The Application Of The Concept Of Enhanced Recovery After Surgery In Knee Arthroplasty

Purpose:To study the application of the concept of enhanced recovery after surgery in knee arthroplasty,to evaluate its application and to provide evidence for clinical popularization.Method:A total of 100 patients were collected from January 2016 to July 2017 for the first knee arthroplasty in the affiliated Hospital of Qingdao University,and 100 patients met the inclusion criteria,of which the patients from January 1,2016 to September 30,2016 were treated as routine rehabilitation group with 50 routine treatment methods.October 1,2016 to July 31,2017 50 patients with rapid rehabilitation were treated as rapid rehabilitation group,and there was no statistically significant difference between the two groups before operation.Compared with the conventional treatment measures in the traditional rehabilitation group,the perioperative management measures and treatment in the rapid rehabilitation group were improved and optimized comprehensively according to the concept of enhanced recovery after surgery.Visual analogue scale(VAS)was used to compare the postoperative pain in the two groups,and the time required for the recovery of the knee motion to 60°?80°?100°?120°after operation.The postoperative knee function score(HSS)was used to evaluate the incidence of postoperative complications in the two groups.And the lowest value of hemoglobin and blood transfusion rate,the length of hospitalization after operation in both groups.Results:The results showed that the VAS score in the rapid rehabilitation group was significantly lower than that in the traditional rehabilitation group(1 day,2 days,3 days,7days after operation)(P < 0.05),The range of motion(ROM)recovered to 60°?80°?100°?120°postoperatively was significantly lower than the traditional rehabilitation group(P <0.05),Postoperative HSS score of knee joint(1 week,2 weeks,1 month and 2 months after operation)was higher than that in the traditional rehabilitation group(P < 0.05),The postoperative hemoglobin value in the rapid rehabilitation group was significantly higher than that in the traditional rehabilitation group(P < 0.05),the blood transfusion rate was also lower than that in the conventional rehabilitation group(P < 0.05),the postoperative hospitalization time in the rapid rehabilitation group was lower than that in the traditional rehabilitation group(P < 0.05),and the incidence of postoperative complications in the rapid rehabilitation group was lower than that in the conventional rehabilitation group(P <0.05).Compared with the traditional rehabilitation group,the patients' satisfaction was significantly higher than that of the traditional rehabilitation group.The quality of life of the patients after operation was also greatly improved than that of the traditional rehabilitation group.Conclusions:Enhanced recovery after surgery(ERAS)is used to manage peri-operative patients by a variety of medical tests,minimize stress responses in perioperative patients,prevention and treatment of organ dysfunction,reduce the probability of complications,and better medical results,to achieve the purpose of treatment and promote the patient to recover as soon as possible.The specific method contains:(1)carry on the rehabilitation education to the patients before operation;(2)improving analgesic,anesthetic and surgical techniques to reduce stress response;(3)scientific and appropriate postoperative rehabilitation.The effect of this method in knee arthroplasty is to improve the management of perioperative patients and improve the skills of operation.Like improving the use of tourniquet,strengthening the application of urinary tube and drainage tube,prevention and treatment of venous thromboembolism(VTE),prevention of post-operative infection,reduce postoperative pain,improve sleep management,and reduce intraoperative trauma and bleeding,so as to improve patient satisfaction,enhancing surgical safety and reducing surgical risk.The concept of enhanced recovery after surgery involves many disciplines,and its treatment measures are not fixed,but are constantly changing with the progress of medical technology.There is no fixed pattern,which puts forward higher requirements for clinical workers.The concept of enhanced recovery after surgery is worth popularizing in clinical medicine,especially in the field of orthopedic joints.