EFFECTS OF KINESIO TAPING IN PATIENTS UNDERGOING KNEE OR HIP ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
The systematic review and meta-analysis were reported in accordance with PRISMA guidelines  and were registered in advance on PROSPERO (registration number CRD42024504113). Search strategy A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CBM, China Science and Technology Journal Database (VIP), Wanfang Data, and China National Knowledge Internet (CNKI) to identify relevant studies published in English or Chinese from inception to 9 January 2024. MeSH terms and keywords, including “Kinesio Taping”, “athlete tape”, “knee replacement”, “knee arthroplasty”, “hip replacement” and “hip arthroplasty”, were employed. Detailed retrieval strategies are provided in Appendix S1 . Additionally, manual searches were performed to identify further articles potentially missed in the electronic databases. Inclusion criteria Eligible studies were considered if they met the PICOS criteria as follows: Participants (P): Patients undergoing rehabilitation after THA or TKA; Interventions (I): Rehabilitative approaches involving KT administered in combination with other rehabilitation treatments; Comparisons (C): Control group receiving the same postoperative rehabilitation without KT; Outcomes (O): For THA, the outcome focused on a visual analogue scale (VAS). For TKA, outcomes included VAS, numeric rating scale (NRS), knee oedema (knee circumference), ROM, and the Hospital for Special Surgery (HSS) knee score. The HSS , which was proposed by the American Hospital in 1976, consists of the following 6 parts: pain, function, range of motion, muscle strength, knee flexion deformity, and stability. Study design (S): Only RCTs were included. Exclusion criteria The exclusion criteria were as follows: ( i ) non-RCTs; ( ii ) reviews, systematic reviews, meta-analyses, letters, clinical registration trials, conference abstracts, or duplicate publications; and ( iii ) incomplete data or original data that could not be obtained. Risk of bias and quality assessment The risk of bias was assessed independently by 2 reviewers (MT and WDD) following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions . In cases of disagreement, a third author (YHP) was consulted to reach a consensus. For RCTs, the Cochrane Risk of Bias tool version 2 (RoB 2) was utilized . The assessment evaluated the following domains: bias arising from the randomization process, bias due to deviations from intended interventions, bias resulting from missing outcome data, bias in outcome measurement, and bias in the selection of the reported results. Data extraction Data extraction was performed independently by 2 reviewers (MT and WDD) using a customized Microsoft Excel sheet (Microsoft Corp, Redmond, WA, USA). Discrepancies in extracted data were resolved with the involvement of a third auditor (YHP). The extracted data included the following: first author, publication year, country, sample size, average age of control and experimental patients, intervention details for each group, and the follow-up period. Outcome measures such as VAS, NRS, ROM, HSS, and lower-leg circumference were assessed at the end of the intervention and last follow-up. Statistical analysis Review Manager 5.4.1 ( https://test-training.cochrane.org/online-learning/core-software-cochrane-reviews/review-manager-revman/download-revman-5 ) and STATA 16.0 (StataCorp LLC, College Station, TX, USA) were used for all statistical analyses. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for continuous outcomes were pooled to compare the experimental and control groups in terms of changes in outcome indicators. The I 2 statistic and Q test (χ 2 ) were employed to quantify heterogeneity among the included studies, with a significance level of p ≤ 0.05 . Random-effect models were used when I 2 > 50%; otherwise, fixed-effect models were applied. Subgroup analyses were conducted based on intervention time to identify potential sources of heterogeneity. A sensitivity analysis was performed to evaluate the influence of outliers and the robustness of the results by sequentially removing each study. Publication bias was assessed qualitatively using funnel plots and quantitatively using Egger’s test. If the funnel plot was generally symmetric, and Egger’s test indicated p > 0.05, publication bias was considered insignificant. When publication bias was significant, the Trim and Fill method was applied for further analysis.   A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CBM, China Science and Technology Journal Database (VIP), Wanfang Data, and China National Knowledge Internet (CNKI) to identify relevant studies published in English or Chinese from inception to 9 January 2024. MeSH terms and keywords, including “Kinesio Taping”, “athlete tape”, “knee replacement”, “knee arthroplasty”, “hip replacement” and “hip arthroplasty”, were employed. Detailed retrieval strategies are provided in Appendix S1 . Additionally, manual searches were performed to identify further articles potentially missed in the electronic databases.   