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髋关节置换术后康复的结果:一项单中心队列研究的结果

The Outcome of Post-Surgical Hip Prosthesis Rehabilitation: Results from a Monocentric Cohort Study.

作者信息

Garifi Maria Chiara, Cartocci Alessandra, Guarducci Giovanni, Praino Francesco, Sanguineti Ileana, Cristiani Simone, Gentile Anna Maria, Nante Nicola

机构信息

Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy.

Department of Medical Sciences, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy.

出版信息

J Clin Med. 2025 Feb 14;14(4):1276. doi: 10.3390/jcm14041276.

Abstract

: With the increase in life expectancy, more patients are undergoing total hip arthroplasty, primarily due to the rising incidence of osteoarthritis. The outcomes of rehabilitation following these surgical interventions are influenced by various factors. This study aims to explore the impact of age, gender, and body mass index (BMI) on pain and functional and rehabilitative outcomes after surgical hip prosthesis rehabilitation. : We enrolled all patients admitted to a private clinic from January 2021 to December 2023 for rehabilitation after unilateral hip arthroplasty. For each patient, we collected data of Barthel Index, Tinetti Scale, Numeric Rating Scale (NRS), and range of motion (ROM) at the beginning and end of the hospitalization. We assessed whether the evaluated outcomes differed based on gender, age, and BMI using the Mann-Whitney and Kruskal-Wallis tests. : A total of 2.167 patients were studied (56% female and 36.5% over 75 years old). Male patients, adults (18-64 years), and those with a BMI < 30 showed higher values of Barthel Index, Tinetti Scale, and ROM at both admission and discharge ( < 0.05), along with significantly lower NRS scores. Each subgroup based on age, gender, and BMI showed an improvement in NRS (difference between admission and discharge) of at least 40%, it was about 50% for men and adults. The improvement in ROM (difference between admission and discharge) was more than 10% in both active and passive flexion, around 20% for passive abduction, and 50% for active abduction, with no significant differences based on age, gender, or BMI. : Despite the absence of specific contraindications for arthroplasty procedures, a high BMI, age over 75 years, and female gender are associated with slightly worse functional and rehabilitation outcomes compared to other patients undergoing the same procedures. A preoperative screening for the evaluation of osteopenia, osteoporosis, and BMI could be a valuable tool for studying and improving outcomes in these patients.

摘要

随着预期寿命的增加,越来越多的患者正在接受全髋关节置换术,主要原因是骨关节炎的发病率不断上升。这些手术干预后的康复结果受到多种因素的影响。本研究旨在探讨年龄、性别和体重指数(BMI)对髋关节假体置换术后疼痛、功能及康复结果的影响。

我们纳入了2021年1月至2023年12月在一家私人诊所接受单侧髋关节置换术后康复治疗的所有患者。对于每位患者,我们收集了住院开始和结束时的Barthel指数、Tinetti量表、数字评分量表(NRS)和关节活动范围(ROM)的数据。我们使用Mann-Whitney检验和Kruskal-Wallis检验评估评估结果是否因性别、年龄和BMI而有所不同。

共研究了2167例患者(56%为女性,36.5%年龄超过75岁)。男性患者、成年人(18 - 64岁)以及BMI < 30的患者在入院和出院时的Barthel指数、Tinetti量表和ROM值均较高(P < 0.05),同时NRS评分显著较低。基于年龄、性别和BMI的每个亚组的NRS(入院和出院之间的差异)改善至少40%,男性和成年人约为50%。ROM(入院和出院之间的差异)在主动和被动屈曲方面均超过10%,被动外展约为20%,主动外展为50%,且在年龄、性别或BMI方面无显著差异。

尽管关节置换手术没有特定的禁忌证,但与接受相同手术的其他患者相比,高BMI、75岁以上年龄和女性性别与功能和康复结果稍差有关。术前对骨质减少、骨质疏松和BMI进行筛查可能是研究和改善这些患者预后的有价值工具。

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