人工全髋关节置换翻修术后的康复

目的探讨人工全髋关节置换翻修术后康复训练的有效方法。方法对24例不同病因行各类人工全髋关节置换翻修术后患者,给予有异于初次人工全髋关节置换术后患者的特殊康复治疗,于手术前和手术后1、3个月进行Harris评分并判定疗效。结果全髋关节翻修手术后1、3个月患者疼痛、活动度、步行能力、日常生活能力比术前均有所提高（P〈0.05或P〈0.001）。术后3个月疗效评定：优4例,良13例,中6例,差1例,优良率70.83%。结论 1）全髋关节翻修术后的早期康复对髋关节功能的恢复有重要的作用;2）由于人工全髋关节置换翻修手术的复杂性,其术后的康复训练需从髋关节骨骼的完整性（是否骨质疏松、骨缺损的程度）、内植物相对的稳定性（选择何种类型的假体固定）、关节周围的软组织条件3个方面进行评定;3）术后康复训练遵循个体化、渐进性、全面性的原则,重点是增加肌力,尤其是髋外展肌肌力的训练。

Rehabilitation after Revision Total Hip Arthroplasty

Objective To explore the effective methods for rehabilitation after revision total hip arthroplasty（RTHA）. Methods Twenty-four patients who underwent RTHA received special rehabilit- ation therapy. Curative efficacy was evaluated using Harris hip score before and 1 and 3 months after significantly improved 1 and 3 months after RTHA （P〈0.05 or P〈0.001 ）. Functional results （3 months after surgery） were excellent in 4 cases, good in 13, fair in 6 and poor in 1. The excellent and good rate was 70.83%. Conclusion 1）the early rehabilitation is important to recovery of hip function;2）because of the complexity of RTHA, postoperative rehabilitation should be evaluated according to three aspects： the integrity of hip bone （osteoprosis and degree of bone defects）, the relative stability of implant （selection of prostheses for hip replacement）, and the conditions of soft tissue around hip joint;3）the rehabilitation after RTHA must obey the principle of individuation, progress and comprehension, and training program should focus on increasing muscle strength, especially hip abductor muscle strength.