The Effects Of Pain Control And Rehabilitation Exercise Of Collaborative Care Model On Patients After Total Knee Arthroplasty

Objective to explore the effect of collaborative care model on pain control,knee joint function and rehabilitation exercise of patients after total knee arthroplasty;seeking scientific rehabilitation exercise intervention program for TKA patients,to sustain effective pain control and rehabilitation exercisereferenceforpatients after TKA.Method From October 2016 to November 2017,120 patientsin incorporated into the standard who were admitted to the Department of orthopedic TKA at Ningxia People's Hospital were selected as the subjects,according to the order of admission of number,using a random number table is divided into two groups at random,intervention group and control group(n = 60).The control group gave the orthopaedic routine care and the intervention group gave the orthopaedic routine care + cooperative nursing.To evaluate the improvement of knee function and somatic symptoms in two groups before and after intervention 1,3 and 6 months;The knee joint activity of the two groups was evaluated before and after 3 days,10 days,1,3 and 6 months after the intervention.The resting pain and activity pain score of the two groups were evaluated at 24 h,48h,72 h and 10 days before intervention,and the effect of the two interventions was compared.Results1.In this study,there were 116 cases of TKA patients who were involved in the intervention,25 cases(21.6%)of males and 91 females(78.4%).The average age(65.75±6.81)years.Intervention in the first two group of patients with baseline data,knee joint HSS score ROM,the WOMAC scores,knee joint,knee joint mobility VAS resting and VAS activities,according to the contrast differences had no statistical significance(P >0.05).2.After intervention,3 days after operation,there was no statistically significant difference in knee joint ROM(91.59 °±5.66°)between the control group and the intervention group(90.50°±4.55°)(P >0.05);On the 10 day after operation,the knee joint ROM(106.59°±4.93°)in the intervention group was higher than that of the control group(101.02°±6.23°);1 months after operation,the knee joint ROM(111.62°±4.19°)in the intervention group was higher than that of the control group ROM(104.76°±5.11°);3 months after operation,the knee joint ROM(116.83°±3.98°)in the intervention group was higher than that of the control group ROM(108.31°±4.32°);At 6 months after operation,the ROM of the knee joint in the intervention group(122.79°±4.42°)was higher than that in the control group(112.48°±4.28°),andthedifferencewas statistically significant(P< 0.05).3.After 1 months of intervention,the HSS score of the intervention group(60.87 ± 1.89)was higher than that of the control group(54.99±3.57);After 3 months of intervention,the HSS score of the intervention group(80.26± 2.59)was higher than that of the control group(71.54±1.81);After 6 months of intervention,the HSS score of the intervention group(89.29±2.64)was higher than that of the control group(80.81±2.19),and thedifference was statistically significant(P< 0.05).4.After 1 month of intervention,the decrease of WOMAC self score(32.48±3.38)in the intervention group was higher than that of the control group(35.02 ±3.78);After 3 months of intervention,the self score of WOMAC in the intervention group(25.78±1.28)was lower than that of the control group(22.74±1.29);After intervention for 6 months,the WOMAC self score of the intervention group(20.28 ±0.83)was lower than that of the control group,WOMAC self score(22.25±0.76),the difference was statistically significant(P< 0.05).5.At the time of 24 h intervention,the VAS resting in the control group was(4.03±0.28)and VAS activity(5.03±0.54)was not significantly different from that in the intervention group(3.98±0.29)and VAS activity(4.98±0.52),was not statistically significant(P > 0.05);After 48 h,VAS resting(3.59±0.13)and VAS activity(4.12±0.13)in the intervention group were lower than that in the control group of VAS resting(3.65±0.14)and VASactivity(4.21±0.11);After72h,VASresting(2.02±0.29)and VAS activity6.(3.40±0.42)in the intervention group were lower than that in the control group of VAS resting(2.50±0.21)and VAS activity(4.41±0.44);On the 10 day after operation,VAS resting in the intervention group was(1.26±0.12)and VAS activity(1.78±0.17)was lower than that in the control group,VAS resting(1.89±0.16)and VAS activity(2.26±0.20),thedifferences werestatistically significant(P< 0.05).Conclusions1.The Collaborative care mode has achieved good results in pain control after TKA,relieving pain,improving pain self-assessmentandpaincoping ability,and improving postoperativesatisfaction.2.The Collaborative care mode can improve the active participation of the rehabilitation exercise after TKA operation,the rehabilitation exercise effect is remarkable,and the rehabilitation of the knee function ispromoted.