Effects of a preoperative simplified home rehabilitation education program on length of stay of total knee arthroplasty patients
Effects of a preoperative simplified home rehabilitation education program on length of stay of total knee arthroplasty patients
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DOI：
10.1016/j.otsr.2011.12.004
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发表时间：
2012-05-01
影响因子：
2.3
通讯作者：
Chou, Y. -H.
中科院分区：
文献类型：
--
作者：
Huang, S. -W.;Chen, P. -H.;Chou, Y. -H.
在严重膝关节骨关节炎(OA)患者中，进行全膝关节置换术(TKA)既是为了缓解症状，又是为了获得更好的日常生活功能。实施有效的全膝关节置换术康复计划，缩短住院时间，减少医疗费用，是临床实践中的一个重要问题。然而，术前康复计划的有效性仍在争论中。大多数术前康复计划持续数周，可能比TKA更昂贵。目的：探讨简化、易学、省时的康复教育方案对人工全膝关节置换术患者的影响。研究组包括126名患者，在TKA前4周参加了40分钟的家庭康复教育计划。结果：研究组住院天数较短(平均7.12d，P=0.027)，住院相关医疗费用较少(平均123726新台币，相当于4266.4美元或3022.1欧元)，(P=0.001)。然而，与对照组相比，研究组在功能上没有明显的改善。讨论：我们的研究表明，简化的术前康复计划可以减少LOS并增加成本节约。该方案被推荐为全膝关节置换术前骨性关节炎患者的常规治疗方案。证据水平：II级。前瞻性随机研究。(C)2012年爱思唯尔·马森公司。版权所有。
In patients with severe knee osteoarthritis (OA), total knee arthroplasty (TKA) is performed for both symptom relief and to achieve better function in daily life. Implementation of efficient TKA rehabilitation programs with shorter length of stay (LOS) and reduced medical expenditures is an important issue in clinical practice. However, the effectiveness of preoperative rehabilitation programs is still under debate. Most preoperative rehabilitation programs last many weeks and may be more expensive than TKA. The purpose of this study was to investigate the effects of a simplified, easy-to-learn, and less time-consuming preoperative rehabilitation education program on TKA patients.Patients and methods: In this randomized controlled study, we allocated all the patients into study and control group according to chart number. The study group, which comprised 126 patients, participated in a 40-min preoperative home rehabilitation education program 4 weeks prior to TKA. One hundred seventeen patients in the control group did not participate in this preoperative program.Results: The study group required a shorter hospital LOS (mean: 7.12 days; P = 0.027) and had less hospitalization-related medical expenditures (mean: 123726 New Taiwan dollars [NTD], equivalent to 4266.4 United States dollars [USD] or 3022.1 [Euros]), (P = 0.001) than the control group. However, the study group showed no significant improvement in function when compared to the control group.Discussion: Our study demonstrates that a simplified preoperative rehabilitation program can reduce LOS and increase cost savings. This program was recommended as a routine protocol for OA patients before admission for TKA. Level of evidence: Level II. Prospective randomized study. (c) 2012 Elsevier Masson SAS. All rights reserved.