Study on early out of bed mobility in patients after Mako robotic-assisted total hip arthroplasty_West China Medical Journal

Authors：

LI Ying ¹ , TIAN Yihua ² , LI Xinyu ¹ , WANG Jiawei ¹ , HUANG Qiuxia ¹ ,  TANG Yongli ¹ ,  WANG Xue ¹ , HUANG Wei ¹ , CHEN Jie ¹

1. Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P. R. China;
2. Nursing Faculty, Chongqing Wuyi Technician College, Chongqing 401320, P. R. China;

Corresponding?author：

TANG Yongli, Email: 1693563595@qq.com; WANG Xue, Email: snowcandy53@126.com

Keywords：

Robot-assisted technology; Total hip arthroplasty; Early bed mobility

DOI：

10.7507/1002-0179.202007367

Video：

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Objective To study the early out-of-bed activities of patients after Mako robotic-assisted total hip arthroplasty.Methods We prospectively included inpatients planned to undergo primary unilateral total hip arthroplasty in the Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University from April to July 2020. Using a randomized numerical table, the patients were divided into trial group to undergo robotic-assisted total hip arthroplasty and control group to undergo traditional total hip arthroplasty, and both groups received the same nursing measures and instructions for training to get out of bed after surgery. Postoperative active pain (assessed with Visual Analogue Scale), the proportion of patients willing to get out of bed within 24 h after surgery, the time and duration for the first out of bed activity, the proportion of patients with a walking distance ≥5 m for first activity, and the level of activity in the first 3 d after surgery between the two groups were compared.Results A total of 38 patients were included in this study, with 17 patients in the trial group and 21 patients in the control group. There was no statistical significance in the baseline demographics between the two groups (P>0.05). There were statistically significant differences in postoperative 6-hour and 24-hour Visual Analogue Scale scores between the two groups (P<0.05). Two hours after oral administration of perioperative energy preparations on the day of surgery, the proportion of patients who were willing to get out of bed early in the trial group was higher than that in the control group (100.0% vs. 57.1%, P<0.05). The first time to get out of bed ［(4.39±0.17) vs. (8.74±4.70) h］, the duration of getting out of bed ［(10.89±3.60) vs. (8.37±3.31) h］, and the proportion of patients with a walking distance ≥5 m for first activity (94.1% vs. 61.9%) were better than those of the control group (P<0.05). There were statistically significant differences between the trial group and the control group in the average level in the first 3 days after surgery, postoperative first-day level, and postoperative second-day level of getting out of bed (P<0.05). There were no falls, dislocation of the prosthesis, fractures around the prosthesis, or deep vein thrombosis in the two groups of patients during their hospitalization.Conclusion The precise surgery method with the help of Mako orthopedic robot-assisted system can help promote patients to get out of bed early after surgery, and can providea reference for how to improve the rehabilitation of patients after traditional total hip replacement in the future.

Citation： LI Ying, TIAN Yihua, LI Xinyu, WANG Jiawei, HUANG Qiuxia, TANG Yongli, WANG Xue, HUANG Wei, CHEN Jie. Study on early out of bed mobility in patients after Mako robotic-assisted total hip arthroplasty. West China Medical Journal, 2020, 35(10): 1189-1194. doi: 10.7507/1002-0179.202007367 Copy

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2.	崔可賾, 郭祥, 韓貴斌, 等. Mako機器人輔助后外側入路全髖關節置換術. 中國矯形外科雜志, 2020, 28(4): 356-359.
3.	Domb BG, Redmond JM, Louis SS, et al. Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance. J Arthroplasty, 2015, 30(12): 2208-2218.
4.	Illgen RL Nd, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up. Surg Technol Int, 2017, 30: 365-372.
5.	周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復—圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
6.	Guerra ML, Singh PJ, Taylor NF. Early mobilization of patients who have had a hip or knee joint replacement reduces length of stay in hospital: a systematic review. Clin Rehabil, 2015, 29(9): 844-854.
7.	岳孟婷, 古晨玉, 張子營. 早期下床活動干預應用于老年人工全髖關節置換患者的效果. 四川生理科學雜志, 2020, 42(2): 158-161.
8.	Labraca NS, Castro-Sánchez AM, Matarán-Pe?arrocha GA, et al. Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial. Clin Rehabil, 2011, 25(6): 557-566.
9.	楊霞, 李國宏, 鄧春花. 骨科護士對髖膝關節置換術后患者早期下床活動認知現狀調查. 齊魯護理雜志, 2018, 24(6): 44-47.
10.	陳曦, 張芳, 王華, 等. 研究髖關節置換術后下床時間對關節假體脫位的影響. 臨床醫藥文獻電子雜志, 2019, 6(50): 23, 25.
11.	鄭志博, 馮賓, 董玉雷, 等. 全髖關節置換術后脫位因素分析及防治策略. 中華骨與關節外科雜志, 2016, 9(3): 198-203.
12.	邵澤宇, 徐文峰, 廖曉玲, 等. 骨科機器人的發展應用及前景. 軍事醫學, 2016, 40(12): 1003-1008.
13.	Li Z, Wang M, Zhang L, et al. Neuronavigation-guided corticospinal tract mapping in brainstem tumor surgery: better preservation of motor function. World Neurosurg, 2018, 116: e291-e297.
14.	Barone A, Giusti A, Pizzonia M, et al. Factors associated with an immediate weight-bearing and early ambulation program for older adults after hip fracture repair. Arch Phys Med Rehabil, 2009, 90(9): 1495-1498.
15.	Brown CJ, Friedkin RJ, Inouye SK. Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc, 2004, 52(8): 1263-1270.
16.	中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018版). 中國實用外科雜志, 2018, 38(1): 1-20.
17.	陳瓊, 許燕玲. 人工全髖關節置換術早期康復影響因素的研究現狀. 實用臨床護理學電子雜志, 2017, 2(11): 6-7.
18.	Dounchis J, Elson L, Bragdon CR. A multi-centre evaluation of acetabular cup positioning in robotic-assisted total hip arthroplasty. Br J Spec Edu, 2013, 22(1): 34-39.
19.	Domb BG, El Bitar YF, Sadik AY, et al. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res, 2014, 472(1): 329-336.
20.	曹旭含, 白子興, 孫承頤, 等. 機器人在骨科手術中應用的可靠性與提升空間. 中國組織工程研究, 2020, 24(9): 1416-1421.

