Brock T M, Sprowson A P, Muller S, Reed M R
Trauma and Orthopaedic Surgery, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Trauma and Orthopaedics, Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
Trials. 2017 Jan 9;18(1):6. doi: 10.1186/s13063-016-1767-5.
Postoperative knee swelling is common and impairs early postoperative function following total knee arthroplasty. It was hypothesised that the use of a short-stretch, inelastic compression bandage would reduce knee swelling and improve pain and early function. The aim of this study was to provide preliminary data and test feasibility with a view to informing a larger, future trial.
Fifty consecutive patients selected for primary total knee arthroplasty underwent distance randomisation to receive a short-stretch, inelastic compression bandage or a standard wool and crepe bandage for the first 24 h postoperatively. Study feasibility including recruitment rates, retention rates and complications were analysed. The Oxford Knee Score, the EQ-5D-3L index score, knee swelling, knee range of motion, visual analogue pain score and length of stay were compared between groups. Analysis of covariance (ANCOVA) was performed adjusting for the preoperative measurement.
Sixty-eight percent of eligible patients were recruited into the trial. The retention rate was 88%. There were no complications regarding compression bandage use. There was a greater mean but non-significant improvement in Oxford Knee Score (p = 0.580; point estimate = 2.1; 95% CI -3.288 to 7.449) and EQ-5D-3L index score (p = 0.057; point estimate = 0.147; 95% CI -0.328 to 0.005) in the compression bandage group at 6 months. There was no significant difference between groups regarding knee swelling, knee range of motion, visual analogue pain score, complications and length of stay.
Preliminary data suggests that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that is acceptable to patients. A larger, multicentre trial is required to determine its effect postoperatively.
The study was registered with Current Controlled Trials, identifier: ISRCTN86903140 . Registered on 30 May 2013.
全膝关节置换术后膝关节肿胀很常见，会影响术后早期功能。研究假设使用短拉伸、无弹性的加压绷带可减轻膝关节肿胀，并改善疼痛和早期功能。本研究的目的是提供初步数据并测试可行性，以便为未来更大规模的试验提供参考。
连续入选的50例初次全膝关节置换患者进行距离随机分组，术后24小时内分别使用短拉伸、无弹性的加压绷带或标准羊毛绉布绷带。分析研究可行性，包括招募率、保留率和并发症。比较两组之间的牛津膝关节评分、EQ-5D-3L指数评分、膝关节肿胀情况、膝关节活动范围、视觉模拟疼痛评分和住院时间。进行协方差分析（ANCOVA）并对术前测量值进行校正。
68%的符合条件患者被纳入试验。保留率为88%。使用加压绷带未出现并发症。在6个月时，加压绷带组的牛津膝关节评分（p = 0.580；点估计值 = 2.1；95%可信区间-3.288至7.449）和EQ-5D-3L指数评分（p = 0.057；点估计值 = 0.147；95%可信区间-0.328至0.005）有更大的平均改善，但差异无统计学意义。两组在膝关节肿胀、膝关节活动范围、视觉模拟疼痛评分、并发症和住院时间方面无显著差异。
初步数据表明，全膝关节置换术后使用无弹性、短拉伸的加压绷带是一种安全的技术，患者可以接受。需要进行更大规模的多中心试验来确定其术后效果。
本研究已在“当前对照试验”注册，标识符：ISRCTN86903140。于2013年5月30日注册。
