摘要
目的研究全膝关节置换术后早期功能锻炼对于膝关节功能恢复的影响。方法选择2010年7月—2012年6月全膝关节置换术治疗膝关节重度骨性关节炎32例，术前制定规范有效的早期功能锻炼方案。术后早期功能锻炼从麻醉恢复开始，分为三个阶段，第一阶段：术后0—2d；第二阶段：3～10d；第三阶段：10—14d，内容包括：肌力训练、关节活动度训练、平衡功能及步态训练，以循序渐进为原则。采用手术前后膝关节功能自身对比研究的方法，分别将术后2周、6周、12周的患肢膝关节最大屈曲度、活动度、HSS评分及WOMAC评分与术前评分进行比较。结果本组32例膝关节置换术，术后经过早期膝关节功能锻炼，仅3例出现膝关节轻微屈曲畸形（10°～20°），其余膝关节屈膝95°～115°，伸膝0°～5°，膝关节获得良好的功能，活动接近无痛，生活完全自理。术后6个月复查按照HSS膝关节评分标准：优27例，良5例；优良率达到100％。结论全膝关节置换术后早期进行合理、有效的功能锻炼，是影响手术效果的重要因素，也是减少并发症、加速康复的关键，对于膝关节功能恢复具有重要的作用。
Objective To study the effect of early functional exercise on postoperative functional rehabilitation after total knee arthroplasty（TKA）. Methods We investigated 32 cases of severe knee osteoaIthritis undergoing TKA in our hospital from July 2010 to June 2012 and made formal and effective plans of early functional exercise. The early postoperative functional exercise began with anesthetic recovery and implemented in three steps. The first part： within 2 days, the second part：3 -10 d, the third part： 10 -14 d. The training included strengthening exercise, range of motion exercises, bal- ance function and gait training. The maximum flexion, range of motion, HSS score and WOMAC score on 2nd,6th and 12th week were compared to those before the operation. Results Among 32 cases,3 cases were with slight flexion deformity for 10 to 20 degrees,other cases were with knee joint flexion degree from 95 to 115 and extension degree from 0 to 5. The knee joints of replacement achieved excellent function, painless activity and living independence. Six months follow-up showed that 27 cases were excellent and 5 cases were good according to HSS scores. Conclusion The early effective functional exercise after THA is an important factor to improve the result of operation treatment. The exercises can also reduce the incidence of complications and promote the recovery of patients.
出处
《中华全科医学》
2014年第8期1331-1332,1343,共3页
Chinese Journal of General Practice
