膝关节屈曲活动训练支具对股骨远端骨肉瘤患者人工关节置换术后膝关节功能的影响

Efficacy of JAS device on knee joint function after distal femoral osteosarcoma joint replacement surgery

目的评价膝关节屈曲活动训练(JAS)支具对股骨远端骨肉瘤患者人工关节置换术后膝关节功能恢复的效果。方法选取2023年1月至2024年3月上海市第一人民医院骨肿瘤科收治的36例股骨远端骨肉瘤人工关节置换术后患者,其中男13例,女23例;年龄9~18岁。随机掷硬币法分为对照组(19例)和试验组(17例),对照组于术后给予传统康复治疗,试验组于术后给予JAS支具联合传统康复治疗。分别于术后1和3个月评估患者治疗前后膝关节主动活动范围(AROM)、美国特种外科医院膝关节评分(HSS)及并发症发生情况。结果与术后1个月比较,术后3个月试验组膝关节AROM明显提高[分别为(58.5±9.0)°和(105.4±10.0)°,P<0.05],对照组膝关节AROM亦有明显提高[分别为(58.0±8.6)°和(90.6±3.3)°,P<0.05],且术后3个月试验组明显高于对照组(P<0.05)。与术后1个月比较,术后3个月试验组HSS评分有明显提高[分别为(68.0±6.4)分和(83.8±3.9)分,P<0.05],对照组HSS评分亦有明显提高[分别为(67.2±6.2)分和(77.3±2.6)分,P<0.05],且术后3个月试验组明显高于对照组(P<0.05)。试验组和对照组并发症的总发生率分别为5.9%(1/17)和10.5%(2/19),差异无统计学意义(P>0.05)。结论应用JAS支具能提高股骨远端骨肉瘤人工关节置换术后患者膝关节活动范围,促进膝关节功能恢复。

Objective To investigate the effect of the JAS device on knee joint function following distal femoral osteosarcoma joint replacement surgery.Methods A total of 36 patients including 13 males and 23 females,ages 9-18,who underwent joint replacement surgery for distal femoral osteosarcoma at the Department of Bone Tumor,Shanghai General Hospital from January 2023 to March 2024 were selected and randomly divided into a control group of 19 cases and an experimental group of 17 cases.The control group received traditional rehabilitation therapy after surgery,while the experimental group received the JAS device combined with traditional rehabilitation therapy.The knee joint active range of motion(AROM)and hospital for special surgery knee score(HSS)were assessed at one month and three months postoperatively.Results At one month and three months postoperatively,there was a significant improvement in the knee AROM within experimental group after treatment[(58.5±9.0)°and(105.4±10.0)°respectively,P<0.05],a significant improvement within control group after treatment[(58.0±8.6)°and(90.6±3.3)°respectively,P<0.05],the experimental group showing a significantly higher improvement than the control group at three months postoperatively(P<0.05).There was a significant improvement in HSS scores within experimental group after treatment(68.0±6.4 and 83.8±3.9 respectively,P<0.05),a significant improvement within control group after treatment(67.2±6.2 and 77.3±2.6 respectively,P<0.05),the experimental group significantly higher than the control group at three months postoperatively(P<0.05).The incidence of complications in the experimental group and the control group were 5.9%(1/17)and 10.5%(2/19),there was no statistical significance(P>0.05).Conclusion The application of the JAS device can improve range of motion of the knee joint and promote the recovery of knee joint function after distal femoral osteosarcoma joint replacement surgery.