1. 周勇剛, 王巖. 全髖關節置換術后并發癥是影響患者滿意度的最主要原因. 中華關節外科雜志(電子版), 2008, 2(5): 479-483.
2. 崔可賾, 郭祥, 韓貴斌, 等. Mako機器人輔助后外側入路全髖關節置換術. 中國矯形外科雜志, 2020, 28(4): 356-359.
3. Domb BG, Redmond JM, Louis SS, et al. Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance. J Arthroplasty, 2015, 30(12): 2208-2218.
4. Illgen RL Nd, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up. Surg Technol Int, 2017, 30: 365-372.
5. 周宗科, 翁習生, 曲鐵兵, 等. 中國髖、膝關節置換術加速康復—圍術期管理策略專家共識. 中華骨與關節外科雜志, 2016, 9(1): 1-9.
6. Guerra ML, Singh PJ, Taylor NF. Early mobilization of patients who have had a hip or knee joint replacement reduces length of stay in hospital: a systematic review. Clin Rehabil, 2015, 29(9): 844-854.
7. 岳孟婷, 古晨玉, 張子營. 早期下床活動干預應用于老年人工全髖關節置換患者的效果. 四川生理科學雜志, 2020, 42(2): 158-161.
8. Labraca NS, Castro-Sánchez AM, Matarán-Pe?arrocha GA, et al. Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: randomized clinical trial. Clin Rehabil, 2011, 25(6): 557-566.
9. 楊霞, 李國宏, 鄧春花. 骨科護士對髖膝關節置換術后患者早期下床活動認知現狀調查. 齊魯護理雜志, 2018, 24(6): 44-47.
10. 陳曦, 張芳, 王華, 等. 研究髖關節置換術后下床時間對關節假體脫位的影響. 臨床醫藥文獻電子雜志, 2019, 6(50): 23, 25.
11. 鄭志博, 馮賓, 董玉雷, 等. 全髖關節置換術后脫位因素分析及防治策略. 中華骨與關節外科雜志, 2016, 9(3): 198-203.
12. 邵澤宇, 徐文峰, 廖曉玲, 等. 骨科機器人的發展應用及前景. 軍事醫學, 2016, 40(12): 1003-1008.
13. Li Z, Wang M, Zhang L, et al. Neuronavigation-guided corticospinal tract mapping in brainstem tumor surgery: better preservation of motor function. World Neurosurg, 2018, 116: e291-e297.
14. Barone A, Giusti A, Pizzonia M, et al. Factors associated with an immediate weight-bearing and early ambulation program for older adults after hip fracture repair. Arch Phys Med Rehabil, 2009, 90(9): 1495-1498.
15. Brown CJ, Friedkin RJ, Inouye SK. Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc, 2004, 52(8): 1263-1270.
16. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識及路徑管理指南(2018版). 中國實用外科雜志, 2018, 38(1): 1-20.
17. 陳瓊, 許燕玲. 人工全髖關節置換術早期康復影響因素的研究現狀. 實用臨床護理學電子雜志, 2017, 2(11): 6-7.
18. Dounchis J, Elson L, Bragdon CR. A multi-centre evaluation of acetabular cup positioning in robotic-assisted total hip arthroplasty. Br J Spec Edu, 2013, 22(1): 34-39.
19. Domb BG, El Bitar YF, Sadik AY, et al. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res, 2014, 472(1): 329-336.
20. 曹旭含, 白子興, 孫承頤, 等. 機器人在骨科手術中應用的可靠性與提升空間. 中國組織工程研究, 2020, 24(9): 1416-1421.

West China Medical Journal

Study on early out of bed mobility in patients after Mako robotic-assisted total hip arthroplasty

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