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内侧开放楔形高位胫骨截骨术的加速术后康复方案可促进早期恢复日常活动

"Accelerated postoperative rehabilitation protocol for Medial Open Wedge High Tibial Osteotomy enhances early return to routine activities".

作者信息

Gupta Ravi, Dudeja Vishal, Bansal Himanshu, Kapoor Anil

机构信息

Fortis Hospital, Mohali, Punjab, India.

Ivy Hospital, Mohali, Punjab, India.

出版信息

J Clin Orthop Trauma. 2024 Oct 16;57:102563. doi: 10.1016/j.jcot.2024.102563. eCollection 2024 Oct.

Abstract

OBJECTIVE

The primary objective of this research was to investigate the timeframe required for the resumption of daily activities following medial open wedge high tibial osteotomy (HTO) with accelerated rehabilitation protocol.

METHOD

ology: This study encompassed a cohort of 26 patients, consisting of 11 males and 15 females, all diagnosed with medial compartment osteoarthritis (grades 2 and 3). Each patient underwent medial open wedge HTO and was subsequently monitored for a minimum period of 8 weeks. Patients were advised to engage in early weight-bearing walking, with or without assistance, based on their comfort levels. The assessment of functionality involved the utilization of the Visual Analog Scale (VAS) score, Katz Index of Independence in Activities of Daily Living (ADL), and Lawton index, performed at intervals of postoperative day 1, 2 weeks, 4 weeks, 6 weeks, and 8 weeks.

RESULTS

The average age of the patients at the time of surgery was 51.5 ± 7.2 years. The mean preoperative VAS score registered at 8.6, which exhibited a substantial reduction to 1.3 at the 8-week postoperative follow-up (p < 0.001). On average, patients were capable of walking with full weight-bearing without any external support at 6.9 weeks post-surgery. The initial preoperative Katz index was tabulated at 6, and within 6 weeks, all patients had successfully regained their pre-surgery functional levels, restoring the Katz index to its original value of 6. In addition, the mean Lawton index both before surgery and at the 8-week postoperative mark remained stable, with no significant variation (n.s.).

CONCLUSIONS

The immediate outcomes observed in knee preservation surgery are indeed promising. Within the 8-week timeframe, a majority of patients successfully reinstated their preoperative levels of independence, accompanied by a notable alleviation of pain.

摘要

目的

本研究的主要目的是调查采用加速康复方案的内侧开放楔形高位胫骨截骨术(HTO)后恢复日常活动所需的时间框架。

方法

本研究纳入了26例患者,其中男性11例,女性15例,均诊断为内侧间室骨关节炎(2级和3级)。每位患者均接受内侧开放楔形HTO手术,随后至少监测8周。根据患者的舒适度,建议患者早期负重行走,可借助或不借助辅助设备。功能评估采用视觉模拟量表(VAS)评分、日常生活活动能力独立指数(ADL)的Katz指数和Lawton指数,分别在术后第1天、2周、4周、6周和8周进行。

结果

手术时患者的平均年龄为51.5±7.2岁。术前VAS评分平均为8.6分,术后8周随访时大幅降至1.3分(p<0.001)。平均而言,患者在术后6.9周能够完全负重行走而无需任何外部支撑。术前初始Katz指数为6,6周内所有患者均成功恢复到术前功能水平,Katz指数恢复到原来的6分。此外,术前和术后8周的平均Lawton指数保持稳定,无显著变化(无统计学意义)。

结论

膝关节保留手术的近期效果确实令人满意。在8周的时间内,大多数患者成功恢复到术前的独立水平,同时疼痛明显减轻。

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1
Recent advances in understanding the phenotypes of osteoarthritis.骨关节炎表型研究的最新进展。
F1000Res. 2019 Dec 12;8. doi: 10.12688/f1000research.20575.1. eCollection 2019.
3
High Tibial Osteotomy: Review of Techniques and Biomechanics.胫骨高位截骨术:技术与生物力学综述。
J Healthc Eng. 2019 May 2;2019:8363128. doi: 10.1155/2019/8363128. eCollection 2019.

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