1.A Prospective Comparative Study of Functional Recovery in Two Different Approaches for Total Hip Arthroplasty
Teruyoshi Nagafuchi ; Koutatsu Nagai ; Akira Tamaki ; Takayuki Nagatomi ; Eriko Matsumoto ; Haruo Ninomiya
The Japanese Journal of Rehabilitation Medicine 2017;54(1):56-66
[Purpose]This study aimed to evaluate the differences in the immediate postoperative muscle strength around the hip and knee joints, joint range of motion, pain, and mobility between the anterolateral-supine (AL-S) approach, as a form of minimally invasive total hip arthroplasty (THA), and the posterior approach (PA), as a form of small-incision THA.
[Methods]The subjects were 68 patients with hip osteoarthritis who underwent unilateral THA for the first time. Maximal isometric muscle strength around the hip and knee joints, joint range of motion, walking ability, and pain were measured before surgery, and on Day 10, Day 21, and 2 months after surgery.
[Results]Significant interactions were found between the time and the type of surgery for hip abduction, external rotation, and extension strength. Interaction was also found between the surgical approach and the time required to achieve optimal hip extension range of motion.
[Conclusion]The differences in the functional recovery after AL-S approach and PA were most likely caused by differences in muscle damage. Therefore, it is necessary to customize rehabilitation programs according to the characteristics of each approach.
2.What Influences Rehabilitation Outcomes after Arthroscopic Rotator Cuff Repair? Investigation of Risk Factors for Prolonged Rehabilitation
Haruo NINOMIYA ; Takesi FUJI ; Takayuki NAGATOMI ; Teruyoshi NAGAFUCHI ; Naoya ARAKI ; Noritaka MIZUTA
The Japanese Journal of Rehabilitation Medicine 2018;55(2):160-167
Purpose:Good functional results have been reported for arthroscopic repair of rotator cuff tears (ARCR) by several orthopedic surgeons, but few studies have examined the factors affecting rehabilitation outcomes.This study was conducted to identify the factors associated with clinical outcome and the duration of rehabilitation after ARCR.Subjects and methods:This was a retrospective evaluation of 576 patients who underwent ARCR between January 2009 and December 2013 (Men:331, Women:245;mean age:63.9±12.3 years).Patients were divided into groups based on the duration of rehabilitation:less than or more than 6 months. Preoperative and postoperative evaluations, including outcome assessments and physical examination parameters, were reviewed:① type of insurance, ② duration of illness, ③ pain on motion, ④ Japanese Orthopaedic Association Score, ⑤ site of cuff tear, ⑥ thickness of cuff tear, ⑦ repair conditions, ⑧ range of motion (ROM) before surgery, ⑨ ROM at 3 months after surgery, ⑩ ROM at 6 months after surgery, ⑪ muscle strength before surgery, and ⑫ muscle strength at 6 months after surgery.Results:Factors influencing the duration of rehabilitation included traffic accident and workman's compensation insurance coverage, thickness of tear, range of motion of flexion and external rotation at 3 months after surgery, and strength on abduction at 6 months after surgery.Conclusions:When beginning rehabilitation, the type of insurance and thickness of tear must be considered;during rehabilitation, ROM at 3 months and strength at 6 months after surgery must be considered.