Paysant J, Jardin C, Biau D, Coudeyre E, Revel M, Rannou F
Institut régional de médecine physique et de réadaptation, 75, boulevard Lobau, 54042 Nancy cedex, France.
Ann Readapt Med Phys. 2008 Mar;51(2):138-43. doi: 10.1016/j.annrmp.2007.11.003. Epub 2008 Jan 8.
To develop clinical practice guidelines for early mobilisation after total knee replacement (TKR).
We used the French Society of Physical and Rehabilitation Medicine (SOFMER) methodology, which associates a systematic review of the literature, collection of information regarding current clinical practice and external review by a multidisciplinary expert panel.
A review of the literature and French clinical practice allow for recommending early mobilisation, at day 0, after TKR. This practice, with continuous passive motion, does not seem to increase the frequency of complications and seems to help with rapid recovery of the joint range of motion. Trials with good methodology must be developed to define the criteria for prescribing early mobilisation after TKR. These trials should focus mainly on joint range of motion but also on economical criteria (duration of hospitalisation, rehabilitation, physiotherapy, use of painkillers) and the satisfaction of the patient.
制定全膝关节置换术(TKR)后早期活动的临床实践指南。
我们采用了法国物理与康复医学协会(SOFMER)的方法,该方法包括对文献的系统回顾、收集有关当前临床实践的信息以及由多学科专家小组进行外部评审。
对文献和法国临床实践的回顾支持在TKR术后第0天进行早期活动的建议。这种结合持续被动运动的做法似乎不会增加并发症的发生率,而且似乎有助于关节活动范围的快速恢复。必须开展方法良好的试验,以确定TKR术后早期活动的处方标准。这些试验应主要关注关节活动范围,同时也应关注经济标准(住院时间、康复、物理治疗、止痛药的使用)以及患者的满意度。