Joint Reconstruction Center, Seoul National University Bundang Hospital, 300 Gumidong, Bundangu, Seongnam-si, Gyunggido 463-707, Korea.
Knee Surg Sports Traumatol Arthrosc. 2009 Oct;17(10):1152-8. doi: 10.1007/s00167-009-0731-2. Epub 2009 Feb 19.
Regular passive ROM exercise (PROME) by a physical therapist is often incorporated in rehabilitation protocols after total knee arthroplasty (TKA). This randomized, controlled trial examined whether or not the incorporation of PROME to a postoperative rehabilitation protocol would offer a better clinical outcome after TKA. Fifty consecutive patients who underwent bilateral TKAs staged 2 weeks apart received PROME for one knee and not for the other. The pain level (7D and 14D), patient's preference (before discharge, 6M), maximum flexion (7D, 14D, 3M, 6M) and American Knee Society and WOMAC scores (6M) were determined in the knees with and without PROME and compared. There were no significant differences in the maximum flexion, pain level, patient's preference, AKS scores and WOMAC scores. This study demonstrates that the incorporation of PROME does not offer additional clinical benefits to the patients after TKA. Our findings may suggest that encouraging patients to perform active ROM exercise would be a better option and that a physiotherapy session by a physical therapist can focus on more functional rehabilitation, such as preparing to return to daily activities.
常规的被动关节活动度（PROME）练习由物理治疗师在全膝关节置换术后（TKA）的康复方案中经常采用。这项随机对照试验研究了在 TKA 术后康复方案中加入 PROME 是否会提供更好的临床结果。50 名连续接受双侧 TKA 分期 2 周的患者，一侧膝关节接受 PROME，另一侧则不接受。在膝关节中确定有无 PROME 时的疼痛水平（7 天和 14 天）、患者偏好（出院前、6 个月）、最大屈曲度（7 天、14 天、3 个月、6 个月）和美国膝关节协会和 WOMAC 评分（6 个月），并进行比较。在最大屈曲度、疼痛水平、患者偏好、AKS 评分和 WOMAC 评分方面均无显著差异。本研究表明，在 TKA 后，加入 PROME 并不能为患者提供额外的临床益处。我们的研究结果表明，鼓励患者进行主动关节活动度锻炼可能是更好的选择，物理治疗师的一次物理治疗课程可以侧重于更功能性的康复，例如准备回归日常生活。
