骨科康复一体化治疗模式在初次单髁膝关节置换术后早期功能恢复中的临床研究

Effectiveness of integrated rehabilitation approach and orthopaedic treatment on functional recovery after primary medical unicompartment knee arthroplasty

目的评价骨科康复一体化治疗模式在初次单髁膝关节置换术后早期的临床疗效,比较其与常规治疗模式的差异。方法回顾性纳入2016年1月至2017年11月在中日友好医院关节外科行初次内侧单髁膝关节置换术的患者96例120膝,采用骨科康复一体化治疗模式者48例60膝作为A组,行常规治疗模式者48例60膝作为B组。记录两组患者手术前后视觉模拟疼痛评分(visual analogue score,VAS)、膝关节活动度(range of motion,ROM)、美国特种外科医院膝关节功能(hospital for special surgery,HSS)评分。结果术后1~3个月,A组膝关节VAS评分优于B组(P<0.05);术后1d、3d、出院当日、6月、1年,两组VAS评分差异无显著性(P>0.05)。出院当日及术后前6个月,A组膝关节ROM、HSS评分优于B组,差异有显著性(P<0.05);术后1年两组ROM、HSS评分差异无显著性(P>0.05)。结论对于行初次内侧单髁膝关节置换术的患者,骨科康复一体化治疗模式术后早期的临床疗效显著,能够有效缓解疼痛,改善膝关节功能,不增加并发症。

Objective To evaluate the effectiveness of integrated rehabilitation approach and orthopedic treatment on early stage functional recovery after primary medical unicompartment knee arthroplasty(UKA),and to compare rehabilitation efficacy with conventional treatment modality.Method One hundred and twenty knees who had underwent primary medial UKA were divided into groups A and B,with 60 knees in each one.Group A was treated with integrated rehabilitation approach and orthopaedic treatment,while group B with conventional treatment modality.Clinical outcomes were evaluated in terms of VAS score,ROM,and HSS score.Result There were no statistically significant differences in VAS scores between both groups at 1 day,3 days,discharge,6 months and 1 year after surgery(P<0.05).However,group A took statistically significant improvement in the VAS scores compared with group B from 1 month to 3 months after operation(P<0.05).In addition,although no significant differences regarding to the ROM and HSS scores were noticed between the two groups 1 year after surgery(P>0.05),group A was marked statistically higher ROM and HSS scores than group B form at discharge to 6 months postoperatively(P<0.05).Conclusion The rehabilitation effects were efficient for patients who had been given integrated rehabilitation approach and orthopaedic treatment after primary medical UKA,with better rehabilitation effects in relieving pain,improving knee function and without increasing complications compared with conventional treatment modality.