Rehabilitative intervention after total knee replacement / 中国组织工程研究

ABSTRACT

BACKGROUND: With the improvement of artificial joint materials, continuous consummation of prothesis design and the maturity of total knee replacement (TKR), excellent effects has been achieved in treatment of serious rheumatoid arthritis (RA) and osteoarthritis with TKR. At present, it is generally thought in China and abroad that staged rehabilitative treatment of step by step should be conducted as early as possible after TKR, which can promote the recovery of patient's knee joint function, and enable patients to freely care themselves so as to enhance their qualities of life.OBJECTIVE: To explain the rehabilitative treatment after TKR and relevant researches.DATA SOURCES A computer based search of Medline database for relevant articles from January 1998 to August 2005 were conducted with the key words of "total knee replacement, rehabilitation, therapy" and the language was limited to English. Meanwhile, Chinese journal full-text database and Wanfang database were retrieved for relevant Chinese papers from January 1990 to December 2004 with the key words of "total knee replacement, rehabilitation, therapy".STUDY SELECTION Data were checked in the first trial, accepting criteria①Items, procedures, process and announcements in the rehabilitative treatment after TKR. ② Retrospective investigations about specific cases. Exclusive criteria repetitive researches.DATA EXTRACTION A total of 37 literatures in accordance with above requirements were retrieved and 22 repetitive researches were excluded.Fifteen articles were in accordance with the inclusive criteria 3 were reviews about TKR and relevant rehabilitative treatment, 8 were clinical researches related to rehabilitative treatment after TKR, 4 were analyzing researches on relevant factors of rehabilitative treatment after TKR. Besides,there were 3 other relevant monographs.DATA SYNTHESIS: Rehabilitative treatment was extremely important to the clinical effects of TKR, which was the key reason why anticipated effects could be achieved after TKR. Exercise for power, training of motion of joint, proprioceptive sensation training and gait training were the most important contents of postoperative rehabilitation treatment. Comprehensive rehabilitative training was essential to maximum recovery of knee joint function including various agonistic muscle training plus extending and flexing power of knee joint; continuous passive training of motion of knee joint in early period plus motion of joint; proprioceptive sensation training in amelioration of motor controllability, postural rectification and balance-keep capability and gait training in correction of abnormal gait.CONCLUSION: Staged rehabilitative treatment of step by step after TKR should be conducted as early as possible, which is absolutely important to exercise for power, training of motion of joint, proprioceptive sensation training, gait training and promotion of functional recovery of knee joints in patients.