• Ilaria Morelli, Nicola Maffulli, Lorenzo Brambilla, Marco Agnoletto, Giuseppe Maria Peretti, and Laura Mangiavini.
• Residency Program in Orthopaedics and Traumatology, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy.
• Br. Med. Bull. 2021 Mar 25; 137 (1): 51-69.

BackgroundThis article systematically summarizes the present evidences, published in the last 20 years, regarding the pre- and post-operative factors, which may influence recovery of the function of the quadriceps muscle group following total knee arthroplasty (TKA). We following the PRISMA methodology, including meta-analyses and high-level evidence studies (prospective trials, and, when unavailable, retrospective studies).Sources Of DataPubmed and Cochrane databases: 582 articles were identified and 54 of them were selected.Areas Of AgreementTourniquets inflated at high pressure exert a detrimental effect on the quadriceps muscle group. Faster quadriceps recovery takes place using mini-invasive approaches, an eight-week rehabilitation period including balance training and the use of nutraceuticals.Areas Of DisagreementPre-habilitation and pre-operative factors, analgesic methods and different TKA implants.Growing Points And Areas Timely For Developing ResearchTelerehabilitation seems a cost-effective tool for rehabilitation after TKA. Patients' optimization protocols before TKA should include standardized nutraceuticals intake.© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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