切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 61 -66. doi: 10.3877/cma.j.issn.1674-134X.2022.01.010

综述

全膝关节置换术后康复治疗现状
黄雨青1, 颜帅1, 王艳萌1, 隗麒轩2, 邓赟2, 王宁2, 何思佳2, 杨信才2,()   
  1. 1. 071000 保定,河北大学附属医院
    2. 071000 保定,河北大学附属医院康复医学科
  • 收稿日期:2021-04-12 出版日期:2022-02-01
  • 通信作者: 杨信才
  • 基金资助:
    河北省卫生和计划生育委员会科研基金项目(20170827)

Current status of rehabilitation after total knee arthroplasty

Yuqing Huang1, Shuai Yan1, Yanmeng Wang1, Qixuan Kui2, Yun Deng2, Ning Wang2, Sijia He2, Xincai Yang2,()   

  1. 1. Affiliated Hospital of Hebei University, Baoding 071000, China
    2. Department of Rehabilitation Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China
  • Received:2021-04-12 Published:2022-02-01
  • Corresponding author: Xincai Yang
引用本文:

黄雨青, 颜帅, 王艳萌, 隗麒轩, 邓赟, 王宁, 何思佳, 杨信才. 全膝关节置换术后康复治疗现状[J/OL]. 中华关节外科杂志(电子版), 2022, 16(01): 61-66.

Yuqing Huang, Shuai Yan, Yanmeng Wang, Qixuan Kui, Yun Deng, Ning Wang, Sijia He, Xincai Yang. Current status of rehabilitation after total knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(01): 61-66.

全膝关节置换术(TKA)是治疗终末期膝关节疾病最有效的方法,能够明显提高患者的生活质量。但TKA手术范围广、创伤大、易产生炎性因子,并且可以导致肿胀、顺应性降低、增加关节活动阻力及患者疼痛,这严重影响了膝关节功能的恢复。因此,疼痛及膝关节功能障碍是TKA术后早期最急需解决的问题,而康复治疗是最佳的手段之一。传统康复治疗技术疗效显著,但同时也存在诸多不足;新型康复治疗技术在患者的疾病管理方面具有优势,但缺乏充分的循证建议及个体化方案。本综述旨在通过总结TKA术后传统和新型的康复治疗方案的实用性及有效性,探讨TKA术后康复治疗的最新进展,为临床制定高质量的康复治疗策略提供参考。

Total Knee Arthroplasty (TKA) is the most effective method for the treatment of terminal stage knee-joint disease, which can significantly improve patients’ life quality. However, the operation involves a large scope, great trauma, and leads to produce inflammatory factors. It causes swelling, compliance-reducing, resistance of the knee joint and increases patients' pain, which seriously affects the recovery of knee joint function. Therefore, the pain and knee dysfunction are the most urgent problems to be solved in the early stage after TKA, and rehabilitation treatment is one of the best methods. Traditional rehabilitation treatment techniques have shown obvious therapeutic effects, but there are also many deficiencies. New rehabilitation treatment techniques have advantages in the patients' disease management, but they are lack of sufficient evidence-based recommendations and individualized programs. The purpose of this review was to explore the latest progress of the TKA rehabilitation treatment by summarizing the practicability and effectiveness of the traditional and new rehabilitation techniques following TKA, and to provide a reference for the high-quality rehabilitation treatment strategies in the future.

