Dauty M, Letenneur J
Pôle de médecine physique et réadaptation, hôpital Saint-Jacques, CHU de Nantes, 85, rue Saint-Jacques, 44035 Nantes cedex 01, France.
Ann Readapt Med Phys. 2007 Dec;50(9):709-15. doi: 10.1016/j.annrmp.2007.08.003. Epub 2007 Oct 4.
To recommand sports activities after joint arthroplasty from the literature analysis, the French surgeon's opinion and wish patients.
From the Medline data base interrogation according to keywords: Sports, Arthroplasty, Athletics, Physical training, two different readers, an orthopedic surgeon and a Physical Medicine and Rehabilitation physician selected articles in French or English language according to the level of proofs of the french classification of the Accreditation and Health Evaluation National Agency (Anaes). Professional practices were estimated by the interrogation of 30 orthopedic surgeons members of the french West Orthopaedics Society (SOO). The demand of sports practice was studied with patients recently operated for a primary total knee arthroplasty (TKA) after gonarthrosis.
Twenty-two articles were selected from 305 articles obtained by the search according to keywords. Ten literature reviews are limited by the absence of prospective randomized study. A level II study and eleven level IV articles are reported.
According to the subjective orthropedic surgeon's opinion, the objective results based on the joint load studied and the percentage of arthroplasty revision, sport is beneficial for the individual health but perhaps not for the arthroplasty survey. However, aerobic and leisure activities are recommended (walking, swimming, cycling) in agreement with the demand of the patients recently operated with a TKA. TKA differs from Total Hip Arthroplasty for jogging because of knee joint constraints during the knee flexion. A single study reports sports possibilities after shoulder arthroplasty and ankle arthroplasty and no study reports results after elbow arthroplasty.
通过文献分析、法国外科医生的意见以及患者意愿,推荐关节置换术后的体育活动。
根据关键词“体育、关节置换术、田径、体育训练”在Medline数据库中进行检索,两位不同的读者,一位骨科医生和一位物理医学与康复医生,根据法国国家卫生评估与认证机构(Anaes)分类的证据水平,选择法语或英语文章。通过询问法国西部骨科协会(SOO)的30名骨科医生成员来评估专业实践。对近期因膝关节骨关节炎接受初次全膝关节置换术(TKA)的患者的体育锻炼需求进行了研究。
根据关键词检索获得的305篇文章中,筛选出22篇。十篇文献综述因缺乏前瞻性随机研究而受到限制。报告了一项II级研究和十一项IV级文章。
根据骨科医生的主观意见、基于关节负荷研究的客观结果以及关节置换术翻修的百分比,运动对个人健康有益,但可能对关节置换术的监测不利。然而,根据近期接受TKA手术患者的需求,建议进行有氧运动和休闲活动(散步、游泳、骑自行车)。由于膝关节屈曲时的膝关节限制,TKA在慢跑方面与全髋关节置换术不同。仅有一项研究报告了肩关节置换术和踝关节置换术后的运动可能性,没有研究报告肘关节置换术后的结果。