摘要
目的:前瞻性地进行双侧一次性全膝关节置换术(TKR)患者围手术期系统康复的临床研究。方法:选择2002年3月—2002年8月住院治疗TKR患者21例,所有入选病例均为膝关节骨性关节炎实施双侧一次性TKR的患者,入院后即开始实施系统个性化康复治疗方案,康复治疗分为3个阶段。第一阶段(手术前)、第二阶段(术后0—20天)、第三阶段(出院后),康复治疗内容包括:肌力训练、关节活动度训练、平衡功能、本体感觉及步态训练,术后康复治疗从术后第1天开始。结果:病例随访6—12个月,总共42个膝关节。膝关节活动度:出院时(术后10—20天):膝关节屈曲:100°—120°,平均101°±11.3°;伸直:10°—30°,平均10.4°±8.6°;膝关节周围肌力达到4级以上;术后半年复查,按照HSS膝关节评分标准:优:18例,良:3例,优良率100%,患者能够脱离拐杖行走及上下楼梯,生活完全自理。结论:双侧TKR患者术后早期系统康复治疗可直接影响手术的效果;早期系统的康复训练对于维持关节的稳定性、减少对人工关节的磨损、延长人工关节的使用寿命、提高患者生活质量是必需的,对双侧TKR患者更为重要。
Objective:To discuss the rehabilitation of bilateral total knee replacement(TKR).Method:21Patients after TKR were investigated,whom were underwent the operation in our hospital from Fe b2002to Aug2002and followed-up6-12months.Outcome evaluations involved knee rang e of movement,and functional mobility at discharge from the hospital and6month p ost operation.The rehabilitation procedure consisted of three parts,preoperative period,0-20days post operation and after-discharge.Passive,active-assisted and active ROM exercises of the knee,daily strengthening,balance exercises,gait tra ining,proprioception exercises and ability to transfer independently were perfor med in different periods.Result:During the postoperative hospitalization was10-20days.In the period,all of the patients had achieved functional independence su fficient for discharge.At discharge,flexion of the knee was100°-120°mean101° ±11.3°,extension10°-30°mean10.4°±8.6°.Follow-up six month after surgery, motion and HSS score of knee were excellent.Conclusion:Early rehabilitation coul d facilitate function restoration and range of motion for the patients with bila teral total knee replacement.The rehabilitation protocol must be modified accord ing to the patient's condition.
出处
《中国康复医学杂志》
CAS
CSCD
2003年第9期517-519,共3页
Chinese Journal of Rehabilitation Medicine
