Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, #135 Nan-Hsiao Street, Changhua 500, Taiwan.
Orthop Traumatol Surg Res. 2012 May;98(3):259-64. doi: 10.1016/j.otsr.2011.12.004. Epub 2012 Apr 4.
In patients with severe knee osteoarthritis (OA), total knee arthroplasty (TKA) is performed for both symptom relief and to achieve better function in daily life. Implementation of efficient TKA rehabilitation programs with shorter length of stay (LOS) and reduced medical expenditures is an important issue in clinical practice. However, the effectiveness of preoperative rehabilitation programs is still under debate. Most preoperative rehabilitation programs last many weeks and may be more expensive than TKA. The purpose of this study was to investigate the effects of a simplified, easy-to-learn, and less time-consuming preoperative rehabilitation education program on TKA patients.
In this randomized controlled study, we allocated all the patients into study and control group according to chart number. The study group, which comprised 126 patients, participated in a 40-min preoperative home rehabilitation education program 4 weeks prior to TKA. One hundred seventeen patients in the control group did not participate in this preoperative program.
The study group required a shorter hospital LOS (mean: 7.12 days; P=0.027) and had less hospitalization-related medical expenditures (mean: 123726 New Taiwan dollars [NTD], equivalent to 4266.4 United States dollars [USD] or 3022.1 [Euros]), (P=0.001) than the control group. However, the study group showed no significant improvement in function when compared to the control group.
Our study demonstrates that a simplified preoperative rehabilitation program can reduce LOS and increase cost savings. This program was recommended as a routine protocol for OA patients before admission for TKA.
目的:本研究旨在探讨一种简化、易学、耗时较少的术前康复教育计划对全膝关节置换术(TKA)患者的影响。
方法:这是一项随机对照研究,我们根据病历号将所有患者分为研究组和对照组。研究组 126 例患者在 TKA 前 4 周参加了 40 分钟的家庭术前康复教育计划。对照组 117 例患者未参加该术前计划。
结果:与对照组相比,研究组的住院时间更短(平均:7.12 天;P=0.027),与住院相关的医疗费用更少(平均:123726 新台币[NTD],相当于 4266.4 美元[USD]或 3022.1 欧元[EUR];P=0.001)。然而,与对照组相比,研究组在功能方面没有显著改善。
讨论:我们的研究表明,简化的术前康复计划可以缩短住院时间并节省成本。该方案被推荐作为 TKA 术前 OA 患者的常规方案。