微创全髋关节置换术后综合康复疗效观察的临床对照试验

目的：探讨综合康复治疗对微创全髋关节置换术后恢复髋关节功能的临床效果。方法：2006年3月至2008年2月入选本研究100例患者，分为治疗组和对照组。治疗组50例，男21例，女29例；年龄56～78岁，平均（67．2±11．0）岁；对照组50例，男26例，女24例；年龄54-79岁，平均（65．5±11．5）岁。两组病程均为10～15年。治疗组患者髋关节置换术后第2天在治疗师指导下，通过阶段性、循序渐进进行关节活动度、日常生活能力、恢复肌力等早期康复训练。对照组患者术后未实施早期康复治疗。然后，分别就其术后髋关节功能恢复、Han-is评分、X线等方面进行分析比较。结果：100例均获随访，平均随访时间13个月（12-14个月）。治疗组与对照组疗效比较，经秩和检验，Zc=12．72，P〈0．001，两组疗效差异有统计学意义。Harris髋关节功能评分对疼痛、关节功能、畸形、关节活动范围等方面进行评定，治疗组总分平均（94．50±29．87）分，优32例，良12例，可4例，差2例；对照组平均（63．50±19．97）分，优12例，良15例，可7例，差16例。治疗组疗效优于对照组。，X线片患髋中无假体松动和股骨颈骨折等并发症。结论：微创全髋关节置换术后早期康复治疗，是预防并发症、决定手术成败的关键。

Clinical effects of comprehensive rehabilitation after minimally invasive total hip arthroplasty

Objective: To explore clinical effects of comprehensive rehabilitation therapy for function restore of hip joint after minimally invasive total hip arthroplasty. Methods: From March 2006 to February 2008,100 patients were randomly divided into the treatment group and the control group. Fifty patients in the treatment group,including 21 males and 29 females, ranging in age from 56 to 78 years,with an average of(67.2±11.0)years. Fifty patients in the control group,including 26 males and 24 females,ranging in age from 54 to 79 years,with an average of(65.5 ± 11.5)years. The course of disease of the two groups were 10 to 15 years. The comprehensive rehabilitations such as joint range of motion,the activities of daily living and restoring muscle strength were performed step-by-step in the treatment group under the guidance of the therapist at the 2nd day after hip arthroplasty. Above rehabilitations were not performed in the control group. The postoperative functional recovery of hip joint,the Harris scores and X-ray were analyzed and compared between the two groups. Results: All the patients were followed and the duration averaged 13 months(12 to 14 months). The therapeutic effects of the two groups had statistical differences,Zc=12.72,P<0.001. In the treatment group,the average Harris score was(94.50±29.87),32 patients got an excellent result,12 good,4 poor and 2 bad. While in the control group,above data were(63.50±19.97),12,15,7 and 16 respectively. The therapeutic effects of treatment group were better than those of control group. The X-ray showed that there were no hip prosthesis loosening, femoral neck fractures and other complications. Conclusion: The early comprehensive rehabilitation after minimally invasive total hip replacement is the key to decrease postoperative complications and to decide the success or failure of surgery.