What’s New in Orthopaedic Rehabilitation 2026

New research in orthopaedic rehabilitation is presented in the latest JBJS Specialty Update, What’s New in Orthopaedic Rehabilitation. Here, we highlight the 5 most impactful studies, as selected by author Daniel L. Riddle, PhD, PT, FAPTA. 

Cervical Spine

The comparative efficacy of various exercises and passive therapies in treating nonspecific neck pain was assessed in a meta-analysis of 137 randomized controlled trials (RCTs) (47,867 patients). Resistance exercise plus coordination training had the highest efficacy, followed by aerobic exercise plus resistance exercise. Passive therapies, such as manual and laser therapies, had moderate benefits¹. 

Lumbar Spine

In a meta-analysis of 75 RCTs (17,935 patients), researchers examined the outcomes of nonoperative interventions for chronic low back pain. Moderate-certainty evidence suggested that cognitive behavioral therapy and mindfulness therapy could reduce pain and disability. Low-certainty evidence suggested that exercise or multidisciplinary care might reduce disability at >2 years of follow-up². 

The effects of spinal manipulation or mobilization on pain, function, and complications were investigated in a Cochrane review of 76 RCTs (11,866 patients with chronic low back pain). Very low-certainty evidence showed small benefits in pain reduction and functional status with spinal manipulation therapy compared with controls, but the clinical relevance of these findings was unclear³. 

Hip and Knee

Different exercise types and dosages were evaluated for their effect on pain in a meta-analysis of 6,079 patients with hip or knee osteoarthritis across 92 RCTs. Evidence quality was low to moderate. No significant differences were found among the exercises, although a probabilistic ranking of effectiveness showed aerobic training with the largest benefit, followed by strength plus flexibility training⁴. 

Foot and Ankle

Operative and nonoperative treatments for Achilles tendon rupture were compared in a meta-analysis of 33 studies (33,896 patients). Primary outcomes included rerupture and infection. The operatively treated group had a lower rerupture rate (risk ratio, 0.44) and a higher infection rate (risk ratio, 2.54) than the nonoperatively treated group⁵. The evidence was of high quality overall but included data from only 4 RCTs⁴. 

What’s New in Orthopaedic Rehabilitation is freely available at JBJS.org. 

What’s New by Subspecialty

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org. 

Recent OrthoBuzz posts include: What’s New in Limb Lengthening and Deformity Correction, What’s New in Musculoskeletal Infection, and What’s New in Spine Surgery. 

References 

1. Xie J, Jin M, Guo J, Guo H, Cai X, Wang B. Comparative efficacy of exercise versus passive physical therapy in improving nonspecific neck pain: a multilevel network meta-analysis and dose-response analysis. Spine J. 2025 Nov;25(11):2357-68. 
2. Jenkins HJ, Corrêa L, Brown BT, Ferreira GE, Nim C, Aspinall SL, Wareham D, Choi J, Maher CG, Hancock MJ. Long-term effectiveness of non-surgical interventions for chronic low back pain: a systematic review and meta-analysis. Lancet Rheumatol. 2025 Sep;7(9):e607-17. 
3. de Zoete A, Innocenti T, Petrozzi MJ, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW, Rubinstein SM. Spinal manipulative therapy for adults with chronic low back pain. Cochrane Database Syst Rev. 2026 Jan 6;1(1):CD008112. 
4. Liang Z, Wang C, Zhang M, Yu Y, Hao F, Tian S. Optimal modality and dose of exercise for relieving pain in patients with knee or hip osteoarthritis: Bayesian pairwise, network, and dose-response meta-analyses. Semin Arthritis Rheum. 2025 Dec;75:152855. 
5. Yang Z, Ge Z, Zheng J, Zhang L, Yang Z. Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis. J Orthop Surg Res. 2025 Jul 8;20(1):626.