Eligible studies were considered if they met the PICOS criteria as follows: Participants (P): Patients undergoing rehabilitation after THA or TKA; Interventions (I): Rehabilitative approaches involving KT administered in combination with other rehabilitation treatments; Comparisons (C): Control group receiving the same postoperative rehabilitation without KT; Outcomes (O): For THA, the outcome focused on a visual analogue scale (VAS). For TKA, outcomes included VAS, numeric rating scale (NRS), knee oedema (knee circumference), ROM, and the Hospital for Special Surgery (HSS) knee score. The HSS , which was proposed by the American Hospital in 1976, consists of the following 6 parts: pain, function, range of motion, muscle strength, knee flexion deformity, and stability. Study design (S): Only RCTs were included.   The exclusion criteria were as follows: ( i ) non-RCTs; ( ii ) reviews, systematic reviews, meta-analyses, letters, clinical registration trials, conference abstracts, or duplicate publications; and ( iii ) incomplete data or original data that could not be obtained.   The risk of bias was assessed independently by 2 reviewers (MT and WDD) following the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions . In cases of disagreement, a third author (YHP) was consulted to reach a consensus. For RCTs, the Cochrane Risk of Bias tool version 2 (RoB 2) was utilized . The assessment evaluated the following domains: bias arising from the randomization process, bias due to deviations from intended interventions, bias resulting from missing outcome data, bias in outcome measurement, and bias in the selection of the reported results.   Data extraction was performed independently by 2 reviewers (MT and WDD) using a customized Microsoft Excel sheet (Microsoft Corp, Redmond, WA, USA). Discrepancies in extracted data were resolved with the involvement of a third auditor (YHP). The extracted data included the following: first author, publication year, country, sample size, average age of control and experimental patients, intervention details for each group, and the follow-up period. Outcome measures such as VAS, NRS, ROM, HSS, and lower-leg circumference were assessed at the end of the intervention and last follow-up.   Review Manager 5.4.1 ( https://test-training.cochrane.org/online-learning/core-software-cochrane-reviews/review-manager-revman/download-revman-5 ) and STATA 16.0 (StataCorp LLC, College Station, TX, USA) were used for all statistical analyses. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for continuous outcomes were pooled to compare the experimental and control groups in terms of changes in outcome indicators. The I 2 statistic and Q test (χ 2 ) were employed to quantify heterogeneity among the included studies, with a significance level of p ≤ 0.05 . Random-effect models were used when I 2 > 50%; otherwise, fixed-effect models were applied. Subgroup analyses were conducted based on intervention time to identify potential sources of heterogeneity. A sensitivity analysis was performed to evaluate the influence of outliers and the robustness of the results by sequentially removing each study. Publication bias was assessed qualitatively using funnel plots and quantitatively using Egger’s test. If the funnel plot was generally symmetric, and Egger’s test indicated p > 0.05, publication bias was considered insignificant. When publication bias was significant, the Trim and Fill method was applied for further analysis.   Study selection The detailed literature screening process is illustrated in . A total of 203 articles were retrieved, and 128 remained after removing 75 duplicate citations. After screening titles and abstracts, 108 studies were excluded, and 1 study was removed because the full text could not be accessed. Nineteen studies were considered potentially eligible following this process. Eight articles were excluded for the following reasons: 2 studies were not randomized, one study had incomplete data, 1 study was not written in English or Chinese, and data from 4 RCTs could not be analysed. Ultimately, 11 RCTs were included in the systematic review and meta-analysis following a full-text review. Study and patient characteristics Detailed characteristics of the 11 eligible studies are presented in . These studies, involving 774 participants from 5 countries, were analysed, with 382 participants in the KT plus exercise group. The sample size ranged from 27 to 125 participants, and the age range of the patients was 19–87 years. The interventions lasted from 3 days to 3 months. Nine RCTs focused on patients with TKA , while 2 studies included patients with THA . Each article detailed the application, frequency, and duration of KT in the experimental group and exercise regimens in the control group. The application period of KT varied from 14 to 30 days, with a frequency ranging from daily to every 4 days. Risk of bias and