OBJECTIVE: To review the research progress of intelligent remote follow-up modes in the application after hip and knee arthroplasty. METHODS: Extensive literature on this topic published in recent years both domestically and internationally was reviewed, and the application of intelligent remote follow-up modes after hip and knee arthroplasty was summarized and analyzed. RESULTS: The intelligent remote follow-up mode is a novel follow-up method based on network information technology. Patients who undergo hip and knee arthroplasty require long-term follow-up and rehabilitation guidance after operation. Traditional outpatient follow-up is relatively time-consuming and inconvenient for some patients in terms of travel and transportation, which makes the application of intelligent remote follow-up modes increasingly widespread worldwide. The inherent attributes of remote interaction and instant feedback of this mode make it particularly valued in the field of hip and knee arthroplasty. Artificial intelligence (AI)-based voice follow-up systems and virtual clinics have significant advantages in improving follow-up efficiency, reducing human resource costs, and enhancing patient satisfaction. CONCLUSION The existing intelligent follow-up system has formed a standardized protocol in remote follow-up and rehabilitation guidance. However, there are still shortcomings in the formulation of personalized rehabilitation plans and the gerontechnological adaptation of human-computer interaction. In the future, it is necessary to construct a multimodal data fusion platform and establish technical application guidelines for different rehabilitation stages.
Humans ; Arthroplasty, Replacement, Knee/rehabilitation* ; Arthroplasty, Replacement, Hip/rehabilitation* ; Artificial Intelligence ; Follow-Up Studies ; Telemedicine

OBJECTIVE: To assess the effectiveness of our devised hybrid physiotherapy regime using an anti-gravity treadmill and a low-frequency electrical stimulation device, as measured in patients with hip osteoarthritis after total hip arthroplasty (THA). METHODS: The outcomes of the postoperative rehabilitation in 44 patients who underwent THA for hip osteoarthritis were retrospectively examined. The conventional group (n=22) underwent the postoperative rehabilitation according to our protocol, while the hybrid group (n=22) underwent the same training, along with training on an anti-gravity treadmill and training using a low-frequency therapeutic device. The outcome measures were recorded and reviewed with the Numerical Rating Scale for pain, which rates pain on an 11-point scale from 0 to 10, surgical side knee joint extension force, 10-m walking test, Timed Up and Go test, and the 6-minute walking distance (6MD). The outcome measurement was taken 2 weeks after conducting pre-operation and antigravity treadmill training and electrical muscle stimulation, and compared the respective results. RESULTS: At the timeframe of 2 weeks from the surgery after conducting a devised hybrid physiotherapy, the values of knee extension muscle strength and 6MD were not worse in the hybrid group than conventional group. In the evaluation at 2 weeks after surgery, the knee extension muscle strength and 6MD values significantly decreased compared with the preoperative values only in the conventional group. CONCLUSION: Lower limb muscular strength and endurance were maintained in the hybrid group, which suggested that hybrid physiotherapy could maintain physical functions early after THA operation.
Arthroplasty, Replacement, Hip ; Electric Stimulation ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Muscle Strength ; Osteoarthritis, Hip ; Outcome Assessment (Health Care) ; Rehabilitation ; Retrospective Studies ; Walking

The purpose of this study was to compare the outcomes focusing on the functional outcome and clinical results of replacement arthroplasty (AP) vs. internal fixation (IF) for the treatment of unstable intertrochanteric femoral fracture in elderly. Systematic review and meta-analysis were performed on 10 available clinical studies (2 randomized controlled trials and 8 comparative studies). Subgroup analysis was performed by type of methodological quality. Partial weight bearing time in AP group was earlier than that in IF group (SMD = −0.86; 95% CI = −0.42, 1.29; P = 0.050). The overall outcomes such as mortality, reoperation rate, and complication showed no significant diffrence between the 2 groups (AP vs. IF). Therefore, this systematic review demonstrates that AP provides superior functional outcomes especially earlier mobilization, as compared to IF in elderly patients with an unstable intertrochanteric femoral fracture.
Aged* ; Arthroplasty* ; Arthroplasty, Replacement ; Femoral Fractures ; Femur* ; Fracture Fixation ; Hip Fractures* ; Humans ; Mortality ; Rehabilitation* ; Reoperation ; Weight-Bearing

