Early full weight-bearing and gait exercise after cemented total ankle arthroplasty with a modified anterolateral approach.

IF 1.8 4区 医学 Q3 RHEUMATOLOGY
Manabu Sakata, Makoto Hirao, Takaaki Noguchi, Gensuke Okamura, Yusei Higuchi, Yuki Tabuse, Yuki Etani, Kosuke Ebina, Hideki Tsuboi, Akira Miyama, Koichiro Takahi, Kenji Takami, Shigeyoshi Tsuji, Seiji Okada, Jun Hashimoto
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引用次数: 0

Abstract

Objectives: According to the conventional postoperative procedure after total ankle arthroplasty (TAA), mobilization and weight-bearing is currently started after completion of wound healing. Recently, early mobilization for dorsiflexion after TAA with modified antero-lateral approach was reported to be feasible and safe. To investigate the further possibility of expediting rehabilitation, this study evaluated the feasibility and safety of early full weight-bearing and gait exercise after cemented TAA.

Materials and methods: This retrospective, observational study investigated 23 consecutive ankles (OA: 14 ankles, RA: 9 ankles) that had received cemented TAA with a modified antero-lateral approach. These ankles were divided into three groups 1. conventional postoperative protocol, 2. early dorsiflexion protocol, 3. early dorsiflexion+full weight-bearing protocol. Postoperative wound complications were observed and recorded. Number of days for hospitalization was also evaluated.

Results: No postoperative complications related to wound healing were observed even after early full weight-bearing and gait exercise. Days for hospitalization was significantly shortened in early full weight-bearing and gait exercise group (group 3) from 35-38 days to 24 days.

Conclusions: Within this small number of cases, early full weight-bearing and gait exercise from 7 days after cemented TAA was feasible and safe with the modified antero-lateral approach. Combination of early dorsiflexion mobilization and weight-bearing/gait exercise contributed to shortening the hospitalization day. Innovations in postoperative procedures for rehabilitation after TAA can be expected.

采用改良前外侧入路的骨水泥全踝关节置换术后早期完全负重和步态锻炼。
背景:根据针对终末期骨关节炎(OA)和类风湿性关节炎(RA)的全踝关节置换术(TAA)的常规术后程序,目前是在伤口愈合完成后开始活动和负重。最近有报道称,采用改良的前外侧入路进行 TAA 术后早期背伸活动是可行且安全的。为了进一步探究加快康复的可能性,本研究评估了采用改良前外侧入路的骨水泥TAA术后早期完全负重和步态锻炼的可行性和安全性:这项回顾性、观察性研究调查了 23 个连续接受了改良前外侧入路骨水泥固定 TAA 的脚踝(OA:14 个脚踝,RA:9 个脚踝)。这些脚踝被分为三组[1.常规术后方案:8 个脚踝,2:早期背屈+完全负重方案:7 个脚踝;3:8 个脚踝]。在第三组中,在早期背屈活动后(第3天),从术后7天开始进行完全负重/步态锻炼(如果增加了踝骨截骨术,则从术后10天开始)。对术后伤口并发症进行观察和记录。还对住院天数进行了评估。测量背屈/跖屈的活动范围(ROM)。患者还在术前和最后随访时填写了自制的足部评估问卷(SAFE-Q)和日本足外科协会(JSSF)踝关节/后足评分量表:结果:即使在早期完全负重和步态锻炼后,也未观察到与伤口愈合有关的术后并发症。早期完全负重和步态锻炼组(第3组)的住院天数从35-38天明显缩短至24天。第 3 组的背屈和跖屈的 ROM 均明显增加,此外,第 3 组的 SAFE-Q 评分的所有指标也有更明显的改善。所有组别在 TAA 后的 JSSF 评分均有明显改善:结论:在少数病例中,采用改良的前外侧方法,在骨水泥固定的 TAA 术后 7 天开始进行早期完全负重和步态锻炼是可行且安全的。早期背屈活动和负重/步态锻炼相结合,有助于缩短住院日,改善术后背屈和跖屈的ROM。TAA术后康复程序的创新值得期待。
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来源期刊
Modern Rheumatology
Modern Rheumatology RHEUMATOLOGY-
CiteScore
4.90
自引率
9.10%
发文量
146
审稿时长
1.5 months
期刊介绍: Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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