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一名骨硬化症患者全髋关节置换术后身体功能的早期恢复:病例报告

Early Recovery of Physical Function After Total Hip Arthroplasty in a Patient With Osteopetrosis: A Case Report.

作者信息

Nojiri Shusuke, Kayamoto Azusa, Terai Chiaki, Osawa Yusuke, Takegami Yasuhiko

机构信息

Department of Rehabilitation, Nagoya University Hospital, Nagoya, JPN.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JPN.

出版信息

Cureus. 2024 Jan 15;16(1):e52293. doi: 10.7759/cureus.52293. eCollection 2024 Jan.

Abstract

Osteopetrosis is an uncommon and inherited disorder. Some disease-specific characteristics, such as diffuse osteosclerosis and a high incidence of fractures, may potentially affect postoperative rehabilitation. This report presents a case of successful rehabilitation early after total hip arthroplasty for osteopetrosis. A 56-year-old Japanese man, who was diagnosed with osteopetrosis at the age of 11, underwent total hip arthroplasty in the right hip. Full weight-bearing was allowed on the day after the operation; the postoperative rehabilitation program was proceeded based on a standard program as done after total hip arthroplasty for osteoarthritis. A shoe lift in the left leg was used in supervised walking training to correct the imbalanced alignment due to leg length discrepancy. The patient could walk independently with a cane 17 days after the operation. Three weeks after the operation, the patient demonstrated comfortable and maximal walking speed of 1.11 and 1.34 m/s, respectively, and maximal hip abductor muscle strength of 3.96 kgf・m, both of which were better than those before the operation. There were no adverse events during the postoperative rehabilitation course. These findings suggest the safety and efficacy of standard rehabilitation programs after total hip arthroplasty even in individuals with osteopetrosis. In addition, it may be important to consider the whole-body condition in the rehabilitation of individuals with osteopetrosis.

摘要

骨质石化症是一种罕见的遗传性疾病。一些疾病特异性特征,如弥漫性骨硬化和高骨折发生率,可能会影响术后康复。本报告介绍了一例骨质石化症患者全髋关节置换术后早期成功康复的病例。一名56岁的日本男性,11岁时被诊断为骨质石化症,接受了右髋全髋关节置换术。术后第一天即允许完全负重;术后康复计划按照骨关节炎全髋关节置换术后的标准计划进行。在监督下的步行训练中,使用左腿鞋垫来纠正因腿长差异导致的不平衡对线。患者术后17天能够拄着拐杖独立行走。术后三周,患者舒适步行速度和最大步行速度分别为1.11和1.34米/秒,最大髋外展肌力量为3.96千克力·米,均优于术前。术后康复过程中未发生不良事件。这些发现表明,即使是骨质石化症患者,全髋关节置换术后标准康复计划也是安全有效的。此外,在骨质石化症患者的康复中考虑全身状况可能很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ce1/10865148/85076349f88c/cureus-0016-00000052293-i01.jpg

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