Relationship of extrusion and elevation of blood-expelling methods during total knee arthroplasty with postoperative complications
10.3969/j.issn.2095-4344-2508
- Author:
Jiandong YIN
1
Author Information
1. Affiliated Hospital of Chengdu University of TCM
- Publication Type:Journal Article
- Keywords:
Complications;
Early pain after operation;
Elevation;
Extrusion;
Rapid rehabilitation;
Total knee arthroplasty;
Tourniquet
- From:
Chinese Journal of Tissue Engineering Research
2020;24(9):1331-1336
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: At present, extrusion is widely used in total knee arthroplasty. Studies have shown that extrusion can aggravate early pain and increase the risk of complications after operation. Therefore, a safer and more effective method it is urgently needed in clinic. OBJECTIVE: To observe the effects of elevation and extrusion of blood-expelling method on clinical outcomes during total knee arthroplasty. METHODS: Sixty-four patients who were scheduled to undergo unilateral total knee arthroplasty for the first time were randomly divided into two groups. During total knee arthroplasty, the control group received extrusion method, while the experimental group received elevation method. The main outcomes of the two groups were compared: Visual analogue scale score, knee joint swelling, C-reactive protein, serum creatine kinase activity and postoperative complications; secondary outcomes: Tourniquet use time, Hospital for Special Surgery score, and SF-36 score. RESULTS AND CONCLUSION: (1) Visual analogue scale scores in the experimental group were significantly lower than those in the control group on the first day, the seventh day, the first month and the third month after operation (P < 0.05). (2) Knee swelling, serum creatine kinase and C-reactive protein increased in both groups after operation, but the increase in experimental group was significantly lower than that in control group (P < 0.05). (3) In terms of postoperative complications, the incidences of tension vesicles and deep vein thrombosis in the control group were higher than those in the experimental group (P < 0.05). The total complication rate was significantly higher in the control group than in the experimental group (P < 0.05). (4) There was no significant difference in tourniquet use time between the two groups (P> 0.05). (5) Hospital for Special Surgery score and SF-36 score were assessed at 1, 3 and 6 months. The results showed that it was better than before, but there was no significant difference between the two groups (P > 0.05). (6) In conclusion, elevation of blood-expelling method could alleviate early pain response, reduce inflammation reaction and soft tissue injury, and decrease the incidence of skin tension blisters and thromboembolism. It is in line with the concept of rapid recovery. Therefore, during total knee arthroplasty, elevation of blood-expelling method is a safer and more effective method than extrusion.
