Recovery Of Knee Joint Function Research Articles

Blood flow restriction training promotes functional recovery of knee joint in patients after arthroscopic partial meniscectomy: A randomized clinical trial.

Purpose: To explore the effect of blood flow restriction training (BFRT) on the recovery of knee function in patients after arthroscopic partial meniscectomy (APM). Methods: Forty patients undergoing APM surgery were included in this parallel group, two-arm, single-assessor blinded, randomized clinical trial. The subjects were randomly divided into two groups: routine rehabilitation group (RR Group, n = 20) and routine rehabilitation + blood flow restriction training group (RR + BFRT Group, n = 20). One subject in each group dropped out during the experiment. All patients received 8 weeks of routine rehabilitation starting from the second day after APM. In addition, patients in the RR + BFRT group required additional BFRT twice a week. Visual analogue scale (VAS) score, range of motion (ROM), one-leg standing test (OLST) score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference were evaluated at preoperative, postoperative, 4 and 8 weeks after surgery. SPSS 25.0 software was used for statistical analysis of the data. Repeated measures ANOVA was used if the data were normally distributed and had homogeneity of variance. Generalized estimating equations were chosen if the data were not normally distributed or had homogeneity of variance. Results: There were no significant differences in VAS score, ROM, OLST score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference between the two groups before surgery (p > 0.05). Compared with postoperative, VAS score, ROM, OLST score, Lysholm knee score, and thigh circumference were significantly improved in the RR group (p < 0.05), while quadriceps muscle strength and quadriceps thickness were not significantly enhanced at 8 weeks postoperatively (p > 0.05). However, VAS score, ROM, OLST score, Lysholm knee score, quadriceps muscle strength, quadriceps thickness, and thigh circumference were all significantly improved in the RR + BFRT group at 8 weeks postoperatively (p < 0.05). Furthermore, compared with the RR group, VAS score (50% vs. 86%), ROM (7.9% vs. 16.0%), OLST score (57.3% vs. 130.1%), Lysholm knee score (38.4% vs. 55.7%), relative peak torque (11.0% vs. 84.7%), mean power (20.6% vs. 88.1%), rectus femoris thickness (0.40% vs. 13.0%), vastus medialis (0.29% vs. 5.32%), vastus lateralis (0% vs. 6.2%), vastus internus (0% vs. 5.8%), and thigh circumference (2.7% vs. 5.8%) in the RR + BFRT group were significantly improved at 4 and 8 weeks postoperatively (p < 0.05). Conclusion: BFRT combined with routine rehabilitation training can better promote the recovery of knee joint function in patients after APM, especially the improvement of quadriceps muscle strength and thickness.

Study on the changes of cartilage metabolites in patients with knee osteoarthritis before and after fibula osteotomy

To explore changes of C-terminal cleavage epitope of type Ⅱ collagen 3/4 fragment in cartilage metabolism (Col2-3/4Clong mono or C2C), carboxyl-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ) and knee joint function before and after osteotomy of fibula in patients with knee osteoarthritis. From January 2019 to March 2020, 65 patients with knee osteoarthritis who underwent fibular osteotomy treatment accompanied with medial pain were selected, including 25 males and 40 females, aged from 44 to 70 years old with an average of (56.20±10.05) years old;25 patients were gradeⅠ, 19 patients with gradeⅡ, 17 patients with grade Ⅲ, and 4 patients with grade Ⅳ according to Kellgren-Lawrence grading. The content of CTX-Ⅱ and C2C in knee joint fluid, serum interleukin 1β ( IL-1β), tumor necrosis factor-α (TNF-α) before osteotomy and 6 months after osteotomy were detected. Visual analogue scale(VAS) was used to evaluate degree of pain relief, American Knee Society Score (KSS) and Hospital for Special Surgery (HSS) were applied to evaluate recovery of knee joint function. Sixty-five patients were followed up from 6 to 18 months with an average of(12.4±3.6) months. VAS, KSS and HSS score at 6 months after osteotomy were better than that of before osteotomy(P<0.05). Serum IL-1β, TNF-α and content of CTX-Ⅱand C2C of knee joint fluid at 6 months after osteotomy were lower than those before osteotomy(P<0.05). Fibula osteotomy could relieve pain of knee osteoarthritis, maintain balance of joint stress, reduce organism inflammatory response, improve cartilage metabolism, reduce decomposition of articular cartilage, and reduce level of CTX-Ⅱand C2C, which is benefit for regeneration of articular cartilage and promote recovery of knee joint function.

