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改良罗伯特·琼斯绷带不能减轻初次全膝关节置换术后无术中止血带的加速康复中的术后肿胀:一项随机对照试验。

Modified Robert Jones bandage can not reduce postoperative swelling in enhanced-recovery after primary total knee arthroplasty without intraoperative tourniquet: a randomized controlled trial.

作者信息

Yu Haoda, Wang Haoyang, Zhou Kai, Rong Xiao, Yao Shunyu, Pei Fuxing, Zhou Zongke

机构信息

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 610041, China.

出版信息

BMC Musculoskelet Disord. 2018 Oct 5;19(1):357. doi: 10.1186/s12891-018-2281-6.

Abstract

BACKGROUND

Compression therapy is commonly used to reduce lower limb swelling and blood loss after knee surgery. This study was performed to investigate whether modified Robert Jones bandage (MRJB) as a postoperative compression therapy is necessary for enhanced-recovery primary total knee arthroplasty without the tourniquet application.

METHODS

In this prospective randomized controlled trial, 90 patients were grouped into 2 groups randomly. The experimental group received compression therapy with MRJB from toes to thigh for 24 h and the control group received no compression therapy. Knee swelling, blood loss, range of motion (ROM), pain, patient reported comfort level and complications were recorded.

RESULTS

No significant differences were observed between the two groups when we compared knee swelling. Similarly, no significant difference on postoperative blood loss, pain, ROM, complications was found. However, patients in control group had significantly higher comfort ratings than compression group during the first 24 h.

CONCLUSIONS

MRJB is not routinely indicated in enhanced-recovery primary total knee arthroplasty without tourniquet application.

TRIAL REGISTRATION

The trial was registered in the Chinese Clinical Trial Registry ( ChiCTR-INR-16010177 ) dated 18th December 2016.

摘要

背景

加压治疗常用于减轻膝关节手术后下肢肿胀和失血。本研究旨在探讨改良罗伯特·琼斯绷带(MRJB)作为一种术后加压治疗方法,对于不使用止血带的加速康复初次全膝关节置换术是否必要。

方法

在这项前瞻性随机对照试验中,90例患者被随机分为两组。试验组从脚趾到大腿使用MRJB进行24小时加压治疗,对照组不进行加压治疗。记录膝关节肿胀、失血、活动范围(ROM)、疼痛、患者报告的舒适度和并发症情况。

结果

比较膝关节肿胀时,两组之间未观察到显著差异。同样,在术后失血、疼痛、ROM、并发症方面也未发现显著差异。然而,在最初24小时内,对照组患者的舒适度评分明显高于加压治疗组。

结论

对于不使用止血带的加速康复初次全膝关节置换术,MRJB并非常规必需。

试验注册

该试验于2016年12月18日在中国临床试验注册中心(ChiCTR-INR-16010177)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175c/6173900/d8b83f24aa5a/12891_2018_2281_Fig1_HTML.jpg

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