术后肌内效贴布对全膝关节置换术和前交叉韧带重建术后膝关节水肿、疼痛及活动范围的影响：一项随机临床试验的系统评价和荟萃分析

Effect of Postoperative Kinesio Taping on Knee Edema, Pain, and Range of Motion After Total Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

作者信息

Azimi Amirali, Dizaji Shayan Roshdi, Tabatabaei Fatemeh-Sadat, Safari Saeed, Nakhaei Amroodi Morteza, Azimi Amir Farbod

机构信息

Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

JBJS Rev. 2024 Mar 15;12(3). doi: e23.00221. eCollection 2024 Mar 1.

DOI:10.2106/JBJS.RVW.23.00221

PMID:38489396

Abstract

BACKGROUND

Kinesio taping (KT) has been shown to be clinically effective in a wide range of musculoskeletal disorders. Despite evidence supporting KT, there still needs to be more certainty regarding its clinical worthiness in managing postoperative conditions. This study aims to assess the effect of postoperative KT on knee edema, pain, and range of motion (ROM) when added to routine physiotherapy after knee surgery.

METHODS

In this systematic review and meta-analysis, MEDLINE, Embase, Scopus, Web of Science, and CENTRAL databases were searched from their inception to July 2023. Randomized controlled trials (RCTs) comparing routine physiotherapy with and without KT were included. Random-effect models were used to calculate the standardized mean difference (SMD), confidence interval, and heterogeneity (I2).

RESULTS

Sixteen RCTs on 842 operated knees were included. KT reduced knee edema in first week (SMD, -0.59, p < 0.001), 14th postoperative day (POD) (SMD, -0.78, p < 0.001), and 28 to 42 days postop (SMD, -0.66, p < 0.001). The KT demonstrated significant pain improvement in second week (SMD, -0.87, p < 0.001) and the fourth week (SMD, -0.53, p < 0.001). The KT groups demonstrated ROM improvement within second week (SMD, 0.69, p = 0.010) and in the 28th POD (SMD, 0.89, p = 0.009). Subgroup analysis demonstrated minimal heterogeneity in anterior cruciate ligament reconstruction (ACLR) cases. However, it did not show significant superiority regarding ankle, calf, or thigh edema and Lysholm scale.

CONCLUSION

This study suggests that adding KT to routine postoperative physiotherapy reduces pain and knee edema after total knee arthroplasty or ACLR. Low to very low certainty of evidence for all outcomes and the limited number of studies emphasize the need for more high-quality primary studies to explore the optimal method of KT application and its effectiveness in specific knee surgeries.

LEVEL OF EVIDENCE

Level I. See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

肌内效贴布（KT）已被证明在多种肌肉骨骼疾病的治疗中具有临床疗效。尽管有证据支持KT，但在其对术后情况的临床价值方面仍需更多的确证。本研究旨在评估膝关节手术后，在常规物理治疗基础上加用术后KT对膝关节水肿、疼痛及活动范围（ROM）的影响。

方法

在本系统评价和荟萃分析中，检索了MEDLINE、Embase、Scopus、Web of Science和CENTRAL数据库自建库至2023年7月的数据。纳入比较有或无KT的常规物理治疗的随机对照试验（RCT）。采用随机效应模型计算标准化均数差（SMD）、置信区间和异质性（I2）。

结果

纳入了16项关于842个手术膝关节的RCT。KT在术后第1周（SMD，-0.59，p < 0.001）、术后第14天（POD）（SMD，-0.78，p < 0.001）以及术后28至42天（SMD，-0.66，p < 0.001）减轻了膝关节水肿。KT在术后第2周（SMD，-0.87，p < 0.001）和第4周（SMD，-0.53，p < 0.001）显示出疼痛显著改善。KT组在术后第2周（SMD，0.69，p = 0.010）和第28个POD（SMD，0.89，p = 0.009）时ROM得到改善。亚组分析显示前交叉韧带重建（ACLR）病例的异质性最小。然而，在踝关节、小腿或大腿水肿以及Lysholm评分方面，KT并未显示出显著优势。