全膝关节置换术后短期膝关节功能及其影响因素

doi:10.3969/j.issn.1006-9771.2024.01.015

Abstract

Abstract:

Objective To investigate the short-term knee function recovery of patients undergoing total knee arthroplasty (TKA) after discharge and analyze its related factors.

Methods From December, 2022 to April, 2023, 140 adult patients who underwent TKA in Nanjing Drum Tower Hospital and being about to be discharged were selected as the survey subjects using convenient sampling. Potential influencing factors were selected based on a literature review. They were investigated with general information questionnaire, Rehabilitation Exercise Compliance Scale, Self-Efficacy Scale for Rehabilitation Exercise (SER), Visual Analog Scale for pain (VAS), and joint range of motion measurements before discharge, and were investigated with the Hospital for Special Surgery Knee Score (HSS) one month after discharge.

Results A total of 130 patients finished follow-up. One month after discharge, the HSS score ranged from 40 to 82, with an average of (70.89±6.26). Multiple linear regression analysis revealed that Body Mass Index (B = -0.423, 95%CI -0.622 to -0.224, P< 0.001), pre-discharge VAS (B = -1.016, 95%CI -1.198 to -0.113, P= 0.028), rehabilitation exercise compliance (B = 0.267, 95%CI 0.121 to 0.413, P< 0.001), SER (B = 0.478, 95%CI 0.315 to 0.642, P< 0.001), and knee joint flexion contracture angle (B = -0.251, 95%CI -0.414 to -0.088, P= 0.003) could influence HSS score one month after discharge (R² = 0.615, F=17.106, P< 0.001).

Conclusion Patients after TKA have recovered well in short time after discharge, however, there is still significant room for improvement. Clinical healthcare providers should design and implement appropriate interventions based on related factors to improve the function.

Key words: total knee arthroplastyt, joint function, short-term rehabilitation, rehabilitation status, related factors

CLC Number:

R684

WANG Zihao, LI Xinhua, JIANG Huiping, GUO Sainan, LIANG Qiuman, SHI Tingqi. Short-term knee function after total knee arthroplasty and related factors[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 111-118.

Figures/Tables 3

Table 1

Table 2

Table 3

References 22

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项目		n	HSS评分	F值/t值	P值
年龄	< 65岁	30	69.04±1.45	1.681	0.180
	65~69岁	40	71.82±0.98
	70~74岁	42	70.98±0.87
	≥ 75岁	18	72.78±1.17
性别	男	24	71.43±5.26	0.314	0.754
	女	106	70.98±6.46
文化程度	初中及以下	113	70.42±6.47	-2.230	0.028
	初中以上(中专、高中、大学)	17	74.00±3.29
住宅类型	平房	64	69.52±6.41	5.599	0.005
	楼梯房	30	70.47±6.56
	电梯房	36	73.69±4.79
主要照顾者	配偶	55	70.24±7.39	0.614	0.543
	子女	70	71.46±5.21
	其他	5	70.20±6.72
人均月收入	< 3000元	50	68.70±7.12	6.571	0.002
	3000~5000元	69	71.86±5.43
	> 5000元	11	74.82±2.93
并发症	0个	43	70.26±5.51	1.004	0.393
	1个	65	71.26±6.99
	2个	17	69.94±5.31
	3个及以上	5	74.80±4.66
疼痛年限	< 5年	40	70.60±7.02	0.275	0.760
	5~10年	65	70.75±6.14
	> 10年	25	71.72±5.39
手术时长	< 90 min	23	71.43±5.67	4.101	0.019
	90~120 min	76	71.84±4.90
	> 120 min	31	68.16±8.63
术后住院时间	≤ 3 d	74	69.88±6.98	-2.153	0.033
	> 3 d	56	72.23±4.91
术中出血量	< 100 mL	90	71.30±5.55	0.930	0.397
	100~200 mL	35	70.97±7.98
	> 200 mL	5	67.40±5.13

因素	r值	P值
VAS评分	-0.346	< 0.001
BMI	-0.208	0.018
康复锻炼依从性	0.513	< 0.001
SER评分	0.652	< 0.001
屈曲角度	0.230	0.009
屈曲挛缩角度	-0.238	0.006

因素	B	SE	β	t值	P值	95%CI
文化程度	0.641	1.151	0.035	0.557	0.579	-1.639~2.921
住宅类型	0.254	0.458	0.035	0.550	0.580	-0.652~1.160
人均月收入	0.615	0.652	0.061	0.944	0.347	-0.675~1.906
手术时长	-0.015	0.016	-0.054	-0.929	0.355	-0.048~0.017
术后住院时间	0.188	0.341	0.032	0.551	0.583	-0.488~0.864
BMI	-0.423	0.100	-0.252	-4.213	< 0.001	-0.622~-0.224
VAS评分	-1.016	0.456	-0.152	-2.228	0.028	-1.198~-0.113
康复锻炼依从性	0.267	0.074	0.240	3.623	< 0.001	0.121~0.413
SER评分	0.478	0.082	0.505	5.807	< 0.001	0.315~0.642
屈曲角度	-0.019	0.036	-0.035	-0.542	0.589	-0.090~0.052
屈曲挛缩角度	-0.251	0.082	-0.184	-3.043	0.003	-0.414~-0.088

Short-term knee function after total knee arthroplasty and related factors

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