quality assessment A summary of the risk of bias is presented in and , illustrating the risk of bias for each included study and for each domain. Green areas indicate a low risk of bias, yellow areas indicate an unclear risk of bias, and red areas represent a high risk of bias. Overall, 2 studies  were judged to have a “low risk” of bias, while 9 studies  were rated as having “some concern”. All included studies were randomized, and provided detailed descriptions of their randomization methods, except 1 study , which did not clarify the randomization process. In 4 studies, concerns arose about deviations from the planned interventions due to the lack of blinding of patients and investigators. In summary, the methodological quality of the included studies was generally low to moderate. Outcome and analysis Pain intensity after surgery: Postoperative pain was measured using the NRS in 2 studies and the VAS in 8 RCTs. Ten studies  involving 682 patients reported pain intensity after the intervention, while 2 RCTs with 149 patients recorded pain intensity during the follow-up period. A random-effect model was adopted for post-intervention data due to heterogeneity between studies (I 2 = 87%, p < 0.00001). For follow-up data, a fixed-effect model was applied as no discernible heterogeneity was detected (I 2 = 0%, p = 0.51). The results indicated that KT improved pain intensity after the intervention compared with that in non-KT groups (SMD = –0.64, 95% CI –1.10 to –0.18, p = 0.006), but no significant difference was observed during the follow-up period (SMD = 0.01, 95% CI –0.31 to 0.33, p = 0.94), as shown in . For RCTs focusing on TKA, 5 studies  implemented interventions lasting less than 1 week, while 3 studies  had interventions lasting more than 1 week. Subgroup analysis based on intervention time revealed that KT combined with other rehabilitation methods reduced pain more effectively than did rehabilitation without KT when the intervention lasted less than 1 week (SMD = –0.44, 95% CI –0.87 to –0.01, p = 0.04). However, no significant difference in pain relief was observed between groups when the intervention lasted more than 1 week (SMD = –0.27, 95% CI –0.99 to 0.45, p = 0.47), as shown in . For RCTs focusing on THA , the intervention times ranged from 5 to 7 days postoperatively. High heterogeneity was observed among the included studies (I 2 = 97%, p < 0.00001), necessitating the use of a random-effect model. Pooled data showed no significant difference between the KT and non-KT groups (SMD = –2.14, 95% CI –5.80 to 1.52, p = 0.25), as shown in . Knee oedema: The knee oedema measurements included thigh, calf, and ankle circumferences. Three RCTs reported lower-limb lymphoedema after KT application, involving 220 patients after TKA. The intervention periods were PODs (postoperative days) 2–4 , PODs 2–6 , and 1 month after surgery . Three RCTs  provided data on thigh circumferences, while 2 RCTs  provided data on calf and ankle circumferences. Low heterogeneity was observed in thigh circumferences (I 2 = 44%, p = 0.17) and ankle circumferences (I 2 = 0%, p = 0.46), and these were analysed using a fixed-effect model. High heterogeneity was identified in calf circumferences (I 2 = 66%, p = 0.09), warranting the use of a random-effect model. The results showed that, compared with non-KT groups, KT significantly reduced thigh circumferences (SMD = –0.38, 95% CI –0.65 to –0.12, p = 0.005) and ankle circumferences (SMD = –0.53, 95% CI –0.95 to –0.12, p = 0.01). However, no significant benefit was observed for calf circumferences (SMD = –0.59, 95% CI –1.40 to 0.22, p = 0.15), as shown in . ROM of the knee joint: Two studies reported the ROM after intervention, involving 167 patients after TKA. The intervention periods were 1 month  and 3 months . Low heterogeneity was observed among the included studies (I 2 = 26%, p = 0.24) and a fixed-effect model was applied. The meta-analysis revealed that KT significantly improved knee ROM (SMD = 1.26, 95% CI 0.93 to 1.60, p < 0.00001), as shown in . Flexion ROM: Four RCTs , studies involving 171 patients, provided data on flexion ROM after intervention. All interventions were conducted within 1 week postoperatively. High heterogeneity was observed among the studies (I 2 = 87%, p < 0.0001), necessitating the use of a random-effect model. The overall estimate indicated no statistically significant difference between the KT and control groups in patients after TKA (SMD = 0.82, 95% CI = 0.11 to 1.75, p = 0.08), as shown in . Knee function score: Postoperative knee function was measured by the HSS. Three RCTs (23–25) involving 256 patients reported postoperative knee function scores at the end of the intervention. The intervention durations varied from 1 month  to 3 months . As shown in , the HSS score in the experimental group was significantly higher than that in the control group in patients after TKA (SMD = 2.17, 95% CI 1.70 to 2.65, p <0.00001). Sensitivity analysis A sensitivity analysis of the meta-analysis was conducted, indicating no considerable variation of the pooled results after the exclusion of each RCT one after another. It indicated that the results of meta-analysis were relatively robust . Publication bias For pain intensity, the funnel plot was not symmetric , and the p -value for Egger’s test was 0.001 (< 0.05), indicating the presence of publication bias due to asymmetry. The asymmetrical funnel plot was corrected using the Trim and Fill method. After 5 iterations, 3 articles were imputed to adjust the result. The final result (SMD = –1.068, 95% CI –1.689 to –0.447, p = 0.001; ) was consistent with the direction of the original result.   