Yang Lin, Li Hui-Wu, Zhai Zan-Jing, Wang Cai-Feng, Wu Bei-Ying, Zhou Jia, Bian Wei-Wei, Ruan Hong
Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200023, China.
School of Nursing, Shanghai Jiao Tong University, Shanghai, 200011, China.
Arthroplasty. 2025 Jan 7;7(1):3. doi: 10.1186/s42836-024-00285-9.
Swelling in the lower limbs after total knee arthroplasty (TKA) affects surgical outcomes. Prolonged swelling requires monitoring and remote management during home-based rehabilitation. Causes of swelling vary but, so far, no indicators are available to monitor and identify causes of lower limb swelling, making it difficult to implement targeted interventions. This study aimed to find the indicators to monitor and identify the causes of lower limb swelling during home-based rehabilitation after TKA by literature research and consulting experts from various disciplines.
The Delphi method was used. Based on literature research and analysis, a set of candidate indicators was developed. Fifteen experts from different disciplines evaluated the validity of the indicators and provided modification suggestions.
After two rounds of Delphi consultations, consensus was reached. Agreement scores ranged from 4.40 to 5.00, with low variability (standard deviation 0.00-0.91) and high consistency (coefficient of variation 0.00-0.20). P was less than 0.05 in Kendall's W with an agreement rate of 80.00-100%. In the final set of indicators, there were five primary indicators (representing four swelling causes and a general category), along with 23 secondary indicators and 40 tertiary indicators.
This study preliminarily established indicators for at-home identification of post-TKA swelling caused by four distinct reasons. Further research is needed to validate the value of these indicators in distinguishing the causes of swelling.
全膝关节置换术（TKA）后下肢肿胀会影响手术效果。长时间肿胀在居家康复期间需要监测及远程管理。肿胀原因各异，但目前尚无用于监测和识别下肢肿胀原因的指标，这使得难以实施针对性干预。本研究旨在通过文献研究和咨询多学科专家，寻找全膝关节置换术后居家康复期间监测和识别下肢肿胀原因的指标。
采用德尔菲法。基于文献研究与分析，制定了一组候选指标。15名来自不同学科的专家对指标的有效性进行评估并提出修改建议。
经过两轮德尔菲咨询，达成了共识。一致性得分范围为4.40至5.00，变异性低（标准差0.00 - 0.91）且一致性高（变异系数0.00 - 0.20）。肯德尔W检验中P小于0.05，一致率为80.00% - 100%。在最终的指标集中，有5个主要指标（代表4个肿胀原因和一个综合类别），以及23个次要指标和40个三级指标。
本研究初步建立了用于居家识别全膝关节置换术后由四种不同原因引起肿胀的指标。需要进一步研究以验证这些指标在区分肿胀原因方面的价值。
