Objective To investigate the influence of self-efficacy and postoperative pain on postoperative kinesiophobia in aged patients with femoral neck fractures and explore the mediating effect of self-efficacy on postoperative pain and kinesiophobia of the patients.Methods A total of 120 aged patients with femoral neck fractures were included in the study.A cross-sectional study was conducted using general questionaire,the rehabilitation self-efficacy scale,digital pain rating scale and Tampa scale for kinesiophobia.Pearson correlation was used to analyse the correlations between postoperative pain,self-efficacy and postoperative kinesiophobia.AMOS21.0 software was used to establish the mediating effect model of self-efficacy between postoperative pain and postoperative kinesiophobia.The mediating effect was verified by Bootstarp confidence interval evaluation.Results All 120 aged patients with femoral neck fractures completed the study.The score of postoperative kinesiophobia was(40.27±12.85).The level of kinesiophobia was negatively correlated with the self-efficacy score(r=-0.571,P<0.01),and positively with the level of postoperative pain(r=0.766,P<0.01).The direct standardized effect of postoperative pain on postoperative panic level was 0.367,the direct standardized effect of self-efficacy on postoperative panic level was-0.485,the direct standardized effect of postoperative pain on self-efficacy was-0.716,the indirect standardized effect of postoperative pain on postoperative panic level was 0.347,and the total standardized effect was 0.714,accounting for 48.60%of the total effect.Conclusions Postoperative pain can directly affect postoperative kinesiophobia or indirectly affect it via self-efficacy in elderly patients with femoral neck fractures.Medical staff should improve the self-efficacy of the aged patients by relieving the postoperative pain and alleviating the postoperative kinesiophobia.

ObjectiveTo explore the effect of kinematic alignment on postoperative knee function for patients after total knee arthroplasty (TKA). MethodsFrom June, 2020 to October, 2021, 200 patients undergoing primary TKA in Beijing Chaoyang Hospital were divided into mechanical alignment (MA) group (n = 100) and kinematic alignment (KA) group (n = 100). All the patients accepted comprehensive rehabilitation after operation. They were assessed with Keen Society Score (KSS) before and three months after operation, with Visual Analogue Scale for pain (VAS) before, and three days and three months after operation. The time of first standing, the time of first straight-leg raising more than 30°, and the active range of motion (AROM) of knee before, and one, two and three days, and one and three months after operation were recorded, as well as where to go after discharge. ResultsA total of 96 patients in MA group and 98 in KA group finished the research. The AROM of knee improved more in the KA group than in the MA group after operation (F_group = 8.816, P = 0.017), and the incidence going to the rehabilitation institutes was less (χ² = 6.542, P = 0.011). ConclusionKA may promote the rapid recovery of AROM of knee for patients after TKA, and reduce the needs of institute-based rehabilitation after discharge, to save medical costs.