BACKGROUND: Both neuraxial and peripheral regional analgesic techniques offer postoperative analgesia for total hip arthroplasty (THA) patients. While no single technique is preferred, quadriceps muscle weakness from peripheral nerve blocks may impede rehabilitation. We designed this study to compare postoperative ambulation outcome in THA patients who were treated with a new ultrasound-guided fascia iliaca catheter (FIC) technique or intrathecal morphine (ITM). METHODS: We reviewed the electronic health records of a sequential series of primary unilateral THA patients who were part of a standardized clinical pathway; apart from differences in regional analgesic technique, all other aspects of the pathway were the same. Our primary outcome was total ambulation distance (meters) combined for postoperative days 1 and 2. Secondary outcomes included daily opioid consumption (morphine milligram equivalents) and analgesic-related side effects. We examined the association between the primary outcome and analgesic technique by performing crude and adjusted ordinary least-squares linear regression. A P value < 0.05 was considered statistically-significant. RESULTS: The study analyzed the records of 179 patients (fascia iliaca, n = 106; intrathecal, n = 73). The primary outcome (total ambulation distance) did not differ between the groups (P = 0.08). Body mass index (BMI) was the only factor (β = -1.7 [95% CI -0.5 to -2.9], P < 0.01) associated with ambulation distance. Opioid consumption did not differ, while increased pruritus was seen in the intrathecal group (P < 0.01). CONCLUSIONS: BMI affects postoperative ambulation outcome after hip arthroplasty, whereas the type of regional analgesic technique used does not. An ultrasound-guided FIC technique offers similar analgesia with fewer side effects when compared with ITM.
Analgesia ; Anesthesia, Conduction ; Anesthesia, Spinal ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Body Mass Index ; Catheters* ; Critical Pathways* ; Electronic Health Records ; Fascia* ; Hip ; Humans ; Linear Models ; Morphine ; Nerve Block ; Peripheral Nerves ; Pruritus ; Quadriceps Muscle ; Rehabilitation ; Ultrasonography ; Walking

Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty.
Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Analgesics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Hip* ; Humans ; Pain Management* ; Peripheral Nerves ; Quality of Life ; Rehabilitation

OBJECTIVE: To determine whether there was a difference in balance, proprioception, and skeletal muscle mass among patients who undergo hip fracture surgery relative to and elective total hip replacement (THR). METHODS: Thirty-one THR patients were enrolled. The patients were categorized into two groups: fracture group (n=15) and non-fracture group (n=16). Berg Balance Scale (BBS) was used to balance the proprioception of the hip joint while a joint position sense (JPS) test was used to evaluate it. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Quality of life (QOL) was also assessed using a 36-item short form health survey (SF-36). All tests were assessed at 3 months after the surgery. An independent t-test was used to compare the fracture group and non-fracture group. Spearman correlation was used to identify the correlation of each variable. RESULTS: In an independent t-test, the BBS score of patients undergoing elective surgery was higher than the BBS score of patients undergoing hip fracture surgery. There was a significant correlation between the BBS and JPS score after a THR. SMI also correlated with the score of BBS. CONCLUSION: It seems that THR patients undergoing surgery for a hip fracture might have more trouble balancing than elective THR patients. Therefore THR patients undergoing hip fracture surgery might need more care during rehabilitation.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Electric Impedance ; Health Surveys ; Hip ; Hip Joint ; Humans ; Joints ; Muscle, Skeletal* ; Pilot Projects* ; Postural Balance ; Proprioception* ; Quality of Life ; Rehabilitation

OBJECTIVETo explore the prognostic significance of hidden blood loss in total hip arthroplasty.

METHODSFrom May 2008 to July 2009, Harris hip score was used to evaluate the functions of 71 patients undergoing single side total hip arthroplasty (including 47 males and 24 females with a mean age of 68.3 years, ranged from 48 to 75 years). The blood loss in the operation was analyzed to study the correlation between hidden blood loss and the functional rehabilitation.

