Clinical Study On The Treatment Of Aseptic Inflammation After TKA With Shangke Huangshui Gauze

ObjectiveTo investigate the clinical efficacy of Shangke Huangshui Gauze in the treatment of aseptic inflammation after Total knee arthroplasty(TKA),thereby providing a more effective combination therapy for osteoarthritis of the knee.MethodsIn this study,we screened patients with osteoarthritis of the knee who met the inclusion criteria between 2022.1-2022.06 and randomized them into two group.Control group: routine treatment after TKA surgery;treatment group: topical application of Shangke Huangshui Gauze was given once daily for 2 weeks after surgery compared with the control group.Data on serum interleukin-6(IL-6),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),leg circumference and skin temperature were recorded at 1d,3d,1w and 2w postoperatively in both groups to compare pre-and post-treatment conditions.To compare the differences in inflammatory trends between the two groups before and after treatment.Rasmussen classification scores were recorded both before and after treatment.SPSS 26.0 statistical software was used to analyze all data.ResultsBaseline information such as male to female ratio,age size,and side of surgery were comparable between the two groups(P>0.05).The baseline data such as male to female ratio,age size,and side of surgery were comparable between the two groups(P>0.05).(1)Leg circumference: At one week after surgery,the leg circumference of the treatment group was significantly reduced compared with that of the control group,indicating that the swelling was reduced well within a short period of time after surgery;the leg circumference of 10 cm below the knee was generally decreasing in both groups,and the degree of swelling reduction was similar,with the swelling reduction effect of the treatment group being more obvious at 1 week after surgery.(2)Skin temperature: At 2 weeks after surgery,the skin temperature of the treatment group was significantly lower compared with that of the control group,considering that the effect of yellow water cooling in the wound section was not as obvious at the early stage as at 2 weeks.There was no significant difference in skin temperature on the healthy side in both groups,which was significant in comparison with the affected side.(3)IL-6: 1 day after surgery was the base value before the respective treatment in both groups of patients.After 3 days and 1 week of treatment in both groups,respectively,there was a tendency for the IL-6 value to decrease,and there was no significant difference in the decrease in both groups.After 2 weeks of treatment,the IL-6 levels of patients in both groups were further reduced,and there were statistical differences between the groups,with the difference in the final IL-6 levels being more pronounced in both groups.(4)ESR: The trend of ESR in the two groups was basically the same(rising first and then decreasing)when external treatment was performed in the early postoperative period.After a period of treatment,the ESR values in the control group increased more than those in the treatment group on the 3rd and 7th postoperative days,with the difference in ESR levels being more significant at 1 week postoperatively.After 2 weeks of treatment,the ESR in both groups returned to the level on postoperative day 1.It indicates that both treatment modalities have an effect on ESR,and the effect of yellow water topical application on lowering ESR is better than that of alcohol topical application group.(5)CRP: After grouping for treatment,the CRP in both groups tended to decrease significantly within 2 weeks,and the decrease was greater in the treatment group,indicating that the CRP-lowering effect of yellow water topical application was better than that of the alcohol topical application group.(6)Rasmussen’s grading score: The patients in both groups had significantly relieved pain and expanded walking ability before and after treatment,and the treatment group had a stronger effect on pain,but the degree of effect of treatment on walking ability was basically the same in both groups.The joint mobility,degree of joint stability,and knee extension angle improved in both groups after treatment,but there was no significant difference in the degree of improvement between the two groups.Safety observation: no serious adverse reactions in the two case study groups.In treatment group,treatment was stopped after one case of allergy and oral loratadine tablets were administered,and the symptoms could be relieved without other discomfort.In 2cases of control group,the pain increased at the beginning of treatment,and analgesic drugs were taken,and the patients had significant pain relief without other discomfort.Except for the three patients mentioned above who experienced adverse reactions,no other patients showed significant discomfort.ConclusionThe use of Shangke Huangshui Gauze topical treatment can significantly reduce the serum levels of IL-6,ESR and CRP in patients after TKA,effectively relieving pain,reducing swelling and lowering skin temperature,but it is not significantly better than the alcohol gauze control group for patients’ postoperative functional rehabilitation,providing a new clinical idea for the prevention of postoperative infection in TKA.