静态进展性牵伸结合关节松动术对全膝关节置换术后患者膝关节功能的影响

The effects of static progressive stretching combined with joint mobilization on dysfunction after total knee arthroplasty

目的探讨静态进展性牵伸（SPS）联合关节松动术对全膝关节置换术（TKA）后患者膝关节功能的影响。方法选取TKA后关节功能障碍患者56例，按照随机数字表法将其分为治疗组和对照组，每组28例。2组患者均采用关节松动术治疗，治疗组在此基础上辅以SPS训练。于治疗前及治疗8周后（治疗后），分别应用视觉模拟评分（VAS）、关节活动度、美国特种外科医院膝关节评分（HSS）评定2组患者的膝关节功能。结果治疗前，2组患者VAS评分、膝关节活动度、膝关节HSS评分比较，差异无统计学意义（P〉0．05）。治疗后，2组患者VAS评分、膝关节活动度、膝关节HSS评分均较组内治疗前改善（P〈O．05）。与对照组治疗后比较，治疗组患者膝关节活动度为（122．14±9．73）°、HSS评分（87．13±9．56）明显较高，差异有统计学意义（P〈0．05）。结论SPS结合关节松动术治疗TKA后关节功能障碍，可有效缓解患者膝关节疼痛，扩大膝关节活动范围，提高膝关节功能。

Objective To explore the effect of static progressive stretching combined with joint mobilization on dysfunction after total knee arthroplasty. Methods Fifty-six patients with knee joint dysfunction after total knee arthroplasty were randomly divided into a treatment group and a control group, each of 28. Both groups were treated with joint mobilization, while the treatment group was additionally provided with static progressive stretching for 8 weeks. Before and after the treatment, both groups＇ pain and knee function were evaluated using visual analogue scale （VAS） scores, the range of motion and the hospital for special surgery knee score （HSS）. Results Before the treatment there were no significant differences between the two groups in any of the measurements. After the treat- ment, all of the measurements had improved in both groups, on average. Compared with the control group, the treat- ment group＇s average range of motion of the knee and HSS score were significantly better. Conclusion Static pro- gressive stretches combined with joint mobilization can effectively relieve pain, expand the range of motion and im- prove the function of a knee joint after total knee arthroplasty.