Zhonghua Yi Xue Za Zhi. 2026 Jan 6;106(1):68-72. doi: 10.3760/cma.j.cn112137-20250712-01710.
ABSTRACT
Objective: To determine the preventive effect of a WeChat platform-based rehabilitation exercise prescription on deep vein thrombosis (DVT) after total knee arthroplasty (TKA). Methods: Prospective data were collected from patients who underwent TKA at the First Affiliated Hospital of Kunming Medical University between December 2023 and March 2025 (set as the experimental group). Retrospective clinical data were collected from patients who underwent TKA at the same hospital between January 2022 and October 2023 (set as the conventional group). All surgeries were performed by the same senior chief physician, and preoperative bilateral lower extremity vascular ultrasound showed no thrombosis in any patient. One day before surgery, the patients in the experimental group received a personalized Quick Response (QR) code for a WeChat public platform from a rehabilitation specialist nurse. After scanning the code, patients could access rehabilitation exercise videos. The rehabilitation nurse explained key points and precautions for the exercises. Patients began rehabilitation training as early as postoperative day 0. The conventional group followed a paper-based rehabilitation exercise prescription and received guidance from rehabilitation nurses on key points and precautions. The incidence of DVT within one week after surgery, postoperative length of stay, total inpatient medical costs (including material costs and non-material costs), and Knee Society Score (KSS) (including clinical and functional scores) were compared between the two groups. Results: A total of 118 patients were enrolled, with 59 in the conventional group and 59 in the experimental group. In the conventional group, there were 14 males and 45 females, aged (68.0±7.2) years. In the experimental group, there were 11 males and 48 females, aged (66.5±7.4) years. There was no statistically significant differences in gender, age, operation time, preoperative thrombosis risk score, or anticoagulant dosage between the two groups (all P>0.05). The incidence of DVT in the operated limb was lower in the experimental group than that in the conventional group [35.6% (21/59) vs 66.1% (39/59), P=0.001]. The postoperative hospital stay was shorter in the experimental group [(6.9±2.7) vs (8.9±2.5) d, P<0.001]. The total inpatient medical costs were lower in the experimental group [18 873 (17 561, 20 880) vs 23 492 (18 362, 45 027) yuan, P<0.001], with both material costs [2 214 (2 214, 5 379) vs 2 899 (2 214, 30 500) yuan, P=0.028] and non-material costs [15 344 (13 837, 16 157) vs 15 912 (14 563, 19 046) yuan, P=0.011] in the experimental group were both lower than those in the conventional group. The clinical score of KSS was higher in the experimental group [(76.5±5.7) vs (68.5±3.6) points, P<0.001], while no significant difference was found in the functional score of KSS between the two groups (P=1.692). Conclusion: The WeChat public platform-based rehabilitation exercise prescription can reduce the incidence of DVT, shorten the hospital stay, and decrease total inpatient medical costs in patients after TKA.
PMID:41483930 | DOI:10.3760/cma.j.cn112137-20250712-01710