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Duy trì Hoạt Động Thể Chất Để Bảo Vệ Sức Khỏe Khớp

Why physical activity protects joints and tendons, how exercise helps osteoarthritis and recovery, and how to stay active safely.

Updated Aug 2026
Một người đang đi bộ nhanh.
Vận động thường xuyên giúp duy trì sức khỏe cho khớp, gân và cơ, đồng thời hỗ trợ quá trình hồi phục — vận động chính là liều thuốc. Kieran Hirpara 4.0

Trang này được dịch bằng máy và chưa được bác sĩ kiểm tra. Bản tiếng Anh là bản chính thức.

Những gì bạn đang cảm thấy

Bạn có thể nhận thấy khớp của mình bị cứng hoặc đau nhức sau khi vận động. Sự khó chịu này thường bùng phát vào ban đêm hoặc khi bạn vừa thức dậy vào buổi sáng. Các hoạt động đơn giản trong sinh hoạt hàng ngày có thể trở nên khó khăn. Bạn có thể gặp khó khăn khi với tay ra sau lưng để cài móc áo bra. Việc nhét áo vào quần cũng có thể cảm thấy bất tiện hoặc gây đau.

Tập thể dục có thể giúp kiểm soát các triệu chứng này. Nếu bạn bắt đầu một chương trình tập thể dục trong vòng 12 tuần sau khi phẫu thuật thay khớp gối toàn phần, bạn sẽ có khả năng cải thiện đáng kể khả năng vận động của mình. Những nỗ lực ban đầu này tập trung vào hiệu suất chức năng. Nếu bạn tiếp tục tập thể dục trong hơn 12 tuần, bạn sẽ đạt được sức mạnh cơ bắp lớn hơn và độ linh hoạt khớp tốt hơn.

Đối với những người bị viêm xương khớp do hao mòn ở khớp gối, bài tập aerobic có thể cải thiện sức khỏe tim mạch và hô hấp. Tập thể dục cũng có thể giúp giảm đau và cải thiện chức năng, mặc dù mức độ lợi ích có thể khác nhau. Điều quan trọng cần biết là việc tự theo dõi hoạt động của bạn bằng các thiết bị đeo không làm thay đổi cách bạn cảm nhận về chức năng khớp hoặc sức khỏe tổng thể của mình.

Trong một số trường hợp, chẳng hạn như viêm gân ngón tay co rút (trigger finger), việc sử dụng nẹp và tập thể dục có thể mang lại sự giảm đau tạm thời. Đối với viêm xương khớp cổ tay, các chương trình tập thể dục có thể giúp kiểm soát triệu chứng theo thời gian, và rất ít người cần phẫu thuật trong vòng hai năm. Mặc dù các bài tập này có ích, nhưng hầu hết các khác biệt về kết quả điều trị đối với các rối loạn ở tay hoặc khuỷu tay có thể không đạt đến mức thay đổi mà bạn cảm thấy có ý nghĩa lâm sàng.

Bác sĩ phẫu thuật của bạn sẽ hướng dẫn bạn về loại hình và lượng hoạt động phù hợp. Mục tiêu là giúp bạn duy trì vận động an toàn trong khi tôn trọng các giới hạn của cơ thể bạn. Hãy lắng nghe khớp của bạn. Nếu một hoạt động gây ra cơn đau nhói, hãy dừng lại và nghỉ ngơi. Vận động nhẹ nhàng, đều đặn thường tốt hơn là cố gắng chịu đựng sự khó chịu.

Những gì thực sự đang xảy ra

Các khớp của bạn được thiết kế để vận động trơn tru. Sụn khớp đóng vai trò như một bộ giảm xóc hoặc một lớp phủ trơn láng ở đầu xương. Khi mô này bị mòn đi, như trong bệnh viêm xương khớp, khớp sẽ trở nên cứng và gây đau. Quá trình hao mòn này làm giảm khả năng vận động tự do của bạn.

Tập thể dục giúp quản lý những thay đổi này. Đối với người bị viêm xương khớp gối, bài tập aerobic cải thiện thể lực tim phổi. Điều này có nghĩa là tim và phổi của bạn hoạt động hiệu quả hơn trong khi vận động. Hoạt động thể chất thường xuyên cũng có thể giúp giảm đau và cải thiện chức năng, mặc dù mức độ cải thiện khác nhau tùy trường hợp.

