关节镜下膝关节前交叉韧带重建术后下床负重训练时间窗研究

Research on time window for weight-bearing training out of bed after arthroscopic reconstruction of anterior cruciate ligament of knee joint

目的探讨关节镜下膝关节前交叉韧带(ACL)重建术后不同时间窗下床负重训练对关节功能恢复的影响。方法将90例ACL术后患者随机分为A组(30例)、B组(31例)和C组(29例),在骨科常规治疗护理基础上,分别于术后第3天、第5天、第7天开始下床负重练习,在术前、出院时、出院后1个月评价三组膝关节功能(HSS)、屈伸活动度(ROM)、功能分级。结果三组出院时和出院后1个月HSS、ROM和功能分级具有统计学差异(P<0.05,P<0.01);两两比较,出院时B组HSS、ROM、功能分级显著优于A组与C组(均P<0.05),出院后1个月B组HSS、ROM显著优于A组与C组,且功能分级显著优于C组(均P<0.05)。结论关节镜下ACL重建术后第5天开始下床负重训练有利于提高膝关节功能及屈伸活动度,促进膝关节功能恢复。

Objective To explore the effect of weight-bearing training out of bed at different time windows on rehabilitation of joint function after arthroscopic reconstruction of anterior cruciate ligament(ACL).Methods Totally 90 ACL patients after surgery were randomized into group A(n=30),group B(n=31)and group C(n=29),who started weight-bearing training out of bed at 3 days,5 days and 7 days after operation based on the routine treatment and nursing in orthopedics department.The knee joint functions(HSS),flexion and extension(ROM)and functional classification of the three groups were evaluated before operation,at discharge and 1 month after discharge.Results There were significant differences in HSS,ROM and functional classification among the 3 groups at discharge and 1 month after discharge(P<0.05,P<0.01).The HSS,ROM and functional classification of group B were significantly better than those of group A and group C(P<0.05 for all),the HSS and ROM in group B were significantly better than those of group A and group C at 1 month after discharge,and the functional classification was significantly better than that of group C(P<0.05 for all).Conclusion Weight-bearing training out of bed starting at 5 days after arthroscopic reconstruction of ACL,is conducive to improving knee joint function and flexion activity,and promoting recovery of knee joint.