非骨水泥型全髋关节置换术患者的早期康复

关键词：全髋关节置换术 非骨水泥 康复 负重

Keywords:total hip arthroplasty  cementless  rehabilitation  weight-bearing

摘要：

      目的：比较早期负重和晚期负重对非骨水泥型全髋关节置换术后患者功能恢复和生存质量的影响.方法：共收集患者30例（32髋）,分为早期负重组（治疗组）和晚期负重组（对照组）,除术后负重方法不同外,均予系统的早期康复治疗.术前、术后12周内进行临床和放射学的评定和比较.结果：术后12周,早期负重组患者能够更早地获得独立步行的能力（P＜0.001）,Harris评分和WOMAC评分改善更明显（P＜0.001）;SF-36量表的评分中,早期负重组患者的生理职能、生理机能,以及社会功能评分更高（P＜0.001）.术后12周,放射学检查结果初步表明早期负重并未导致假体固定失败.结论：术后12周,早期负重组患者功能改善更明显,更快地获得独立的日常生活和社会活动能力,生存质量更高.早期负重的康复治疗,必须在一定条件下进行.

Abstract:

      Objective:To study the early rehabilitation by comparing the outcomes in two matched groups of patients after cementless total hip arthroplasty, according to International Classification of Functioning, Disability and Health.Method: Thirty patients with 32 hips received cementless total hip arthroplasty. The patients were randomly divided into early full weight-bearing group and late full weight-bearing group.The preoperative and postoperative rehabilitation of the patients was similar except weight-bearing. The patients were evaluated clinically and radiographically before, and after surgery at 12 week. Result:At 12 week after surgery the patients in early full weight-bearing group gained the ability to walk faster than those in late full weight-bearing group(P<0.001), and got better scores and improvement both in the Harris hip scores and WOMAC scores(P<0.001). For the SF-36 scores at 12 week, the patients in early full weight-bearing group got higher scores in physical function, social function, and social role(P<0.001). Early full weight-bearing after cementless total hip arthroplasty under some conditions was safe without showing the signs of implant instability or failure to roentgenographly at 12 week. Conclusion: The patients in early full weight-bearing group got better activities of daily living, social function and quality of life. Early full weight-bearing rehabilitation after cementless total hip arthroplasty can be carried out in patients under certain situations.