早期大角度被动ROM练习对全膝置换术后膝关节功能的影响

关键词：微创全膝置换  关节活动度  康复

Keywords:minimally invasive surgery-total knee arthroplasty  range of motion  rehabilitation

摘要：

      目的：观察全膝置换术（TKA）后早期大角度膝关节被动活动度（ROM）练习与常规被动ROM练习对TKA后膝关节功能改善的影响。方法：将34例老年骨性关节炎（OA）患者按手术顺序随机分成术后常规被动ROM练习组和大角度被动ROM练习组。所有患者均由同一术者用微创全膝置换术式（MIS-TKA）进行手术。大角度被动ROM组在术后2周内的被动ROM练习角度比常规被动ROM练习组大20°—30°，其他康复方案和术后镇痛方案均相同。结果：两组患者术前HSS评分差异无显著性，但术后第1、2、6、12和24周大角度被动ROM练习组的HSS评分均高于常规被动ROM练习组。其中，术后第1、2周的HSS差异有显著性（P<0.05）。两组患者的术前膝关节主动和被动ROM差异均无显著性，但术后第4天、1周、2周、6周、12周、24周膝的主动和被动ROM差异均有显著性意义（P<0.05）。结论：对MIS-TKA患者术后早期大角度被动ROM练习不仅能改善患膝的主动和被动ROM，还能改善膝HSS功能评分。

Abstract:

      Objective: To investigate the influence of early large-angle passive ROM exercises or routine passive ROM exercises on patients′ knee function post TKA. Method: Thirty-four old osteoarthritis(OA) patients post TKA operation were included in routine passive ROM exercises group and early large-angle passive ROM exercises group, optionally by operating date at random, seventeen patients in each group. The operations of all the cases were done by one operator with the MIS-TKA technique. Within 2 weeks post operation, the angle of passive ROM exercises in early large-angle passive ROM exercises group was 20°—30° more than that in routine passive ROM exercises group. The other rehabilitation procedures were the same in both groups. Result: The HSS scores pre-operation had no significant difference between 2 groups. Post MIS-TKA operation 1 week, 2 weeks, 6 weeks, 12 weeks and 24 weeks, the HSS scores in large-angle passive ROM exercises group was higher than that in routine passive ROM exercises group. The HSS scores were significant higher in large-angle passive ROM exercises group 1 week and 2 weeks post MIS- TKA(P<0.05). The active ROM and passive ROM of operated knee pre-operation showed no significant difference between 2 groups. But 4 days, 1 week, 2 weeks, 6 weeks, 12 weeks and 24 weeks post MIS-TKA, the active and passive ROM in early large-angle exercises group was significant higher (P<0.05). Conclusion: For MIS-TKA patients, early large-angle passive ROM exercises could not only improve the active and passive ROM, but could improve the HSS knee functional scores also.