Sau phẫu thuật thay khớp, thời điểm tập luyện rất quan trọng. Nếu bắt đầu các can thiệp tập thể dục trong vòng 12 tuần sau phẫu thuật thay khớp gối toàn phần, bạn chủ yếu thấy cải thiện về hiệu suất chức năng. Điều này giúp bạn quay trở lại các hoạt động hàng ngày. Nếu các can thiệp tập thể dục kéo dài hơn 12 tuần sau phẫu thuật thay khớp gối toàn phần, bạn sẽ đạt được những tiến bộ lớn hơn về sức mạnh cơ bắp và độ linh hoạt của khớp. Cơ bắp khỏe mạnh hỗ trợ khớp tốt hơn, làm giảm căng thẳng lên sụn khớp bị mòn.

Đối với các khớp khác, bằng chứng còn mâu thuẫn. Việc tự theo dõi hoạt động thể chất bằng thiết bị đeo theo dõi hoạt động không có tác động nào đến chức năng khớp cảm nhận được hoặc chất lượng cuộc sống liên quan đến sức khỏe ở những người bị viêm xương khớp háng và gối. Tương tự, hầu hết các khác biệt về kết quả chức năng từ các chương trình tập luyện xương bả vai cho các rối loạn bàn tay, cổ tay hoặc khuỷu tay đều không đạt ngưỡng tối thiểu để được coi là quan trọng về mặt lâm sàng.

Trong một số trường hợp, như ngón tay cái bập, nẹp khớp liên đốt gần và bài tập trị liệu cho thấy tính khả thi và cải thiện lâm sàng ngắn hạn. Tuy nhiên, điều này không thể thiết lập tính ưu việt so với các phương pháp điều trị bảo tồn khác do thiếu nhóm chứng. Đối với viêm xương khớp cổ tay, rất ít người tham gia ở cả hai nhóm cần phẫu thuật sau 24 tháng trong một thử nghiệm ngẫu nhiên có kiểm soát về liệu pháp tập luyện thần kinh cơ. Điều này cho thấy các chương trình tập thể dục có thể góp phần quản lý triệu chứng theo thời gian.

Bác sĩ phẫu thuật của bạn có thể không ưu tiên các kết quả của phẫu thuật thay khớp háng toàn phần chỉ dành cho những bệnh nhân có triệu chứng viêm xương khớp háng nghiêm trọng, mặc dù điều này cần được xác nhận trong một thử nghiệm lâm sàng. Mục tiêu là giữ cho bạn năng động và quản lý triệu chứng thông qua vận động, được cá nhân hóa dựa trên khớp và tình trạng cụ thể của bạn.

Những điều cần biết

Hành trình của bạn hướng tới sức khỏe khớp tốt hơn phụ thuộc rất nhiều vào cách thức và thời điểm bạn bắt đầu vận động. Nếu bạn đã được thay khớp gối toàn phần, việc bắt đầu tập thể dục trong vòng 12 tuần giúp bạn khôi phục chức năng hàng ngày. Nếu bạn tiếp tục các bài tập này trong hơn 12 tuần, bạn sẽ đạt được những cải thiện đáng kể về sức mạnh cơ bắp và độ linh hoạt của khớp. Cách tiếp cận ổn định này xây dựng sự hỗ trợ cần thiết cho khớp mới của bạn để duy trì bền lâu.

Đối với những người đang quản lý viêm xương khớp do hao mòn ở khớp gối, việc tập thể dục aerobic thường xuyên cải thiện sức khỏe tim mạch và hô hấp. Bạn cũng có thể nhận thấy giảm đau và khả năng vận động tốt hơn. Tuy nhiên, bằng chứng hiện có chưa đủ mạnh để đảm bảo rằng những thay đổi này sẽ mang lại cảm giác cải thiện cuộc sống đáng kể cho tất cả mọi người. Đây là một công cụ hữu ích, nhưng kết quả có thể khác nhau.

Nếu bạn đang cân nhắc phẫu thuật thay khớp háng toàn phần, đừng đợi cho đến khi các triệu chứng trở nên nghiêm trọng. Mặc dù dữ liệu hiện tại ủng hộ quan điểm này, nhưng nó cần được xác nhận thêm trong các thử nghiệm lâm sàng. Hành động sớm thường dẫn đến kết quả suôn sẻ hơn.

Bạn có thể tự hỏi liệu việc theo dõi số bước đi có thay đổi góc nhìn của bạn hay không. Việc sử dụng thiết bị đeo theo dõi hoạt động để giám sát chuyển động không cải thiện cảm nhận của bạn về chức năng khớp hoặc chất lượng cuộc sống tổng thể. Dữ liệu cho thấy không có lợi ích đáng kể nào từ việc tự theo dõi này đối với viêm khớp háng và gối.