The detailed literature screening process is illustrated in . A total of 203 articles were retrieved, and 128 remained after removing 75 duplicate citations. After screening titles and abstracts, 108 studies were excluded, and 1 study was removed because the full text could not be accessed. Nineteen studies were considered potentially eligible following this process. Eight articles were excluded for the following reasons: 2 studies were not randomized, one study had incomplete data, 1 study was not written in English or Chinese, and data from 4 RCTs could not be analysed. Ultimately, 11 RCTs were included in the systematic review and meta-analysis following a full-text review.   Detailed characteristics of the 11 eligible studies are presented in . These studies, involving 774 participants from 5 countries, were analysed, with 382 participants in the KT plus exercise group. The sample size ranged from 27 to 125 participants, and the age range of the patients was 19–87 years. The interventions lasted from 3 days to 3 months. Nine RCTs focused on patients with TKA , while 2 studies included patients with THA . Each article detailed the application, frequency, and duration of KT in the experimental group and exercise regimens in the control group. The application period of KT varied from 14 to 30 days, with a frequency ranging from daily to every 4 days.   A summary of the risk of bias is presented in and , illustrating the risk of bias for each included study and for each domain. Green areas indicate a low risk of bias, yellow areas indicate an unclear risk of bias, and red areas represent a high risk of bias. Overall, 2 studies  were judged to have a “low risk” of bias, while 9 studies  were rated as having “some concern”. All included studies were randomized, and provided detailed descriptions of their randomization methods, except 1 study , which did not clarify the randomization process. In 4 studies, concerns arose about deviations from the planned interventions due to the lack of blinding of patients and investigators. In summary, the methodological quality of the included studies was generally low to moderate.   Pain intensity after surgery: Postoperative pain was measured using the NRS in 2 studies and the VAS in 8 RCTs. Ten studies  involving 682 patients reported pain intensity after the intervention, while 2 RCTs with 149 patients recorded pain intensity during the follow-up period. A random-effect model was adopted for post-intervention data due to heterogeneity between studies (I 2 = 87%, p < 0.00001). For follow-up data, a fixed-effect model was applied as no discernible heterogeneity was detected (I 2 = 0%, p = 0.51). The results indicated that KT improved pain intensity after the intervention compared with that in non-KT groups (SMD = –0.64, 95% CI –1.10 to –0.18, p = 0.006), but no significant difference was observed during the follow-up period (SMD = 0.01, 95% CI –0.31 to 0.33, p = 0.94), as shown in . For RCTs focusing on TKA, 5 studies  implemented interventions lasting less than 1 week, while 3 studies  had interventions lasting more than 1 week. Subgroup analysis based on intervention time revealed that KT combined with other rehabilitation methods reduced pain more effectively than did rehabilitation without KT when the intervention lasted less than 1 week (SMD = –0.44, 95% CI –0.87 to –0.01, p = 0.04). However, no significant difference in pain relief was observed between groups when the intervention lasted more than 1 week (SMD = –0.27, 95% CI –0.99 to 0.45, p = 0.47), as shown in . For RCTs focusing on THA , the intervention times ranged from 5 to 7 days postoperatively. High heterogeneity was observed among the included studies (I 2 = 97%, p < 0.00001), necessitating the use of a random-effect model. Pooled data showed no significant difference between the KT and non-KT groups (SMD = –2.14, 95% CI –5.80 to 1.52, p = 0.25), as shown in . Knee oedema: The knee oedema measurements included thigh, calf, and ankle circumferences. Three RCTs reported lower-limb lymphoedema after KT application, involving 220 patients after TKA. The intervention periods were PODs (postoperative days) 2–4 , PODs 2–6 , and 1 month after surgery . Three RCTs  provided data on thigh circumferences, while 2 RCTs  provided data on calf and ankle circumferences. Low heterogeneity was observed in thigh