Healy W L, Seidman J, Pfeifer B A, Brown D G
Department of Orthopaedic Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
Clin Orthop Relat Res. 1994 Feb(299):143-6.
The efficacy of a cold compressive dressing after total knee arthroplasty (TKA) was prospectively studied in 105 knees in 76 patients. All components were cemented. All patients were placed in continuous passive motion machines after operation. A cold compressive Cryocuff dressing was applied to 50 knees after operation. An ACE wrap and ice pack were applied to the knees of 55 control patients after operation. Postoperative range of motion was recorded as maximum active flexion at two to four days (interval one), at seven to 14 days (interval two), and four to six weeks (interval three). Swelling was measured at the same time intervals by circumference at the midpatella and circumference at the distal thigh one inch proximal to the superior pole of the patella. Use of postoperative narcotics was calculated for postoperative days zero to three and for postoperative days four to seven. Wound drainage was recorded for all knees. The use of a cold compressive dressing after TKA was not associated with an increase in range of motion at any point after the operation. The Cryocuff dressing did not appreciably reduce swelling around the knee after TKA. No significant difference was found in the amount of postoperative wound drainage between the two groups of patients. In patients undergoing unilateral TKA, no significant difference existed between the narcotic requirements of control patients and patients wearing the cold compressive dressing.
对76例患者的105个膝关节进行了前瞻性研究，以探讨全膝关节置换术（TKA）后使用冷压缩敷料的疗效。所有组件均采用骨水泥固定。所有患者术后均置于持续被动运动机上。术后对50个膝关节应用冷压缩Cryocuff敷料。对55例对照患者的膝关节术后应用ACE绷带和冰袋。记录术后2至4天（间隔1）、7至14天（间隔2）和4至6周（间隔3）时的最大主动屈曲度作为术后活动范围。在相同时间间隔通过髌骨中部周长和髌骨上极近端1英寸处大腿远端周长测量肿胀情况。计算术后0至3天和术后4至7天的术后麻醉药使用量。记录所有膝关节的伤口引流量。TKA后使用冷压缩敷料与术后任何时间点的活动范围增加均无关。Cryocuff敷料并未明显减少TKA后膝关节周围的肿胀。两组患者术后伤口引流量无显著差异。在接受单侧TKA的患者中，对照患者和使用冷压缩敷料患者的麻醉药需求量无显著差异。