Efficacy Evaluation of the Combined Platelet-Rich Plasma and Hyaluronic Acid after Arthroscopic Joint Debridement in Treating Knee Osteoarthritis.

Objective The study is aimed at observing the efficacy of the combined platelet-rich plasma and hyaluronic acid after arthroscopic joint debridement in treating knee osteoarthritis (KOA). Methods 126 patients with KOA admitted to the Affiliated People's Hospital of Ningbo University and Taizhou Orthopaedic Hospital from 2018-11 to 2021-11 were selected. All nominees were grouped by random drawing; group B (63 cases) received arthroscopic joint debridement while group A (63 cases) received platelet-rich plasma and hyaluronic acid based on group B. The following metrics are counted, including total efficiency, knee joint pain and function, inflammatory cytokines levels, and oxidative stress indicator levels; the complication rate is counted. Results The total effective rate of group A (93.65%) was higher than that of group B (77.78%) (P < 0.05), and there was no significant difference in the incidence of complications between the groups (P > 0.05). Three months after treatment, knee joint pain and function, inflammatory cytokine levels, and oxidative stress indicators levels in group A were better than in group B (P < 0.05). Conclusion The combined platelet-rich plasma and hyaluronic acid after arthroscopic joint debridement in treating KOA can achieve significant effects, reduce knee pain, accelerate the recovery of knee joint function, relieve inflammation, and inhibit oxidative stress and has high safety.

Treatment of avulsion fracture of inferior pole of patella with improved angle of anchor and double pulley technique

To evaluate the angle of modified anchor nail placement and the curative effect of double pulley technology for the treatment of extreme avulsion fracture of lower patella. From December 2015 to December 2018, a total of 22 patients(10 males and 12 females) with avulsion fracture of the inferior pole of patella were retrospectively analyzed. The average age was (44.00±15.24) years old(range, 19 to 70 years). All patients were treated with modified anchor angle and double pulley technique. The range of motion(ROM) and Bostman score system were used to evaluate the functional recovery of knee joint. All 22 cases were followed up with an average of (30.86±8.00) weeks (18 to 46 weeks). At the last follow-up, ROM of the affected knee was (130.82±4.69) °, and the contralateral knee was (133.23 ± 3.15) °, there was no significant difference between two groups (P>0.05). The average Bostman score was (28.45±1.41) scores, 18 cases were excellent results, 4 cases were good. Improved anchor placement angle and double pulley technique for treatment of extreme avulsion fracture of lower patella is easy to operate, with satisfactory curative effect and good recovery of knee joint function.

Effect of Proprioception and Balance Training Combined with Continuous Nursing on BBS Score and HSS Score of Patients Undergoing Total Knee Arthroplasty.

Background Total knee arthroplasty is one of the most effective methods for the treatment of end-stage knee osteoarthritis, but 10% of patients still show insufficient function, strength, and mobility. Continuous nursing service plays an important role in the rehabilitation of patients undergoing total knee arthroplasty. For discharged and convalescent patients, the traditional follow-up model cannot solve the nursing problems of discharged patients. How to meet the health needs of discharged patients under the limited nursing resources has become an existing problem. Objective To explore the effect of proprioception and balance training combined with continuous nursing on Berg balance scale (BBS) score and Hospital for Special Surgery (HSS) score of patients undergoing total knee arthroplasty (TKA) is the objective of this study. Methods Sixty patients undergoing TKA in our hospital from December 2019 to April 2021 were enrolled. The patients were randomly assigned into the control group and the study group. The control group received continuous nursing, and the study group received proprioception and balance training combined with continuous nursing. Results The nursing satisfaction of the study group was higher than that of the control group (P < 0.05). The HSS scores at discharge, 1 month, 3 months, and 6 months after discharge in the study group were higher than those in the control group (P < 0.05). It was higher in the study group than in the control group at 1 month, 3 months, and 6 months after discharge (P < 0.05). The pain catastrophizing score of the study group at discharge was lower than that of the control group at 1 month, 3 months, and 6 months after discharge (P < 0.05). The BBS scores at discharge, 1 month, 3 months, and 6 months after discharge in the study group were higher than those in the control group (P < 0.05). The Lindmark balance scores at discharge, 1 month, 3 months, and 6 months after discharge in the study group were lower than those in the control group (P < 0.05). Conclusion Proprioception and balance training combined with continuous nursing can effectively promote the recovery of knee joint function of patients after TKA, enhance patients' pain catastrophizing grade, enhance patients' quality of life, effectively promote patients' knee joint function and BBS score, and promote the improvement of disease.

