scholarly journals Comparison of Short-Term Efficacy of Total Knee Arthroplasty Versus Arthroscopy in Chinese Patients with Knee Osteoarthritis

2020 ◽  
Author(s):  
Xiaolin Jia ◽  
San Cai ◽  
Wei Hu ◽  
Qiang Gan ◽  
Mingquan Zhou
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Scientific Basis ◽  
Knee Function ◽  
Chinese Patients ◽  
Control Group ◽  
Total Knee ◽  
The Difference ◽  
Experimental Group

Abstract Background: The purpose of this study was to compare the improvement of knee function in patients with knee osteoarthritis who underwent total knee arthroplasty and arthroscopy in China, and to provide a scientific basis for the application of clinical total knee arthroplasty in knee osteoarthritis.Methods: A total of 160 patients with knee osteoarthritis who were admitted to Chinese hospital from January 2017 to December 2018 were studied. They were divided into experimental group and control group according to their willingness of treatment. The control group was treated with arthroscopy and the experimental group was treated with total knee arthroplasty. All patients were followed for a period of 6 months. The knee joint function score (HSS), visual analog scale (VAS), and anxiety self-assessment scale (SAS) scores before and after surgery were compared between the two groups. Results: The proportion of "excellent or good" in the efficacy of the experimental group (91.25%) was higher than that of the control group (72.50%), and the difference was statistically significant (χ2=9.476, P<0.05). The HSS score of the experimental group was higher than that of the control group (P<0.05), while the VAS and SAS scores were lower than those of the control group (P<0.05). The scores of various SF-36 scales in the experimental group were higher than those in the control group after operation (P<0.05).Conclusions: Total knee arthroplasty was considered effective in treating patients with knee osteoarthritis that meet the indications, and is beneficial to improve knee function and reduce pain in patients. The surgical treatment also reduced the level of anxiety and effectively improve the quality of life of patients. Further investigation of its clinical application on treatment of knee osteoarthritis is warranted.

Does Preoperative Pain Catastrophizing Influence Objectively Measured Physical Activity Before and After Total Knee Arthroplasty: A Prospective Cohort Study

2020 ◽  
pp. 1-7
Author(s):  
Sara Birch ◽  
Torben Bæk Hansen ◽  
Maiken Stilling ◽  
Inger Mechlenburg
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Muscle Mass ◽  
Knee Arthroplasty ◽  
Pain Catastrophizing ◽  
Knee Function ◽  
Preoperative Pain ◽  
Before And After ◽  
Total Knee

Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.

scholarly journals Assessment of post-surgical pain after the application of ultrasound-guided percutaneous neuromodulation in total knee arthroplasty

2019 ◽  
Vol 02 (02) ◽  
pp. 092-092
Author(s):  
Martín-Macho Martínez M. ◽  
Ventero Gómez A. ◽  
Carrió Font M. ◽  
Martín Buigues A.
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Conventional Treatment ◽  
Control Group ◽  
Ultrasound Guided ◽  
Surgical Pain ◽  
Total Knee ◽  
Experimental Group

Abstract Background and Aim The use of prosthetic knee replacements currently represent an alternative for patients who suffer from severe gonarthrosis. Treatment via the technique of ultrasound-guided percutaneous neuromodulation (US-guided PNM) is a therapeutic alternative worth considering as a new tool in physical therapy for the post-surgical recovery of total knee arthroplasty (TKA). The aim of this study was to evaluate the effectiveness of treatment with US-guided PNM in the post-surgical stage among patients intervened with TKA. Material and Methods Patients were selected between February and May 2017 at the Hospital of Denia and were randomly assigned into two groups. The initial sample was 13 patients. The experimental group (n = 7) received treatment with US-guided PNM plus conventional treatment. The control group (n = 6) only received conventional physiotherapy treatment. Patients in the experimental group received an application of PNM, which consisted of an alternate low frequency current at 10 Hz¸ pulse width 250 μs, with an intensity to the pain threshold. The intervention was performed during four consecutive weeks after hospital discharge. The control group received conventional treatment based on manual therapy, active mobilization and the use of the arthromotor until 115° of knee flexion and 0° knee extension was achieved. The main clinical variables evaluated were pain, measured using the Visual Analog Scale (VAS), quality of life, based on physical and mental components, using the SF12 scale and functional assessment using the Oxford Knee Score. Lastly, pain, stiffness and functional capacity was measured using the WOMAC scale. Results Both groups obtained statistically significant results in the four variables evaluated compared to the pre-surgery stage, however, the changes were more evident in the intervention group (p < 0.05). Furthermore, no significant differences were found in the variables evaluated regarding quality of life between the experimental and control group except for the emotional component of the SF-12 scale, where the result was only significant in the experimental group treated with US-guided PNM (P < 0.05). Regarding the improvement in the health status and decreased pain in the postoperative stage after TKA, no significant differences were observed between groups (p > 0.05). Conclusion The application of the US-guided PNM technique provides greater benefits than conventional therapy for decreasing the post-surgical pain in patients who have undergone knee arthroplasty and for emotional function, evaluated using the SF-12 questionnaire.

