老年患者非骨水泥固定型全髋关节置换术后早期负重锻炼的效果

目的探讨老年患者非骨水泥固定型全髋关节置换(THA)术后早期负重锻炼的可行性及效果.方法将48例(52髋)60岁以上非骨水泥固定型THA术患者随机分为两组,实验组23例(25髋),术后第1天即下地完全负重行走,并依据THA术后功能锻炼程序进行系统练习;对照组25例(27髋),按传统方法于术后第3周开始部分负重,至术后6周完全负重.两组于术后12周和术后2年分别进行临床和X线摄片评价.结果术后12周实验组Harris评分与对照组比较差异有显著性(t＝4.57,P<0.01),术后2年两组在临床效果和X线摄片评价方面无显著性差异.结论老年患者非骨水泥固定型THA术后早期负重锻炼是安全有效的.

Effect of full weight-bearing exercise on elderly patients early after uncemented total hip arthroplasty

Objective To study the feasibility and effect of immediate full weight-bearing exercises on elderly patients(>60 years) after uncemented total hip arthroplasty.Methods Forty-eight patients (52 hips)underwent primary uncemented total hip arthroplasty. At the end of the surgery,the patients were allocated randomly into either early (experimental group) or late (countrol group) weight-bearing groups. The experimental group consisting of 23 patients (25 hips) received full weight-bearing as tolerated on both lower extremities on the first day after the surgery. The control group consisting of 25 patients (27 hips) were instructed to use 2 crutches with a load of <10% of body weight in the 3 rdweek postoperatively. Patients in both groups were matched for gender, age, weight and Harris. The clinical and radiographic results were compared 12 weeks after the surgery, and again at 2 years after.Results There was no significant difference in the results of 2 years after surgery between the two groups.However, there was a difference in that of 12 weeks after surgery(t=4.57,P<0.01).Conclusion Full weight-bearing exercise on elderly patients early after uncemented total hip arthroplasty is safe and effective.