Observation of the clinical effect of preoperative exercise intervention on posterior lateral approach total hip replacement_West China Medical Journal

Authors：

YI Jiang ,  LIU Zhongliang , WEI Yanlong , LIU Hong

Department of Rehabilitation, the Second Hospital of Jilin University, Changchun, Jilin 130041, P. R. China;

Corresponding author：

LIU Zhongliang, Email: lzltim@163.com

Keywords：

Preoperative exercise intervention; Rehabilitation training; Total hip replacement

DOI：

10.7507/1002-0179.201806051

Video：

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Objective To investigate and explore the clinical effect of preoperative exercise intervention on total hip arthroplasty. Methods Seventy-three patients who underwent primary unilateral total hip replacement (THR) in the Orthopedics Department, the Second Hospital of Jilin University between March 2017 and January 2018 were divided into 2 groups: treatment group (n=37) and control group (n=36). Patients in treatment group received exercise intervention and routine education since 4 weeks before surgery; the control group just received routine education before surgery and both groups underwent the same routine rehabilitation training. The Visual Analogue Scale (VAS) was evaluated and compared separately between the two groups at 4 weeks before surgery (T₀), 1 day before surgery (T₁), before discharge (T₂), 1 month after discharge (T₃), and 3 months after discharge (T₄). The results of Hip Harris score and Time Up and Go test (TUG) were evaluated and compared separately between the two groups at T₀, T₁, T₃ and T₄. Results Time of TUG of the treatment group and the control group at T₁, T₃ and T₄ were (14.59±3.15) vs. (16.31±3.31) s, (13.61±2.76)vs. (15.25±3.08) s, (12.49±2.37)vs. (14.22±2.65) s, respectively, and the differences between the two groups at T₁, T₃ and T₄ were all statistically significant (P<0.05). In terms of VAS and Harris scores, both groups showed significant improvement after surgery at different time nodes (P<0.05), but the differences between the two groups was not statistically significant (P>0.05). Conclusion Preoperative exercise intervention can effectively improve the walking ability of THR patients and reduce the risk of falls after discharge, but it did not reduce postoperative pain or improve postoperative hip Harris score after discharge.

Citation： YI Jiang, LIU Zhongliang, WEI Yanlong, LIU Hong. Observation of the clinical effect of preoperative exercise intervention on posterior lateral approach total hip replacement. West China Medical Journal, 2018, 33(10): 1242-1246. doi: 10.7507/1002-0179.201806051 Copy

1.	Felson DT, Lawrence RC, Hochberg MC, et al. Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med, 2000, 133(9): 726-737.
2.	Masonis JL, Bourne RB. Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res, 2002(405): 46-53.
3.	施培华, 赵凯. 全髋关节置换及其康复治疗. 中国矫形外科杂志, 1998, 5(4): 313-314.
4.	Shan L, Shan B, Suzuki A, et al. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am, 2015, 97(2): 156-168.
5.	何梅, 陈晓莉. 康复训练对全髋关节置换术后康复效果的系统评价. 中国康复医学杂志, 2017, 32(1): 71-77.
6.	Ackerman IN, Bennell KL. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review. Aust J Physiother, 2004, 50(1): 25-30.
7.	陆芸, 周谋望, 李世民, 等. 骨科术后康复指南. 天津: 天津翻译出版社, 2009: 7-11.
8.	李强, 罗先正, 王志义, 等. 人工髋关节置换术后评估方法的研究. 中华骨科杂志, 2001, 21(12): 725.
9.	Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the " get-up and go” test. Arch Phys Med Rehabil, 1986, 67(6): 387-389.
10.	Wright AA, Cook CE, Baxter GD, et al. A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis. J Orthop Sports Phys Ther, 2011, 41(5): 319-327.
11.	Rydwik E, Bergland A, Forséén L, et al. Psychometric properties of timed up and go in elderly people: a systematic review. Phys Occup Ther Geriatr, 2011, 29(2): 102-125.
12.	Rose DJ, Jones CJ, Lucchese N. Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: a new measure of functional mobility. JAPA, 2002, 10(4): 466-475.
13.	林国联. 早期规范化康复治疗在髋关节置换术中的应用价值. 广州医学院学报, 2016, 44(3): 98-99.
14.	Oosting E, Jans MP, Dronkers JJ, et al. Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. Arch Phys Med Rehabil, 2012, 93(4): 610-616.
15.	Vukomanović A, Popović Z, Durović A, et al. The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty. Vojnosanit Pregl, 2008, 65(4): 291-297.
16.	Chang CF, Lin KC, Chen WM, et al. Effects of a home-based resistance training program on recovery from total hip replacement surgery: feasibility and pilot testing. J Nurs Res, 2017, 25(1): 21-30.
17.	Gill SD, Mcburney H. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil, 2013, 94(1): 164-176.
18.	Wang L, Lee M, Zhang Z, et al. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open, 2016, 6(2): e009857.
19.	Garbuz DS, Xu M, Duncan CP, et al. Delays worsen quality of life outcome of primary total hip arthroplasty. Clin Orthop Relat Res, 2006(447): 79-84.
20.	Hochman JR, Gagliese L, Davis AM, et al. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage, 2011, 19(6): 647-654.
21.	Dimitroulas T, Duarte RV, Behura A, et al. Neuropathic pain in osteoarthritis: a review of pathophysiological mechanisms and implications for treatment. Semin Arthritis Rheum, 2014, 44(2): 145-154.
22.	Lluch E, Torres R, Nijs J, et al. Evidence for central sensitization in patients with osteoarthritis pain: a systematic literature review. Eur J Pain, 2014, 18(10): 1367-1375.
23.	刘小立. 骨关节炎神经病理性疼痛诊疗概述. 中国新药杂志, 2015, 24(18): 2073-2076.
24.	McDonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev, 2014(5): CD003526.
25.	Jordan RW, Smith NA, Chahal GS, et al. Enhanced education and physiotherapy before knee replacement; is it worth it? A systematic review. Physiotherapy, 2014, 100(4): 305-312.
26.	Smith MD, Mccall J, Plank L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev, 2014(8): CD009161.
27.	Su EP, Perna M, Boettner F, et al. A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. J Bone Joint Surg Br, 2012, 94(11 Suppl A): 153-156.
28.	Gocen Z, Sen A, Unver B, et al. The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil, 2004, 18(4): 353-358.
29.	吕汐妍, 王跃, 谭波. 人工全髋关节置换术前康复干预对术后早期关节功能恢复的影响. 中国修复重建外科杂志, 2013, 27(6): 653-656.