scholarly journals Synergistic Effect of a Prolonged Combination Course of Tranexamic Acid and Dexamethasone Involving High Initial Doses in Total Knee Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Hong Xu ◽  
Jinwei Xie ◽  
Jingli Yang ◽  
Zeyu Huang ◽  
Duan Wang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Inflammatory Markers ◽  
Knee Function ◽  
Control Group ◽  
Group A ◽  
Total Knee ◽  
Secondary Outcomes

AbstractThe optimal regimes of tranexamic acid (TXA) and dexamethasone (DXM) in total knee arthroplasty (TKA) are still uncertain. The aim of this study was to assess the efficacy and safety of a prolonged course of intravenous TXA and DXM involving a high initial dose in TKA. Patients who underwent primary TKA at our center were randomized to receive one of four regimes: control (group A), prolonged course of TXA (B), prolonged course of DXM (C), or the combination of a prolonged course of TXA and DXM (D). The four groups were compared in primary outcomes (fibrinolytic and inflammatory markers, knee function, postoperative pain levels, and consumption of opioids) and secondary outcomes (blood loss, maximal drop in hemoglobin, coagulation, fasting blood glucose, and complications). A total of 162 patients were enrolled. On postoperative days 2 and 3, fibrinolytic markers were lower in groups B and D than in groups A and C; inflammatory markers were lower in groups C and D than in groups A and B. Inflammatory markers were lower in group B than in group A on postoperative day 3. Postoperative pain levels and oxycodone consumption were lower, and knee function was better in groups C and D. The four groups did not differ in any of the secondary outcomes. A prolonged course of intravenous TXA and DXM involving high initial doses can effectively inhibit postoperative fibrinolytic and inflammatory responses, reduce pain, and improve knee function after TKA.

Clinical Application of TCM-Characteristic Rehabilitation Program after Total Knee Arthroplasty

2021 ◽  
Author(s):  
Xin-Xia Gao ◽  
Xiong Xiao ◽  
Ying Chen ◽  
Li Yang ◽  
Yun-Xia Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Treatment Group ◽  
Knee Arthroplasty ◽  
Rehabilitation Program ◽  
Control Group ◽  
Pain Scores ◽  
Total Knee ◽  
Random Number Table ◽  
The Difference

<B>Objective:</B> To evaluate the effect of traditional Chinese medicine (TCM)-characteristic rehabilitation program on levels of pain and swelling after total knee arthroplasty. <B>Methods:</B> A total of 72 in-patients who recovered from total knee arthroplasty in our department were selected as the study subjects. They were divided into two groups according to a random number table: the control group (n = 36) with routine nursing and the treatment group (n = 36) with TCM rehabilitation nursing. The pain scores and joint swelling were statistically analyzed. <B>Results:</B> The pain scores in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05).<B>Conclusion:</B> The implementation of a TCM rehabilitation program for patients after total knee arthroplasty can effectively and quickly reduce the pain and swelling of the affected limb, promote the local blood circulation, and promote the quality of life of patients after rehabilitation.

scholarly journals Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study

2018 ◽  
Vol 27 (5) ◽  
pp. 481-488
Author(s):  
Xun Xu ◽  
Weilin Sang ◽  
Yu Liu ◽  
Libo Zhu ◽  
Haiming Lu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Sedimentation Rate ◽  
Control Group ◽  
C Reactive Protein ◽  
Tramadol Hydrochloride ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Total Knee ◽  
Experimental Group

