Evaluation of the effect of early total weight-bearing training after cementless total hip arthroplasty

doi:10.3969/j.issn.2095-4344.1196

Abstract

Abstract:

BACKGROUND: There is no consensus on the way of weight-bearing after total hip arthroplasty, and early weight-bearing exercise in clinical practice still remains controversial.

OBJECTIVE: To investigate the clinical efficacy of applying enhanced recovery after surgery in guiding early weight-bearing exercises after cementless total hip arthroplasty.

METHODS: One hundred patients undergoing cementless total hip arthroplasty for femoral neck fractures at Department of Orthopedics, Tianjin Hospital from March 2016 to April 2017 were enrolled, and were then randomized into two groups (n=50/group). The trial group received early weight-bearing exercise with the concept of enhanced recovery after surgery, and control group was given weight-bearing exercise at 3 weeks with the traditional rehabilitation concept. Informed consents were obtained from all patients, and the trial was approved by the Ethics Committee of Tianjin Hospital.

RESULTS AND CONCLUSION: (1) All patients were followed up for 18 months. (2) The Visual Analog Scale score in the trial group was significantly lower than that in the control group at 3 days, 2 weeks and 3 months after operation (P < 0.05). (3) Hip range of motion in the trail group was significantly superior to the control group at postoperative 3 months (P < 0.05). (4) The Harris hip score in the trial group was significantly superior to the control group at 6 months, 1 and 1.5 years postoperatively (P < 0.05). (5) At postoperative 1.5 years, the SF-36 score showed that the physiological function and bodily pain in the trial group were significantly superior to the control group (P < 0.05). (6) X-ray measurements was performed at 1.5 years postoperatively, and there was no significant difference in the incidence of femoral prosthesis subsidence (P=0.117). (7) The incidence of postoperative complications in the trial group (18%) was significantly lower than that in the control group (38%) (P=0.022). The incidences of nausea and vomiting and venous thrombosis perioperatively, and postoperative anxiety in the trial group were significantly lower than those in the control group (P < 0.05). (8) In summary, the application of enhanced recovery after surgery combined with early weight-bearing exercises in cementless total hip arthroplasty can achieve a good clinical effect, and will not cause prosthesis loosening.

Key words: enhanced recovery after surgery, cementless prosthesis, total hip arthroplasty, early weight-bearing exercises, range of motion of knee joint, Harris score

CLC Number:

R459.9

Wu Weiyong, Xu Weiguo. Evaluation of the effect of early total weight-bearing training after cementless total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(18): 2827-2832.

Figures/Tables 6

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