Đối với các khớp khác, chẳng hạn như bàn tay, cổ tay hoặc khuỷu tay, các chương trình tập thể dục cho kết quả không đồng nhất. Hầu hết các cải thiện về chức năng hàng ngày từ các bài tập cơ bả vai (scapular) đều không đạt ngưỡng được coi là quan trọng về mặt lâm sàng. Tương tự, mặc dù nẹp chỉnh hình và tập thể dục có thể hỗ trợ ngón tay cái cái (trigger finger) trong ngắn hạn, nhưng chúng chưa được chứng minh là vượt trội so với các phương pháp điều trị bảo tồn khác.

Trong các trường hợp viêm xương khớp cổ tay, rất ít người cần phẫu thuật sau 24 tháng khi tuân thủ chương trình tập neuromuscular. Điều này cho thấy rằng việc tập thể dục nhất quán có thể giúp kiểm soát các triệu chứng theo thời gian và có thể làm chậm hoặc tránh nhu cầu can thiệp phẫu thuật. Bác sĩ phẫu thuật của bạn sẽ giúp bạn lựa chọn phương án phù hợp dựa trên khớp cụ thể và các triệu chứng của bạn.


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
  • Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
  • Total hip arthroplasty outcomes should not be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
  • Self-monitoring physical activity with wearable activity trackers does not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Scapular exercise programs for hand, wrist, or elbow disorders result in functional outcome differences that most often do not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Neuromuscular exercise therapy contributes to symptom management in wrist osteoarthritis over time, with few participants requiring surgical conversion at 24 months [10].

How It Works

  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty [5].
  • It is uncertain whether the improvements in pain and function from exercise for knee osteoarthritis are clinically important [5].
  • The addition of wearable activity tracker use did not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Most differences in functional outcomes from scapular exercise programs for hand, wrist, or elbow disorders did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management [9].
  • Few participants in either group required surgery at 24 months in a trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may optimize the benefits of exercise therapy [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis [14].
  • Pain science education is less successful when delivered standalone compared to when it is part of an exercise intervention [14].
  • There is heterogeneity in functional recovery among joint arthroplasty patients, highlighting the importance of a personalised, data-driven approach to post-operative care [15].

What the Evidence Shows

  • Findings question whether total hip arthroplasty should be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Most differences in functional outcomes for patients with hand, wrist, or elbow disorders following a scapular exercise program did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The document for Fu’s subcutaneous needling versus bracing combined with exercise therapy is a study protocol and does not report results or conclusions [11].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize exercise benefits [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction in a murine model [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction in a murine model [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis, and is less successful when delivered standalone [14].
  • An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program before anterior cruciate ligament reconstruction [16].
  • Both combined mode kinetic chain exercises with core strengthening and combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved overall quality of life in patients with knee osteoarthritis [17].
  • Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy resulted in statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline [18].
  • Mobile game-based home exercise programs may be a potentially effective option for thumb rehabilitation, with significantly higher adherence observed compared to standard home exercise programs [19].
  • Ankle pump exercises significantly reduce the incidence of deep vein thrombosis and increase venous haemodynamic parameters—specifically maximum venous outflow and maximum venous capacity—in patients undergoing lower limb orthopaedic surgery [20].
  • There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis [21].
  • Tai Chi may be the best mind–body exercise for improving quality of life in knee osteoarthritis [21].

Practical Considerations

  • Total hip arthroplasty should not necessarily be prioritized only for patients with severe hip osteoarthritis symptoms, although this requires confirmation in a trial [2].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to symptom management over time [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize the benefits of exercise therapy [12].
  • Heterogeneity in functional recovery among joint arthroplasty patients underscores the importance of a personalized, data-driven approach to post-operative care to optimize long-term outcomes [15].

