Namba Robert S, Inacio Maria
Department of Orthopedic Surgery, Kaiser Permanente, Orange County, Anaheim, California 92807, USA.
J Arthroplasty. 2007 Sep;22(6 Suppl 2):58-61. doi: 10.1016/j.arth.2007.02.010. Epub 2007 Jul 26.
Manipulations have been considered effective only in the early postoperative period. From a total joint registry containing 9640 primary total knee arthroplasties (TKAs), 195 patients who underwent manipulation under anesthesia (MUA) were identified. A total of 102 had MUA within 90 days (early), and 93 more than 90 days (late) after TKA. Average pain (10-point scale), satisfaction (10-point scale), flexion (degrees), and extension (degrees) were recorded before and after MUA. Flexion was significantly improved after MUA for both groups: early MUA from 68.4 degrees (+/-17.2 degrees ) to 101.4 degrees (+/-16.15 degrees ), P < .001; late MUA from 81.0 degrees (+/-13.3 degrees ) to 98.0 degrees (+/-18.0 degrees ), P = .001. Pain decreased significantly with early MUA from 4.92 (+/-2.25) to 3.34 (+/-2.67) and with late MUA from 4.51 (+/-2.62) to 3.44 (+/-2.78), P = .048. Extension improved only in the early MUA group from 7.15 (+/-10.1) to 2.50 (+/-4.98). Satisfaction scores were not improved. Both early and late manipulation can improve TKA pain and flexion.
手法操作仅在术后早期被认为是有效的。从一个包含9640例初次全膝关节置换术（TKA）的全关节登记系统中，识别出195例行麻醉下手法操作（MUA）的患者。其中，共有102例在TKA术后90天内（早期）进行了MUA，另外93例在术后90天以上（晚期）进行了MUA。记录了MUA前后的平均疼痛（10分制）、满意度（10分制）、屈曲度（度）和伸展度（度）。两组患者在MUA后屈曲度均显著改善：早期MUA组从68.4度（±17.2度）改善至101.4度（±16.15度），P <.001；晚期MUA组从81.0度（±13.3度）改善至98.0度（±18.0度），P =.001。早期MUA后疼痛显著减轻，从4.92（±2.25）降至3.34（±2.67），晚期MUA后从4.51（±2.62）降至3.44（±2.78），P =.048。仅早期MUA组的伸展度从7.15（±10.1）改善至2.50（±4.98）。满意度评分未得到改善。早期和晚期手法操作均可改善TKA术后的疼痛和屈曲度。
