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生物型全髋关节置换后早期全负重训练的效果评价 预览 被引量:2

Evaluation of the effect of early total weight-bearing training after cementless total hip arthroplasty
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摘要 背景:生物全髋关节置换后的负重方式尚未达成一致,临床上对于早期负重锻炼仍存在质疑。目的:在加速康复外科理论指导下,观察生物型非骨水泥全髋关节置换后早期全负重训练的临床疗效。方法:纳入2016年3月至2017年4月天津医院骨科收治因股骨颈骨折而行生物型非骨水泥全髋关节置换的患者100例,随机分为2组,试验组50例应用加速康复外科理念术后早期全负重锻炼;对照组50例采用传统康复理念术后3周内限制完全负重。所有患者对治疗及试验方案均知情同意,且符合天津医院对研究的相关伦理要求。结果与结论:①所有患者术后均完成18个月随访;②术后3 d、2周、3个月目测类比疼痛评分试验组均低于对照组,差异有显著性意义(P <0.05);③术后3个月测量髋关节活动度,试验组优于对照组,差异有显著性意义(P <0.05);④术后6个月、1年、1.5年分别评估髋关节Harris评分,试验组均优于对照组(P <0.05);⑤术后1.5年SF-36评分显示生理机能及肢体疼痛对比试验组优于对照组,差异有显著性意义(P <0.05);⑥术后1.5年进行影像学评估,股骨假体下沉量试验组与对照组差异无显著性意义(P=0.117);⑦术后试验组并发症发生率18%显著低于对照组38%,差异有显著性意义(P=0.022);试验组围术期恶心呕吐、静脉血栓、术后焦虑发生率均低于对照组(P <0.05);⑧结果表明,应用加速康复外科理论联合早期全负重锻炼在生物型全髋关节置换中可以达到较好的临床疗效,并且不会造成假体松动。 BACKGROUND: There is no consensus on the way of weight-bearing after total hip arthroplasty, and early weight-bearing exercise in clinical practice still remains controversial.OBJECTIVE: To investigate the clinical efficacy of applying enhanced recovery after surgery in guiding early weight-bearing exercises after cementless total hip arthroplasty.METHODS: One hundred patients undergoing cementless total hip arthroplasty for femoral neck fractures at Department of Orthopedics,Tianjin Hospital from March 2016 to April 2017 were enrolled, and were then randomized into two groups(n=50/group). The trial group received early weight-bearing exercise with the concept of enhanced recovery after surgery, and control group was given weight-bearing exercise at 3 weeks with the traditional rehabilitation concept. Informed consents were obtained from all patients, and the trial was approved by the Ethics Committee of Tianjin Hospital.RESULTS AND CONCLUSION:(1) All patients were followed up for 18 months.(2) The Visual Analog Scale score in the trial group was significantly lower than that in the control group at 3 days, 2 weeks and 3 months after operation(P < 0.05).(3) Hip range of motion in the trail group was significantly superior to the control group at postoperative 3 months(P < 0.05).(4) The Harris hip score in the trial group was significantly superior to the control group at 6 months, 1 and 1.5 years postoperatively(P < 0.05).(5) At postoperative 1.5 years, the SF-36 score showed that the physiological function and bodily pain in the trial group were significantly superior to the control group(P < 0.05).(6)X-ray measurements was performed at 1.5 years postoperatively, and there was no significant difference in the incidence of femoral prosthesis subsidence(P=0.117).(7) The incidence of postoperative complications in the trial group(18%) was significantly lower than that in the control group(38%)(P=0.022). The incidences of nausea and vomiting and venous thrombosis perioperatively, and postoperative anxiety in the tri
作者 吴维勇 徐卫国 Wu Weiyong;Xu Weiguo(Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;Department of Orthopedics,Tianjin Hospital,Tianjin 300211,China)
出处 《中国组织工程研究》 CAS 北大核心 2019年第18期2827-2832,共6页 Journal of Clinical Rehabilitative Tissue Engineering Research
基金 天津市科技计划项目(17ZXHLSY00140),课题名称:面向家庭的老年髋部骨折术后康复管理系统的研发.
关键词 加速康复外科 非骨水泥假体 全髋关节置换 早期全负重康复 髋关节活动度 HARRIS评分 enhanced recovery after surgery cementless prosthesis total hip arthroplasty early weight-bearing exercises range of motion of knee joint Harris score
作者简介 吴维勇,男,1992年生,江苏省盐城市人,天津中医药大学在读硕士,主要从事骨科方向的研究;通讯作者:徐卫国,博士,主任医师,天津医院骨科,天津市300211.
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