The Application Of Acupuncture Combined With Proprioception Training In Rehabilitation After Total Knee Replacement

Background:In recent years,the application of the concept of accelerated rehabilitation surgery in various medical disciplines has been gradually expanded,such as Department of orthopedics,cardiothoracic surgery,general surgery and other disciplines,most of them have good clinical results.Now the application of ERAS concept in most of the Department of orthopedics surgery in China is now in the process of continuous improvement and growth,and is slowly forming the domestic characteristics of the ERAS.Total knee arthroplasty(one of the operation as severe osteoarthritis of the knee surgery generally choose the key to get good results in surgery postprocessing and rehabilitation training,the clinical use of multimodal analgesia(opioid based analgesia,oral non opioid / non steroidal anti-inflammatory drugs,intravenous analgesia on time,analgesia,analgesia,individual),some patients still plan abnormal pain phenomenon or adverse reactions of opioids,and postoperative rehabilitation training on proprioception training lack of attention.In view of the above problems,we have carried out this study.Purpose:This study aims to investigate the total knee arthroplasty(TKA)routine treatment after operation,the increase of acupuncture and proprioceptive training of these two kinds of effects of rehabilitation therapy on rehabilitation of patients after TKA,in order to enrich the total knee arthroplasty after the rapid rehabilitation of existing content,carry forward the traditional medicine,as the concept of rapid rehabilitation surgery add a new combination of traditional Chinese and Western medicine,and provide evidence of evidence-based medicine.Methods:During the period from September 2015 to October 2017 in Wuhan City Hospital of traditional Chinese and Western medicine for joint surgery of hospitalized TKA patients with primary knee osteoarthritis,according to the pre established inclusion / exclusion criteria screening test in 160 cases,according to the selected successively number,were randomly divided into combined group,acupuncture group,proprioception training group and control group,40 cases in each group.The basic data were recorded before the operation,the routine records were recorded,the patients were informed of the basic test situation and the informed consent was signed.Rehabilitation therapy was started after operation.Four groups were treated with routine rehabilitation therapy after TKA.The combined group also increased acupuncture treatment and proprioception training.Acupuncture group increased acupuncture treatment,proprioception training group increased proprioception training.Results:There was no significant difference in VAS score between 3D group,acupuncture group,proprioceptive training group and control group after operation(P>0.05),but the VAS scores in the former two groups were significantly lower than those in the latter two groups(P<0.05).After 7d,VAS score between four groups was not significant(P>0.05);4 weeks after surgery,the HSS score of the four groups in pain,function,activity,muscle strength and flexion deformity,no significant difference(P>0.05),combination group and proprioception training group of the two groups in the scores of stability significantly higher than the acupuncture group and control group(P<0.05);after 8 weeks,HSS scores of the four groups in pain,function,activity and muscle strength,no significant difference(P>0.05),combination group and proprioception training group of the two groups in the two aspects of stability,flexion deformity score was significantly higher than that in the acupuncture group and the control group(P<0.05);after 12 weeks,HSS scores of the four groups in pain,activity and muscle strength,no significant difference(P>0.05),combination group and proprioception training group of the two groups in the stability,function,flexion deformity three rating The score was significantly higher than that in the acupuncture group and the control group(P<0.05).(3)there was no significant difference in the angle between the four groups of patients in the isokinetic system before the total knee arthroplasty(P>0.05).After 12 weeks,compared with the preoperative group,the angle values of the active reduction errors in the four groups were significantly reduced.After 12 groups of patients with active Thursday reset error angle value there is a significant difference between the 22(P<0.05),in comparison,combined with the group proprioception training group,acupuncture group and control group respectively,there was no significant difference of active reset angle error(P>0.05),but the first two were significantly lower than those in their active reset error angle(P<0.05).Conclusion:Acupuncture treatment has a good clinical effect in acute pain after TKA.After proprioception training,the proprioception of patients after TKA is obviously improved,and at the same time,it can further restore the function of the knee joint.Therefore,increasing acupuncture and proprioceptive intensive training are two kinds of rehabilitation therapy,which have great help for the rehabilitation after TKA,which is worthy of clinical promotion.