Sadoghi Patrick, Hasenhütl Sandro, Gruber Gerald, Leitner Lukas, Leithner Andreas, Rumpold-Seitlinger Gudrun, Kastner Norbert, Poolman Rudolf W, Glehr Mathias
Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Division of Special Anaesthesiology, Pain and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
Int Orthop. 2018 Jun;42(6):1265-1273. doi: 10.1007/s00264-018-3766-5. Epub 2018 Jan 22.
The aim of this prospective, randomised and single blinded study was to evaluate the efficiency and safety of a new cryotherapy device in patients undergoing unilateral, primary total knee arthroplasty (TKA). Our hypothesis was that patients administered to the new cryotherapy device would perform better than patients receiving a conventional standard cold therapy regimen.
Ninety-seven patients were randomised into two groups receiving either the cTreatment® (new cryotherapy device) or the standard cold therapy protocol (including cold pack application for six days after the surgical intervention). We evaluated the following endpoints consisting of range of motion (ROM), pain intensity, and knee girth on admission day and the second, fourth, and sixth post-operative day (POD).
A statistically significant benefit of the new cryotherapy device was detected regarding the ROM on the sixth POD with an average gain of 7 degrees (p = 0.021). Pain in the numeric rating scale (NRS) score in motion was significantly lower in the cTreatment® group on the second POD (p = 0.034). There were no statistically significant differences between groups regarding the NRS in rest, patient controlled analgesia (PCA) consumption, and girth measurements. No adverse effects were observed in both study groups.
The new computer-controlled cooling therapy device provides benefits in terms of early post-operative remobilisation with respect to ROM and pain, which might be attributed to a reduced inflammatory response, as well as reduced secretion and bleeding. The cTreatment® system appears to be a safe and efficient procedure.
本前瞻性、随机单盲研究旨在评估一种新型冷冻治疗设备在接受单侧初次全膝关节置换术(TKA)患者中的有效性和安全性。我们的假设是,使用新型冷冻治疗设备的患者比接受传统标准冷疗方案的患者表现更好。
97名患者被随机分为两组,分别接受cTreatment®(新型冷冻治疗设备)或标准冷疗方案(包括手术干预后六天使用冷敷包)。我们评估了以下终点指标,包括入院当天以及术后第二天、第四天和第六天(POD)的关节活动范围(ROM)、疼痛强度和膝关节周长。
在术后第六天的ROM方面,检测到新型冷冻治疗设备具有统计学显著益处,平均增加了7度(p = 0.021)。在术后第二天,cTreatment®组运动时的数字评分量表(NRS)疼痛评分显著更低(p = 0.034)。在静息时的NRS、患者自控镇痛(PCA)用量和周长测量方面,两组之间没有统计学显著差异。两个研究组均未观察到不良反应。
新型计算机控制的冷却治疗设备在术后早期活动方面,在ROM和疼痛方面提供了益处,这可能归因于炎症反应减轻以及分泌物和出血减少。cTreatment®系统似乎是一种安全有效的方法。