全膝关节置换术患者术后早期屈曲活动度对远期活动度的影响

Effect of early postoperative flexion on long-term activity of patients after total knee replacement

目的分析全膝关节置换术术后早期屈曲活动度对远期活动度的影响。方法选择2012年1月-2015年2月首次行全膝关节置换术的患者98例127膝关节,术后早期开始膝关节功能康复训练,分析术后1 d、1周、2周膝关节屈曲度数与术后1年膝关节屈曲度数的关系;比较术后早期即术后2周屈曲活动度≥90°和〈90°的患者术后1年膝关节评分（HSS）。结果术后1周达到屈曲度数≥90°,患者疼痛度均为最高（P〈0.05）。术后1 d、1周、2周屈曲度数〈90°,患者术后1年屈曲度数均分别明显小于同期屈曲度数≥90°（P〈0.05）;术后1 d、1周、2周屈曲度数≥90°,患者术后1年屈曲度数差异有统计学意义（P〈0.05）。术后2周屈曲度数≥90°,患者术后1年屈曲度数均明显大于术后1 d、1周屈曲度数≥90°（P〈0.05）。结论全膝关节置换术术后2周屈曲活动度与术后1年屈曲活动度相关,在术后2周屈曲度数达到≥90°的患者远期膝关节活动度和功能预后均更好。

Objective To analyze the impact of early postoperative flexion on long-term activity of total knee arthroplasty patients. Methods 98 patients who underwent total knee replacement（127 knees） during January 2012- February 2015 in Qingdao Municipal Hospital were selected for analysis. After early postoperative knee function rehabilitation training,Patients＇ knee flexion degrees 1 day,1 week and two weeks after training were compared with those 1 year from training;1 year knee score（HSS）of patients with flexion degree ≥ 90 ° and 90 ° 2 weeks after operation were compared. Results Patients whose flexion degree reached ≥ 90 °1 week after operation suffered from the highest level of pain（P〈0.05）. Patients whose flexion degree were 90 °1day,1 week and 2 weeks after operations had lower HSS scored compared with patients whose flexion degree were ≥ 90 °at the same points-in-time（P〈0.05）. Patients whose flexion degree reached 90 ° 1 day,1 week and 2 weeks after operation showed different HSS scores with statistical significance（P〈0.05）, Patients whose flexion degree reached 90 °had high HSS scored compared with those whose flexion degree reached 90 °1 day or 1 week after operation（P〈0.05）. Conclusion Flexion degree of patients 2 weeks after total knee replacement surgery are correlated with their flexion degree 1 year after operation; patients with flexion degree ≥ 90°two weeks after operations will have better knee function after recovery.