Berend Keith R, Lombardi Adolph V, Mallory Thomas H
Joint Implant Surgeons, Inc., Division of Adult Reconstruction, Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
Surg Technol Int. 2004;13:239-47.
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most successful procedures performed in terms of quality-of-life years gained. The long-term goals of arthroplasty, to relieve pain, increase function, provide stability, and obtain durability, are accomplished in the vast majority of cases. The short-term goals, however, have become the target of aggressive peri-operative programs that aim to speed recovery, reduce morbidity and complications, and create a program of efficiency while maintaining the highest level of patient care. The concept of rapid recovery is built upon the burgeoning interest in less-invasive and small-incision surgeries for (THA and TKA). However, the incision size does not appear to be the most critical aspect of the program. This article outlines the specific elements of the rapid-recovery program for lower-extremity arthroplasty patients, including pre-operative patient education, peri-operative nutrition, vitamin and herbal medication supplementation, preemptive analgesia, and post-operative rehabilitation. A holistic peri-operative, rapid-recovery program has lead to a significantly decreased hospital length of stay and significantly lower hospital readmission rates in patients who undergo primary THAs and TKAs. Combining these results with minimally invasive techniques and instrumentation should make recovery even faster.
全髋关节置换术（THA）和全膝关节置换术（TKA）在改善生活质量方面是最成功的手术之一。关节置换术的长期目标，即缓解疼痛、增强功能、提供稳定性和实现耐用性，在绝大多数情况下都能实现。然而，短期目标已成为积极的围手术期方案的目标，这些方案旨在加速康复、降低发病率和并发症，并在保持最高水平患者护理的同时制定高效方案。快速康复的概念基于对（THA和TKA）的微创和小切口手术日益增长的兴趣。然而，切口大小似乎并不是该方案最关键的方面。本文概述了下肢关节置换术患者快速康复方案的具体要素，包括术前患者教育、围手术期营养、维生素和草药补充、超前镇痛以及术后康复。一个全面的围手术期快速康复方案已使接受初次THA和TKA的患者住院时间显著缩短，医院再入院率显著降低。将这些结果与微创技术和器械相结合应能使康复更快。