Comparison of Rapid Rehabilitation after Anterior Cruciate Ligament Reconstruction with Tensioning Technique and Traditional Rehabilitation.

To investigate the efficacy of a fast rehabilitation program for the recovery of knee joint function after arthroscopic autologous hamstring tendon transplantation for reconstruction of the anterior cruciate ligament (ACL), from January 1, 2017, to March 31, 2019, a total of 65 patients with ACL injury were randomly divided into a study group and a control group. Both groups were treated with autologous hamstring tendon to reconstruct the anterior cruciate ligament, arthroscopic transplantation, and decompression techniques. The research group was treated with a fast rehabilitation program. The control group was treated with traditional rehabilitation program. Knee flexion angles were measured at 2, 4, and 8 weeks postoperatively. KT-1000 knee anterior stability was measured at 3, 6, and 12 months after operation. Knee function was assessed by subjective knee function assessment scale (IKDC) and Lysholm knee score. The knee curvature, KT-1000 measurement, IKDC score, and Lysholm score were compared between the two groups before and after treatment. KT-1000 measured value, IKDC score, and Lysholm score in 2 groups were significantly improved 3, 6, and 12 months compared with those before treatment, and the difference was statistically significant (P < 0.001). Comparison between the two groups: 2 weeks, 4 weeks, and 8 weeks after treatment, the knee curvature in the study group was better than that in the control group, and the difference was statistically significant (P < 0.001); there was no significant difference in the measured values of KT-1000 between the two groups 3, 6, and 12 months after treatment (P > 0.05); IKDC score and Lysholm score in the study group 3 and 6 months after treatment were significantly better than those in the control group, with statistical significance (P < 0.001); there was no significant difference in IKDC score and Lysholm score between the two groups 12 months after treatment (P >0.05). Autograft hamstring tendon transplantation and tense-reducing technique for anatomical reconstruction of anterior cruciate ligament under arthroscopy combined with rapid rehabilitation program can quickly, safely, and effectively restore the knee function of patients, greatly shortening the rehabilitation period of patients.

Meta-Analysis of Knee Joint Function Recovery after Anterior Cruciate Ligament Reconstruction by Accelerated Rehabilitation Surgery.

Objective This investigation was undertaken to systematically assess the impact of increasingly rapid recovery treatment on the functional status of the knee following anterior cruciate ligament restructuring. Methods Computer search from the establishment of the database to March 2022 in China Knowledge Network Database (CNKI), PubMed, EMBASE, ScienceDirect, CochraneLibrary, China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM). The control group was given only traditional rehabilitation training, and the observation group was treated with perioperative accelerated rehabilitation surgery intervention randomized controlled trial (RCT). Data for all included studies were extracted by two independent researchers, and the risk of bias for the quality of each included study was assessed by the Cochrane Handbook 5.1.0 criteria. Meta-analysis of the collected data by using RevMan5.4 statistical software. Results A total of 593 articles were retrieved from the computer database and 8 RCT articles with a total of 636 samples were finally included for meta-analysis. According to the Jadad scale, the RCT score of 8 articles was ≥4 points. Meta-analysis was performed on the postoperative VAS scores of the ERAS group and the traditional rehabilitation group, and the heterogeneity test showed Chi2 = 288.60, df = 5, P < 0.00001, and I2 = 99%. There was a statistically significant difference in the postoperative VAS scale between the intervention and the traditional rehabilitation model (P < 0.05). Eight articles reported the effect of accelerated rehabilitation surgery on the recovery of knee joint motion after ACL rehabilitation. After meta-analysis, the heterogeneity test showed Chi2 = 314.98, df = 7, P < 0.00001, and I2 = 98%, and it can be concluded from the analysis that, compared with the traditional rehabilitation model, the enhanced rehabilitation surgery has an effect on the joint function after anterior cruciate ligament reconstruction. The improvement effect was more significant, and the difference was statistically significant (P < 0.05). Four articles reported the effect of enhanced recovery after surgery intervention on the range of motion of the knee joint of patients, the heterogeneity test showed Chi2 = 117.52, df = 2, P < 0.00001, and I2 = 98%, through analysis, and compared with the traditional rehabilitation model and the enhanced recovery. The effect of surgery on the range of motion of the knee joint after ACL reconstruction was more significant, and the difference was statistically significant (P < 0.05). The effect of enhanced recovery after surgery and traditional rehabilitation mode on the incidence of postoperative adverse reactions in patients undergoing ACL reoperation was analyzed. The results of heterogeneity test showed that Chi2 = 1.59, df = 2, P=0.66 > 0.05, and I2 = 98%, and the analysis showed that, compared with the traditional rehabilitation mode, enhanced rehabilitation surgery can significantly reduce the risk of adverse reactions after anterior cruciate ligament reconstruction (P < 0.05). An inverted funnel plot was used to analyze publication bias in studies with quality of life as an outcome measure. The results showed that Egger's test P=0.0005 < 0.001 suggesting that there may be a certain degree of publication bias. Conclusion The existing research evidence shows that accelerating the reconstruction of anterior cruciate ligament can effectively promote the recovery of knee joint function, reduce the pain of patients, and reduce postoperative complications. However, more research is needed to further verify this.

