同侧髋、膝关节同时置换术后康复

Rehabilitation of ipsilateral total hip and total knee replacement

目的:探讨同侧髋膝关节同时置换术的康复方法。方法:对1992年—1999年间收治的30例43侧严重风湿病下肢同侧髋膝关节同时置换术患者进行术后康复治疗,针对这些严重的风湿病患者制订一系列康复措施,并针对同侧髋膝关节同时置换术后的病例特点进行康复。结果:术前术后对比,髋关节术后总活动度平均提高93.7°,髋关节Harris评分较术前提高45分。膝关节活动度平均较术前提高44°,HSS平均较术前提高46.5分。全部患者经过平均5.2年的随访。随访期内,1例1膝患者复发屈膝挛缩,1例1膝出院后家庭康复时不慎摔倒致左股骨干骨折,经手术治疗后骨折愈合。其余患者均对患肢功能主观评价满意,术后疼痛症状明显缓解,出院时所有患者的不扶拐行走距离均超过100m。结论:同侧髋膝关节同时置换术患者的康复应在术前详细制订康复计划,针对病人不同情况采取不同的康复措施,严格遵守循序渐进、因人而异、随时调整的原则。

Objective:To discuss rehabilitation methods of ipsilateral total hip and total knee replacement Method:From1992to1999,30cases43ipsilateral total hip and total knee replacement were rehabilitated,the rehabilita-tion plan was made according to the characters of individual and operation.Result:Compared with pre-operation,general motion and Harris score of hip were average improved93.7°and45points respectively.Motion and HSS score of knee were average improved44°and46.5points respectively.After5.2years follow-up,flexional contrac-ture was reoccur in one case one knee,a femoral shaft fracture was occurred in on case,which was recovered af-ter operation.Others was satisfied with the results,the pain was released and the distance of ambulation was ex-ceed100m.Conclusion:Detailed plan must be made before operation of ipsilateral total hip and total knee re-placement,different rehabilitation method should be made for different individual.Our principle was following the order and step by step,adjusting at real time.