Abstract
BackgroundTotal knee arthroplasty (TKA) is a gold standard for patients with terminal term gonarthrosis for reducing pain, correcting deformities, and regaining stability. However, post-TKA muscle strength recovery is often difficult. Although electroacupuncture (EA) enhances lower extremity muscle strength of the lower extremity, there is limited evidence regarding its effect on lower extremity muscle strength in post-TKA patients. Consequently, this trial intends to evaluate the efficacy of post-TKA EA on the recovery of lower extremity muscle strength, specifically, during the early post-TKA period.Methods/designThis is a double-blinded, randomized, and controlled trial. It will be conducted between August 2020 and December 2020. Ninety-four participants with KOA who have undergone unilateral TKA will be randomized into a treatment (EA) group and a control (sham EA) group. The former and latter groups will receive EA and sham EA, respectively, at ST37, ST36, SP10, and SP9 acupoints. The participants will undergo ten treatment sessions over 2 weeks (5 sessions per week). The primary outcomes will include changes in muscle strength and the Hospital for Special Surgery score at the second week from baseline (pre-op 1 day or POD 3). The secondary outcomes will include a 4-m walk test, numerical rating scale score, the Hamilton Anxiety Scale score, and additional analgesia use. Additional outcomes will include the incidence of analgesia-related side effects and the participant satisfaction rate. Participant blinding will also be assessed where they will be asked to guess whether they received EA after the latest intervention. Adverse EA events will be documented and assessed throughout the trial.DiscussionEA is helpful for post-TKA recovery and enhancement of lower limb muscle strength.Trial registrationChinese Clinical Trial Registry ChiCTR1900027806. Registered on 29 November 2019
Highlights
Total knee arthroplasty (TKA) is a gold standard for patients with terminal term gonarthrosis for reducing pain, correcting deformities, and regaining stability
EA is helpful for post-TKA recovery and enhancement of lower limb muscle strength
Muscle strength rehabilitation of the knee extensor and flexor is essential for functional improvement of patients with knee osteoarthritis (KOA) since knee stability is primarily supported by the soft tissue of the quadriceps femoris and hamstring
Summary
Total knee arthroplasty (TKA) is a gold standard for patients with terminal term gonarthrosis for reducing pain, correcting deformities, and regaining stability. Compared with non-surgical treatment, TKA significantly relieves pain and promotes functional improvement in patients with severe KOA [3]. Muscle strength rehabilitation of the knee extensor and flexor is essential for functional improvement of patients with KOA since knee stability is primarily supported by the soft tissue of the quadriceps femoris and hamstring. A post-TKA decrease in the strength of the quadriceps femoris and hamstring [9,10,11,12], which is associated with decreased function [13, 14], has been reported. The strength of the quadriceps improves over time, approximately 30% of post-TKA patients have reported deficits at > 2 postoperative years compared with healthy adults [16]. Effective post-TKA neuroregulatory techniques can enhance lower limb muscle strength, which fast-tracks rehabilitation and reduces the financial burden of patients [22]
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