Effects of Parecoxib Sodium Application Combined with Enhanced Recovery After Surgery Nursing on Inflammatory Factors and Knee Joint Function in Elderly Patients After Total Knee Arthroplasty.

ObjectivesTo study the effect of parecoxib sodium (PS) application, combined with enhanced recovery after surgery (ERAS) nursing, on inflammation and knee joint function in elderly patients after total knee arthroplasty (TKA).MethodsIn this prospective cross-sectional study, we recruited 120 elderly patients treated with TKA who were randomly divided into two groups, the combine group and the control group, with 60 patients in each group. Patients in the control group received ERAS nursing and normal saline, and the patients in the combine group received ERAS nursing and PS. At different times after surgery, we compared the hemoglobin (Hb), complete white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and serum IL-1β, TNF-α, and IL-6, and recovery time for different ranges of joint motion and the knee joint function HSS (hospital for special surgery scale) score between the two groups.ResultsOn the third and seventh postoperative days, the levels of Hb in the patients of the combine group were significantly lower than those in the control group (p < 0.05), while the levels of WBC, ESR, serum IL-1β, TNF-α, and IL-6 in the patients of the combine group were all significantly lower than those in the control group (p < 0.05). Compared with the patients in the control group, the recovery time for 30, 60, 90, and 120 angles of joint motion in patients of the combine group was significantly decreased (p < 0.05), and the HSS score of patients in the combine group was significantly higher than that in the control group on the first, third, and sixth postoperative months (p < 0.05).ConclusionElderly TKA patients who received PS application, combined with ERAS nursing, had lower inflammation in peripheral blood 2 weeks after operation and faster postoperative recovery of knee joint function.

Perioperative Nursing of Knee Joint Function Recovery in Patients Undergoing Arthroscopic Meniscus Injury Suture and Its Influence on Patients' Satisfaction

Perioperative Nursing of Knee Joint Function Recovery in Patients Undergoing Arthroscopic Meniscus Injury Suture and Its Influence on Patients' Satisfaction

Sodium Hyaluronate Combined with Jintiange on Knee Joint Function After Arthroscopy for Knee Osteoarthritis

Objective: To explore the effects of sodium hyaluronate combined with Jintiange on knee joint function after arthroscopic debridement. Methods: Totally 122 knee osteoarthritis patients underwent arthroscopic debridement were randomized into control and experimental groups. The interleukin-1β, interleukin-6 and tumor necrosis factor-α serum levels were tested via Elisa before and after treatment. The Lysholm knee joint function score, effective rate of treatment, interleukin-1β, interleukin-6 and tumor necrosis factor-α expression, visual analogue scale of pain, incidence of adverse reactions and patient satisfaction were compared. Results: Compared with the control group, the effective rate of treatment and the score of Lysholm knee joint function in the other were higher (both P &lt;0.001), and the serum interleukin-1β, interleukin-6, tumor necrosis factor-α expression and visual analogue scale score were lower (all P &lt;0.001). The incidence of adverse reactions revealed no marked difference (P &gt;0.05), but the satisfaction scores of the experimental group were higher (P &lt;0.01). Conclusion: sodium hyaluronate combined with Jintiange is helpful for knee joint function recovery after arthroscopic knee osteoarthritis, which effectively decreases the level of inflammatory factors and increase patients’ satisfaction.

Recognition of Factors of Postoperative Complications of Knee Osteoarthritis Patients and Comprehensive Nursing Intervention.

