胫骨高位截骨后康复功能锻炼的系统综述  

Rehabilitation and functional exercises after high tibial osteotomy: a systematic review

作　　者：刘爱峰[1] 马信龙[2] 马剑雄[2] 巩树伟 余伟杰 靳博 LIU Ai-feng;MA Xin-long;MA Jian-xiong;GONG Shu-wei;YU Wei-jie;JIN Bo(Department of Orthopedics and Traumatology,The First Affiliated Hospital,Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;Institute of Orthopedics,Tianjin Hospital,Tianjin 300050,China;Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学第一附属医院骨伤科,天津300381 [2]天津市天津医院骨科研究所,天津300050 [3]天津中医药大学,天津300193

出　　处：《中国矫形外科杂志》2021年第18期1668-1672,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81873316);国家自然科学基金项目(编号:81673994);国家自然科学基金项目(编号:81102607);天津市企业博士后创新项目。

摘　　要：[目的]比较和分析胫骨高位截骨(high tibial osteotomy, HTO)术后不同时间段康复功能锻炼的最佳选择,为"保膝"理念和HTO手术推广提供借鉴和指导依据。[方法]计算机检索PubMed、万方数据库、知网数据库中2008—2020年出版的"高位胫骨截骨,功能锻炼,康复,膝骨性关节炎"相关文章,按纳入标准进行人工筛选纳入符合标准的文献。[结果]共纳入30篇文献。结果显示HTO手术方式可以有效缓解膝关节疼痛,矫正骨关节炎引起的肢体畸形,恢复关节活动度。相比于人工关节置换术,HTO适应证较为宽泛,更适用于年轻患者。HTO术后康复功能锻炼应体现分阶段、早活动的原则,从肌力训练、关节活动度训练和有氧运动出发,将阶梯化康复治疗方案应用到术后康复的每一阶段。术后各项康复运动的具体开展时间文献未达到完全统一,仍需要在今后临床中深入讨论并实践。[结论] HTO术后康复功能锻炼应遵循分阶段早活动的原则。早期主要进行肌力练习,增加关节活动,后期着重于改善功能。[Objective] To search and analyze the optimal options for rehabilitation and functional exercises at different time periods after high tibial osteotomy(HTO), and to provide reference and guidance for the concept of "knee protection" and the promotion of HTO surgery. [Methods] Articles related to "high tibial osteotomy, functional exercise, rehabilitation, knee osteoarthritis" published from 2008 to 2020 were searched in PubMed, Wanfang database, and CNKI database by using a computer, and then the literatures were manually screened according to the inclusion criteria and those in compliance with the criteria were enrolled. [Results] A total of 30 articles were included. The HTO does effectively relieve knee joint pain, correct limb deformities caused by osteoarthritis, and restore joint mobility. Compared with joint arthroplasty, the HTO has broader indications, especially suitable for young patients. Rehabilitation and functional exercises after HTO should follow the principle of stage by stage, and early active motion. Starting from muscle strength training, joint mobility training and aerobic exercise, the stepped rehabilitation treatment plan should be applied to each stage of postoperative rehabilitation. The specific development time of the various rehabilitation exercises after the operation has not been completely unified, and it still needs to be discussed and practiced in depth in the future. [Conclusion] Rehabilitation and functional exercises after HTO should follow the principle of stage by stage, and early active motion. In the early stage, muscle strength exercises are mainly used to increase joint activity, later, the focus is on improving function.

关 键 词：胫骨高位截骨术 功能锻炼 膝关节骨性关节炎 

分 类 号：R687[医药卫生—骨科学]