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Exercise reduces pain and improves physical function for people awaiting hip replacement surgery
  1. Nicholas Henschke1,
  2. Joanna Diong2,3
  1. 1Institute of Public Health, University of Heidelberg, Heidelberg, Germany
  2. 2Discipline of Biomedical Science, The University of Sydney, Lidcombe, New South Wales, Australia
  3. 3Musculoskeletal Division, The George Institute for Global Health, Sydney, Australia
  1. Correspondence to Dr Nicholas Henschke, Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg 69120, Germany; henschke{at}

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▸ Gill SD, McBurney H. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomised controlled trials. Arch Phys Med Rehabil 2013;94:164–76


Hip and knee replacement surgery can reduce pain and improve physical function in people with osteoarthritis.1 Interventions to improve or maintain physical function before surgery may improve postoperative outcomes,2 but only a small proportion of people receive such interventions before surgery3 and the effects of most preoperative exercise interventions remain uncertain.4


This systematic review aimed to determine whether preoperative exercise interventions can reduce pain and improve physical function before hip or knee joint replacement surgery.

Searches and inclusion criteria

Four computer databases (CINAHL, MEDLINE, EMBASE and Cochrane Library) were searched up to July 2012 and reference lists of retrieved articles were screened. Titles and abstracts were screened by one reviewer for eligibility.

Studies were eligible if the effect of preoperative exercise-based intervention compared to no intervention on pain and/or physical function was assessed in participants awaiting hip or knee replacement surgery using a randomised or quasi-randomised design, and the study …

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  • Contributors NH selected the systematic review and wrote the first draft of the manuscript. NH and JD contributed to interpretation of the data and revision of the final manuscript and are the guarantors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.