Lin Yi, Luo Xingwen
The Eighth Affiliated Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, 528308, China.
J Orthop Surg Res. 2025 Jul 15;20(1):660. doi: 10.1186/s13018-025-06047-w.
Early phase rehabilitation protocols are critical for optimizing functional outcomes following unicompartmental knee arthroplasty (UKA). Mobilization with movement (MWM), a manual therapy technique targeting joint kinematics and neuromuscular control, may synergize with rapid rehabilitation to address postoperative dysfunction.
To evaluate the adjunctive effects of MWM on early postoperative functional recovery, pain control, and knee joint stability in patients receiving a standardized rapid rehabilitation protocol for UKA.
This double-blind, randomized controlled trial enrolled 72 UKA patients (April 2022-October 2024). The participants were stratified into two cohorts: the control group (rapid rehabilitation intervention alone) and the observation group (rapid rehabilitation intervention + MWM). MWM: Therapist applies a rotational gliding force toward the tibia and an anteroposterior force (anterior or posterior) at the distal femur to stabilize the joint, coordinating with the patient's active knee flexion-extension movements within a minimally painful range.The functional outcomes were quantitatively assessed via Passive range of motion (PROM), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Hospital for Special Surgery (HSS) score at five time points: preoperative, postoperative day 1, 2 weeks, 4 weeks, and 12 weeks.
Both groups demonstrated progressive improvement in PROM, WOMAC and HSS scores across all follow-up intervals compared with the scores of preoperative and postoperative day 1 (P < 0.01). Compared with the control group, the observation group presented superior functional recovery trajectories: PROM and HSS scoreswere significantly elevated at 2, 4 and 12 weeks (P < 0.01).WOMAC pain/stiffness subscales showed accelerated resolution in the observation group (P < 0.01).
Integrating MWM protocols synergistically enhances early functional restoration post-UKA, as evidenced by validated outcome measures.
早期康复方案对于优化单髁膝关节置换术（UKA）后的功能结局至关重要。运动中松动术（MWM）是一种针对关节运动学和神经肌肉控制的手动治疗技术，可能与快速康复协同作用以解决术后功能障碍。
评估MWM对接受UKA标准化快速康复方案患者术后早期功能恢复、疼痛控制和膝关节稳定性的辅助作用。
这项双盲、随机对照试验纳入了72例UKA患者（2022年4月至2024年10月）。参与者被分为两个队列：对照组（仅进行快速康复干预）和观察组（快速康复干预 + MWM）。MWM：治疗师向胫骨施加旋转滑动力量，并在股骨远端施加前后方向的力量（向前或向后）以稳定关节，在最小疼痛范围内与患者主动的膝关节屈伸运动相配合。通过被动活动范围（PROM）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及特殊外科医院（HSS）评分在五个时间点对功能结局进行定量评估：术前、术后第1天、2周、4周和12周。
与术前和术后第1天的评分相比，两组在所有随访间隔的PROM、WOMAC和HSS评分均呈现逐步改善（P < 0.01）。与对照组相比，观察组呈现出更好的功能恢复轨迹：在2周、4周和12周时，PROM和HSS评分显著升高（P < 0.01）。WOMAC疼痛/僵硬子量表显示观察组的缓解速度加快（P < 0.01）。
如经过验证的结局指标所示，整合MWM方案可协同增强UKA术后的早期功能恢复。
