中国骨伤2025，Vol.38Issue(6)：594-600,7.DOI:10.12200/j.issn.1003-0034.20240471
类风湿关节炎患者全膝关节置换术后劳动功能康复情况分析
Analysis of labor function rehabilitation after total knee arthroplasty in patients with rheumatoid arthritis
摘要
Abstract
Objective To explore the functional rehabilitation of patients with rheumatoid arthritis(RA)after total knee arthroplasty(TKA).Methods A retrospective analysis was conducted on 101 patients who needed TKA due to rheumatoid arthritis(RA)involving both knees from January 2017 to December 2020,including 16 males and 85 females,aged from 41 to 65 years old with an average of(58.13±5.53)years old;body mass index(BMI)ranged from 16.88 to 33.33 kg·m-2 with an average of(23.16±3.49)kg·m-2;63 patients with grade 1,29 patients with grade 2,and 9 patients with grade 3 according to classification of American Society of Anesthesiologists(ASA).According to the latest follow-up results at 12 months after op-eration,82 patients returned to work and 19 patients did not return to work.Visual analogue scale(VAS)was used to evaluate the degree of pain relief before operation and 12 months after operation,and work,osteoarthritis and joint replacement ques-tionnaire(WORQ)was used to evaluate knee joint activity status of all patients before and after operation,and the working a-bility index was used to evaluate working ability of all patients before operation and 12 months after operation.For the 82 pa-tients who returned to work,the labor time stopped before operation and within 12 months after operation was compared,and the changes in labor grades,types of work and labor hours of patients before and after operation were recorded.For the 19 pa-tients who did not return to work,the specific reasons for their non-return to work was analyzed;the postoperative satisfaction of patients was evaluated by using Likert satisfaction scale.All patients were followed up for at least 12 months.VAS was de-creased from(6.49±0.59)before operation to(1.10±0.43)at 12 months after operation(P＜0.05);for WORQ questionnaire survey,scores of walking,sitting posture,standing and stair climbing were increased from(1.07±0.35),(1.05±0.29),(1.06±0.34)and(1.14±0.42)before operation to(3.00±0.00),(2.87±0.33),(2.95±0.21)and(2.95±0.21)after operation,respec-tively,had statistically significant(P＜0.05);the labor work index of all patients increased from 1.11±0.46 before operation to 2.99±0.10 at 12 months after operation,and the difference was statistically significant(P＜0.05).Among the 82 patients who returned to work after operation,regarding the time of stopping labor,81 patients stopped working within 3 months before oper-ation,1 patient stopped working for 4 to 6 months after operation,and the number of patients who stopped working was 81,1,and 0 respectively.Forty patients returned to work within 3 months after operation,4 to 6 months after operation for 29 pa-tients,and 12 months after operation for 13 patients.95.1％(78/82)of patients engaged in light labor before operation,and 85.4％(70/82)of patients engaged in moderate labor after operation.At 12 months after operation,the types of jobs and work-ing hours available to all patients increased compared with those before operation.Among 19 patients who did not return to work after TKA,7 patients had poor control of rheumatoid arthritis,5 patients still felt pain,swelling and numbness on knee joint,2 patients had retired,and 5 patients had other reasons.Eighty-six patients(85％)expressed great satisfaction with the postoperative working ability,8 patients(8％)expressed satisfaction with the postoperative working ability,6 patients(6％)expressed acceptance of postoperative working ability,and 1 patient(1％)expressed dissatisfaction with postoperative working ability.Conclusion TKA is an effective treatment option for patients with RA.After undergoing TKA,patients could signifi-cantly improve pain and functional activities of knee joint,and effectively enhance the quality of life and working ability.For patients whose rehabilitation labor capacity is not fully met,postoperative management and personalized rehabilitation treat-ment need to be strengthened to achieve the best rehabilitation effect.关键词
类风湿关节炎/膝关节/关节置换/功能康复/术后康复Key words
Rheumatoid arthritis/Knee joint/Joint arthroplasty/Functional rehabilitation/Postoperative reha-bilitation分类
医药卫生引用本文复制引用
柯彤,郝阳泉,王孟飞,闫宇衡,蔡元真,鲁超..类风湿关节炎患者全膝关节置换术后劳动功能康复情况分析[J].中国骨伤,2025,38(6):594-600,7.基金项目
陕西省重点研发计划(编号:2024SF-ZDCYL-04-12)Shaanxi Province Key Research and Development Plan(No.2024SF-ZDCYL-04-12) （编号:2024SF-ZDCYL-04-12）
