| [Objective] By observing the comparative photon therapy in Total Knee replacement (Total Knee Arthroplasty, TKA) after early Continuous Passive Motion device (Continuous Passive Motion, CPM), the application of functional exercise, objective evaluation the photon therapy this way of treatment after Total Knee Arthroplasty, the clinical effect of early functional exercise Passive movement, discuss of this early functional exercise after Total Knee Arthroplasty.[Method] This study of clinical intervention by adopting the method randomized controlled trial,90 patients were randomly divided into 3 groups:the CPM group, CPM+ drug group, CPM+photon therapy group,30 cases in each group. The CPM group only CPM TKA surgery early exercise. CPM+ drug groups on the basis of CPM TKA surgery early exercise, add a nonsteroidal anti-inflammatory drug celebrex. CPM+ photon therapy group on the basis of CPM TKA surgery early exercise, combined with the photon therapy. Three groups all functional exercise on day 2 after surgery, postoperative day 1 (exercise) before and after 3,5, and 7 days (exercise 2,4,6 days) measured on 10 centimeters, patellar midpoint, patellar patellar next week 10 cm diameter in order to observe the postoperative limb swelling; Using Visual analog pain score (Visual Analogue Scale, VAS) 3,5, and 7 days after surgery (exercise 2,4,6 days) when resting state and activity (CPM exercise) to observe the postoperative pain; Daily CPM after knee flexion degree measurement, observation of knee joint function recovery to 45 degrees and 90 degrees; 2 weeks in The preoperative and postoperative exercise (exercise 13 days) on knee joint American Hospital For Special Surgery (The Hospital For Special Surgery, HSS) function score; After 2 weeks (exercise 13 days) for the treatment of satisfaction investigation.[Results] (1) The comparison swelling in the three groups of patients in postoperative day 1 has no statistical significance (P>0.05),3,5, and 7 days after surgery swelling numerical comparison, statistically significant (P<0.05), CPM+ effect of detumescence photon therapy group is better than the CPM+ drug group and CPM group. (2) The three groups of patients with pain VAS score resting and activities in 3 days,5 and 7 days after the operation all have significant difference (P<0.05), and the pain scores were CPM+ drug group is superior to the CPM+ photon therapy group, and the CPM+ photon therapy pain score better than CPM group. Activity result is the same as the rest pain pain score. (3) The three group of patients in postoperative limb flexion reached 45 degrees and 90 degrees time needed for comparison, a statistical difference (P<0.05), CPM+ drug group and the CPM in time+ photon therapy group were shorter than the CPM group, CPM+ drug group and CPM, no statistical difference between the photon therapy group (P>0.05). (4) Three groups of patients with knee joint HSS score in the preoperative comparison, no statistical significance (P>0.05); 2 weeks after knee joint function of HSS score three group were better than that of their preoperative scores, statistically significant (P<0.05); Three groups of 2 weeks after knee joint function of HSS score compared between two groups, CPM+ drug group and CPM+ on the function of knee joint HSS score photon therapy group were better than the CPM group, statistically significant (P<0.05), while CPM+ drug group and the comparison between CPM+ photon therapy group has no statistical significance (P>0.05). (5) Satisfaction survey of three groups of patients to treatment was statistically difference (P<0.05), the patient was most satisfied with CPM+ photon therapy group.[Conclusion] The CPM postoperative functional exercise combined with photon therapy used all over the knee joint to alleviate postoperative lower limb swelling in clinical effect is obvious, patients are easy to accept, and simple, no side effect, can be a very good exercise to improve patients comfort. |
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