| Objective:To explore the effect of different rehabilitation training methods on the function and swelling of knee joint after total knee replacement,and to provide an effective way for patients to recover early.Methods:A total of 92 patients who underwent total knee arthroplasty and met the inclusion criteria in the Department of Orthopaedics of the first affiliated Hospital of Anhui Medical College from July 2019 to December 2020 were selected as the research objects.Excel was used to generate random sequence numbers,and the subjects were divided into three groups: group A(31 cases),group B(31 cases),and group C(30cases).Patients in group A received routine rehabilitation training;Patients in group B were given continuous passive uniform speed rehabilitation training on the basis of routine rehabilitation training.Patients in group C were received passive manual rehabilitation training on the basis of routine rehabilitation training.The effects of three groups of patients were observed.:(1)General data of the three groups of patients were collected on admission;(2)The flexion range of motion of knee joint in the three groups was measured before surgery,on the second,third and fourth day after surgery,at discharge,and 1 month after surgery;(3)The VAS score was used to evaluate the resting pain and movement pain of patients in the three groups before and on the first,second and third day after surgery;(4)The diameter of the affected limbs(10cm above and bellow the patellar bone)of the three groups were collected before the surgery,3 days,5 days after surgery,and at discharge to evaluate the swelling of the affected limbs;(5)The postoperative hospital stay and HSS score was used to evaluate the recovery of knee function(HSS)in the three groups preoperatively,at discharge and 1 month after discharge.SPSS22.0 statistical software was used for statistical analysis of all data,and the rehabilitation effect of the three groups of patients was comparedResults:1.Comparison of general information: there were no statistical differences in age,body mass index,gender,anesthesia method,surgical site,education level and course of disease among the three groups(P > 0.05),indicating comparability.2.Comparison of knee flexion range of motion among the three groups before operation,on the 2nd day,3rd day,4th day,discharge and 1 month after operation: there was no statistical difference between the three groups before operation(P > 0.05),which was comparable.There were statistical differences on the second,the third and the fourth day after surgery,at discharge and 1 month after surgery(P < 0.05),group B and group C were superior to group A.There was no statistical difference between group B and group C on the second day and one month after surgery(P > 0.05).However,there were statistical differences on postoperative day 3,4 and discharge(P < 0.05),and the range of flexion of group B was better than that of group C.3.Comparison of visual analog scale(VAS)scores between the three groups before surgery and on the first,second and third day after surgery:(1)Comparison of resting pain among the three groups:There was no statistical difference between the three groups before surgery(P > 0.05),which was comparable.There was statistically significant difference on the second and third days after surgery(P < 0.05).Among them,Compared with group A,there was statistical significance between group B,group C(P < 0.05),the pain of group B and group C was less than group A;There was statistical difference between group B and group C(P < 0.05),and group C was superior to group B.(2)Comparison of exercise pain among three groups:There was no statistical difference between the three groups before surgery(P > 0.05),which was comparable.There were statistically significant differences on postoperative day 1,2 and 3(P < 0.05).Among them,Compared with group A,there was statistical difference between group B,group C(P <0.05),the exercise pain of group B and group C was less than that of group A;There was statistical difference between group B and group C(P < 0.05),and group C was superior to group B.4.Comparison of the diameter of the affected limbs(10cm above and bellow the patellar bone)of patients in the three groups at preoperative,postoperative day 3,postoperative day5,and discharge:there was no significant difference in the diameter of affected limbs(10cm above and bellow the patellar bone)of the three groups before the operation(P >0.05),which showed comparability.There were significant differences at postoperative day3,day 5 and discharge(P < 0.05).Among them,Compared with group A,there were statistical differences between group B,group C at postoperative day 3,day 5 and discharge(P < 0.05),group B and group C were superior to group A.There was no statistical difference between group B and group C on the third day after surgery(P >0.05),and there were also statistical differences on the fifth day after surgery and at discharge(P < 0.05),and group B was superior to group C.5.Comparison of postoperative hospitalization days and(HSS)score of knee joint function before operation,at discharge and 1 month after operation among the three groups:(1)There was significant difference in the length of hospital stay among the three groups(P < 0.05),Among them,there was statistical difference between group B,group C and group A(P < 0.05),and the postoperative hospital stay of group B and group C were shorter than that of group A.There was no significant difference between group B and group C(P > 0.05).(2)There was no statistical difference in HSS between the three groups before surgery(P > 0.05),which was comparable.There was significant difference in HSS among the three groups at discharge and 1 month after operation,and the HSS in group B was better than that in group A and group C.There was significant difference between group A and group C at discharge(P < 0.05),but there was no significant difference between the two groups at 1 month after operation(P > 0.05).Conclusions: Different rehabilitation training methods have different effects on rehabilitation after total knee arthroplasty.In improving the flexion range of motion of the knee joint and reducing the swelling of the affected limb,continuous passive uniform speed rehabilitation training is better than passive manual rehabilitation training and even better than routine rehabilitation training.In the aspect of relieving limb pain,passive manual rehabilitation training can adjust the training intensity in time according to the degree of pain,which is flexible,convenient and humanized;continuous passive uniform speed rehabilitation training is more mechanical and slightly weaker in early pain relief.however,the effect of long-term training on pain relief is better,and these two training methods are better than conventional rehabilitation training.Continuous passive uniform speed rehabilitation training and passive manual rehabilitation training can shorten the postoperative hospital stay and promote the early recovery of knee joint function. |
PDF Full Text Request