PONE-D-21-28882Amount and type of physical activity and sports performed by persons after hip or knee arthroplasty − a systematic reviewPLOS ONE

Dear Dr. Stevens,

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Sinan Kardeş, M.D.

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Amount and type of physical activity and sports performed by persons after hip or knee

arthroplasty − a systematic review

The manuscript is an interesting systematic review (narrative) regarding the physical activity levels, sedentary behaviour, and sport participation of people with Total hip arthroplasty (THA) and total knee arthroplasty (TKA) after one-year post-surgery. The title, objectives and conclusions are well aligned, but there might be room for improvement in the results section. The title is very similar to previous studies published; however, the authors highlighted the novelty. The methods considered an unbiased sampling of existing literature. Statistical analysis was not detailed or not performed. Authors appear to meet research integrity. Congratulations on their effort to summarise a huge quantity of papers.

Please find below suggestions that might improve the manuscript and make it more enjoyable for readers:

Major issues:

• Please clarify whether an inclusion criterion was physical activity measurement performed after one-year post-surgery onwards. I think this is the essence of the study and the main difference in respect to other published studies. The authors might consider reflecting the manuscript’s novelty in the title.

• Please discuss any changes or amendments to the protocol published in Prospero, especially regarding the initially proposed authors.

• Please include a paragraph regarding the statistical analysis or data synthesis

• The results’ section is about 11 pages long, which is considerably extensive. In my opinion, the authors failed to synthesise the data.

Minor issues:

Introduction

In the first line of the introduction, the authors wrote that both, Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are cost-effective, however, the references provided were not focused on cost-effectiveness analysis. Similarly, the same references do not endorse the statement “Total hip arthroplasty (THA) and total knee arthroplasty (TKA) improve the ability to stay physically active”.

Methods

• Please state the criteria of the type of study design included in the review.

• The data extraction section was brilliantly written.

Results

• Please check a possible typo in line 160 “(98, 80%)”.

• Please expand about “found comparable results” in line 221.

• Please explain, in the methods section, about the “non-response analysis” mentioned in line 156.

• The tables summarise valuable information, congratulations to the authors for their effort.

• Please display the first header row on each page to ease reading the tables

• Please explain how to interpret the outcome in the appendixes, especially number 6 (eg question used to assess PA, min. value, max value, range, higher score representing more (and more intense) PA)

Discussion

It shows a better summary of the review.

• Please include a statement about the decision not to perform a meta-analysis. It might be a limitation,

• What are the clinical or practical repercussions/recommendations regarding the findings of low intensity and low activity levels for those populations?

Conclusions

• How was calculated the result for: “Time spent in sports was about 3 hours/week” in line 527?

• Can the authors conclude or give an idea of what percentage of these populations or papers meet the WHO physical activity guidelines?

Reviewer #2: The authors have assessed the quality of the articles using the adapted tool from Borghouts et al. This tool was developed in 1998. Why did the authors select this tool? I think that a more up-to-date tool could have been used instead of this tool.

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Reviewer #1: Yes: Carlos Mesa Castrillon

Reviewer #2: No

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Amount and type of physical activity and sports from one year forward after hip or knee arthroplasty − a systematic review

PONE-D-21-28882R1

Dear Dr. Stevens,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Sinan Kardeş, M.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: No

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thanks to the authors that adressed all comments succesfully. They declared the statistically analysis did not apply to the narrative review and that the PROSPERO protocol was updated.

Reviewer #2: The revised manuscript seems adequate scientifical value. I would like to thank the authors for the addmission to the reviewer's suggestions.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Carlos Mesa Castrillon

Reviewer #2: No