circumferences (I 2 = 44%, p = 0.17) and ankle circumferences (I 2 = 0%, p = 0.46), and these were analysed using a fixed-effect model. High heterogeneity was identified in calf circumferences (I 2 = 66%, p = 0.09), warranting the use of a random-effect model. The results showed that, compared with non-KT groups, KT significantly reduced thigh circumferences (SMD = –0.38, 95% CI –0.65 to –0.12, p = 0.005) and ankle circumferences (SMD = –0.53, 95% CI –0.95 to –0.12, p = 0.01). However, no significant benefit was observed for calf circumferences (SMD = –0.59, 95% CI –1.40 to 0.22, p = 0.15), as shown in . ROM of the knee joint: Two studies reported the ROM after intervention, involving 167 patients after TKA. The intervention periods were 1 month  and 3 months . Low heterogeneity was observed among the included studies (I 2 = 26%, p = 0.24) and a fixed-effect model was applied. The meta-analysis revealed that KT significantly improved knee ROM (SMD = 1.26, 95% CI 0.93 to 1.60, p < 0.00001), as shown in . Flexion ROM: Four RCTs , studies involving 171 patients, provided data on flexion ROM after intervention. All interventions were conducted within 1 week postoperatively. High heterogeneity was observed among the studies (I 2 = 87%, p < 0.0001), necessitating the use of a random-effect model. The overall estimate indicated no statistically significant difference between the KT and control groups in patients after TKA (SMD = 0.82, 95% CI = 0.11 to 1.75, p = 0.08), as shown in . Knee function score: Postoperative knee function was measured by the HSS. Three RCTs (23–25) involving 256 patients reported postoperative knee function scores at the end of the intervention. The intervention durations varied from 1 month  to 3 months . As shown in , the HSS score in the experimental group was significantly higher than that in the control group in patients after TKA (SMD = 2.17, 95% CI 1.70 to 2.65, p <0.00001).   A sensitivity analysis of the meta-analysis was conducted, indicating no considerable variation of the pooled results after the exclusion of each RCT one after another. It indicated that the results of meta-analysis were relatively robust .   For pain intensity, the funnel plot was not symmetric , and the p -value for Egger’s test was 0.001 (< 0.05), indicating the presence of publication bias due to asymmetry. The asymmetrical funnel plot was corrected using the Trim and Fill method. After 5 iterations, 3 articles were imputed to adjust the result. The final result (SMD = –1.068, 95% CI –1.689 to –0.447, p = 0.001; ) was consistent with the direction of the original result.   KT has been widely adopted in the rehabilitation of musculoskeletal disorders to reduce oedema, alleviate pain, and improve joint function. KT exerts its effects by lifting the skin and expanding the subcutaneous space, facilitating enhanced blood and lymphatic circulation, which in turn attenuates oedema and reduces pain . Additionally, KT enhances proprioception and alleviates pain by stimulating cutaneous mechanoreceptors . The present meta-analysis of RCTs demonstrated that KT was associated with significant improvements in pain, swelling, ROM, and knee function following knee arthroplasty, but no significant improvement in the pain intensity in hip replacement patients. Pain is a common complication after TKA, and uncontrolled pain can delay the recovery process and lead to chronic pain . Thus, effective pain management is critical. This meta-analysis revealed that in patients with TKA, KT combined with postoperative therapy significantly reduced pain when the intervention period was less than 1 week. However, no significant reduction in pain was observed when the intervention period exceeded 1 week or during the follow-up period. In other words, KT was effective for short-term pain relief in the immediate postoperative period but showed no significant long-term benefits, which is consistent with previous findings . KT lifts the skin, which increases blood circulation and lymphatic drainage to reduce swelling, and also to reduce pressure on subcutaneous nociceptors, thereby alleviating pain . Acute swelling is believed to be closely associated with pain in the early postoperative stage. As KT significantly alleviates the acute swelling, it may consequently relieve pain. During our meta-analysis on pain intensity, we identified a significant outlier in Wang’s (2021) study that substantially influenced the results. Several factors may explain this discrepancy. First, the interventions in Wang’s study included manual lymphatic drainage, which differs from the interventions in other included studies. Second, Wang’s research focused on hip arthroplasty, whereas most other studies focused on knee arthroplasty. To address this, we conducted a subgroup analysis specifically examining postoperative pain following hip arthroplasty. The analysis revealed no significant improvement in pain for patients with THA. Only 2 studies reported on this outcome, and differences in KT application