單側全膝關節置換術後與身體功能恢復之相關因素探討

Factors Associated with the Recovery of Physical Function After Unilateral Total Knee Arthroplasty

陳伊伶(Yi-Ling Chen) ； 楊燦(Tsan Yang)

《澄清醫護管理雜誌》 17卷1期 (2021/01) Pp. 17-26

摘要

目的：本研究主要探討中老年骨關節炎患者行單側全膝關節置換術後，影響身體功能恢復之相關因素。方法：採橫斷式研究，於2018年9月10日至2019年3月31日南部某地區醫院骨科病房，共收集101位行單側全膝關節置換術個案。術前與術後評估日常生活功能量表（ADL）、疼痛視覺類比量表（VAS）、自填西安大略及麥可麥司特大學關節炎問卷（WOMAC）。結果：年齡、手術麻醉方式、術後下床活動次數、術前疼痛分數、術前執行日常生活功能五者為術後身體功能恢復之重要預測因子（F=11.791, p＜0.001），可解釋總變異量的56.4％。結論：術後住院期間若多處於臥床，未下床活動，易延長膝關節功能恢復時間，建議在住院期間固定時間給予止痛劑，對膝關節恢復有顯著關係；術後鼓勵下床並增加活動次數，可促進膝關節功能穩定與增加股四頭肌肌肉力量，進而提升手術後身體功能恢復。本研究結果可做為行單側全膝關節置換術患者促進術後恢復之臨床照護參考。

關鍵字

骨關節炎 ； 全膝關節置換術 ； 恢復 ； 身體功能

並列摘要

Purposes: To identify the factors that influence the recovery of physical function after unilateral total knee arthroplasty (TKA) in middle-aged and elderly patients with osteoarthritis. Methods: A cross-sectional study design was adopted, and 101 patients who underwent unilateral TKA between September 10, 2018, and March 31, 2019, were recruited from the orthopedics ward of a regional hospital in South Taiwan as the subjects of this study. The patients were assessed preoperatively and postoperatively using the activities of daily living scale, visual analogue scale (VAS), and self-administered Western Ontario and McMaster Universities Osteoarthritis questionnaire. Results: Patient age, anesthetic technique, frequency of postoperative ambulatory activity, preoperative VAS score, and preoperative ability to perform activities of daily living were identified as important predictors of postoperative recovery of physical function (F=11.791, p＜0.001) and explained 56.4% of the total variance. Conclusions: Bed rest for long periods with little engagement in ambulatory activities during postoperative hospitalization led to a higher tendency of prolonged knee function recovery time. Therefore, regular administration of analgesics during hospitalization is recommended, as it is significantly correlated with knee joint recovery. Engaging in ambulation and increased frequency of postoperative ambulatory activity are also recommended to promote the stabilization of knee function and increase quadriceps muscle strength, which will consequently enhance the postoperative recovery of physical function. The results of this study can serve as a reference for the provision of clinical care during the postoperative recovery period of patients after undergoing unilateral TKA.

並列關鍵字

Osteoarthritis ； Total knee arthroplasty ； Recovery ； Physical function