58 (46/12) | 67.9 | 27.6 | Preoperative Six months postoperative One year postoperative | 12,56 ± 6,23 10,8 ± 4,99 15,53 ± 7,98 | 14,19 ± 7,61 14,07 ± 7,8 15,18 ± 8,36 | 88,51 | Unknown | Dynamometer | Everything was given as needed | China |
Şavkin et al. [39] | 20 (1/19) | 64.25 ± 5.52 | 31.85 ± 5.74 | Preoperative 3 months postoperative | 95,08 ± 22,9 98,01 ± 22,79 | 94,25 ± 17,3 100,9 ± 28,76 | 101,00 | N | Hand-held dynamometer (Commander Muscle Tester, J Tech, USA) | Everything was given as needed | Belgium |
Risk of Bias of individual studies
Non-randomized studies
Randomized controlled studies
Result of the main syntheses: strength/torque
Three months post-surgery
Six months post-surgery
Results of the lean leg tissue mass progression
Meta-regression
Coefficients | Estimate | Standard error | Confidence interval lower level | Confidence interval upper level |
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Intercept | − 2.63 | 56,477 | − 13,6992 84,396 | 84,396 |
Time after the operation (months) | 0.0456 | 0.0495 | − 0.0514 | 0.1427 |
Share of female participants (%) | − 0.0033 | 0.0073 | − 0.0176 | 0.011 |
Age (years) | 0.0299 | 0.0447 | − 0.0577 | 0.1175 |
Body mass index (kg/m2) | 0.0153 | 0.1041 | − 0.1887 | 0.2192 |