RESULTSAll 71 patients undergoing THA were involved in the result analysis. The mean total blood loss was 1473 ml and the hidden blood loss was 545 ml (37%). Hidden blood loss significantly correlated with functional rehabilitation (P = 0.001), but there were no correlations between functional rehabilitation and age, gender, operative limb of patients (P = 0.067, 0.527, 0.926, 0.072).

CONCLUSIONHidden blood loss maybe a useful prognostic information contributing to the functional rehabilitation of total hip arthroplasty.

Aged ; Arthroplasty, Replacement, Hip ; rehabilitation ; Blood Loss, Surgical ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Recovery of Function

OBJECTIVETo explore clinical effects of comprehensive rehabilitation therapy for function restore of hip joint after minimally invasive total hip arthroplasty.

METHODSFrom March 2006 to February 2008, 100 patients were randomly divided into the treatment group and the control group. Fifty patients in the treatment group, including 21 males and 29 females, ranging in age from 56 to 78 years, with an average of (67.2 +/- 11.0) years. Fifty patients in the control group, including 26 males and 24 females, ranging in age from 54 to 79 years, with an average of (65.5 +/- 11.5) years. The course of disease of the two groups were 10 to 15 years. The comprehensive rehabilitations such as joint range of motion, the activities of daily living and restoring muscle strength were performed step-by-step in the treatment group under the guidance of the therapist at the 2nd day after hip arthroplasty. Above rehabilitations were not performed in the control group. The postoperative functional recovery of hip joint, the Harris scores and X-ray were analyzed and compared between the two groups.

RESULTSAll the patients were followed and the duration averaged 13 months (12 to 14 months). The therapeutic effects of the two groups had statistical differences, Zc =12.72, P<0.001. In the treatment group, the average Harris score was (94.50 +/- 29.87), 32 patients got an excellent result, 12 good, 4 poor and 2 bad. While in the control group, above data were (63.50 +/- 19.97), 12, 15, 7 and 16 respectively. The therapeutic effects of treatment group were better than those of control group. The X-ray showed that there were no hip prosthesis loosening, femoral neck fractures and other complications.

CONCLUSIONThe early comprehensive rehabilitation after minimally invasive total hip replacement is the key to decrease postoperative complications and to decide the success or failure of surgery.

Aged ; Arthroplasty, Replacement, Hip ; rehabilitation ; Female ; Humans ; Male ; Middle Aged ; Neoplasm, Residual ; rehabilitation ; Postoperative Complications ; prevention & control

Arthroplasty, Replacement, Hip ; rehabilitation ; Hip ; surgery ; Hip Prosthesis ; Hospitalization ; Humans ; Perioperative Care ; Postoperative Period

OBJECTIVE: To determine the functional outcomes of the patients with total hip replacement and to evaluate the variables associated with the functional recovery. METHOD: Subjects were 188 patients, who had undertaken total hip replacement between March 1, 1997 and July 31, 1999 at Asan Medial Center. The four functional milestones including sitting, standing, 50 m walking, and climbing stairs were evaluated. RESULTS: The average duration of treatment was 8.3 +/- 7.0 days, and the days required for sitting were 1.9 +/- 1.0; standing 2.4 +/- 1.8; walking 50 m 6.4 +/- 4.3; climbing stairs 7.9 +/- 4.5 days. In results of analysis of each variable, male patients showed faster functional improvement than female patients in standing and climbing stairs. The patients of age 60 years and over had slower recovery in sitting and standing. The patients with sequelae of septic hip or Legg-Calve-Perthes disease had slower recovery than the others in standing. The patient with the use of cement showed rapid improvement in sitting and standing. Those who could bear full weight had rapid recovery than those with partial weight. CONCLUSION: We would like to suggest that careful consideration on characteristics of each patient should be given in determining the duration of rehabilitation management of the patients who had total hip replacement.
Arthroplasty, Replacement, Hip* ; Chungcheongnam-do ; Female ; Hip ; Humans ; Inpatients* ; Legg-Calve-Perthes Disease ; Male ; Rehabilitation* ; Walking