Duffaydar Hamza, Dong Huan, Jebur Maha, Mughal Ejaz
Surgery, Royal Wolverhampton NHS Trust, Wolverhampton, GBR.
Trauma and Orthopaedics, Royal Orthopaedic Hospital, Birmingham, GBR.
Cureus. 2023 Dec 10;15(12):e50279. doi: 10.7759/cureus.50279. eCollection 2023 Dec.
Purpose The objective of this study was to investigate whether cryotherapy is effective in reducing pain, opioid consumption, and length of stay (LOS) in hospital following total knee arthroplasty (TKA). Methods This prospective cohort study included 191 consecutive patients who underwent TKA without having access to cryotherapy, followed by 193 consecutive patients who underwent TKA and received automated cryotherapy as part of the recovery phase. All patients had their surgical procedures performed by the same surgeons and received post-operative care by the same nursing, medical, and physiotherapy team. The pain score using the visual analog scale (VAS)and the amount of opioid used on the first three post-operative days were recorded along with the length of hospital stay. Results There was no difference in baseline characteristics between the two groups. The use of cryotherapy was associated with a reduced pain score on all three days compared to when cryotherapy was not used: Day 1 pain score was 5.2 versus 6.1 (p < 0.01), Day 2 was 3.6 versus 4.8 (p = 0.03), and Day 3 was 2.8 versus 3.8 (p < 0.01). Cryotherapy was also associated with a significant reduction in analgesia consumption on all three days. The median amount of Oramorph used on all three days in the cryotherapy group was 15.0 mg compared to 40.0 mg in the control arm (p < 0.01). Additionally, the LOS was shorter in the cryotherapy group, with a mean of 3.86 days versus 4.20 days in the control group (p = 0.02). Conclusion The use of cryotherapy following TKA was associated with decreased pain and opioid consumption along with a reduced time to hospital discharge compared to when no cryotherapy was used.
目的 本研究的目的是调查冷冻疗法在全膝关节置换术（TKA）后减轻疼痛、减少阿片类药物使用量以及缩短住院时间（LOS）方面是否有效。方法 这项前瞻性队列研究包括191例连续接受TKA且未接受冷冻疗法的患者，随后是193例连续接受TKA并在恢复阶段接受自动冷冻疗法的患者。所有患者均由同一组外科医生进行手术，并由同一护理、医疗和物理治疗团队提供术后护理。记录使用视觉模拟量表（VAS）的疼痛评分、术后前三天使用的阿片类药物量以及住院时间。结果 两组患者的基线特征无差异。与未使用冷冻疗法相比，使用冷冻疗法在所有三天的疼痛评分均降低：第1天疼痛评分分别为5.2和6.1（p<0.01），第2天分别为3.6和4.8（p = 0.03），第3天分别为2.8和3.8（p<0.01）。冷冻疗法在所有三天的镇痛药物使用量也显著减少。冷冻疗法组所有三天使用的奥施康定中位数为15.0mg，而对照组为40.0mg（p<0.01）。此外，冷冻疗法组的住院时间较短，平均为3.86天，而对照组为4.20天（p = 0.02）。结论 与未使用冷冻疗法相比，TKA后使用冷冻疗法可减轻疼痛、减少阿片类药物使用量，并缩短出院时间。