methods may have contributed to the high heterogeneity. Additionally, we noted that the included studies lacked detailed information regarding analgesic medications. Variations in medication types and administration protocols could have further influenced the pain intensity outcomes. Future research should aim to address these limitations by standardizing intervention protocols and providing comprehensive details on concomitant treatments. Lower-extremity swelling contributes significantly to dissatisfaction with functional recovery following TKA. Untreated oedema may exacerbate pain, impair mobility, and increase the risk of infection . The pooled data demonstrated that KT effectively alleviated oedema. KT has been shown to be a beneficial method for reducing lymphoedema by accelerating lymphatic and venous microcirculation . Previous studies have also highlighted the positive effects of KT on oedema reduction in patients undergoing anterior cruciate ligament reconstruction  and in those with breast cancer-related lymphoedema . Combining our data with prior evidence, we maintain a positive outlook regarding the efficacy of KT in reducing oedema. However, it is important to note that only 3 studies measured this outcome, and differences in circumference measurement methods may have contributed to the observed heterogeneity. Future research should employ more precise assessment techniques for evaluating oedema severity, such as volumetric measurements or ultrasound-assisted evaluations, to enhance the reliability and comparability of findings. Swelling and pain following TKA can significantly impede knee joint mobility and lead to joint stiffness, adversely i mpacting patients’ quality of life. Previous evidence suggests that KT application improves ROM, particularly in patients with OA . However, the current study presents inconsistent findings. While KT was shown to significantly impact knee ROM, no significant difference in joint flexion was observed between the groups. Our data indicate that KT may influence knee extension rather than flexion in patients undergoing TKA. We propose several potential reasons for this observation. In the early postoperative stage, swelling and pain can cause quadriceps muscle inhibition, leading to reduced quadriceps strength. Studies report an average loss of 60–83% of knee extension strength in the operated leg during this period . By alleviating postoperative pain and swelling, KT may help restore quadriceps strength, potentially contributing to improved knee extension. To evaluate the overall effectiveness of KT in patients who underwent TKA, we explored the knee function following KT application. Our findings showed an improvement in HSS scores in those patients treated with KT. As the HSS scale encompasses multiple factors, including ROM, pain, muscle strength, and other parameters, the KT-associated improvement in HSS scores may result from combined effects. However, variations in the timing of evaluations across studies may contribute to the observed heterogeneity. To our knowledge, this is the most recent review and meta-analysis comparing the efficacy of KT plus exercise therapy with that of exercise alone in patients undergoing TKA or THA. However, some limitations must be acknowledged: (1) although this study adhered to PRISMA guidelines, the risk of selection bias may persist. For instance, only studies published in Chinese and English were included, potentially excluding relevant studies in other languages; (2) the number of included studies was limited, with only 11 RCTs with sample sizes ranging from 27 to 125 participants. Certain outcomes, such as pain intensity following THA, were analysed based on relatively small sample sizes. These results should be interpreted with caution; (3) most studies did not include a placebo intervention, making it challenging to rule out the potential influence of placebo effects; (4) heterogeneity was high due to the diverse types of KT techniques applied in the included studies; (5) variations in rehabilitation training content and medication usage across studies may have affected the accuracy and generalizability of the results; (6) some measurement methods for outcomes, such as manual circumference assessments, are prone to human error. Employing more objective and standardized measurement techniques, such as volumetric analysis or ultrasound-based evaluations, is recommended to improve result reliability. To overcome these limitations, future research should include larger sample sizes and employ more rigorous, high-quality RCTs that focus on KT applications and standardized methodologies. In conclusion, this review and meta-analysis shows the positive effects of KT on postoperative pain intensity, lower-limb swelling, and joint function in patients undergoing TKA, but shows no benefits on pain relief in patients after THA. Future research should prioritize large-scale, high-quality RCTs with standardized outcome indicators and rigorous methodologies.   