Kayamori Satomi, Tsukada Sachiyuki, Sato Masako, Komata Kenichi, Isida Yumiko, Wakui Motohiro
Department of Nursing, Nekoyama Miyao Hospital, Niigata, Niigata, Japan.
Department of Orthopaedic Surgery, Nekoyama Miyao Hospital, Niigata, Niigata, Japan.
Arthroplast Today. 2016 Jun 21;2(4):199-204. doi: 10.1016/j.artd.2016.05.004. eCollection 2016 Dec.
The multimodal approach is commonly applied to improve knee swelling after total knee arthroplasty. Although the use of a knee compression pad may improve knee swelling, its impact in the multimodal protocol remains unclear.
A total of 57 knees were randomly assigned to one of 2 groups receiving treatment with either a compression dressing using a polyethylene foam pad designed to effectively compress the postoperative knee combined with an elastic bandage or a compression dressing with use of an elastic bandage only. All patients were treated with the multimodal approach, including an external cooling system, intravenous tranexamic acid, no pneumonic tourniquet, and periarticular multidrug injection.
In intention-to-treat analysis, the circumferences of the thigh measured on postoperative days 1 and 7 were not significantly different between the 2 groups. In addition, there were no differences between the 2 groups in knee flexion angle, perioperative total blood loss, or complication rate.
The polyethylene foam pad had no significant beneficial effect on knee swelling in patients undergoing total knee arthroplasty using the multimodal approach.
多模式方法常用于改善全膝关节置换术后的膝关节肿胀。尽管使用膝关节加压垫可能会改善膝关节肿胀,但其在多模式方案中的作用仍不明确。
总共57个膝关节被随机分配到两组中的一组,分别接受使用聚乙烯泡沫垫的加压包扎治疗(该泡沫垫旨在有效压迫术后膝关节并结合弹性绷带)或仅使用弹性绷带的加压包扎治疗。所有患者均采用多模式方法进行治疗,包括外部冷却系统、静脉注射氨甲环酸、不使用气动止血带以及关节周围多药注射。
在意向性分析中,两组术后第1天和第7天测量的大腿周长无显著差异。此外,两组在膝关节屈曲角度、围手术期总失血量或并发症发生率方面也无差异。
对于采用多模式方法进行全膝关节置换术的患者,聚乙烯泡沫垫对膝关节肿胀没有显著的有益作用。