创伤后膝关节松解术后关节活动度反弹现象及其影响因素

doi:10.3969/j.issn.1006-9771.2024.05.010

Abstract

Abstract:

Objective To observe the temporary loss (re-falling) of knee range of motion (ROM) during rehabilitation after arthrolysis for post-traumatic knee stiffness, and analyze the factors related to it.

Methods From July, 2016 to September, 2019, 64 patients (68 knees) in Beijing Bo'ai Hospital accepted minimally invasive arthrolysis for post-traumatic knee stiffness, and were followed up for twelve months. ROM of flexion and extension of knee was measured before operation, and one, six and twelve weeks, and six and twelve months after operation; while they were asssessed with Hospital for Special Surgery Knee Score (HSS). Multivariate Logistic regression was performed on re-falling.

Results The ROM and HSS score improved as a whole after operation; however, HSS score improved constantly, but ROM decreased six weeks after operation compared with that one weeks after operation, involving 46 knees of 44 cases. Arthrolysis longer than 12 months from primary injuries, multiple complicated fracture and history of infection were the risk factors for re-falling (OR > 8.058, P < 0.05).

Conclusion Minimally invasive arthrolysis is effective on knee function after arthrolysis for post-traumatic knee stiffness. However, re-falling of ROM may happen during rehabilitation. Delay of operation, multiple complicated fracture and history of infection may increase the risk of re-falling.

Key words: post-traumatic knee stiffness, arthrolysis, range of motion, rehabilitation

CLC Number:

R687.4

CUI Zhigang, JIN Taoran, LIU Sihai, WANG Fei, LIU Kemin, LI Jianjun. Factors related to re-falling of knee range of motion after arthrolysis for post-traumatic knee stiffness[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 565-569.

Figures/Tables 3

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Table 3

References 30

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时间	n	ROM/°	HSS评分
术前	68	31.73±21.06	40±24
术后1周	68	85.52±52.50^a	47±15^a
术后6周	68	60.10±33.01^a,b	57±26^a
术后12周	68	79.33±44.10^a,c	80±41^a
术后6个月	68	91.80±31.41^a,c	88±33^a
术后12个月	68	94.52±46.90^a,c	93±36^a

变量		n	反弹组 (n = 46)^a	无反弹组 (n = 22)	χ²值	P值	变量		n	反弹组 (n = 46)^a	无反弹组 (n = 22)	χ²值	P值
性别	男	51	36	15	0.806	0.528	术前ROM	< 60°	22	13	9	1.088	0.138
	女	17	10	7				≥ 60°	46	33	13
年龄	< 40岁	49	34	15	0.243	0.414	术前HSS评分	< 70	43	31	12	1.056	0.223
	≥ 40岁	19	12	7				≥ 70	25	15	10
病因	创伤性	40	28	18	2.984	0.071	骨折部位	关节外	46	28	12	0.246	0.406
	非创伤性	28	18	4				关节内或混合性	22	18	10
损伤类型	闭合性	56	35	21	2.624	0.575	既往感染	无	49	29	20	5.740	0.014
	开放性	12	11	1				有	19	17	2
术前ADL	< 60分	20	10	10	4.032	0.106	是否使用	否	50	35	15	0.478	0.348
评分	≥ 60分	48	36	12			外固定	是	18	11	7
骨折数量	单纯骨折	35	18	17	8.668	0.003	术后是否使用	否	24	17	7	0.172	0.537
	复杂骨折	33	28	5			CPM	是	44	29	15
手术时病程	< 12个月	32	14	18	15.722	< 0.001	术后是否使用	否	13	8	5	0.274	0.414
	≥ 12个月	36	32	4			夹板或石膏	是	55	38	17

变量	B	SE	Wald	自由度	P值	OR
病因	1.343	0.778	2.981	1	0.084	3.829
骨折数量	2.087	0.809	6.658	1	0.010	8.058
手术时病程	2.112	0.712	8.797	1	0.003	8.266
既往感染	2.246	0.998	5.062	1	0.024	9.454
常量	-13.413	3.551	14.269	1	0.000

Factors related to re-falling of knee range of motion after arthrolysis for post-traumatic knee stiffness

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