Key Evidence

  • [L1] The interventions implemented at ≤12 weeks primarily improved the functional performance, whereas those lasting >12 weeks resulted in greater gains in the muscle strength and joint flexibility. [1] (10.1186/s13018-025-06430-7)
  • [L3] These findings question whether THA should be prioritized only for those patients who have severe hip OA symptoms, but require confirmation in a trial. [2] (10.1016/j.arth.2025.04.032)
  • [L1] These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. [3] (10.1186/s12891-025-08746-1)
  • [L1] Exercise may improve pain and function with low to moderate certainty, but it is uncertain whether differences are clinically important. [5] (10.1097/corr.0000000000003476)
  • [L1] The addition of WAT-use did not have any effect on perceived joint function or HRQoL. [7] (10.1186/s12891-024-08238-8)
  • [L1] However, most of these differences did not reach the minimum threshold to be considered clinically important. [8] (10.1016/j.jht.2024.07.006)
  • [L4] Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments. [9] (10.1016/j.jhsg.2026.101038)
  • [L1] Nevertheless, few participants in either group required surgery at 24 months, indicating that both exercise programs may contribute to symptom management over time. [10] (10.1186/s12891-025-09463-5)
  • [Paper] This document is a study protocol outlining the design of a randomized controlled trial to compare Fu's subcutaneous needling with bracing combined with exercise therapy; it does not report results or conclusions. [11] (10.1186/s13018-026-06719-1)
  • [L3] The addition of WBV to exercise therapy led to greater improvements in several outcomes, suggesting that WBV may be a valuable adjunct to optimize the benefits of exercise therapy. [12] (10.1186/s42836-025-00301-6)
  • [L5] Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing, whereas prolonged immobilization has a detrimental effect on physical recovery. [13] (10.1177/2325967125s00320)
  • [L1] PSE may act as a mechanism of action for exercise interventions, and is less successful delivered standalone. [14] (10.1186/s12891-025-09313-4)
  • [L3] The findings highlight heterogeneity in functional recovery and underscore the importance of a personalised, data-driven approach to post-operative care to optimise long-term outcomes. [15] (10.1186/s42836-025-00339-6)
  • [L1] An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program. [16] (10.1177/2325967126s00041)
  • [L2] The study concluded that both the experimental group receiving core strengthening exercises with combined mode kinetic chain exercises and the control group receiving combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved the overall quality of life of patients with knee Osteoarthritis. [17] (10.1186/s12891-026-09531-4)
  • [L2] The intervention group showed statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline. [18] (10.1016/j.jisako.2026.101105)
  • [L2] Mobile game-based home exercise programs may be considered a potentially effective option in thumb rehabilitation and, at the very least, not inferior to standard home exercise programs, with significantly higher adherence to home exercises observed in the mobile game group. [19] (10.1177/17589983251387079)
  • [L1] This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters—specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)—in patients undergoing lower limb orthopaedic surgery. [20] (10.1186/s13018-025-06236-7)
  • [L1] There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. [21] (10.1186/s13018-025-05682-7)

References

[1] Changes in knee outcome measures following later-stage exercise interventions implemented ≤ 12 weeks vs. > 12 weeks after total knee arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06430-7

[2] Total Hip Arthroplasty versus Education and Exercise: A Secondary Analysis of Propensity Matched Data Comparing Outcomes Across Hip Osteoarthritis Symptom Severity. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.032

[3] Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08746-1

[5] Cochrane in CORR®: Exercise for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003476

[7] Effects of self-monitoring physical activity with wearable activity trackers on perceived joint function and health-related quality of life in people with hip and knee osteoarthritis: a secondary analysis of a cluster-randomised clinical trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08238-8

[8] Effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders: A comprehensive systematic review with meta-analysis. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2024.07.006

[9] Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101038

[10] Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09463-5

[11] Fu’s subcutaneous needling versus bracing combined with exercise therapy in the treatment of postacute lateral ankle sprain and the prevention of chronic ankle instability: a randomized controlled trial protocol. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06719-1

[12] Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00301-6

[13] Poster 234: Improvement of Tendon-Bone Interface Healing by Moderate Treadmill Exercise Combined with Knee Brace Immobilization Following an Anterior Cruciate Ligament Reconstruction in a Murine Model. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00320

[14] Pain science education and exercise interventions for people with knee or hip osteoarthritis: a systematic review, content and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09313-4

[15] Unsupervised machine learning models reveal two distinct post-operative physical activity profiles among joint arthroplasty patients: a United Kingdom biobank cohort study. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00339-6

[16] Effectiveness of Exercise Prehabilitation Before Anterior Cruciate Ligament Reconstruction on Functional Outcomes – A Single-Blinded Randomized Controlled Trial: Prevention, Prehab and Rehab. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00041

[17] Combined mode-kinetic chain exercise with and without core stability exercises on patients with knee osteoarthritis. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09531-4

[18] Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy improves postural control, quadriceps strength, and pain: A randomized clinical trial. Journal of ISAKOS. 2026. DOI: 10.1016/j.jisako.2026.101105

[19] Effects of home exercise-based mobile games on thumb rehabilitation outcomes. Hand Therapy. 2025. DOI: 10.1177/17589983251387079

[20] Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis and venous hemodynamics following lower limb orthopedic surgery: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06236-7

[21] Comparative efficacy of mind–body exercise for pain, function, quality of life in knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05682-7

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