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髋关节和膝关节全关节置换术后患者转入康复病房是否有预测标准?法国临床实践指南阐述

Is there predictive criteria for transfer of patients to a rehabilitation ward after hip and knee total arthroplasty? Elaboration of French clinical practice guidelines.

作者信息

Coudeyre E, Lefevre-Colau M-M, Griffon A, Camilleri A, Ribinik P, Revel M, Rannou F

机构信息

Centre de médecine physique et réadaptation Notre-Dame, BP 86, 4, avenue Joseph-Claussat, 63404 Chamalières cedex, France.

出版信息

Ann Readapt Med Phys. 2007 Jun;50(5):327-36; 317-26. doi: 10.1016/j.annrmp.2007.04.002. Epub 2007 Apr 11.

Abstract

OBJECTIVE

To develop clinical practice guidelines concerning predictive criteria for transfer of patients to a rehabilitation ward after hip and knee total arthroplasty.

METHOD

The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used.

RESULTS

From systematic literature review and collection of French professional practice, we cannot distinguish the patients undergoing THA and TKA who can transfer to a rehabilitation ward. For both types of patients, the main criteria determining transfer are demographic criteria such as older age or female sex; psychosocial and environmental criteria such as living alone, feeling unable to return home directly (pre-operative education could modify this criterion); and surgeon advice based on the pre and post-operative clinical and functional status.

CONCLUSION

Studies with good methodological quality are urgently needed to evaluate the use of predictive tools such as the RAPT, separating THA and TKA, and using as parameters of assessment functional status and handicap reduction.

摘要

目的

制定关于髋膝关节置换术后患者转入康复病房的预测标准的临床实践指南。

方法

采用了SOFMER(法国物理医学与康复学会)方法,该方法结合了系统的文献综述、日常临床实践收集以及多学科专家小组的外部评审。

结果

通过系统的文献综述和法国专业实践收集,我们无法区分哪些接受全髋关节置换术(THA)和全膝关节置换术(TKA)的患者可以转入康复病房。对于这两类患者,决定转入的主要标准是人口统计学标准,如年龄较大或女性;心理社会和环境标准,如独居、感觉无法直接回家(术前教育可能会改变这一标准);以及基于术前和术后临床及功能状态的外科医生建议。

结论

迫切需要开展方法学质量良好的研究,以评估如RAPT等预测工具的使用情况,区分THA和TKA,并将功能状态和残疾减轻作为评估参数。

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