[关节置换术后重返运动场]。

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI:10.1055/a-2337-2606
Andreas M Halder, Corinna Di Michele
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引用次数: 0

摘要

髋关节置换术已成为最成功的外科手术之一,并在上个世纪取得了重大进展。随着这些发展,患者的期望已从仅仅实现无痛日常活动转变为期待完全康复,包括能够参加体育运动。这种转变推动了假体材料和手术技术的创新,例如开发出高度交联聚乙烯等耐磨材料,以及采用微创手术来促进康复。然而,患者对术后恢复运动的风险仍心存顾虑,特别是担心假体会发生意外或故障。一项针对 300 名德国外科医生的调查显示,假体周围骨折是最大的风险,其次是聚乙烯磨损和假体松动。该研究还将骨质疏松症作为一个风险因素进行了研究,认为虽然运动有助于预防假体周围骨质疏松症,但高能量创伤可能会增加受伤的严重程度。虽然现代假体材料已经减少了磨损并提高了耐用性,但体育锻炼的类型和强度仍会影响假体的寿命。因此,建议在术后3-6个月恢复低强度运动,而高强度运动则应谨慎对待,尤其是在术后第一年,以最大限度地降低并发症的风险。此外,还要强调术前和术后的协调训练,以降低跌倒和受伤的风险。总之,该研究强调,一般情况下不建议进行高冲击力运动,因为在全髋关节置换术后,协调障碍可能会持续长达 12 个月。此类活动只能在术后考虑,而且只能由在这些特定运动方面有经验的患者进行。
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[Return to Sports After Arthroplasty].

Arthroplasty of the hip has become one of the most successful surgical interventions and has seen significant advancements over the last century. With these developments, patient expectations have shifted from merely achieving pain-free daily mobility to anticipating a full recovery, including the ability to participate in sports. This shift has driven innovations in prosthetic materials and surgical techniques, such as the development of wear-resistant materials like highly cross-linked polyethylene and the adoption of minimally invasive procedures to enhance recovery.However, concerns persist among patients about the risks of resuming sports postoperatively, particularly the fear of prosthesis-related accidents or failures. A survey of 300 German surgeons identified periprosthetic fractures as the greatest risk, followed by polyethylene wear and implant loosening. The study also examines osteoporosis as a risk factor, suggesting that while sports can help prevent periprosthetic osteoporosis, high-energy trauma may increase the severity of injuries. Although modern prosthetic materials have reduced wear and improved durability, the type and intensity of physical activity continue to influence prosthesis longevity.Therefore, it is recommended that low-impact sports be resumed 3-6 months postoperatively, while high-impact sports should be approached with caution, particularly during the first year after surgery, to minimize the risk of complications. Coordination training before and after surgery is also emphasized to reduce the risk of falls and injuries. In summary, the study highlights that high-impact sports cannot be generally recommended, as coordination deficits may persist for up to 12 months following total hip replacement. Such activities should only be considered later-on and only by patients who are experienced in these specific sports.

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