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by articular cartilage degeneration, cartilage exfoliation, osteophyte formation, and synovitis. It seriously affects the knee joint function and quality of life of patients. Total knee arthroplasty is now the most frequently used therapy for end-stage knee arthritis because it can successfully modify the line of lower extremities, restore knee joint function, alleviate pain, and enhance patients' quality of life; nevertheless, it may cause significant trauma and bleeding. It can easily lead to infection and anemia. In this study, the control group chose total knee arthroplasty and the observation group chose total knee arthroplasty combined with PRP. The results showed that the knee joint function score, visual analog score, blood transfusion, total blood loss, total postoperative drainage, and complications in the observation group were superior to those in the control group. Total knee arthroplasty takes a long time and needs a lot of soft tissue incision, which leads to a lot of blood loss and can cause a variety of complications. Gel has been shown in studies to successfully decrease blood loss during and after total knee arthroplasty, enhance knee joint function recovery, and improve patient quality of life. In this paper, the complications and causes of knee osteoarthritis after total knee arthroplasty were studied. Combined with comprehensive nursing intervention for postoperative recovery, it helps to improve the formation of thrombin and calcium ion, which can effectively reduce blood loss, relieve pain, and promote the recovery of knee joint function. This study analyzed the application of total knee arthroplasty combined with gel in the treatment of knee osteoarthritis.

Nano-ligament combined with sports rehabilitation training on the therapeutic effect after ligament reconstruction

As for the postoperative treatment effect of joint reconstruction, researchers have recognized the following point of view: surgical treatment alone not only has many complications, but also the recovery of knee joint function in some patients is not ideal. The effect of ligament reconstruction depends not only on the level of operation, but also on the postoperative rehabilitation. In order to study the effect of the new nano ligament combined with sports rehabilitation training on the treatment effect of ligament reconstruction, strict method analysis and control experiment were carried out in this paper.This paper first studies the importance, significance and related research status of link reconstruction at home and abroad, and then studies the proprioception training rehabilitation methods, rood multi sensory stimulation promotion, Mrs lower limb training methods and so on. Based on the theoretical support of these methods, this paper carried out the experimental study on the influence of rehabilitation training on the therapeutic effect of ligament reconstruction and the experimental results. This paper innovated on the traditional rehabilitation training: using more technical experimental results and comparing the experimental results of this paper, setting more control groups than the traditional reference experiments. In order to achieve more in-depth research results.The results showed that at the early stage of recovery, the passive flexion of bilateral knee joints was also slightly limited. After 24 weeks of rehabilitation training, the passive flexibility angle of the injured side of the three patients increased from 84 degrees to 92 degrees, from 148 degrees to 154 degrees, and the maximum increase was 64 degrees. At the early stage of rehabilitation, it gradually decreases with the rehabilitation process, and finally tends to be stable, which shows that the effect of early rehabilitation is very obvious, and it proves that early rehabilitation is more important in the whole rehabilitation training.

Efficacy of intramedullary nail fixation for the tretament of tibial shaft fracture with difference approachs

To compare clinical effect of intramedullary nailing through suprapatellar, infrapatellar and paracpatellar approach in treating tibial shaft fracture. From June 2012 to June 2018, 36 patients with tibial shaft fracture were treated with intramedullary nails, and were divided into three groups according to surgical approach. Twleve patients were through suprapatellar approach, including 7 males and 5 females aged from 25 to 53 years old with an average of (37.8±11.4) years old;and 4 patients were type A, 4 patients were type B, and 4 patients were type C according to AO classification. Ten patients were through infrapatellar approach, including 6 males and 4 females aged from 19 to 56 years old with an average of (35.6±10.0) years old;and 3 patients were type A, 4 patients were type B, and 3 patients were type C according to AO classification. Forteen patients were through paracpatellar approach, including 8 males and 6 females aged from 21 to 58 years old with an average of (36.6±10.0) years old;and 4 patients were type A, 6 patients were type B, and 4 patients were type C according to AO classification. Operation time, intraoperative blood loss, fluoroscopy times, fracture healing time and complications among three groups were observed, and knee joint functions were evaluated by Lysholm score. All patients were followed up from 12 to 18 months with an average of (15.0±3.0) months. There were no difference in intraoperative blood loss and fracture healing time among three groups (P>0.05). There were statistical difference in operation time, fluoroscopy times and complications compared with suprapatellar approach and infrapatellar approach, paracpatellar approach (P<0.05). While there were no difference in operation time, fluoroscopy times and complications between infrapatellar approach and paracpatellar approach (P>0.05). Lysholm score among suprapatellar approach, infrapatellar approach and paracpatellar approach were (87.5±7.5), (78.2±6.7) and (77.4±6.3) respectively, and had differences among three groups (P<0.05). Compared with suprapatellar approach and infrapatellar approach, paracpatellar approach, there were difference in squatting, climbing stairs, pain and total scores (P<0.05);while there were no difference between infrapatellar and paracpatellar group (P>0.05). intramedullary nailing through suprapatellar for the treatment of tibial shaft fracture is benefit for fracture healing and recovery of knee joint function, while infrapatellar and paracpatellar approach have advantages in exposure of insertion point. We should select approach reasonably according to our experience.

