Jiao Songsong, Feng Zhencheng, Dai Tianming, Huang Jian, Liu Ruijia, Meng Qingqi
Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.
Guangzhou Institute of Traumatic Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China.
J Arthroplasty. 2024 Mar;39(3):665-671.e2. doi: 10.1016/j.arth.2023.08.052. Epub 2023 Aug 26.
This study aimed to compare the effectiveness of high-intensity progressive rehabilitation training with routine training in the early treatment of patients undergoing total knee arthroplasty.
There were 78 patients who underwent total knee arthroplasty and were randomized into high-intensity progressive training and routine rehabilitation training groups (RRT). The primary outcome measures were the American Hospital for Special Surgery Knee Score (HSS), with secondary outcomes including patient satisfaction, visual analog pain score, first time of standing after surgery, 6-minute walk test, 36-Item Short Form Survey (SF-36), and length of hospital stay. The incidence of postoperative complications were recorded.
The HSS scores were higher in the intervention group at 2 weeks, 3 months, and 12 months postoperatively (P < .001). The RRT group had higher visual analog pain scores than the intervention group at 24 hours, 3 days, and 2 weeks after surgery (P < .001). The intervention group had an earlier the first time of standing after surgery and a longer 6-minute walk test distance (P < .001, P = .028, P < .001, P < .001). Patient satisfaction was higher in the intervention group, with a higher quality of life rating at 3 months postoperatively (P < .001). However, 1 year after surgery, the 2 groups had no significant differences in mental component summaries. The length of hospital stay was shorter in the intervention group than in the RRT group.
Compared to routine training, high-intensity progressive rehabilitation training is more effective. It reduces postoperative patient pain, accelerates recovery of joint function, increases patient satisfaction, improves quality of life, shortens hospital stays, and promotes rapid recovery.
本研究旨在比较高强度渐进性康复训练与常规训练在全膝关节置换术患者早期治疗中的效果。
78例行全膝关节置换术的患者被随机分为高强度渐进性训练组和常规康复训练组（RRT）。主要结局指标为美国特种外科医院膝关节评分（HSS），次要结局指标包括患者满意度、视觉模拟疼痛评分、术后首次站立时间、6分钟步行试验、36项简明健康状况调查（SF-36）以及住院时间。记录术后并发症的发生率。
干预组术后2周、3个月和12个月时的HSS评分更高（P <.001）。RRT组在术后24小时、3天和2周时的视觉模拟疼痛评分高于干预组（P <.001）。干预组术后首次站立时间更早，6分钟步行试验距离更长（P <.001，P =.028，P <.001，P <.001）。干预组患者满意度更高，术后3个月时生活质量评分更高（P <.001）。然而，术后1年，两组在心理综合评分方面无显著差异。干预组的住院时间比RRT组短。
与常规训练相比，高强度渐进性康复训练更有效。它可减轻患者术后疼痛，加速关节功能恢复，提高患者满意度，改善生活质量，缩短住院时间，并促进快速康复。
