在计算机辅助全膝关节置换术中使用住院患者持续被动运动与不使用持续被动运动的对比
Use of inpatient continuous passive motion versus no CPM in computer-assisted total knee arthroplasty.
作者信息
Alkire Martha R, Swank Michael L
机构信息
Cincinnati Orthopedic Research Institute, Cincinnati, OH, USA.
出版信息
Orthop Nurs. 2010 Jan-Feb;29(1):36-40. doi: 10.1097/NOR.0b013e3181c8ce23.
BACKGROUND
Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined.
PURPOSE
The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain.
METHODS
This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months.
RESULTS
Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.
背景
持续被动运动(CPM)已被证明对组织愈合、水肿、关节积血和关节功能有积极影响(L. Brosseau等人,2004年)。CPM还被证明可增加短期早期屈曲度并缩短住院时间(L. Brosseau等人,2004年;C.M. Chiarello、C.M.S. Gundersen和T. O'Halloran,2004年)。CPM对接受计算机辅助全膝关节置换术(TKA)患者群体的益处尚未得到研究。
目的
本研究的主要目的是确定计算机辅助TKA术后使用CPM是否会导致运动范围、水肿/引流、功能能力和疼痛方面的差异。
方法
这是一项对接受单侧计算机辅助TKA患者的实验性、前瞻性、随机研究。实验组在住院期间每天接受三次CPM和两次物理治疗(PT)。对照组在住院期间每天接受两次PT且不接受CPM。两组在出院后均接受PT。测量指标包括膝关节协会评分、西安大略和麦克马斯特大学骨关节炎指数值、运动范围、膝关节周长和负压引流。从术前到术后3个月的不同时间间隔收集数据。
结果
尽管发现对照组术前功能较高,但在为期3个月的研究期间,两组在屈曲度、水肿或引流、功能或疼痛方面没有统计学上的显著差异。