1. Felson DT, Lawrence RC, Hochberg MC, et al. Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med, 2000, 133(9): 726-737.
2. Masonis JL, Bourne RB. Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res, 2002(405): 46-53.
3. 施培华, 赵凯. 全髋关节置换及其康复治疗. 中国矫形外科杂志, 1998, 5(4): 313-314.
4. Shan L, Shan B, Suzuki A, et al. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am, 2015, 97(2): 156-168.
5. 何梅, 陈晓莉. 康复训练对全髋关节置换术后康复效果的系统评价. 中国康复医学杂志, 2017, 32(1): 71-77.
6. Ackerman IN, Bennell KL. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review. Aust J Physiother, 2004, 50(1): 25-30.
7. 陆芸, 周谋望, 李世民, 等. 骨科术后康复指南. 天津: 天津翻译出版社, 2009: 7-11.
8. 李强, 罗先正, 王志义, 等. 人工髋关节置换术后评估方法的研究. 中华骨科杂志, 2001, 21(12): 725.
9. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the " get-up and go” test. Arch Phys Med Rehabil, 1986, 67(6): 387-389.
10. Wright AA, Cook CE, Baxter GD, et al. A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis. J Orthop Sports Phys Ther, 2011, 41(5): 319-327.
11. Rydwik E, Bergland A, Forséén L, et al. Psychometric properties of timed up and go in elderly people: a systematic review. Phys Occup Ther Geriatr, 2011, 29(2): 102-125.
12. Rose DJ, Jones CJ, Lucchese N. Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: a new measure of functional mobility. JAPA, 2002, 10(4): 466-475.
13. 林国联. 早期规范化康复治疗在髋关节置换术中的应用价值. 广州医学院学报, 2016, 44(3): 98-99.
14. Oosting E, Jans MP, Dronkers JJ, et al. Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. Arch Phys Med Rehabil, 2012, 93(4): 610-616.
15. Vukomanović A, Popović Z, Durović A, et al. The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty. Vojnosanit Pregl, 2008, 65(4): 291-297.
16. Chang CF, Lin KC, Chen WM, et al. Effects of a home-based resistance training program on recovery from total hip replacement surgery: feasibility and pilot testing. J Nurs Res, 2017, 25(1): 21-30.
17. Gill SD, Mcburney H. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil, 2013, 94(1): 164-176.
18. Wang L, Lee M, Zhang Z, et al. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open, 2016, 6(2): e009857.
19. Garbuz DS, Xu M, Duncan CP, et al. Delays worsen quality of life outcome of primary total hip arthroplasty. Clin Orthop Relat Res, 2006(447): 79-84.
20. Hochman JR, Gagliese L, Davis AM, et al. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage, 2011, 19(6): 647-654.
21. Dimitroulas T, Duarte RV, Behura A, et al. Neuropathic pain in osteoarthritis: a review of pathophysiological mechanisms and implications for treatment. Semin Arthritis Rheum, 2014, 44(2): 145-154.
22. Lluch E, Torres R, Nijs J, et al. Evidence for central sensitization in patients with osteoarthritis pain: a systematic literature review. Eur J Pain, 2014, 18(10): 1367-1375.
23. 刘小立. 骨关节炎神经病理性疼痛诊疗概述. 中国新药杂志, 2015, 24(18): 2073-2076.
24. McDonald S, Page MJ, Beringer K, et al. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev, 2014(5): CD003526.
25. Jordan RW, Smith NA, Chahal GS, et al. Enhanced education and physiotherapy before knee replacement; is it worth it? A systematic review. Physiotherapy, 2014, 100(4): 305-312.
26. Smith MD, Mccall J, Plank L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev, 2014(8): CD009161.
27. Su EP, Perna M, Boettner F, et al. A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. J Bone Joint Surg Br, 2012, 94(11 Suppl A): 153-156.
28. Gocen Z, Sen A, Unver B, et al. The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil, 2004, 18(4): 353-358.
29. 吕汐妍, 王跃, 谭波. 人工全髋关节置换术前康复干预对术后早期关节功能恢复的影响. 中国修复重建外科杂志, 2013, 27(6): 653-656.

West China Medical Journal

Observation of the clinical effect of preoperative exercise intervention on posterior lateral approach total hip replacement

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