Scherak O, Kolarz G, Wottawa A, Maager M, el Shohoumi M
Institut für Rheumatologie, Rheuma-Sonderkrankenanstalt Baden der SVA der Bauern, Baden bei Wien.
Acta Med Austriaca. 1996;23(4):142-5.
159 patients were examined approximately 15 months after hip arthroplasty. 116 of these patients have had at that time point a postoperative 4 week hospital stay for rehabilitation. A score that considered pain at motion and at rest, maximal walking capacity and activity of daily living was used for evaluation. The preoperative conditions did not differ between patients that had their postoperative hospital stay for rehabilitation (n = 116) and those that did not (n = 43). The results at the time of examination were regarded as excellent (group 1; score 3) in 64 (40.3%) patients, as good (group 2; score 4) in 56 (35.2%) patients and as poor (group 3; score > or = 5) in 39 (24.5%) patients. The amount of patients with a hospital stay for rehabilitation was significantly (p = 0.025) higher in the patient groups with excellent or good results in comparison with the patients with poor postoperative outcome. The most excellent results were obtained in patients who had their rehabilitation within the first two months after surgery (p = 0.008). Apart from the above mentioned score the following-additionally assessed-parameters differed significantly between the 3 groups: hip mobility; pain elicited by pressure on the operated joint; pain in the contralateral hip or knee joints; consumption of analgetics; walking time for 15 meters; degree of handicap as assessed by the patient or the occupational therapist or the physician; coping with household activities (for females only). We conclude that a poor result of hip arthroplasty may be due not only to degenerative joint disease of the lower limbs but also (or in combination) to the lack of a postoperative hospital stay for rehabilitation.
159名患者在髋关节置换术后约15个月接受了检查。其中116名患者在该时间点接受了为期4周的术后住院康复治疗。使用一个综合考虑运动和静息时疼痛、最大步行能力以及日常生活活动的评分来进行评估。接受术后住院康复治疗的患者（n = 116）和未接受康复治疗的患者（n = 43）术前情况并无差异。检查时的结果，64名（40.3%）患者被视为优秀（第1组；评分3），56名（35.2%）患者为良好（第2组；评分4），39名（24.5%）患者为差（第3组；评分≥5）。与术后结果差的患者相比，结果优秀或良好的患者组中接受住院康复治疗的患者数量显著更高（p = 0.025）。术后头两个月内接受康复治疗的患者取得了最佳效果（p = 0.008）。除上述评分外，三组之间在以下额外评估参数上存在显著差异：髋关节活动度；手术关节受压引发的疼痛；对侧髋关节或膝关节疼痛；镇痛药消耗量；15米步行时间；患者、职业治疗师或医生评估的残疾程度；应对家务活动（仅针对女性）。我们得出结论，髋关节置换术效果不佳可能不仅归因于下肢退行性关节疾病，还可能（或联合）归因于缺乏术后住院康复治疗。