Objective: To evaluate the anti-inflammatory effectiveness of celecoxib and its effect on the rehabilitation of joint function after total knee arthroplasty. Methods: 72 patients presented between 2016 and 2017 and were divided into two groups. The experimental group was given 200 mg celecoxib twice daily with tramadol hydrochloride 50 mg twice daily (as required); the control group was given tramadol hydrochloride 50 mg twice daily for 6 weeks from the first day after total knee arthroplasty. Skin temperature around the knee was measured 1 day before surgery, on postoperative days 1 and 3, and at weeks 1, 2, and 6. Inflammatory markers (white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6) were measured preoperatively, on postoperative day 3, and at weeks 1 and 6. Knee Society Score was recorded preoperatively and at postoperative weeks 1, 2, and 6. Results: Except for preoperative skin temperature, the recorded skin temperatures of the experimental group were significantly different compared to those of the control group (p = 0.001, 0.024, 0.030, 0.041, 0.047, respectively). Levels of C-reactive protein were significantly different at the 1st and the 6th week after surgery, differing by 19.3 ± 4.64 mg/L (p < 0.001) and 2.6 ± 0.92 mg/L (p = 0.006). Levels of interleukin-6 showed a significant difference of 6.61 ± 2.36 pg/mL (p = 0.007) at the 1st week after surgery. Until the 6th week after surgery, the erythrocyte sedimentation rate in the experimental group and the control group differed by 17 ± 4.6 mm/h (p = 0.001). Conclusions: Celecoxib has a significant inhibitory effect on postoperative aseptic inflammation.

scholarly journals Effects of Denervation on the Mid-term Results of Knee Joint Functions after Non-resurfaced Total Knee Arthroplasty

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Ningning Liu ◽  
Huanhuan Su ◽  
Yuanhe Wang ◽  
Yu Zhang ◽  
Hongjian Yu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Control Group ◽  
Double Blind Study ◽  
Positive Effects ◽  
Total Knee ◽  
Experimental Group

Objective: Total knee arthroplasty (TKA) has become an effective treatment modality for end-stage osteoarthritis and rheumatoid arthritis. Postoperative problems such as anterior knee pain affect postoperative patient satisfaction. Patellar denervation has been proposed as a technique to relieve pain, but its efficacy remains controversial. This study evaluated the mid- and long-term effects of patellar denervation on postoperative knee joint functions, hoping to provide better guidance for clinical practice. Methods: This study is a prospective randomized controlled double-blind study. 58 patients undergoing bilateral non-resurfaced total knee arthroplasty were included and randomized into two groups. Both groups underwent total knee arthroplasty while patellar denervation was performed only on the experimental group. Information regarding whether if patellar denervation was performed were withheld from all patients and outcome assessors. All surgeries were performed by the same high-level professional physician, and the post-stable knee prosthesis system (PS Scorpio NRG PS, Stryker) was used during the surgeries. The knee joint functions were evaluated by professional assessors before and after surgery. The evaluation indicators mainly include KSS scoring, Western Ontario and McMaster Universities (WOMAC) scoring and Visual Analogue Scale (VAS), FJS scoring, etc. The follow-up period was 3 years and 5 years after surgery. Results: The experimental group had better KSS and FJS scores than the control group, the difference was statistically significant. There was no significant inter-group difference in WOMAC and VAS scores. Conclusion: The patellar denervation in TKA patients has positive effects on the mid- and long-term recovery of knee joint functions, and the postoperative satisfaction is better.

scholarly journals Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty

2018 ◽  
Vol 46 (6) ◽  
pp. 2301-2306 ◽  
Author(s):  
Guangjun Zhong ◽  
Zhu Liang ◽  
Jiang Kan ◽  
Aikeremujiang Muheremu
Keyword(s):  
Total Knee Arthroplasty ◽  
Neuropathic Pain ◽  
Knee Joint ◽  
Peripheral Nerve ◽  
Knee Arthroplasty ◽  
Persistent Pain ◽  
Control Group ◽  
Pain Scores ◽  
Total Knee ◽  
Experimental Group

Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

scholarly journals Single-Blinded, Randomised Preliminary Study Evaluating the Effects of 2 hz Electroacupuncture for Postoperative Pain in Patients with Total Knee Arthroplasty

2015 ◽  
Vol 33 (4) ◽  
pp. 284-288 ◽  
Author(s):  
Chung-Yuh Tzeng ◽  
Shih-Liang Chang ◽  
Chih-Cheng Wu ◽  
Chu-Ling Chang ◽  
Wen-Gii Chen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Point Group ◽  
Specific Effect ◽  
Control Group ◽  
Total Dosage ◽  
Total Knee ◽  
Preliminary Study ◽  
The Difference

Objective To explore the point-specific clinical effect of 2 Hz electroacupuncture (EA) in treating postoperative pain in patients undergoing total knee arthroplasty (TKA), Methods In a randomised, partially single-blinded preliminary study, 47patients with TKA were randomly divided into three groups: control group (CG, n=17) using only patient-controlled analgesia (PCA); EA group (EAG, n=16) with 2 Hz EA applied at ST36 ( Zusanli) and GB34 ( Yanglingquan) contralateral to the operated leg for 30 min on the first two postoperative days, also receiving PCA; and non-point group (NPG, n=14), with EA identical to the EAG except given 1 cm lateral to both ST36 and GB34. The Mann–Whitney test was used to show the difference between two groups and the Kruskal–Wallis test to show the difference between the three groups. Results The time until patients first required PCA in the CG was 34.1±22.0 min, which was significantly shorter than the 92.0±82.7 min in the EAG (p<0.001) and 90.7±94.8 min in the NPG (p<0.001); there was no difference between the EAG and NPG groups (p>0.05). The total dosage of PCA solution given was 4.6±0.9 mL/kg body weight in the CG, 4.2±1.0 mL/kg in the EAG and 4.5±1.0 mL/kg in the NPG; there were no significant differences (p>0.05) among the three groups. Conclusions In this small preliminary study, EA retarded the first demand for PCA in comparison with no EA. No effect was seen on the total dosage of PCA required and no point-specific effect was seen.

Providing Inpatient Mobilization with a Mobility Technician Constrains Cost in Primary Total Knee Arthroplasty

2020 ◽  
Author(s):  
Thomas A. Novack ◽  
Christopher J. Mazzei ◽  
Jay N. Patel ◽  
Eileen B. Poletick ◽  
Roberta D'Achille ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Care Pathway ◽  
Primary Total Knee Arthroplasty ◽  
Cost Savings ◽  
Patient Discharge ◽  
Control Group ◽  
Study Group ◽  
Bundled Payment ◽  
Total Knee

AbstractSince the 2016 implementation of the comprehensive care for joint replacement (CJR) bundled payment model, our institutions have sought to decrease inpatient physical therapy (PT) costs by piloting a mobility technician program (MTP), where mobility technicians (MTs) ambulate postoperative total knee arthroplasty (TKA) patients under the supervision of nursing staff members. MTs are certified medical assistants given specialized gate and ambulation training by the PT department. The aim of this study was to examine the economic and clinical impact of MTs on the primary TKA postoperative pathway. We performed a retrospective review of TKA patients who underwent surgery at our institution between April 2018 and March 2019 and who were postoperatively ambulated by MTs. The control group included patients who had surgery during the same months of the prior year, preceding introduction of MTs to the floor. Inclusion criteria included: unilateral primary TKA for arthritic conditions and conversion to unilateral primary TKA from a previous knee surgery. Minitab Software (State College, PA) was used to perform the statistical analysis. There were 658 patients enrolled in the study group and 1,400 in the control group. The two groups shared similar demographics and an average age of 68 (p = 0.177). The median length of stay (LOS) was 2 days in both groups (p = 0.133) with 90.5% of patients in the study group discharged to home versus 81.5% of patients in the control group (p < 0.001). The ability of MTs to increase patient discharge to home without negatively impacting LOS suggest MTs are valuable both clinically to patients, and economically to the institution. Cost analysis highlighted the substantial cost savings that MTs may create in a bundled payment system. With the well-documented benefits of early ambulation following TKA, we demonstrate how MTs can be an asset to optimizing the care pathway of TKA patients.

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