[1]
刘旭,方锐.针灸防治膝关节置换术后恶心呕吐症状的现状研究[J].中医临床研究,202012(13): 146-148.
[2]
张永辉,张林,卢敏.循经针刺联合股神经阻滞干预膝关节置换术后镇痛及功能康复:随机对照研究[J].中国针灸,201838(3): 251-255.
[3]
陈达,盛东,徐景利,等.电针在全膝关节置换术后镇痛的临床疗效分析[J].针刺研究,201843(10): 616-621.
[4]
孔维维,李菊兰,刘帆,等.耳穴贴压在全膝关节置换术后急性疼痛及早期康复中的疗效研究[J].西部中医药,202033(12): 109-112.
[5]
许辉,康冰心,高晨鑫,等.推拿治疗膝骨关节炎全膝关节置换后疼痛的有效性[J].中国组织工程研究,202125(18): 2840-2845.
[6]
何云波.推拿手法在全膝关节置换术围手术期康复治疗的价值观察[J].中医临床研究,201911(18): 121-122.
[7]
王念宏,严隽陶,孙武权,等.全膝关节表面置换早期推拿的疗效评价[J].中国组织工程研究,201317(9): 1543-1548.
[8]
Farias RD, Closs LQ, Miguens SJ. Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: a randomized split-mouth clinical trial[J]. Angle Orthod, 2016, 86(2): 193-198.
[9]
牛雪飞,苏辉棠.关节松动术联合物理因子治疗全膝关节置换术后膝关节活动受限的疗效观察[J].中华物理医学与康复杂志,201537(10): 776-777.
[10]
韩利民,罗黎娟,陈淑娥. 腕针配合磁疗治疗踝关节扭伤疗效观察[J]. 中华物理医学与康复杂志,200123(4): 211-214.
[11]
Ruffilli A, Castagnini F, Traina F, et al. Temperature-Controlled continuous cold flow device after total knee arthroplasty: a randomized controlled trial study[J]. J Knee Surg, 2017, 30(7): 675-681.
[12]
Da RC, Mcnair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives[J]. Semin Arthritis Rheum, 2010, 40(3): 250-266.
[13]
Becker BE. The biologic aspects of hydrotherapy[J]. J Back Musculoskelet Rehabil, 1994, 4(4): 255-264.
[14]
Valtonen A, Pöyhönen T, Sipilä S, et al. Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement[J]. Arch Phys Med Rehabil, 2010, 91(6): 833-839.
[15]
Passeri EV, Martinelli M, Gatteri V, et al. Standard and water rehabilitation: an analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery[J]. Haemophilia, 2019, 25(4): 699-707.
[16]
Harmer AR, Naylor JM, Crosbie J, et al. Land-based versus water-based rehabilitation following total knee replacement: a randomized, single-blind trial[J]. Arthritis Rheum, 2009, 61(2): 184-191.
[17]
Liao CD, Yc H, Lin LF, et al. Continuous passive motion and its effects on knee flexion after total knee arthroplasty in patients with knee osteoarthritis[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(8): 2578-2586.
[18]
Hsu CC, Chen SR, Lee PH, et al. The effect of music listening on pain, heart rate variability, and range of motion in older adults after total knee replacement[J]. Clin Nurs Res, 2019, 28(5): 529-547.
[19]
Werner S, Jacofsky M, Kocisky S, et al. A standardized protocol for the treatment of early postoperative stiffness following total knee arthroplasty[J]. J Knee Surg, 2015, 28(5): 425-427.
[20]
Mau-Moeller A, Behrens M, Finze S, et al. The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study[J/OL]. Health Qual Life Outcomes, 2014, 12: 68. DOI: 10.1186/1477-7525-12-68.
[21]
Liao CD, Yc H, Chiu YS, et al. Effect of body mass index on knee function outcomes following continuous passive motion in patients with osteoarthritis after total knee replacement: a retrospective study[J]. Physiotherapy, 2017, 103(3): 266-275.
[22]
Mayr A, Kofler M, Quirbach E, et al. Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis[J]. Neurorehabil Neural Repair, 2007, 21(4): 307-314.
[23]
尹正录,孟兆祥,林舜艳,等.MOTOmed智能运动训练结合神经肌肉本体感觉促进技术对全膝关节置换术后功能恢复的影响[J/CD].中华老年骨科与康复电子杂志,20173(1): 50-54.
[24]
Liao CD, Liou TH, Huang YY, et al. Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(8): 697-709.
[25]
Roig-Casasús S, Blasco JM, López-Bueno L, et al. Balance training with a dynamometric platform following total knee replacement: a randomized controlled trial[J]. J Geriatr Phys Ther, 2018, 41(4): 204-209.
[26]
Liao CD, Lin LF, Huang YC, et al. Functional outcomes of outpatient balance training following total knee replacement in patients with knee osteoarthritis: a randomized controlled trial[J]. Clin Rehabil, 2015, 29(9): 855-867.
[27]
Blasco JM, Acosta-Ballester Y, Martínez-Garrido I, et al. The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial[J]. Clin Rehabil, 2020, 34(2): 182-193.
[28]
Moutzouri M, Gleeson N, Coutts F, et al. Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial[J]. Clin Rehabil, 2018, 32(7): 888-898.
[29]
