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一种采用加速术后康复的多学科全髋关节置换方案:患者是否从中受益?

A multidisciplinary total hip arthroplasty protocol with accelerated postoperative rehabilitation: does the patient benefit?

作者信息

Robbins Claire E, Casey Daniel, Bono James V, Murphy Stephen B, Talmo Carl T, Ward Daniel M

机构信息

Department of Orthopedics, New England Baptist Hospital, Boston, MA.

出版信息

Am J Orthop (Belle Mead NJ). 2014 Apr;43(4):178-81.

Abstract

Since its debut over 10 years ago, minimally invasive total hip arthroplasty (THA) has often been associated with accelerated postoperative rehabilitation when compared with THA performed with a traditional surgical approach. The objective of this study was to investigate the effect of accelerated postoperative rehabilitation and early mobilization on length of stay and hospital readmissions in patients undergoing THA at one institution. We retrospectively reviewed a consecutive series of 590 patients who underwent THA between January 31, 2011 and April 30, 2011. Six arthroplasty surgeons using varying surgical techniques participated. One hundred ninety patients received accelerated rehabilitation and were mobilized on the day of surgery. The remaining 400 patients were mobilized on postoperative day one (POD1). Length of stay for the accelerated rehabilitation group was 2.06 days and 3.38 days for the standard group. One patient was readmitted to the hospital within 30 days (.52%) in the accelerated group compared to 19 re-hospitalizations (4.72%) in the POD1 group. Ninety-six percent of the accelerated group were discharged home versus 62% in POD1 group. Our results support the use of an accelerated rehabilitation protocol at one institution following total hip replacement surgery.

摘要

自10多年前首次亮相以来,与采用传统手术方法进行的全髋关节置换术(THA)相比,微创全髋关节置换术常常与术后康复加速相关。本研究的目的是调查一家机构中接受THA手术的患者术后加速康复和早期活动对住院时间和再入院情况的影响。我们回顾性分析了2011年1月31日至2011年4月30日期间连续接受THA手术的590例患者。六名采用不同手术技术的关节置换外科医生参与其中。190例患者接受加速康复并在手术当天开始活动。其余400例患者在术后第1天(POD1)开始活动。加速康复组的住院时间为2.06天,标准组为3.38天。加速康复组有1例患者在30天内再次入院(0.52%),而POD1组有19例再次住院(4.72%)。加速康复组96%的患者出院回家,而POD1组为62%。我们的结果支持一家机构在全髋关节置换术后采用加速康复方案。

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