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关节镜下髋关节手术后使用持续被动运动装置可减轻术后疼痛:一项随机对照试验。

Use of continuous passive motion device after arthroscopic hip surgery decreases post-operative pain: A randomized controlled trial.

作者信息

Munsch Maria, Vajapey Sravya P, Vasileff W Kelton, Ellis Thomas, DeWitt John, Ryan John

机构信息

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Orthopedic One, Dublin, OH, USA.

出版信息

J Clin Orthop Trauma. 2021 Oct 18;23:101646. doi: 10.1016/j.jcot.2021.101646. eCollection 2021 Dec.

Abstract

BACKGROUND

We sought to determine whether continuous passive motion (CPM) usage improves outcomes following arthroscopic hip surgery involving acetabular labral repair. Our hypothesis is that CPM usage reduces pain and pain medication use and improves quality of life in individuals who undergo hip arthroscopy.

METHODS

We created a randomized controlled trial consisting of 54 patients who underwent arthroscopic acetabular labral repair. Patients were randomized to two groups, one with CPM use post-operatively and one without. Primary outcomes measured were pain level, patient satisfaction, and quality of life. Parameters used to measure these outcomes were self-reported pain scores on Likert scale, frequency of analgesic medication use, and self-reported scores on Hip Outcome Score Activity of Daily Living (HOS ADL). These parameters were compared between the two randomized groups using -test for statistical analysis.

RESULTS

There was no statistical difference between the treatment and control groups in terms of patient characteristics. There was no statistical difference between the two groups in terms of HOS ADL scores, although the patients in the control group demonstrated a trend toward higher HOS ADL scores. The patients in the CPM group had a statistically significant decrease in pain levels after surgery compared to patients in the control group. The total morphine equivalent dose consumed in the first two post-operative weeks was higher in the control group compared to the CPM group, although this difference was not statistically significant.

CONCLUSIONS

Use of CPM resulted in lower pain level scores in patients after hip arthroscopy. Although there is no statistical difference in quality of life or quantity of analgesics consumed post-operatively, patients who used CPM tended to have lower HOS ADL scores (which is desirable) and less consumption of pain medication. A study with a larger sample of patients might elucidate more differences between the two groups.

LEVEL OF EVIDENCE

II, therapeutic.

摘要

背景

我们试图确定在涉及髋臼盂唇修复的关节镜髋关节手术后使用持续被动运动(CPM)是否能改善治疗效果。我们的假设是,使用CPM可减轻疼痛、减少止痛药物的使用,并改善接受髋关节镜检查患者的生活质量。

方法

我们开展了一项随机对照试验,纳入54例行关节镜下髋臼盂唇修复术的患者。患者被随机分为两组,一组术后使用CPM,另一组不使用。主要测量指标为疼痛程度、患者满意度和生活质量。用于测量这些指标的参数包括李克特量表自我报告的疼痛评分、止痛药物使用频率以及日常生活髋关节结果评分(HOS-ADL)自我报告评分。使用t检验对这两个随机分组进行统计学分析,比较这些参数。

结果

治疗组和对照组在患者特征方面无统计学差异。两组在HOS-ADL评分方面无统计学差异,尽管对照组患者的HOS-ADL评分有升高趋势。与对照组患者相比,CPM组患者术后疼痛程度有统计学意义的降低。术后前两周,对照组消耗的吗啡当量总量高于CPM组,尽管这一差异无统计学意义。

结论

髋关节镜检查后使用CPM可降低患者的疼痛评分。尽管术后生活质量或止痛药物消耗量无统计学差异,但使用CPM的患者HOS-ADL评分往往较低(这是理想的),且止痛药物消耗量较少。纳入更多患者样本的研究可能会阐明两组之间更多的差异。

证据级别

II级,治疗性。

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