Joint Reconstruction Research Center, Tehran University Of Medical Sciences, Tehran, Iran.
Fellowship of Hip Surgery, Zanjan University of Medical Sciences, Tehran, Iran.
Int Orthop. 2022 Aug;46(8):1749-1759. doi: 10.1007/s00264-022-05428-8. Epub 2022 May 19.
Investigate the effect of semirigid extension bracing after total knee arthroplasty (TKA) on articular pain and function.
The present randomized clinical trial included 72 patients undergoing unilateral primary TKA. Patients in the case group received eight days of post-operative semirigid extension-locked knee bracing, whereas controls did not. The outcomes assessed preoperatively and on the first, ninth, 30th day, and one year post-operatively included the knee society score (KSS), functional KSS (FKSS), VAS pain score, amount of postoperative opiate painkiller usage (tablet oxycodone 5mg), and knee ROM.
The case group had a significantly lower flexion ROM on postoperative day nine compared to the control group (95.3° vs. 100.8°, p=0.03), while it became significantly higher 1 month (114.1° vs. 104.7°, p=0.03) and one year post-operative (128.0° vs. 120.5°, p=0.002). Also, FKSS was significantly higher in the case group than in the controls in the one month post-operative assessment (37.0 vs. 32.6, p=0.009) but not in the one year post-operative assessment. The case group patients had a significantly lower pain than the controls on days one (5.8 vs. 7.2, p=0.02) and nine post-operative (4.1 vs. 5.2, p=0.048), but not at later assessments. The amount of one month post-operative opium (oxycodone) consumption was significantly lower in the brace group (12.4 vs. 14.1 tablets, p=0.03). The KSS were not significantly different between the groups after the surgery.
Extension-locked splinting immediately after TKA is a noninvasive, non-pharmacological, and inexpensive intervention with possible promising effects on knee ROM, short-term functional improvement, and acute post-operative pain management.
研究全膝关节置换术后使用半刚性伸直位支具对关节疼痛和功能的影响。
本随机临床试验纳入了 72 例行单侧初次全膝关节置换术的患者。病例组患者术后接受 8 天的半刚性伸直位锁定支具治疗，而对照组则不接受。在术前、术后第 1、9、30 天和 1 年时评估的结果包括膝关节学会评分（KSS）、功能 KSS（FKSS）、视觉模拟评分（VAS 疼痛评分）、术后阿片类止痛药（奥施康定 5mg 片）的使用量和膝关节活动度。
病例组在术后第 9 天的膝关节屈曲活动度明显低于对照组（95.3° vs. 100.8°，p=0.03），而在术后 1 个月（114.1° vs. 104.7°，p=0.03）和 1 年时（128.0° vs. 120.5°，p=0.002）明显更高。此外，病例组在术后 1 个月时的 FKSS 明显高于对照组（37.0 vs. 32.6，p=0.009），但在术后 1 年时则无差异。病例组患者在术后第 1 天（5.8 vs. 7.2，p=0.02）和第 9 天（4.1 vs. 5.2，p=0.048）的疼痛明显低于对照组，但在其他评估时则无差异。支具组术后 1 个月时的鸦片（羟考酮）用量明显低于对照组（12.4 片 vs. 14.1 片，p=0.03）。术后两组的 KSS 无明显差异。
TKA 术后立即使用伸直位锁定支具是一种非侵入性、非药物性、低成本的干预措施，可能对膝关节活动度、短期功能改善和急性术后疼痛管理有积极影响。
