| Objective:Observing the effects and some indexes of rehabilitation on the patient s of osteoarthritis after total knee arthroplasty with early compositive manipulation in tervention, study on the function of the manipulation technique for rehabilitation and t he effectiveness for preventing deep vein thrombosis of the patients.Methods:60subjects with osteoarthritis and pretreatment for total knee arthroplast y were randomly divided into treatment group and control group,30cases in each gr oup. The control group was treated with conventional rehabilitation therapy, while the patients in treatment group were treated with early comprehensive manipulation based on conventional rehabilitation therapy. Two group patients were taking routine antico agulant. The duration of treatment was2weeks, and worked follow-up after1month. Change before treatment, after treatment and follow-up when Comparing with two g roups of patients at visual analogue score, rangeofmotion, the hospital for special surg ery score, keen society score, the western Ontario and McMaster universities osteoarth ritis index, leg circumference, D-dimer levels and lower Colour Doppler Ultrasound e xamination.Result.1. Comparison of visual analogue pain score:comparison between groups before treatment in two groups:visual analogue pain there was no statistically significant diff erence in score (P>0.05);4days after treatment,7days,14days and at follow-up tw o groups of patients with visual analogue score a statistically significant difference in treatment group than in control group and (P<0.05). Within group comparisons:two p atients had:from before treatment to follow-up visual analogue pain score decreased a nd there was a statistically significant difference (P<0.05). 2. Comparison of the joint activity:comparison between groups:patients in the t wo groups were before treatment, after treatment for7days,14days after treatment and follow-up comparison, joint activity showed no statistically significant difference (P<0.05). Within group comparisons:two groups of patients were:7days after treatm ent and before treatment showed no statistically significant difference (P>0.05);14da ys after treatment, follow-up joint activity increase was more than7days before treat ment and after treatment (P<0.05), and compared with each other with a statistically s ignificant difference (P<0.05).3. Comparison of special hospitals American joint function score: comparison bet ween groups before treatment, two groups of patients: joint function score were not st atistically significant difference (P>0.05);14days after the treatment and follow-up of patients in the two groups score of treatment group was superior to the control grou p (P<0.05). Within group comparisons:two groups of patients before treatment, after t reatment were:14days and at follow-up two patients joint function score gradually in creased and there was no significant difference (P<0.05) between.4. USA Knee Society score: comparison between groups:before treatment, after t reatment in two groups of patients Knee Society score showed no statistically signific ant difference (P>0.05); follow-up two patients joint function score in treatment group than in control group (P<0.05). Within group comparisons:two groups of patients be fore treatment were: comparison with the Knee Society score after treatment there wa s no statistically significant difference (P>0.05); follow-up two patients joint function score have significant difference of the ratio of treatment before and after treatment w ere higher than the (P<0.05).5. Osteoarthritis Index: comparison between groups: before treatment two groups of patients with osteoarthritis index showed no statistically significant difference (P>0.05);14days after the treatment and follow-up of two patients with osteoarthritis inde x comparison in the treatment group than in control group (P<0.05). Within group co mparisons:two groups of patients before treatment, after treatment were:14days and at follow-up two patients with osteoarthritis index increased gradually and there is st atistically significant difference (P<0.05) between.6. The leg circumferences comparison:comparison between groups:two groups of patients before treatment, after treatment for14days and the follow-up calf circumfe rence showed no statistically significant difference (P>0.05); therapy after3days,7d ays after treatment were compared between the two groups showed significant differen ces in calf circumference and the treatment group than the control group (P<0.05). W ithin group comparison:the two groups of patients with leg circumferences treatment after3days and before treatment were increased (P<0.05); therapy after7days,14d ays after treatment and follow-up decreased gradually, and the treatment group after tr eatment in7days and other time differences were statistically significant (P<0.05), w hile the control group therapy after14days and the other time point compared with t he differences were statistically significant (P<0.05); the follow-up, patients in the two groups before treatment and there were no statistically significant difference (P>0.05).7. The thigh circumference comparison:comparison between groups:two groups of patients before treatment, after treatment for3days,7days after treatment, treatme nt after14days and the follow-up thigh circumference are showed no statistically sig nificant difference (P>0.05). Within group comparisons:two groups of patients were:3days before treatment, after treatment and compared with the thigh circumference in creased, and then decreased gradually (P<0.05).8. D-dimer:comparing the two groups before treatment, two patients with D-di mer, there was no statistically significant difference (P>0.05) between two groups of p atients, after treatment of D-two dimer content were increased (P<0.05), and the treat ment group was lower than the control group (P<0.05).9. Color Doppler ultrasound examination:two groups of patients before treatment, color Doppler ultrasound in the diagnosis of femoral vein blood flow peak there was no statistically significant difference (P>0.05), compared two groups of patients with femoral vein blood flow peak increased after treatment (P<0.05), and the treatment gr oup than the control group (P<0.05). Two groups of patients with superficial venous t hrombosis compared the treatment group than the control group (P<0.05).Conclusion:1Early comprehensive manipulation therapy can improve the patients after total knee arthroplasty pain, swelling and promote the rehabilitation of knee joint function.2Early comprehensive manipulation therapy can improve the total knee arthroplasty i n patients with lower limb blood circulation to a certain extent, and prevention of dee p venous thrombosis of the lower extremity. |
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