Valle Christina, Stemmler Sebastian, Baier Clemens, Matziolis Georg
Medical Park Chiemsee, Birkenallee 41, 83233, Bernau am Chiemsee, Deutschland.
Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Deutschland.
Orthopadie (Heidelb). 2024 Nov;53(11):824-832. doi: 10.1007/s00132-024-04560-0. Epub 2024 Sep 23.
Postoperative rehabilitation after knee arthroplasty plays a decisive role in restoring the function and mobility of the affected joint. However, there is still disagreement regarding the setting, structure and content of rehabilitation after knee arthroplasty, and the evidence on the individual measures is largely unclear. The aim of this article is to provide an evidence-based overview of the current status of rehabilitation after knee arthroplasty and to critically discuss the points that are still unclear. In view of the increasing prevalence of knee osteoarthritis and the rising number of knee endoprosthesis implantations, the optimization and scientific processing of postoperative rehabilitation is more important than ever in order to be able to offer scientifically sound, practice-oriented and cost-effective rehabilitation measures in the future.
This review is based on a systematic literature search in Medline, Cochrane Library and Web of Science databases on the topic of postoperative rehabilitation after knee arthroplasty.
Regarding specific treatment components, duration and frequency after knee arthroplasty, the evidence is unclear. Passive therapies should only be used supportive to active interventions. Educational programmes before and after knee arthroplasty can play a crucial role in outcome and patient satisfaction. Regular strength training should always be combined with centrally oriented components, such as motor imagery, to achieve better movement visualization and central anchoring. There is still a frequent lack of scientific evidence regarding individual therapeutic measures, their intensity, frequency, duration, exercise selection and their specific implementation in rehabilitation after knee arthroplasty. In the future, digital diagnostic and training tools will become established in both inpatient and outpatient therapy, supporting the urgently needed data collection for the scientific analysis of individual therapeutic measures.
膝关节置换术后的康复治疗对于恢复患侧关节的功能和活动能力起着决定性作用。然而,对于膝关节置换术后康复治疗的设置、结构和内容仍存在分歧,而且关于各项具体措施的证据在很大程度上尚不明确。本文旨在对膝关节置换术后康复治疗的现状进行循证综述,并对仍不明确的要点进行批判性讨论。鉴于膝关节骨关节炎的患病率不断上升以及膝关节假体植入数量的增加,优化和科学开展术后康复治疗比以往任何时候都更为重要,以便在未来能够提供科学合理、以实践为导向且具有成本效益的康复措施。
本综述基于对Medline、Cochrane图书馆和科学网数据库中有关膝关节置换术后康复治疗主题的系统文献检索。
关于膝关节置换术后具体的治疗组成部分、持续时间和频率,证据尚不明确。被动治疗仅应作为主动干预的辅助手段。膝关节置换术前和术后的教育计划对治疗效果和患者满意度可起到关键作用。常规力量训练应始终与以中枢为导向的组成部分相结合,如运动想象,以实现更好的运动可视化和中枢锚定。关于膝关节置换术后个体治疗措施、其强度、频率、持续时间、运动选择及其在康复中的具体实施,仍然经常缺乏科学证据。未来,数字诊断和训练工具将在住院和门诊治疗中得到应用,支持对个体治疗措施进行科学分析所需的迫切数据收集。