Применение различных реабилитационных мероприятий в восстановительном лечении больных с имплантатом тазобедренного сустава (собственные данные и обзор литературы)

S.V Kolesnikov,E.S Komarova,G.V Diachkova

doi:10.18019/1028-4427-2020-26-2-254-260

Abstract

Introduction Total hip arthroplasty (THA) is one of the most successful orthopedic procedures performed today. Rates of THA have been steadily increasing over the past several decades with increasing number of patients who need proper effective rehabilitation therapy after orthopaedic surgery. Evaluation and introduction of new rehabilitation techniques is crucial for patients undergoing replacement of major joints. Objective Review the literature and our own findings with various rehabilitation programs used for THA patients to aid recovery following surgery at a short and long term. Material and methods The study included 57 THA patients referred to rehabilitation department of the Kurgan Ilizarov Center to help manage pain at different terms following surgery. The sample was divided into main (n = 29) and control (n = 28) groups. Post-isometric relaxation techniques were included in rehabilitation program of the main group. Clinical outcomes were evaluated with VAS, the Lequesne Index, McGill Pain Questionnaire, WOMAC, and Harris Hip Score. Results Outcome measures showed 1.5 times improvement in controls with high statistical significance (p > 0.01) and 3.3 times improvement in patients who received post-isometric relaxation therapy with greater significance level (p > 0.001). Conclusion The findings suggest that post-isometric relaxation techniques applied as a part of restorative treatment facilitate improved outcomes of rehabilitation. The optimal rehabilitation protocols have been shown to be largely unknown for THA patients.

Highlights

In Russia during 90-es of the last century joint arthroplasties were performed in leading orthopaedic hospitals and have evolved into one of the most common orthopaedic procedures [1]
No statistically significant differences in baseline were noted to change with decreased pain intensity that measurements of orthopaedoc status were revealed resulted in improved quality of life
Following rehabilitation with Post-isometric relaxation (PIR) techniques in PIR techniques provided for patients of the the main group with the high significance level at main group resulted in a 2.2 times increase in their p < 0.001

Summary

Introduction

In Russia during 90-es of the last century joint arthroplasties were performed in leading orthopaedic hospitals and have evolved into one of the most common orthopaedic procedures [1]. Di Monaco et al (2009) suggest that total hip arthroplasty (THA) has revolutionized the care of patients with end-stage joint disease, leading to pain relief, functional recovery, and substantial improvement in quality of life [2]. Arthroplasty provides radical rehabilitation for severely damaged joints of lower limbs improving functional mobility and relieving pain [5]. Inpatient-based rehabilitation following orthopaedic surgery cannot be provided for THA patients in many hospitals for organizational reasons, and the surgeons have to rely rather on terms of ambulation accepted in a particular medical institution than functionality of the patients. Due to the circumstances home-based programs are unmonitored with rehabilitation resources to be inappropriately used and underestimated by surgeons. These considerations remain problematic in rehabilitation of patients after arthroplasties [11].

Methods

Results

Conclusion