The effect of cold therapy combined with ERAS in the postoperative care of patients undergoing total knee arthroplasty.

OBJECTIVE

To investigate the nursing effect of cold therapy combined with enhanced recovery after surgery (ERAS) in patients undergoing total knee arthroplasty (TKA).

METHODS

Eighty patients with knee osteoarthritis who underwent TKA in our hospital from August 2020 to January 2021 were enrolled in this study, and they were divided into a control group (n=40) and a study group (n=40) according to the nursing procedures. The time and cost of rehabilitation, pain level, recovery of knee function, incidence of postoperative complications, self-care ability, quality of life, and nursing satisfaction were compared between the two groups.

RESULTS

The time of rehabilitation and time to out-of-bed activities in the study group were significantly shorter than those in the control group ( < 0.05), and the cost of rehabilitation in the study group was significantly lower than that in the control group ( < 0.05). There was no significant difference in preoperative visual analogue scale (VAS) scores (at rest, during exercise) between the two groups ( > 0.05). These scores in the study group were significantly lower than those in the control group at 6 h, 24 h, 48 h, and 72 h postoperatively ( < 0.05). The preoperative Hospital for Special Surgery (HSS), range of motion (ROM) and Barthel scores did not differ significantly between the two groups ( > 0.05). The postoperative ROM and Barthel scores were decreased to the lowest at 3 d postoperatively and gradually increased with time, and the HSS, ROM and Barthel scores in the study group were significantly higher than those in the control group ( < 0.05). The incidence of postoperative complications in the study group was significantly lower than those in the control group, and overall nursing satisfaction in the study group was significantly higher than those in the control group ( < 0.05). After discharge, the SF-36 scores of patients in both groups were higher than those before surgery, and the SF-36 scores in the study group were significantly higher than those in the control group ( < 0.05).

CONCLUSION

The cold therapy combined with ERAS for patients undergoing TKA can improve the postoperative swelling and pain of the affected limb, inspire patients' autonomy in postoperative rehabilitation training, shorten the time to out-of-bed activity, prevent patients from developing venous thrombosis, promote recovery of knee function, and improve patients' postoperative self-care ability and quality of life.