後藤 俊作
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Impeding factors of early rehabilitation postoperatively after rheumatoid toe arthroplasty: a single-center retrospective cohort study.
Journal Formal name:JA clinical reports
Abbreviation:JA Clin Rep
ISSN code:23639024/23639024
Domestic / ForeginForegin
Volume, Issue, Page 6(1),pp.50
Author and coauthor Goto Shunsaku, Kasuya Yusuke, Okuyama Keiko, Ikari Katsunori, Ozaki Makoto
Authorship Lead author,Corresponding author
Publication date 2020/07
Summary INTRODUCTION:Previous studies explored the benefits related to early ambulation postoperatively, but few focused on patients with rheumatoid arthritis (RA). We retrospectively evaluated the incidence and predictors of the inability to begin walking on the first postoperative day (POD) after toe arthroplasty for rheumatoid arthritis.METHODS:RA patients who underwent toe arthroplasty at one hospital were retrospectively reviewed. A total of 300 patients were included and divided into two groups: possible group (n = 191), who were able to walk on the first POD, and impossible group (n = 109), who were unable to walk on the first POD. Data were analyzed using odds ratios (OR) with 95% confidence intervals (CI) between various patient factors and the impossible group with logistic regression analysis.RESULTS:The incidence of postoperative nausea and vomiting before rehabilitation was significantly associated with the infeasibility of walking rehabilitation on the first POD [OR = 2.43, 95% CI 1.22-4.14, P = 0.003]. The number of rescue analgesics administered before rehabilitation and the supplementation of peripheral nerve block was also associated with the infeasibility of walking rehabilitation on the first POD [OR = 1.29, 95% CI 1.04-1.59, P = 0.003; OR = 0.41, 95% CI 0.20-0.79, P = 0.010, respectively].CONCLUSION:The incidence of postoperative nausea and vomiting and inadequate postoperative pain management hindered early rehabilitation. Adding peripheral nerve block to general anesthesia had an advantage for postoperative rehabilitation after toe arthroplasty for rheumatoid arthritis.
DOI 10.1186/s40981-020-00356-1
PMID 32638138