Ma Jimin, Zhu Yakun, Dong Zhen, Guo Ziming, Song Rui, Cheng Wendan
Department of Orthopaedics, Fuyang Hospital of Anhui Medical University, Fuyang, 236000, Anhui province, China.
Department of Orthopaedics, The Second Hospital of Anhui Medical University, 678 Furong Road, Shushan District, Hefei, 230000, Anhui province, China.
BMC Musculoskelet Disord. 2025 Jun 4;26(1):555. doi: 10.1186/s12891-025-08802-w.
The study aimed to investigate the impact of high knee range of motion at discharge on functional outcome after total knee arthroplasty (TKA).
We conducted a retrospective study of 136 patients with primary osteoarthritis who were treated between January 2022 and June 2023. Patients were classified according to the type of rehabilitation program: high range of motion (HROM) group or control group. In the HROM group, patients underwent high-intensity rehabilitation, especially without restricting the range of motion (ROM) following knee surgery. In the control group, patients received routine rehabilitation, with the affected knee achieving approximately 90 degrees of flexion at discharge. Patients' data related to postoperative knee ROM, Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) score, transfusion rate, wound complications, thrombus of lower limb, and usage of analgesic drugs were recorded to assess the influence of ROM at discharge on clinical outcomes.
The HROM group had a higher knee ROM compared to the control group at discharge (P < 0.001). There were no significant differences between the HROM group and the control group in the basic demographic information, hospital stay and operation time (P > 0.05). HSS scores and knee ROM in the HROM group were significantly higher than those in the control group 1 and 2 months after surgery (P < 0.001). There were no significant differences in VAS at 1, 2 and 7 days after surgery between the two groups. The usage of analgesic drugs, wound complications, thrombus of lower limb, and transfusion rates were similar between the two groups (P > 0.05).
High knee ROM at discharge achieved through high-intensity rehabilitation is an effective and simple way to improve early knee mobility and function. The routine application of this protocol did not increase the incidence of wound complications.
本研究旨在探讨全膝关节置换术（TKA）出院时膝关节活动度高对功能结局的影响。
我们对2022年1月至2023年6月期间接受治疗的136例原发性骨关节炎患者进行了回顾性研究。根据康复计划类型将患者分为：高活动度（HROM）组或对照组。在HROM组中，患者接受高强度康复，尤其是在膝关节手术后不限制活动范围（ROM）。在对照组中，患者接受常规康复，患膝在出院时达到约90度屈曲。记录患者术后膝关节ROM、特种外科医院（HSS）评分、视觉模拟量表（VAS）评分、输血率、伤口并发症、下肢血栓及镇痛药使用情况，以评估出院时ROM对临床结局的影响。
出院时HROM组膝关节ROM高于对照组（P < 0.001）。HROM组与对照组在基本人口统计学信息、住院时间和手术时间方面无显著差异（P > 0.05）。术后1个月和2个月，HROM组的HSS评分和膝关节ROM显著高于对照组（P < 0.001）。两组术后1天、2天和7天的VAS无显著差异。两组之间镇痛药使用、伤口并发症、下肢血栓和输血率相似（P > 0.05）。
通过高强度康复在出院时实现高膝关节ROM是改善早期膝关节活动度和功能的有效且简单的方法。该方案的常规应用并未增加伤口并发症的发生率。
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