Effectiveness of extended Carlson approach in treatment of lateral femoral condylar Hoffa fractures

To investigate the effectiveness of the extended Carlson approach in the treatment of lateral femoral condylar Hoffa fractures. The clinical data of 17 patients with lateral femoral condyle Hoffa fractures between September 2012 and January 2019 were retrospectively analyzed. There were 10 males and 7 females, with a mean age of 43 years (range, 32-68 years). Fractures were caused by traffic accident in 9 cases, by falling from height in 6 cases, and by the other mechanism in 2 cases. According to the Letenneur's classification, there were 8 cases of typeⅠ, 6 cases of type Ⅱ, and 3 cases of type Ⅲ. The mean time from injury to operation was 7 days (range, 3-32 days). All patients were treated with extended Carlson approach. Patients with Letenneur types Ⅰ and Ⅲ were fixed by a posterior antigliding plate combined with headless compression screws from anteroposterior direction, and patients with Letenneur typeⅡ were fixed by headless compression screws from anteroposterior direction. The anteroposterior and lateral X-ray films, CT and three-dimensional reconstruction of the knee joint were taken after operation to assess fracture healing and position of the internal fixators. The knee function was evaluated according to Letenneur's functional assessment system. All patients were followed up 13-28 months (mean, 15 months). All the incisions healed by first intention, and no complication such as fracture redisplacement, fracture nonunion, internal fixator fracture, and common peroneal nerve injury occurred. The mean time of fracture healing was 18 weeks (range, 16-32 weeks). At last follow-up, according to Letenneur's functional assessment system, the knee function was excellent in 12 cases and good in 5 cases, with an excellent and good rate of 100%. The extended Carlson approach for the treatment of lateral femoral condylar Hoffa fractures has the advantages of clear exposure, easy reduction and fixation, high fracture healing rate, few complications, and good recovery of knee joint function.

The effectiveness of traditional Chinese medicine fumigation and washing nursing care after arthroscopic debridement of Knee Osteoarthritis: A protocol for systematic review and meta-analysis.

Background:Knee Osteoarthritis (KOA) is a degenerative osteoarthrosis with knee joint pain as the main symptom. In recent years, arthroscopic removal of loose body and repair of meniscus have become common methods for the treatment of KOA. However, postoperative pain, swelling and limited joint movement affect the functional recovery of knee joint and the effect of surgical treatment. Early postoperative control of pain and swelling is of great significance to improve the curative effect of arthroscopic debridement and promote the recovery of knee joint function. In recent years, many clinical studies have reported that the nursing method of fumigation and washing with Chinese medicine after arthroscopic debridement of KOA can relieve pain, promote the recovery of joint function and improve the clinical curative effect, but there is a lack of evidence-based medicine. The purpose of this study is to evaluate the efficacy and safety of fumigation and washing with traditional Chinese medicine after KOA arthroscopy.Methods:Computer retrieval English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (China National Knowledge Infrastructure, Wanfang, VIP Database for Chinese Technical Periodicals, China Biology Medicine disc), moreover manual retrieval academic, Google and baidu from building to since December 2020, traditional Chinese medicine fumigation applied to KOA arthroscopy postoperative nursing of randomized controlled clinical research, by two researchers independently evaluated the quality of the included study and extracted the data. Meta-analysis of the included literatures was performed using RevMan5.3 software.Results:The main observation index of this study was the effective rate, and the secondary indexes included Visual Analogue Scale Score, the Western Ontario and McMaster university orthopedic index, Lysholms score and adverse reactions, so as to evaluate the efficacy and safety of traditional Chinese medicine fumigation nursing after KOA arthroscopy.Conclusion:This study will provide reliable evidence for the clinical application of Fumigation and washing nursing of traditional Chinese medicine after KOA arthroscopy.Ethics and dissemination:Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/THZP4

Feasibility and efficacy of knee extension training using a single-joint hybrid assistive limb, versus conventional rehabilitation during the early postoperative period after total knee arthroplasty.

