Iwakiri Kentaro, Kobayashi Akio, Takeuchi Yuichi, Kimura Yusuke, Ohta Yoichi, Nakamura Hiroaki
Department of Orthopaedic Surgery, Shiraniwa Hospital, 6-10-1 Shiraniwadai Ikoma-city, 630-0136 Nara, Japan.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku Osaka-city, 545-8585 Osaka, Japan.
SICOT J. 2019;5:13. doi: 10.1051/sicotj/2019010. Epub 2019 May 3.
Cryotherapy is rarely reported on the usefulness of cryotherapy applied after total hip arthroplasty (THA), and there are no reports about patient satisfaction against the cryotherapy following THA. The aim of this study was whether cryotherapy can be useful for relieving pain, reducing blood loss, and swelling, and improving patient satisfaction after THA.
Thirty patients who had undergone THA were treated by a controlled cooling device for 72 h following THA (defined as the cryotherapy group). The other 30 patients without cryotherapy were not treated with cryotherapy (defined as the control group). Blood samples (creatine kinase, and C-reactive protein), estimated blood loss, visual analog scale (VAS) of pain score, total doses of diclofenac sodium suppository used for pain relief, thigh swelling, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and adverse outcomes were compared between two groups.
Thigh circumference, measured on only day 4 postoperatively, was significantly lower in the cryotherapy than in the control group. Furthermore, patient satisfaction on postoperative days 4 and 7 was significantly higher in the cryotherapy than in the control group. There were no significant differences in other outcomes between groups.
These results support the potential benefit of cryotherapy for the reduction of swelling, and patient satisfaction during postoperative recovery of patients undergoing THA, even in the presence of periarticular injection and tranexamic acid administration for the prevention of postoperative pain and bleeding. Postoperative cryotherapy is a potentially simple, noninvasive, and relatively inexpensive option for post-THA management.
关于全髋关节置换术(THA)后应用冷冻疗法的有效性鲜有报道,且尚无关于THA后患者对冷冻疗法满意度的报告。本研究的目的是探讨冷冻疗法对缓解THA后疼痛、减少失血和肿胀以及提高患者满意度是否有用。
30例行THA的患者在THA后使用控温装置治疗72小时(定义为冷冻治疗组)。另外30例未接受冷冻治疗的患者作为对照组。比较两组的血样(肌酸激酶和C反应蛋白)、估计失血量、疼痛评分的视觉模拟量表(VAS)、用于缓解疼痛的双氯芬酸钠栓剂总剂量、大腿肿胀情况、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及不良结局。
仅在术后第4天测量的大腿围,冷冻治疗组明显低于对照组。此外,冷冻治疗组术后第4天和第7天的患者满意度明显高于对照组。两组在其他结局方面无显著差异。
这些结果支持了冷冻疗法在减少THA患者术后恢复期间肿胀和提高患者满意度方面的潜在益处,即使在使用关节周围注射和氨甲环酸预防术后疼痛和出血的情况下也是如此。术后冷冻疗法是THA术后管理中一种潜在的简单、无创且相对便宜的选择。