Study On The Status Of Home Rehabilitation And Its Influencing Factors After The First Revision Of Total Hip Arthroplasty

Objective To investigate the joint function of home rehabilitation patients with revision of total hip arthroplasty and its influencing factors.Providing a reference for the formulation and adjustment of the late intervention program and rehabilitation plan in clinical,in order to reduce the rate of re-revision hip arthroplasty and improve the patients,quality of life.Methods Select the patients who had undergone surgery in two large hospitals of HeFei and rehabilitated in home from January 2012 to December 2016.Collecting patients' general information and disease related information through a hospital case management system.After obtaining the patient's informed consent,the general data questionnaire,Harris hip function score,self rating Anxiety Scale(SAS)and self rating Depression Scale(SDS),self-care ability scale(ESCA),social support rating scale(SSRS)and survey compliance behavior questionnaire were used to investigate the patients through telephone,letter,outpatient,home visit,WeChat and so on.Result(1)The total score of hip joint function in home rehabilitation patients after revision total hip arthroplasty was(75.02±14.96),the excellent and good rate was47.1%,and 52.9% patients with poor hip function.(2)The anxiety score of revision total hip arthroplasty patients was(42.13±12.52),74.1% patients without anxiety symptoms,25.9%patients with anxiety symptom;the depression score was(47.68±11.47),63.5%patients with no depressive symptoms,36.5% patients with anxiety.Thelevel of anxiety and depression of the patients were negatively correlated with the hip function(P<0.001).(3)The total score of self-care ability of home rehabilitation patients after revision of total hip arthroplasty was(102.98±17.49),the self-care skill was the highest,followed by the concept of self-concept,and the lowest score was the concept of self-care responsibility.42.7% patients had higher self-care ability,57.3% patients were in the middle and low level.The total score of self-care ability and the scores of all dimensions were positively correlated with the score of hip joint(P<0.001).(4)The total score of social support in home rehabilitation patients after revision of total hip arthroplasty was(33.37±6.88),the score of subjective support dimension was the highest and the social utility dimension was the lowest.There were 93.3% patients with low and middle social support level,and 6.7%patients in the advanced level.There was a positive correlation between the total score of social support and the degree of hip joint function(P<0.001).(5)The total score of compliance behavior of home rehabilitation patients after revision of total hip arthroplasty was(70.65±12.39),the highest score was behavior dimension,followed by regular examination dimension,and the lowest score was functional exercise.There were positive correlation between the total score and the dimensions of compliance with the function of the hip joint(P<0.05).(6)Univariate analysis showed that there were differences in hip function between family residence,different age,education level,body mass index,occupation,marital status,family income,disease combination,walking time after operation,prosthesis material type,the status of two lower extremity veins,the time of post operation abduction,complication and postoperative time(P<0.05).Multiple linear regression analysis showed that education level,disease combination,postoperative abduction time,complication,depression,self-care ability,social support and compliance behavior had influences on the hip function of patients.Conclusion The recovery of hip joint function in patients after revision of total hiparthroplasty was not satisfactory.Education level,disease combination,abandoning crutches time,complications,depression,self care ability,social support and compliance behavior were important factors to affect joint function of patients after operation.Suggesting that the clinical medical workers should carry out patients missionary work actively,establish the long-term follow-up work,timely intervene the influence factors of the joint function,to improve the quality of life of patients and reduce the rate of hip joint revision.