Marinko Lee N, Christie Renee E, Lewis Cara L
Department of Physical Therapy and Athletic Training, Boston University, Boston, MA.
Department of Physical Therapy and Athletic Training, Boston University, 635 Commonwealth Avenue, Boston, MA 02215.
PM R. 2015 Aug;7(8):895-900. doi: 10.1016/j.pmrj.2015.04.002. Epub 2015 Apr 7.
This is a case presentation of a female patient who underwent a Girdlestone arthroplasty at age 10 years and a total hip arthroplasty at age 21. Despite early postoperative rehabilitation, the patient experienced increasing pain, progressive gait deviations, and functional limitations during the year after surgery. This course of care was initiated 1 year after surgery and focused on motor retraining to address pain and gait deviations. This case demonstrates that positive outcomes can be achieved after longstanding musculoskeletal dysfunction is corrected, but that prolonged rehabilitation may be necessary to produce changes in movement patterns at both the local (joint and muscle) and central (cortical) levels. Correction of both the structural problem and the learned movement patterns is necessary for a successful outcome.
这是一例女性患者的病例报告，该患者10岁时接受了Girdlestone关节成形术，21岁时接受了全髋关节置换术。尽管术后早期进行了康复治疗，但患者在术后一年仍出现疼痛加剧、步态逐渐偏差和功能受限。该治疗方案在术后1年开始，重点是运动再训练以解决疼痛和步态偏差问题。该病例表明，长期的肌肉骨骼功能障碍得到纠正后可以取得积极的效果，但可能需要长时间的康复治疗才能在局部（关节和肌肉）和中枢（皮质）水平上改变运动模式。成功的治疗结果需要同时纠正结构问题和习得的运动模式。
