HSS膝关节康复方案对单髁置换术后早期关节功能和步态的影响

Effects of HSS knee rehabilitation program on short-term joint function and gait after unicondylar replacement

目的研究美国特种外科医院(hospital for special surgery,HSS)膝关节康复方案对膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)术后关节功能及步态的近期影响。方法回顾性分析2018年1月至2021年6月间在湖北省中医院行UKA术的60例患者。将采用HSS膝关节成形术康复指南进行康复治疗的30例患者作为HSS组;将同期采用常规康复方案的30例患者作为常规组。记录术后1周、3个月、6个月、1年两组患者的膝关节活动范围(range of motion,ROM)、美国特种外科医院膝关节HSS评分、人工关节遗忘指数(forgotten joint index,FJS)。分别于术后6个月、1年时采用GaitWatch三维步态分析及运动训练系统进行步态信息数据的采集,并比较两组间差异。结果两组均完成术后1年以上随访,膝关节功能比较:术后3个月随访,HSS组膝关节ROM、HSS评分高于常规组,差异有统计学意义(P<0.05);术后6个月随访,HSS组患者膝关节ROM、HSS评分高于常规组,FJS评分低于常规组,差异有统计学意义(P<0.05);术后1年随访,HSS组的HSS评分高于常规组、FJS评分低于常规组,差异有统计学意义(P<0.05)。步态参数比较:术后6个月随访,HSS组的步数、步长及单足支撑相较常规组高,差异有统计学意义(P<0.05);术后1年随访,HSS组的步数、步频、单足支撑相较常规组高,差异有统计学意义(P<0.05)。结论HSS膝关节成形术后康复方案在UKA术后早期可显著改善膝关节功能和步态,有利于UKA术后早期康复。

Objective To investigate the short-term effects of the Hospital for Special Surgery(HSS)knee rehabilitation program on joint function and gait after unicompartmental knee arthroplasty(UKA).Methods A retrospective analysis was performed on 60 patients who underwent UKA in Hubei Provincial Hospital of Traditional Chinese Medicine from January 2018 to June 2021.A total of 30 patients who received rehabilitation treatment according to the HSS knee arthroplasty rehabilitation guidelines were selected as the HSS group.The 30 patients who received conventional rehabilitation program during the same period were selected as the control group.The range of motion(ROM),Hospital for Special Surgery(HSS)score and forgotten joint score(FJS)were recorded at 1 week,3 months,6 months and 1 year after operation.The GaitWatch three-dimensional gait analysis and exercise training system were used to collect gait data at 6 months and 1 year after operation,and the differences between the two groups were compared.Results All patients were followed up for more than 1 year after operation.The ROM and HSS scores of the HSS group were significantly higher than those of the control group at 3 months after operation(P<0.05).After 6 months of follow-up,the knee ROM and HSS scores of the HSS group were higher than those of the control group,and the FJS score was lower than that of the control group,and the differences were statistically significant(P<0.05).After 1 year of follow-up,the HSS score of the HSS group was higher than that of the control group,and the FJS score was lower than that of control group,and the differences were significant(P<0.05).Comparison of gait parameters:The number of steps,step length and single leg support in the HSS group were higher than those in the control group at 6 months after operation,and the difference was statistically significant(P<0.05).After one-year follow-up,the number of steps,step frequency,and single leg STUDYsupport of the HSS group were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The HSS rehabilitation program after UKA can significantly improve knee function and gait in the early postoperative period,which is beneficial to the early rehabilitation after UKA.