Moutzouri M, Coutts F, Gliatis J, et al. Early initiation of home-based sensori-motor training improves muscle strength, activation and size in patients after knee replacement: a secondary analysis of a controlled clinical trial[J/OL]. BMC Musculoskelet Disord, 2019, 20(1): 231. DOI: 10.1186/512891-019-2575-3
[30]
Khan F, Ng L, Gonzalez S, et al. Multidisciplinary rehabilitation programmes followingjoint replacement at the hip and knee in chronic arthropathy[J/OL]. Cochrane Database Syst Rev, 2008, (2): CD004957. DOI: 10.1002/14651858.CD004957.pub3.
[31]
Birch B, Haslam E, Heerah I, et al. Design of a continuous passive and active motion device for hand rehabilitation[J]. Annu Int Conf IEEE Eng Med Biol Soc, 2008: 4306-4309.
[32]
Fitz W, Shukla P, Li L, et al. Early regain of function and proprioceptive improvement following knee arthroplasty[J]. Arch Bone Jt Surg, 2018, 6(6): 523-531.
[33]
Schulz M, Krohne B, Röder W, et al. Randomized, prospective, monocentric study to compare the outcome of continuous passive motion and controlled active motion after total knee arthroplasty[J]. Technol Health Care, 2018, 26(3): 499-506.
[34]
Howard JS, Mattacola CG, Romine SE, et al. Continuous passive motion, early weight bearing, and active motion following knee articular cartilage repair: evidence for clinical practice[J]. Cartilage, 2010, 1(4): 276-286.
[35]
Piva SR, Teixeira PE, Gj A, et al. Contribution of hip abductor strength to physical function in patients with total knee arthroplasty[J]. Phys Ther, 2011, 91(2): 225-233.
[36]
Yuenyongviwat V, Duangmanee S, Iamthanaporn K, et al. Effect of hip abductor strengthening exercises in knee osteoarthritis: a randomized controlled trial[J/OL]. BMC Musculoskelet Disord, 2020, 21(1): 284. DOI: 10.1186/s12891-020-03316-z.
[37]
Harikesavan K, Chakravarty RD, Maiya AG, et al. Hip abductor strengthening improves physical function following total knee replacement: one-year follow-up of a randomized pilot study[J]. Open Rheumatol J, 2017, 11(1): 30-42.
[38]
Schache MB, Mcclelland JA, Webster KE. Incorporating hip abductor strengthening exercises into a rehabilitation program did not improve outcomes in people following total knee arthroplasty:a randomised trial[J]. J Physiother, 2019, 65(3): 136-143.
[39]
Oktas B, Vergili O. The effect of intensive exercise program and kinesiotaping following total knee arthroplasty on functional recovery of patients[J/OL]. J Orthop Surg Res, 2018, 13(1): 233. DOI: 10.1186/s13018-018-0924-9.
[40]
Woźniak-Czekierda W, Woźniak K, Hadamus A, et al. Use of kinesiology taping in rehabilitation after knee arthroplasty: a randomised clinical study[J]. Ortop Traumatol Rehabil, 2017, 19(5): 461-468.
[41]
Donec V, Kriščiūnas A. The effectiveness of Kinesio Taping® after total knee replacement in early postoperative rehabilitation period. A randomized controlled trial[J]. Eur J Phys Rehabil Med, 2014, 50(4): 363-371.
[42]
Öğüt H, Güler H, Yildizgören MT, et al. Does kinesiology taping improve muscle strength and function in knee osteoarthritis? A single-blind, randomized and controlled study[J]. Arch Rheumatol, 2018, 33(3): 335-343.
[43]
Liu K, Qian J, Gao Q, et al. Effects of kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture: a retrospective case series[J/OL]. Medicine (Baltimore), 2019, 98(48): e17956. DOI: 10.1097/MD.0000000000017956.
[44]
Kehlet H. Surgery for the elderly is an urgent multidisciplinary challenge[J]. Ugeskr Laeger, 2013, 175(41): 2394. DOI: 10.1007/s12439-013-0049-x.
[45]
Gianola S, Stucovitz E, Castellini G, et al. Effects of early virtual reality-based rehabilitation in patients with total knee arthroplasty: a randomized controlled trial[J/OL]. Medicine (Baltimore), 2020, 99(7): e19136. DOI: 10.1097/MD.0000000000019136.
[46]
Hong S, Lee G. Effects of an immersive virtual reality environment on muscle strength, proprioception, balance, and gait of a middle-aged woman who had total knee replacement: a case report[J/OL]. Am J Case Rep, 2019, 20: 1636-1642. DOI:10.12659/AJCR.918521.
