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全膝关节置换术后的快速康复可缩短住院时间:一项前瞻性病例对照临床试验。

Fast-track rehabilitation after total knee arthroplasty reduces length of hospital stay: A prospective, case-control clinical trial.

作者信息

Arienti Chiara, Pollet Joel, Buraschi Riccardo, Piovanelli Barbara, Villafañe Jorge Hugo, Galeri Silvia, Negrini Stefano

机构信息

IRCCS Fondazione Don Carlo Gnocchi, N/A, Milan, Italy.

Department of Biomedical, University of Milan, Surgical and Dental Sciences, Milan, Italy.

出版信息

Turk J Phys Med Rehabil. 2020 Nov 9;66(4):398-404. doi: 10.5606/tftrd.2020.6266. eCollection 2020 Dec.

Abstract

OBJECTIVES

The aim of this study was to compare the impact of fast-track rehabilitation (FTR) and conventional rehabilitation (CR) on early recovery pattern after fast-track surgery for knee arthroplasty and conventional total knee arthroplasty (TKA).

PATIENTS AND METHODS

This prospective, case-control study included a total of 43 adult patients (10 males, 33 females; mean age 69 years; range, 50 to 82 years) who were clinically stable and admitted for rehabilitation after fast-track surgery for knee arthroplasty or conventional TKA January 2016 and August 2016. The patients were divided into two groups as the FTR and CR treatment groups. The FTR program was designed as a patient-focused care, early mobilization, and standardized postoperative milestones. The CR program was designed by standard postoperative rehabilitation care. Primary outcomes were the length of stay (LOS) in the hospital and knee function. Secondary outcomes were pain and activities of daily living.

RESULTS

At baseline, both groups were similar in terms of demographic data and primary outcomes. At discharge, intra-group analysis showed significant differences in both groups in all functional outcomes, except for pain, while the inter-group LOS was also significantly different (p<0.001).

CONCLUSION

Our study results indicate that LOS can be reduced by FTR, yielding the same results in functional recovery and autonomy as CR.

摘要

目的

本研究旨在比较快速康复(FTR)与传统康复(CR)对膝关节置换术快速康复手术和传统全膝关节置换术(TKA)后早期恢复模式的影响。

患者与方法

这项前瞻性病例对照研究共纳入43例成年患者(10例男性,33例女性;平均年龄69岁;范围50至82岁),这些患者临床稳定,于2016年1月至2016年8月在膝关节置换术快速康复手术或传统TKA术后接受康复治疗。患者分为FTR和CR治疗组。FTR方案设计为以患者为中心的护理、早期活动及标准化术后里程碑。CR方案通过标准术后康复护理设计。主要结局指标为住院时间(LOS)和膝关节功能。次要结局指标为疼痛和日常生活活动能力。

结果

基线时,两组在人口统计学数据和主要结局指标方面相似。出院时,组内分析显示两组在除疼痛外的所有功能结局方面均存在显著差异,而组间LOS也存在显著差异(p<0.001)。

结论

我们的研究结果表明,FTR可缩短LOS,在功能恢复和自主性方面与CR产生相同结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c73c/7756836/106ac711bb3b/TJPMR-2020-66-4-398-404-F1.jpg

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