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In recent years, pain management coordinated with enhanced recovery after surgery (ERAS) has been widely applied and rapidly developed in orthopedics, showing promising prospects. Since 2016, our hospital has used a series of continuously improved pain management schemes for patients with knee OA who underwent total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and high tibial osteotomy (HTO). Here, we retrospectively analyze these patients' clinical data to compare the effects of different pain intervention measures during the perioperative period on postoperative pain, functional exercise, hospital stay, and prognosis of the three surgical methods in an attempt to provide a feasible solution for pain management of these patients.
We retrospectively analyzed the clinical data of patients with knee osteoarthritis (OA) who received surgical treatment to provide a feasible solution for perioperative pain management of these patients. The medical records of 714 patients with knee OA who had undergone total knee arthroplasty (n=551), unicompartmental knee arthroplasty (n=92) and high tibial osteotomy (n=71) were retrospectively analyzed and the cases were divided into Groups A, B, and C, according to the continuously optimized pain management. Clinical data including anesthesia grade, surgery time, functional exercise, hospital stay, pain, emotion, complications and prognosis were compared.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Total knee arthroplasty (TKA) | Total knee arthroplasty |
| |
| Unicompartmental knee arthroplasty (UKA) | Unicompartmental knee arthroplasty |
| |
| High tibial osteotomy (HTO) | High tibial osteotomy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative pain managment | Procedure | propaganda and education on pain; Preemptive analgesia with celecoxib (200 mg bid) 2 days before surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| visual analogue score (VAS) | visual analogue score (VAS) | 24 hours after surgery |
| visual analogue score (VAS) | visual analogue score (VAS) | 72 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps muscle strength | Quadriceps muscle strength | 24 hours after surgery |
| Quadriceps muscle strength | Quadriceps muscle strength |
| Measure | Description | Time Frame |
|---|---|---|
| Self-Rating Anxiety Scale (SAS) | Self-Rating Anxiety Scale (SAS) | 24 hours after surgery |
| Self-Rating Anxiety Scale (SAS) | Self-Rating Anxiety Scale (SAS) |
Inclusion Criteria:
Exclusion Criteria:
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The medical records of 714 patients (142 men, 40 women; mean age: 38.5 years; age range: 18-64 years) with moderate or severe knee OA who had undergone TKA (n=551), UKA (n=92), or HTO (n=71) in a group of joint surgery at Sichuan Provincial People's Hospital between March 2016 and February 2022 were retrospectively analyzed. Clinical data, including age, weight, height, anesthesia grade, surgery, and time, as well as continuously improved perioperative pain management measures, were recorded.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sichuan Provincial People's Hospital | Chengdu | Sichuan | 610072 | China |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| Intraoperative pain managment | Procedure | Squeeze to expel blood (tourniquet); Before skin suture, 20 mL 0.5% ropivacaine was given subcutaneously for local infiltration anesthesia; |
|
| Postoperative pain managment | Procedure | The intravenous analgesia pump was placed until 48 h after surgery;On the second day after surgery, celecoxib (200 mg bid) was administered orally, and buprenorphine transdermal patch was applied externally until hospital discharge;FNB catheter was placed under the guidance of ultrasound and connected with an analgesic pump, the anesthesia lasted until 48 h after surgery ‡ |
|
| 72 hours after surgery |
| Scope of activities to knee joint | Scope of activities to knee joint | 24 hours after surgery |
| Scope of activities to knee joint | Scope of activities to knee joint | 72 hours after surgery |
| 72 hours after surgery |
| Self-Rating Depression Scale (SDS) | Self-Rating Depression Scale (SDS) | 24 hours after surgery |
| Self-Rating Depression Scale (SDS) | Self-Rating Depression Scale (SDS) | 72 hours after surgery |
| D012216 |
| Rheumatic Diseases |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |