Nakao Shigetaka, Takata Shinjiro, Uemura Hirokazu, Nakano Shunji, Egawa Hiroshi, Kawasaki Yoshiteru, Kashihara Michiharu, Yasui Natsuo
Department of Orthopedics Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2010 Feb;57(1-2):146-51. doi: 10.2152/jmi.57.146.
This study aimed to clarify the therapeutic effects of postoperative ambulation after total knee arthroplasty (TKA) on deep venous thrombosis (DVT) in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) after TKA. Subjects of this study were thirty-seven inpatients (21 inpatients: OA, 16 inpatients: RA) undergoing TKA (32 female and 5 male). Subjects were divided into two groups, deep venous thrombosis (DVT) group (n=25) and non-DVT group (N group, n=12). The cutoff value was 10.0 microg/ml plasma D-dimer level measured on 7(th) postoperative day. The N group was below the cutoff value. Another cutoff value divided into two groups, ambulatory group (n=26) and non-ambulatory group (n=11). Ambulatory group was the date of ambulation beginning below 7(th) day. Statistical analysis confirmed that all subjects showed a significant correlation to the date of ambulation. Postoperative ambulation beginning had strong association with the level of D-dimer (r=0.71). Group comparison showed that the non-ambulatory group had significant higher values of D-dimer than ambulatory group (P=0.022). Typical case supported these results. Postoperative early ambulation within a week after TKA kept patients with OA and RA after TKA lower level of D-dimer.
本研究旨在阐明全膝关节置换术（TKA）后早期活动对骨关节炎（OA）和类风湿关节炎（RA）患者全膝关节置换术后深静脉血栓形成（DVT）的治疗效果。本研究的受试者为37例接受TKA的住院患者（21例OA患者，16例RA患者）（32例女性，5例男性）。受试者分为两组，深静脉血栓形成（DVT）组（n = 25）和非DVT组（N组，n = 12）。临界值为术后第7天测得的血浆D - 二聚体水平10.0微克/毫升。N组低于临界值。另一个临界值将患者分为两组，早期活动组（n = 26）和非早期活动组（n = 11）。早期活动组是指术后第7天之前开始活动的日期。统计分析证实，所有受试者的活动日期均显示出显著相关性。术后开始活动与D - 二聚体水平密切相关（r = 0.71）。组间比较显示，非早期活动组的D - 二聚体值显著高于早期活动组（P = 0.022）。典型病例支持了这些结果。TKA术后一周内早期活动使TKA术后的OA和RA患者的D - 二聚体水平降低。
