| Objective:In this study,local non-sustained cryotherapy was applied,and the relevant indicators of patients were evaluated to evaluate the adjuvant effect of the method on postoperative rapid recovery of TKA patients,and the safety was evaluated.The aim is to improve the rapid recovery efficiency of TKA patients,increase patient satisfaction,shorten hospitalization time,improve patient turnover rate and achieve twice the result with half the effort by implementing simple,efficient and low-cost auxiliary means.Methods:A prospective controlled study was performed between January 20 and February 2019 in the Department of Orthopaedics,First Affiliated Hospital of Kunming Medical University,who was diagnosed with simple severe knee osteoarthritis(Kellgren-Lawrence grade 3-4).A total of 60 patients with total knee arthroplasty were treated with conservative treatment.?Experimental group:The patients were randomly divided into the experimental group of 30 cases and the control group of 30 cases.All patients were managed using a standardized rapid rehabilitation process.Among them,the experimental group patients received non-sustained local cold therapy on the basis of conventional treatment,the control group did not receive cold therapy,and the remaining treatment and functional exercise were the same.?There was significant difference in the drainage volume between the two groups at 6h,24h and 48h after operation(P<0.05).At the same time,the difference of hemoglobin(HGB)between the two groups at 1d,3d,5d and 7d was statistically significant.(P<0.05).This shows that the use of cryotherapy has the effect of reducing patient exudation and reducing blood loss.?Safety index observation:Observed the local skin temperature of the incision before,1st,3rd,5th,7th day after operation,hematological related indicators at 1,3,5,7d,wound healing at 2w,wound infection and DVT The situation was used to assess the safety of cryotherapy in patients after TKA.Resu ts:?DThere were no significant differences in gender,age distribution,body mass index(BMI),and operative time between the two groups(P>0.05).?There was significant difference in the drainage volume between the two groups at 6h,24h and 48h after operation(P<0.05).At the same time,the difference of hemoglobin(HGB)between the two groups at 1d,3d,5d and 7d was statistically significant.(P<0.05).This shows that the use of cryotherapy has the effect of reducing patient exudation and reducing blood loss.?There were no significant differences in resting and dynamic VAS scores between the two groups before operation(P>0.05).There were significant differences in resting and dynamic VAS scores between the two groups at 6h,24h,48h and 72h.P<0.05),indicating that the experimental group using cryotherapy was superior to the control group.?There was no significant difference in knee ROM between the two groups before operation(P>0.05).There was significant difference in knee ROM between the two groups at 1d,2d,3d and 5d(P<0.05),indicating the use of low temperature.The efficacy of the experimental group of cold therapy was better than that of the control group.?There were significant differences in HSS scores between the two groups before and after surgery(P<0.05),and the difference in pain assistance between the two groups was statistically significant(P<0.05).At the same time,the difference in hospitalization time between the two groups was statistically significant(P<0.05).It shows that the application of cryotherapy can improve the HSS score,reduce the use of pain medications and reduce hospital stay.?Compared with the preoperative group,the difference between the two groups was higher than that of the preoperative group(P<0.05).There was no difference between the two groups on the 1st,3rd,5th,and 7th after the operation.Statistically significant,the skin temperature control group at Id,3d,and 5d after operation was higher than the experimental group.The mean skin temperature of the control group was 0.35?,0.54?,and 0.43? higher than the experimental group,and the difference was Statistically significant(P<0.05),the difference in skin temperature between the two groups was not significant(P>0.05).It is indicated that the use of hypothermia in the affected knee can reduce the local skin temperature.?The WBC,CRP,ESR and PCT indexes of the two groups were compared with those before operation at 1d,3d,5d and 7d,respectively.The difference was statistically significant(P<0.05).There was no statistical difference between the two groups.Significance(P>0.05).?Among the two groups of patients in the experimental group,there were 2 cases of incision complications in the experimental group and 1 case in the control group.There was no significant difference between the two groups(P>0.05).At the same time,there was no significant difference in the number of invasive grade A(28 VS 29)and DVT(7 VS 6)at 2w between the two groups(P>0.05).It shows that the application of cryotherapy does not increase the incidence of related complications.Conclusion(s):?Application of non-sustained hypothermia cold therapy can significantly reduce patient pain,improve knee mobility(ROM),reduce bleeding exudation,improve HSS score,reduce pain assistance,and improve patient rapid recovery efficiency and hospitalization time.?In the early stage after TKA,local skin temperature and blood WBC,CRP,ESR,PCT and other indicators will show an increasing trend,under normal circumstances,WBC peaked on the first day after surgery,CRP,ESR,PCT on the third day after surgery The peak is reached and then a downward trend occurs.The application of non-sustained cryotherapy can slightly reduce the knee skin temperature after surgery,but it does not significantly increase the relevant infection index.Therefore,the evaluation of blood infection indicators,reasonable application of non-sustained local cryotherapy will not increase patients.The incidence of postoperative infection.?By observing the healing of the incision and the occurrence of DVT in the two groups of patients,the application of cryotherapy did not significantly increase the incidence of complications,so the rational application of cryotherapy after TKA was relatively safe. |
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