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全膝关节置换术后急性期膝关节屈曲活动范围的重要性。

Importance of knee flexion range of motion during the acute phase after total knee arthroplasty.

作者信息

Oka Tomohiro, Wada Osamu, Asai Tsuyoshi, Maruno Hideto, Mizuno Kiyonori

机构信息

Department of Rehabilitation, Anshin Hospital.

Department of Public Health, Kobe University Graduate School of Health Sciences.

出版信息

Phys Ther Res. 2020 Aug 5;23(2):143-148. doi: 10.1298/ptr.E9996. eCollection 2020.

Abstract

BACKGROUND

We investigate the association with knee flexion range of motion (ROM) during the acute phases and that at 12 months after total knee arthroplasty (TKA). We also clarified the cut-off ROM during the acute phases in predicting the goal of knee flexion ROM at 12 months.

METHODS

In this retrospective study, 193 patients with knee osteoarthritis (female:144 patients, age:73.2 ± 7.7 years) who underwent unilateral TKA at an orthopedic clinic were recruited. They underwent assessments of knee flexion ROM at 5 days, 1 month, and 12 months after TKA. The goal of knee flexion ROM at 12 months after TKA was set at 120°. Single and logistic-regression analyses were performed with the dependent variables including the outcome of the goal of knee flexion ROM at 12 months, and the independent variables included knee flexion ROM at 5 days and 1 month, separately. We calculated the cut-off ROM at 5 days and 1 month for predicting the goal of knee flexion ROM at 12 months with receiver operating curve analysis.

RESULTS

Knee flexion ROM at 5 days and 1 month were significantly associated with the goal of that at 12 months (p < 0.01). The cut-off ROM were 85° at 5 days and 105° at 1 month separately.

CONCLUSIONS

Our results suggest the importance of early improvement in knee flexion ROM after TKA, and that at 1 month postoperatively indicates the likelihood of achievement of the goal of knee flexion ROM at 12 months after TKA.

摘要

背景

我们研究了全膝关节置换术(TKA)急性期膝关节屈曲活动度(ROM)与术后12个月时的膝关节屈曲活动度之间的关联。我们还明确了急性期膝关节屈曲ROM的临界值,以预测术后12个月膝关节屈曲ROM的目标。

方法

在这项回顾性研究中,招募了193例在骨科诊所接受单侧TKA的膝骨关节炎患者(女性:144例,年龄:73.2±7.7岁)。他们在TKA术后5天、1个月和12个月接受膝关节屈曲ROM评估。将TKA术后12个月膝关节屈曲ROM的目标设定为120°。分别以术后12个月膝关节屈曲ROM目标的结果作为因变量,以术后5天和1个月的膝关节屈曲ROM作为自变量,进行单因素和逻辑回归分析。我们通过受试者工作特征曲线分析计算出术后5天和1个月时预测术后12个月膝关节屈曲ROM目标的临界ROM。

结果

术后5天和1个月时的膝关节屈曲ROM与术后12个月时的目标显著相关(p<0.01)。术后5天和1个月时的临界ROM分别为85°和105°。

结论

我们的结果表明TKA术后早期改善膝关节屈曲ROM很重要,且术后1个月时的膝关节屈曲ROM表明了TKA术后12个月实现膝关节屈曲ROM目标的可能性。

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