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同期双侧与单侧计算机辅助全膝关节置换术:术后早期疼痛与功能恢复的前瞻性比较

Simultaneous bilateral versus unilateral computer-assisted total knee arthroplasty: a prospective comparison of early postoperative pain and functional recovery.

作者信息

Shetty Gautam M, Mullaji Arun, Bhayde Sagar, Chandra Vadapalli Ramesh, Desai Devanshu

机构信息

Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.

出版信息

Knee. 2010 Jun;17(3):191-5. doi: 10.1016/j.knee.2009.08.009. Epub 2009 Sep 27.

Abstract

Whether simultaneous bilateral TKAs (SBTKAs) are more painful and the postoperative functional recovery slower compared to staged bilateral TKAs or unilateral TKAs are issues that frequently concerns patients. The purpose of the current study was to compare the early postoperative pain, function and recovery in simultaneous bilateral versus unilateral computer-assisted TKA. In this prospective study, 50 consecutive patients undergoing unilateral computer-assisted total knee arthroplasties (TKAs) were compared with 50 consecutive patients undergoing SBTKAs in terms of pain, length of hospital stay and rehabilitative milestones during the immediate postoperative period. The mean visual analogue pain scores, mean knee range of motion, straight leg raising and extensor lag were equal in both the groups at the time of discharge. Patients in the SBTKA group lagged behind the unilateral group in stick walking by approximately 24 h. The results of this study demonstrate excellent pain relief and functional recovery with simultaneous bilateral computer-assisted TKAs comparable to unilateral TKAs. Patients eligible for bilateral TKAs can undergo them simultaneously without excessive pain or slower functional outcome.

摘要

与分期双侧全膝关节置换术(TKA)或单侧TKA相比,同期双侧TKA是否更疼痛且术后功能恢复更慢是患者经常关注的问题。本研究的目的是比较同期双侧与单侧计算机辅助TKA术后早期的疼痛、功能和恢复情况。在这项前瞻性研究中,将50例连续接受单侧计算机辅助全膝关节置换术(TKA)的患者与50例连续接受同期双侧TKA的患者在术后即刻的疼痛、住院时间和康复里程碑方面进行了比较。出院时,两组的平均视觉模拟疼痛评分、平均膝关节活动范围、直腿抬高和伸肌滞后情况均相同。同期双侧TKA组患者在使用拐杖行走方面比单侧组落后约24小时。本研究结果表明,同期双侧计算机辅助TKA具有良好的疼痛缓解和功能恢复效果,与单侧TKA相当。适合双侧TKA的患者可以同时进行手术,而不会出现过度疼痛或功能恢复缓慢的情况。

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