VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO.
Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO.
J Orthop Sports Phys Ther. 2023 Sep;53(9):566–574. doi: 10.2519/jospt.2023.11840.
There is no consensus for how to use rehabilitation visits after total knee arthroplasty (TKA). We sought to develop expert recommendations for outpatient rehabilitation visit usage after TKA. Delphi study. First, we developed a broad list of preliminary visit usage recommendations, which were specific to patients' recovery status (ie, slow, typical, or fast recovery) and time since surgery. We then invited 49 TKA experts to participate on a Delphi panel. During round 1, we surveyed panelists regarding their level of agreement with each preliminary recommendation. We conducted additional Delphi rounds as needed to build consensus, which we defined using the RAND/UCLA method. We updated the survey each round based on panelist feedback and responses from the previous round. Thirty panelists agreed to participate, and 29 panelists completed 2 Delphi rounds. The panel reached consensus on recommendations related to visit frequency, visit timing, and the use of telerehabilitation. The panel recommended that outpatient rehabilitation should begin within 1 week after surgery at a frequency of 2 times per week for the first postoperative month regardless of recovery status. The panel recommended different visit frequencies depending on the patient's recovery status for postoperative months 2 to 3. The panel agreed that telerehabilitation can be recommended for most patients after TKA, but not for patients recovering slowly. We used the Delphi process to develop expert recommendations for the use of outpatient rehabilitation visits after TKA. We envision these recommendations could help patients decide how to use visits based on their own preferences. .
对于全膝关节置换术后（TKA）如何使用康复访视，目前尚无共识。我们旨在为 TKA 后门诊康复访视的使用制定专家建议。 德尔菲研究。 首先，我们制定了一份初步访视使用建议的广泛清单，这些建议具体针对患者的恢复状况（即恢复缓慢、典型或快速）和手术时间。然后，我们邀请了 49 名 TKA 专家参加德尔菲小组。在第一轮中，我们调查了小组成员对每项初步建议的同意程度。如有必要，我们会进行额外的德尔菲轮次以达成共识，我们使用 RAND/UCLA 方法定义了共识。我们根据小组成员的反馈和上一轮的回应，在每一轮中更新调查。 30 名小组成员同意参加，其中 29 名小组成员完成了 2 轮德尔菲调查。小组就与访视频率、访视时间和远程康复使用相关的建议达成共识。小组建议，无论恢复状况如何，术后第 1 个月应在术后 1 周内开始门诊康复治疗，频率为每周 2 次。对于术后第 2 至 3 个月，小组建议根据患者的恢复状况，采用不同的访视频率。小组同意，远程康复可推荐给大多数 TKA 后患者，但不适用于恢复缓慢的患者。 我们使用德尔菲法为 TKA 后门诊康复访视的使用制定了专家建议。我们设想这些建议可以帮助患者根据自己的喜好决定如何使用访视。 。
