School of Physical Therapy, Marshall University, Huntington, WV, USA.
Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Physiother Theory Pract. 2020 Jan;36(1):176-185. doi: 10.1080/09593985.2018.1482980. Epub 2018 Jun 13.
: Retrospective analysis of routinely collected clinical data. : This study modeled the recovery in knee flexion and extension range of motion (ROM) over 1 year after total knee replacement (TKR). : Recovery after TKR has been characterized for self-reported pain and functional status. Literature describing target knee ROM at different follow-up periods after TKR is scarce. : Data were extracted for patients who had undergone TKR at a tertiary care hospital at 2, 8, 12, 26, and 52 weeks after TKR. A linear mixed-effects growth model was constructed that investigated the following covariates age, sex, pre-TKR range, body mass index, duration of symptoms, and their interaction with weeks post TKR. : Of the 559 patients included (age 64.8 ± 8.5 years), 370 were women and 189 were men. Knee ROM showed the greatest change during the first 12 weeks after TKR, plateauing by 26 weeks. For an average patient, knee flexion increased from approximately 100º 2 weeks post TKR to 117º 52 weeks post TKR. Knee extension increased from approximately 3º knee flexion 2 weeks post TKR to 1º flexion 52 weeks post TKR. : The results showed that the maximum gains in knee ROM should be expected within the first 12 weeks with small changes occurring up to 26 weeks after TKR. In addition, age and presurgery knee ROM are associated with the gains in knee ROM and should be factored into the estimation of expected knee ROM at a given follow-up interval after TKR.
回顾性分析常规收集的临床数据。本研究对全膝关节置换(TKR)后 1 年内膝关节屈伸活动范围(ROM)的恢复情况进行了建模。TKR 后,人们已经对自我报告的疼痛和功能状态的恢复情况进行了研究。描述 TKR 后不同随访期目标膝关节 ROM 的文献很少。从一家三级护理医院接受 TKR 的患者中提取数据,时间分别为 TKR 后 2、8、12、26 和 52 周。构建了一个线性混合效应增长模型,研究了以下协变量:年龄、性别、术前 ROM、体重指数、症状持续时间及其与 TKR 后周数的交互作用。在纳入的 559 例患者中(年龄 64.8±8.5 岁),370 例为女性,189 例为男性。膝关节 ROM 在 TKR 后最初的 12 周内变化最大,到 26 周时趋于稳定。对于一般患者,膝关节屈曲从 TKR 后 2 周时的约 100°增加到 TKR 后 52 周时的 117°。膝关节伸展从 TKR 后 2 周时的约 3°屈膝增加到 TKR 后 52 周时的 1°屈膝。结果表明,膝关节 ROM 的最大增益应在 TKR 后最初的 12 周内预期,在 TKR 后 26 周内会有较小的变化。此外,年龄和术前膝关节 ROM 与膝关节 ROM 的增益相关,应在 TKR 后给定随访间隔内预测预期膝关节 ROM 时考虑这些因素。