量化评估早期康复模式对运动学对线全膝关节置换术患者膝关节功能及生活质量的影响

Effects of early rehabilitation based on quantitative evaluation on knee function and quality of life of patients undergoing total knee arthroplasty by kinematic alignment technology

目的探讨量化评估早期康复模式对运动学对线全膝关节置换术(TKA)患者膝关节功能及生活质量的影响。方法选择2020年2月至2022年11月联勤保障部队第九○四医院骨科收治的82例TKA患者作为研究对象,根据患者入院时间先后将其分为观察组和对照组,每组各41例,对照组中1例患者失访予以剔除。2组患者均行常规运动学对线TKA,对照组实施常规康复训练,在此基础上,观察组实施量化评估早期康复模式。观察比较2组患者术后次日和术后3个月的膝关节功能和生活质量。结果2组患者膝关节主动屈曲角度的组间、时点及交互比较差异均有统计学意义(P<0.05);进一步两两比较,组内比较,2组患者术后1、2、3个月膝关节主动屈曲角度均较术后次日增大;组间比较,2组患者术后次日和术后1个月膝关节主动屈曲角度差异无统计学意义(P>0.05),观察组患者术后2个月和术后3个月膝关节主动屈曲角度均大于对照组,差异有统计学意义(P<0.05)。术后次日,2组患者关节炎生活质量测量量表2-短卷(AIMS2-SF)各维度评分及总分差异无统计学意义(P>0.05);术后3个月,2组患者AIMS2-SF各维度评分及总分均较术后次日降低(P<0.05),且观察组患者AIMS2-SF各维度评分及总分均低于对照组(P<0.05)。结论量化评估早期康复模式有助于改善运动学对线TKA患者膝关节功能,并有效提高其生活质量。

Objective To explore the effects of early rehabilitation based on quantitative evaluation on knee function and quality of life of patients undergoing total knee arthroplasty(TKA).Methods A total of 82 patients undergoing TKA from February 2020 to November 2022 in No.904 Hospital of Joint Logistics Support Force of PLA were selected as study subjects.They were divided into control and observation groups according to their admission time,with 41 cases in each group.One patient in the control group was excluded due to loss of follow⁃up.Kinematic alignment was adopted in all the patients.Routine rehabilitation training was carried out in the control group,and early rehabilitation based on quantitative evaluation was applied in the observation group.The knee function and quality of life of the two groups were observed and compared on the next day and 3 months after operation.Results There were significant differences in the inter⁃group,time,and interaction of active flexion angle of knee joint between the two groups(P<0.05).The active flexion angle of knee joint at 1,2 and 3 months after operation was larger than that on the next day after operation in both groups.There was no statistically significant difference in the active flexion angle of knee joint between the two groups on the next day and 1 month after operation(P>0.05).The active flexion angle of knee joint in the observation group was significantly larger than that in the control group at 2 months and 3 months after operation(P<0.05).There was no statistically significant difference in the scores of each dimension or the total score of the short⁃form arthritis impact measurement scales 2(AIMS2⁃SF)on the next day after operation between the two groups(P>0.05).The scores of each dimension and total scores of AIMS2⁃SF at 3 months after operation were significantly lower than those on the next day after operation in both groups(P<0.05).And theses scores in the observation group were significantly lower than those in the control group at 3 months after operation(P<0.05).Conclusion Early rehabilitation based on quantitative evaluation is helpful to improve the knee function of patients undergoing TKA by kinematic alignment technology and has a positive impact on the improvement of the quality of life.