Objectives: To evaluate the feasibility and efficacy of treatment for the recovery of knee joint function after total knee arthroplasty (TKA) using a robotic suit.Patients and Methods: Knee joint extension exercise sessions were started with a robotic suit (single-joint hybrid assistive limb [HAL-SJ, Cyberdyne, Inc., Tsukuba, Japan]) in one group of patients after TKA. Patients who underwent standard rehabilitation were enrolled in the control group. To evaluate feasibility and safety, we assessed the adverse events, the number of training sessions, and training time. We compared the changes in knee joint pain and extension lag (°) between the groups.Results: The average age was 71.3 ± 6.2 years in the HAL-SJ group and 74.9 ± 8.7 years in the control group. There were no severe adverse events. In the HAL-SJ group, training was performed 2.9 times, on average, and lasted 18.8 min. In the HAL-SJ group, there was a reduction in the visual analog scale (VAS) for pain after training, which was not significant. In the control group, the VAS score worsened after the sessions. The extension lag significantly improved in the HAL-SJ group after the 2nd and 3rd sessions, and this was more due to improvements in their active extension range of motion than their passive extension range of motion.Conclusions: HAL-SJ-based training is safe and effective, and leads to instantaneous improvement of extension lag, without worsening knee joint pain. HAL-SJ-based knee extension training could represent a viable novel post-TKA rehabilitation modality.

Clinical efficacy of arthroscopy in the treatment of discoid meniscus injury and related risk factors for postoperative pain.

Discoid meniscus is an abnormal meniscus of the knee joint. This study aimed to analyze the clinical efficacy of arthroscopy in the treatment of discoid meniscus injury, and determine the related risk factors for postoperative pain. A total of 80 patients with a discoid meniscus injury who were diagnosed and treated in our hospital from May 2017 to May 2018 were selected. According to the different surgical methods, they were divided into the study group (treated with meniscus plasty) or the control group (treated with subtotal meniscectomy). Knee joint motion and knee joint function were measured at 2, 6 and 12 weeks post-surgery. Knee joint function was measured using the Lysholm Knee Scoring Scale to determine clinical efficacy. Patients with an excellent and good rating were included in the painless group, and patients with an average and poor rating were included in the pain group. The risk factors for postoperative pain were analyzed using multivariate logistic regression. Knee joint motion in the study group and the control group gradually increased and reached a peak 12 weeks after surgery (P<0.05), however, there was no significant difference between the 2 groups at each time point after surgery (P>0.05). The excellent and good rate, according to the Lysholm Knee Scoring Scale, was 84.62% in the study group and 84.38% in the control group. There was no significant difference between the 2 groups (P>0.05). There were differences between the pain group and the painless group in Watanabe classification, age, preoperative symptom time, cold compress, joint soft tissue injury, and postoperative weight-bearing time ≤1 week (P<0.05). Arthroscopy demonstrated efficacy for the treatment of patients with a discoid meniscus injury. Age, duration of preoperative symptoms, articular cartilage injury, postoperative cold compress and postoperative weight-bearing time were independent risk factors that affected postoperative pain after arthroscopic surgery. For high-risk patients, effective prevention and control measures should be taken to improve postoperative pain and promote the recovery of knee joint function.

Effect of tranexamic acid on the timing of drainage tube removal in total knee arthroplasty

Introduction:To investigate the effect of tranexamic acid on the removal time of drainage tube in the first unilateral total knee arthroplasty.Hypotheses:The timing of removing the drinage system can be changed when using TXA.Methods:From June 2017 to December 2018, 182 patients (42 males and 140 females) who planned to undergo primary unilateral total knee replacement were included.Age (68.1±7.1) years (60-76 years).According to the random number table method, it was divided into four groups: 45 cases of Tranexamic acid group 1 (TXA1), 46 cases of Tranexamic acid group 2 (TXA2), 46 cases of Tranexamic acid group 3 (TXA3) and None Tranexamic acid group (NTXA).TXA1-3 group intraoperative intravenous infusion combined with local application of tranexamic acid;NTXA group was locally perfused in the joint cavity with 100ml normal saline only after surgery.Differences in drainage volume, total blood loss, invisible blood loss, degree of postoperative joint swelling, Hospital for special surgery (HSS) and visual analogue scale (VAS) of pain were compared among the four groups.Results:The postoperative drainage volume of TXA1˜3 groups was 85.5±34.3ml, 189.4±72.3ml and 215.3±93.4ml, respectively, which was less than that of the non-tranexamic acid group (351.3±113.5ml). The overall difference was statistically significant (F=11.5,P=0.005). The postoperative drainage volume of tranexamic acid 1 group was less than that of tranexamic acid 2 and 3 groups.The total postoperative blood loss was 699.0±255.7ml, 710.4±296.1ml, and 715.8±248.2ml in the tranexamic acid 1-3 groups, respectively, which was less than 1130.5±354.2ml in the non-tranexamic acid group, and the overall difference was statistically significant (F=13.1,P=0.001).On the 4th day after the operation, the knee swelling degree of the tranexamic acid 1- 3 groups was 1.25±0.07, 1.13±0.12, and 1.12±0.13, respectively, which were smaller than that of the non-tranexamic acid group (1.43±0.22), and the overall difference was statistically significant (F=8.23, P=0.015).There were 2 cases of positive bacterial culture in non-tranexamic acid group and tranexamic acid group.There were 3 cases of hematoma in the non-tranexamic acid group,and 1 case of delayed wound healing.Conclusion:The application of tranexamic acid after TKA can reduce postoperative drainage volume, latent blood loss and total blood loss.The removal of the drainage tube 18h after the operation can not only fully drain,relieve pain, promote the recovery of knee joint function, but also effectively reduce the risk of infection caused by the drainage tube.

