骨科康复一体化模式对全膝关节置换术患者运动功能的效果

doi:10.3969/j.issn.1006-9771.2022.02.003

Abstract

Abstract:

Objective To study the effects of integrated orthopedic rehabilitation pathway on motor function in six months after total knee arthroplasty (TKA), including pain, stiffness, range of motion and muscle strength, etc. Methods From March, 2016 to March, 2019, 180 patients who underwent TKA and treated with integrated orthopedic rehabilitation pathway were enrolled. Age, gender, operation time, time of follow-up, the scores of Hospital for Special Surgery-Knee Scale (HSS-KS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) at preoperative/postoperative/one-month after operation/three-month after operation/six-month after operation time points were collected. The sub items, such as muscle strength, range of motion, flexion deformity, pain, stiffness, functional difficulty were primarily focused on. Results A total of 42 patients were followed up for three months and 22 patients were followed up for six months. There was no significant difference in the scores of HSS-KS and WOMAC before and after operation (P > 0.05). Within three months after operation, the HSS-KS scores gradually increased (P < 0.05) and the WOMAC scores gradually decreased (P < 0.05). The active knee flexion range of motion and knee extensor muscle strength scores of HSS-KS significantly decreased after operation (P < 0.05), and gradually recovered one month and three months after operation (P < 0.05). The flexion deformity scores of HSS-KS increased after operation (P < 0.05), decreased one month after operation (P < 0.05), and got a trend of incensement again three months after operation. The pain score of WOMAC decreased continuously within three months after operation (P < 0.05); the stiffness score of WOMAC did not change after operation (P > 0.05), decreased significantly one month after operation (P < 0.05), and did not change three months after operation (P > 0.05). The degree of functional difficulty of WOMAC decreased after operation (P < 0.05), and improved continuously within six months after operation (P < 0.05). Conclusion The overall function after TKA shows a trend of improvement within three months, and there is no obvious improvement from three to six months after operation. The flexion deformity score showed a downward trend in one month after operation, and it could be improved again after strengthening rehabilitation, which needs more attention in the postoperative rehabilitation.

Key words: total knee arthroplasty, integrated orthopedic rehabilitation pathway, motion, pain, flexion deformity

CLC Number:

R687.4

LI Ran, DU Jubao, CAO Guanglei, LI Zheng, LI Ziyi, GE Yali, QIAN Long. Effects of integrated orthopedic rehabilitation pathway on motor function after total knee arthroplasty[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 144-149.

Figures/Tables 2

References 25

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时间	n	HSS-KS评分	HSS-KS			WOMAC 评分	WOMAC
时间	n	HSS-KS评分	关节活动范围	肌力	屈曲畸形	WOMAC 评分	疼痛	僵硬	功能活动困难程度
术前	42	54.05±12.25	10.60±2.95	8.90±2.13	3.88±4.00	46.67±17.39	9.90±3.81	2.74±2.07	34.02±12.88
术后	42	54.76±12.67	9.36±3.23^a	6.71±3.05^a	6.83±3.63^a	53.29±12.64	7.21±4.09^a	3.17±1.75	42.93±9.49^a
术后1个月	42	68.29±11.11^a,b	11.69±2.25^a,b	9.24±1.32^b	5.98±3.74^a	29.57±12.73^a,b	4.33±2.90^a,b	1.83±1.32^a,b	23.38±10.57^a,b
术后3个月	42	78.43±8.14^c	12.19±2.00	9.86±0.52^c	6.98±3.18	22.29±10.67^c	2.48±2.38^c	1.50±1.57	18.31±9.63^c
F值		53.204	14.638	21.412	8.453	49.301	37.829	11.531	45.530
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

时间	n	HSS-KS评分	HSS-KS			WOMAC 评分	WOMAC
时间	n	HSS-KS评分	关节活动范围	肌力	屈曲畸形	WOMAC 评分	疼痛	僵硬	功能活动困难程度
术前	22	51.32±12.08	9.86±2.88	9.00±2.12	2.73±4.00	43.32±17.18	8.86±3.45	2.59±1.76	31.86±13.02
术后	22	53.05±13.78	8.82±3.83	6.91±3.13^a	6.55±4.08^a	55.00±14.00^a	8.09±4.24	2.59±1.50	44.32±11.09^a
术后1个月	22	70.45±10.38^a,b	11.18±2.02^b	9.27±0.98^b	5.41±3.92^a	28.32±12.24^a,b	3.68±2.88^a,b	1.5±1.30^a,b	23.14±10.04^a,b
术后3个月	22	76.82±8.96^c	11.77±2.18	9.91±0.43^c	6.18±3.36	23.14±11.23	2.91±2.62	1.45±1.57	18.77±9.14
术后6个月	22	78.27±12.67	11.82±2.15	9.91±0.43	6.86±3.36	18.09±13.69	2.36±3.66	1.27±1.42	14.45±10.77
F值		32.285	7.146	12.304	6.086	30.450	18.098	6.368	29.205
P值		< 0.001	0.001	< 0.001	< 0.001	< 0.001	< 0.001	0.002	< 0.001

Effects of integrated orthopedic rehabilitation pathway on motor function after total knee arthroplasty

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