Wang Chen, Yang Pu, Zhang Dongfang, Zhang Yi, Shen Youliang, Li Haifeng, Yu Tengbo, Qi Chao
Department of Sports Medicine, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266103, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):178-182. doi: 10.7507/1002-1892.202006134.
To investigate the effect of different saline irrigation volume under arthroscopy on early postoperative pain and swelling of the knee.
The clinical data of 539 patients with meniscus injury treated by arthroscopic menisci reformation who met the selection criteria between July 2016 and February 2020 were retrospectively analyzed. They were divided into three groups according to the continuous saline irrigation volume during the operation: 176 patients in the non-irrigation group (group A), 183 patients in the 1 liter-irrigation group (group B), and 180 patients in the 3 liters-irrigation group (group C). There was no significant difference in gender, age, cause of injury, sides of injury, body mass index, disease duration, smoking history, and classification of meniscus injury among 3 groups ( >0.05). At 6, 12, 24, 48, and 72 hours after operation, the patient's pain level was evaluated by the visual analogue scale (VAS) score, and the knee swelling situation was evaluated by the swelling ratings (the difference between both sides in circumference of the 2 cm upper patella of the knee). Knee skin temperature (the difference of the skin temperature between both sides) and the C-reactive protein (CRP) level in serum were measured at the 1st and 3rd days after operation. Range of motion of the knee was measured at the 1st, 3rd, and 5th days after operation.
All incisions healed by first intention without any complication after operation. The VAS scores of each group showed a slow increase trend after operation, and gradually decreased to less than the VAS score of 6 hours at 48 hours after operation. There was no significant difference in VAS scores among the 3 groups at each time point after operation ( >0.05). The swelling ratings of the knee in each group showed a gradually decrease trend after operation. There was no significant difference in the swelling ratings of the knee among the 3 groups at each time point after operation ( >0.05). The skin temperature of the knee in each group decreased at the 3rd day after operation than the 1st day, and there was no significant difference in the skin temperature of the knee among the 3 groups at each time point after operation ( >0.05). There was no significant difference in CRP level within the group and among the 3 groups at each time point after operation ( >0.05). Range of motion of the knee in each group increased gradually at the 1st, 3rd, and 5th days after operation, and there was no significant difference among the 3 groups at each time point after operation ( >0.05).
The different continuous saline irrigation volume would not affect the early postoperative pain, swelling, and inflammation of the knee during the arthroscopic menisci plasty.
探讨关节镜下不同生理盐水灌洗量对膝关节术后早期疼痛及肿胀的影响。
回顾性分析2016年7月至2020年2月间539例符合入选标准的经关节镜半月板成形术治疗的半月板损伤患者的临床资料。根据术中持续生理盐水灌洗量将其分为三组：非灌洗组（A组）176例，1升灌洗组（B组）183例，3升灌洗组（C组）180例。三组患者在性别、年龄、损伤原因、损伤侧别、体重指数、病程、吸烟史及半月板损伤分型等方面比较，差异均无统计学意义（P>0.05）。术后6、12、24、48及72小时，采用视觉模拟评分法（VAS）评估患者疼痛程度，采用肿胀评分（膝关节髌骨上2 cm处两侧周径之差）评估膝关节肿胀情况。术后第1天和第3天测量膝关节皮肤温度（两侧皮肤温度之差）及血清C反应蛋白（CRP）水平。术后第1、3及5天测量膝关节活动度。
术后所有切口均一期愈合，无任何并发症。各组VAS评分术后呈缓慢上升趋势，术后48小时逐渐降至低于术后6小时的VAS评分。术后各时间点三组VAS评分比较，差异均无统计学意义（P>0.05）。各组膝关节肿胀评分术后呈逐渐下降趋势。术后各时间点三组膝关节肿胀评分比较，差异均无统计学意义（P>0.05）。各组膝关节皮肤温度术后第3天低于第1天，术后各时间点三组膝关节皮肤温度比较，差异均无统计学意义（P>0.05）。术后各时间点组内及三组间CRP水平比较，差异均无统计学意义（P>0.05）。各组膝关节活动度术后第1、3及5天逐渐增加，术后各时间点三组间比较，差异均无统计学意义（P>0.05）。
关节镜下半月板成形术中不同持续生理盐水灌洗量对膝关节术后早期疼痛、肿胀及炎症无影响。