[47]
Piqueras M, Marco E, Coll M, et al. Effectiveness of an interactive virtual telerehabilitation system in patients after total knee arthoplasty: a randomized controlled trial[J]. J Rehabil Med, 2013, 45(4): 392-396.
[48]
Lin HT, Li Y, Hu WP, et al. A scoping review of the efficacy of virtual reality and exergaming on patients of musculoskeletal system disorder[J/OL]. J Clin Med, 2019, 8(6): 791. DOI: 10.3390/jcm8060791.
[49]
Argent R, Slevin P, Bevilacqua A, et al. Clinician perceptions of a prototype wearable exercise biofeedback system for orthopaedic rehabilitation: a qualitative exploration[J/OL]. BMJ Open, 2018, 8(10): e026326. DOI: 10.1136/bmjopen-2018-026326.
[50]
Argent R, Slevin P, Bevilacqua A, et al. Wearable Sensor-Based exercise biofeedback for orthopaedic rehabilitation: a mixed methods user evaluation of a prototype system[J/OL]. Sensors (Basel), 2019, 19(2): 432. DOI: 10.3390/s19020432.
[51]
Correia FD, Nogueira A, Magalhães I, et al. Home-based rehabilitation with a novel digital biofeedback system versus conventional in-person rehabilitation after total knee replacement: a feasibility study[J/OL]. Sci Rep, 2018, 8(1): 11299.DOI: 10.1038/s41598-018-29668-0.
[52]
李玮玮. 心理护理对骨肉瘤患者人工膝关节置换术后生活质量和康复的影响价值体会[J]. 心理月刊,2021, 16(4): 113-114.
[53]
陈丽,黄菲菲,陈晓慧. 合理情绪疗法结合个体化运动计划对膝关节置换术后患者的影响[J].心理月刊,2021, 16(8): 105-106, 128.
[54]
赵春玲. 膝关节置换术患者术前负性情感及护理对策[J]. 中国医药导报,2009, 6(3): 97-98.
[55]
黄群英,刘素霞,杨春英.焦点解决模式在全膝关节置换术早期康复锻炼中的应用[J/CD].中华关节外科杂志(电子版),201711(2): 146-149.
[56]
沈红星,陈裔英,马彬,等.早期综合康复疗法对全膝关节置换术后膝功能和ADL能力的效果[J].中国康复医学杂志,201025(6): 577-579.
[57]
Friemert B, Bach C, Schwarz W, et al. Benefits of active motion for joint position sense[J]. Knee Surg Sports Traumatol Arthrosc, 2006, 14(6): 564-570.
[58]
Chang AH, Chmiel JS, Almagor O, et al. Hip muscle strength and protection against structural worsening and poor function and disability outcomes in knee osteoarthritis[J]. Osteoarthritis Cartilage, 2019, 27(6): 885-894.
[59]
Hadamus A, Grabowicz M, Wąsowski P, et al. Assessment of the impact of kinesiology taping application versus placebo taping on the knee joint position sense. preliminary report[J]. Ortop Traumatol Rehabil, 2018, 20(2): 139-148.
[60]
Kase KWallis JKase T. Clinical therapeutic applications of the Kinesio Taping method[M]. Tokyo: Ken I kai Co Ltd, 2003: 155-187.
[1] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[2] 杨占宇, 黄艳华, 马小迪, 冯安莹, 王旼娴, 龙青燕. 本体感觉训练对踝关节周围骨折患者步行能力的改善[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 477-483.
[3] 许亚龙, 巩栋, 陈晓涛. 超前镇痛在全膝关节置换术中的研究进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 517-523.
[4] 孙俊锋, 涂家金, 付丹, 蒋满香, 刘金晶, 崔乃硕. 手部烧伤瘢痕挛缩畸形整形术后综合康复联合点阵二氧化碳激光治疗的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 411-415.
[5] 钟锴, 蒋铁民, 张瑞青, 吐尔干艾力·阿吉, 邵英梅, 郭强. 加速康复外科在肝囊型棘球蚴病肝切除术中的应用分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 425-429.
[6] 李月平, 李科, 乔禹铭, 钟美浓. 前列腺热蒸汽消融术医护康一体化快速康复模式初探[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 464-472.
[7] 曹健, 冯高华, 周卫军, 陈诚, 沈王丰, 吴英姿. 补脾益肺膏联合肺康复训练治疗慢性阻塞性肺疾病的临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 781-784.
[8] 杨轲, 丁增巴姆, 马静, 李盼盼, 陈婷. 全程无缝隙肺康复训练在单孔胸腔镜肺叶切除术中的临床应用[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 801-804.
[9] 任甜甜, 张玉慧, 祁玲霞, 朱梅冬, 胡佳. 多学科疼痛管理对胸腔镜肺叶切除术后胸痛及应激反应的影响分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 630-633.
[10] 郭少琳, 郭建英, 左秀萍, 高苗. 慢性阻塞性肺疾病康复训练依从性影响因素分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 652-654.
[11] 陈冬冬, 余程冬, 曹晓光. 上肢外骨骼机器人在脑卒中康复中的应用与研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 312-317.
[12] 谢浩文, 丁建英, 刘小霞, 冯毅, 姚婧. 椎旁神经阻滞对微创胃切除肥胖患者术中血流、术后应激及康复质量的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 569-573.
[13] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[14] 刘芳明, 石秀秀, 唐冲, 张克石, 徐影, 王桂杉, 关振鹏, 李晓. 骨科康复患者对数字疗法应用的知晓度和需求度:一项基于928 份问卷调查结果分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 654-661.
[15] 刘晓鹏, 柳聪艳, 杨宁, 蔡琛, 李晓兵, 王红宇, 张思森. 三穴五针联合腹部提压法在机械通气患者肺康复中的疗效[J/OL]. 中华卫生应急电子杂志, 2024, 10(04): 193-198.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?