人工股関節全置換術における手術当日リハビリテーション介入は有効か―早期機能回復への影響

Accelerated Rehabilitation Starting on the Surgery Day of Total Hip Arthroplasty : Accelerated Rehabilitation Effective in Accelerating Recovery?

　目的：術当日のリハビリテーション(以下，リハ)実施が術後の機能回復に対して有効であるかを検証した．

　対象と方法：mini-one antero-lateral incision法で人工股関節全置換術を施行した女性変形性股関節症患者148例を対象とした．術当日リハを行った当日群74例と，術翌日からリハを開始した翌日群74例とで比較した．

　結果：当日群は有意に高齢であったが，術後1～4日目までの外転筋力が有意に高値であった．また，C反応性蛋白は両群で差がなく，術当日リハは炎症症状を助長しないことが示唆された．

　まとめ：本研究の結果から，術当日にリハを実施することは高齢であっても円滑な機能回復を可能とし，安全に壮年者と同じプロトコルの適用を可能とすることが示唆された．

　Purpose：The purpose of this study was to assess the efficacy of starting accelerated rehabilitation on the day of surgery.

　Methods：This prospective study enrolled 148 osteoarthritis patients who were scheduled for total hip arthroplasty(THA).　The patients were divided into two groups according to the postoperative rehabilitation schedule：an accelerated rehabilitation group, in which rehabilitation was started on the day of surgery, and a control group in which rehabilitation was started on postoperative day (POD) 1.

　Results：The patients in the accelerated group were older, and their isometric hip abductor strength on PODs 1 to 4 was significantly greater different.　There were no significant differences between the two groups in serum C-reactive protein or other laboratory test values.

　Conclusion：The results of this study suggested that accelerated rehabilitation starting on the day of surgery was effective in accelerating recovery of the lower limb function of elderly patients.　Starting rehabilitation on the day of surgery led to earlier recovery and discharge of elderly patients after THA.