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微创全髋关节置换术实现快速康复与恢复

Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty.

作者信息

Berger Richard A, Jacobs Joshua J, Meneghini R Michael, Della Valle Craig, Paprosky Wayne, Rosenberg Aaron G

机构信息

Department of Orthopaedic Surgery, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612, USA.

出版信息

Clin Orthop Relat Res. 2004 Dec(429):239-47. doi: 10.1097/01.blo.0000150127.80647.80.

Abstract

To assess the potential recovery rate of a minimally invasive total hip replacement technique with minimal soft tissue disruption, an accelerated rehabilitation protocol was implemented with weightbearing as tolerated on the day of surgery. One hundred consecutive patients were enrolled in this prospective study. Ninety-seven patients (97%) met all the inpatient physical therapy goals required for discharge to home on the day of surgery; 100% of patients achieved these goals within 23 hours of surgery. Outpatient therapy was initiated in 9% of patients immediately, 62% of patients by 1 week, and all patients by 2 weeks. The mean time to discontinued use of crutches, discontinued use of narcotic pain medications, and resumed driving was 6 days postoperatively. The mean time to return to work was 8 days, discontinued use of any assistive device was 9 days, and resumption of all activities of daily living was 10 days. The mean time to walk (1/2) mile was 16 days. Furthermore, there were no readmissions, no dislocations, and no reoperations. Therefore, a rapid rehabilitation protocol is safe and fulfills the potential benefits of a rapid recovery with minimally invasive total hip arthroplasty.

摘要

为评估一种软组织破坏最小的微创全髋关节置换技术的潜在恢复率,实施了一项加速康复方案,允许患者在手术当天根据耐受情况负重。100例连续患者纳入了这项前瞻性研究。97例患者(97%)在手术当天达到了出院所需的所有住院物理治疗目标;100%的患者在手术23小时内实现了这些目标。9%的患者立即开始门诊治疗,62%的患者在1周内开始,所有患者在2周内开始。术后停止使用拐杖、停止使用麻醉性止痛药和恢复驾驶的平均时间为6天。恢复工作的平均时间为8天,停止使用任何辅助装置的平均时间为9天,恢复所有日常生活活动的平均时间为10天。步行半英里的平均时间为16天。此外,没有再次入院、没有脱位、也没有再次手术。因此,快速康复方案是安全的,并且实现了微创全髋关节置换术快速恢复的潜在益处。

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