Comparative Study of the Reconstruction of Anterior Cruciate Ligament with Peroneal Longus Tendon and Hamstring Tendon Based on Magnetic Resonance Imaging

Objective: To compare the effect of reconstruction of anterior cruciate ligament (ACL) with peroneal longus tendon (PLT) and hamstring tendon (HT) using magnetic resonance image (MRI). Methods: Fifty-six patients with ACL rupture were treated with ACL reconstruction. Among them, 28 patients were treated with PLT reconstruction (treatment group) and 28 patients were treated with HT reconstruction (control group). There were no significant differences in gender, age, injury side, course of disease, preoperative Lachman test, Lysholm score, IKDC score, joint mobility, MRI image between the two groups (P &gt; 0.05). Result: The incision healed in the first stage after operation in both groups, and there were no significant neurovascular injuries and knee synovitis complications. Comparing the MRI of the two groups after operation, the effect of the treatment group was better than that of the control group. There were no complications in both groups. The Lysholm score and IKDC score of the treatment group were better than those of the control group at 6 and 12 months after operation (P &gt; 0.05). There was no significant difference in Lachman test between the two groups at 6 and 12 months after operation (P &gt; 0.05). At 3 and 12 months after operation, the joint activity of the treatment group was better than that of the control group, with no significant difference (P &gt; 0.05). The degree of tibial anterior displacement decreased significantly in both groups before and after operation (P &lt; 0.05), but there was no significant difference between the two groups (P &gt; 0.05). Discussion: MRI scanning technology can significantly expand the scope of human body examination, improve the detection rate and diagnostic accuracy of lesions. In traditional surgery, HT is often used as reconstruction material. However, there are many factors to be considered in the formulation of operation plan for double cruciate ligament injury, such as limb blood supply, accompanied by a variety of structural injuries, so the requirement for reconstruction is high. There was no significant difference in the recovery of knee stability between the two groups, but in terms of early recovery of knee function and subjective satisfaction of patients, the reconstruction of PLT was superior to that of HT. Conclusion: Magnetic resonance imaging can effectively diagnose the curative effect, and it is worth popularizing and applying widely. Compared with HT, ACL reconstruction with PLT is easier to operate, and the early recovery of knee joint function and it is worth popularizing and applying widely.

A simultaneous bilateral quadriceps and patellar tendons rupture in patients with chronic kidney disease undergoing long-term hemodialysis: a case report

BackgroundThe incidence of rupture of the quadriceps or patellar tendon s is low, especially that of bilateral quadriceps tendon rupture, and it is generally considered a complication secondary to chronic systemic disorders. We report two rare cases of simultaneous bilateral tendon rupture affecting the extensor function of the knee in patients with chronic kidney disease who have been treated with long-term haemodialysis.Case presentationTwo young males with a history of chronic kidney disease who were being treated with long-term haemodialysis presented to our hospital with clinical signs of disruption of the extensor mechanism of the knee. One patient was diagnosed with bilateral quadriceps tendon rupture, and the other patient had bilateral patellar tendon rupture. They underwent surgical repair of the tendons, and their knees were actively mobilized during physiotherapy.ConclusionBilateral quadriceps or patellar tendons rupture is a rare occurrence in patients with chronic kidney disease who are being treated with long-term haemodialysis. Timely surgical treatment and scientific physiotherapy can lead to good recovery of knee joint function.