改变以运动为基础的术前康复的说法:与患者讨论是否需要进行全膝关节置换术时的循证决策和共同决策

Thomas Bandholm , Rasmus Skov Husted , Anders Troelsen , Kristian Thorborg
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引用次数: 0

摘要

摘要:本综述讨论了在全膝关节置换术(TKA)的临床决策过程中使用运动的情况。它综合了有关运动前康复的研究数据,包括患者选择、实施及其对手术选择的影响。结果有证据表明,术前评估运动可以改善症状管理,并可推迟或减少手术干预。结论 膝关节骨性关节炎的术前评估运动是一种可行的策略,通过促进符合指南的手术决策,补充了现有的 ERAS 计划。将其纳入手术前护理路径可促进患者相关结果的改善和医疗资源的优化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changing the narrative for exercise-based prehabilitation: Evidence-informed and shared decision making when discussing the need for a total knee arthroplasty with patients

Objective

To examine a novel application of exercise-based prehabilitation in severe knee osteoarthritis—termed “pre-evaluation exercise"—focused on supporting surgical decision-making and adherence to clinical guidelines, rather than attempting to enhance post-operative recovery.

Design

This narrative review discusses the usage of exercise in the clinical decision process for total knee arthroplasty (TKA). It synthesizes data from studies on exercise-based prehabilitation, covering patient selection, implementation, and its effects on surgical choices. Emphasis is placed on multi-disciplinary coordination within an Enhanced Recovery After Surgery (ERAS) framework.

Results

Evidence suggests that pre-evaluation exercise can improve symptom management and may lead to delayed or reduced surgical intervention. This approach shows significant potential in reducing the rate of TKA surgeries among patients with severe knee osteoarthritis by improving physical conditioning, addressing symptom variability, and enhancing informed, patient-centered surgical decisions.

Conclusions

Pre-evaluation exercise in knee osteoarthritis is a viable strategy that complements existing ERAS initiatives by facilitating guideline-conformant surgical decision-making. Incorporating this into pre-surgical care pathways can foster improved patient-related outcomes and healthcare resource optimization.
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来源期刊
Osteoarthritis and cartilage open
Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation
CiteScore
3.30
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0.00%
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