[A randomized controlled study on application of giant needle electroacupuncture at different times for improving pain and joint function after total knee arthroplasty].

Abstract

Objective: To explore clinical efficacy of applying giant needle electroacupuncture at different times in improving pain and joint function after total knee arthroplasty(TKA).

Methods: A total of 120 patients who underwent TKA from July 2022 to March 2023 were included. They were divided into preoperative electro-acupuncture group, postoperative electro-acupuncture group, and control group according to different intervention times of electro-acupuncture, and 38 patients in each group, 2 patients from each group were dropped out, resulting in a final inclusion of 114 patients. In preoperative electro-acupuncture group, there were 7 males and 31 females;aged from 60 to 80 years old with an average of (72.0±5.8) years old;electro-acupuncture was performed on Weishu acupoint (ST32), Zusanli acupoint (ST36), Yinlingquan acupoint (SP9), and Yanglingquan acupoint (GB34) of non-operated lower limbs at 1 day before operation, 30 min before anesthesia induction, and 1 to 3 days after operation. In postoperative electro-acupuncture group, there were 9 males and 29 females;aged from 60 to 80 years old with average of (71.6±6.7) years old;the same acupuncture points and parameters were treated 1 to 3 days after operation. In control group, there were 6 males and 32 females;aged from 60 to 80 years old with an average of (71.6±7.1) years old;and were received pseudo-electroacupuncture treatment. Pain was scored at rest and during movement respectively before operation and 4 to 7 days after operation by using numerical rating scale at rest (NRSR) and numerical rating scale with movement (NRSM), joint function was evaluated by active range of motion (AROM) of knee joint, Hospital for Special Surgery(HSS) knee score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Results: A total of 114 patients were followed up, with the follow-up period being 7 days after operation. There were no statistically significant differences in preoperative NRSR, NRSM, AROM, HSS, and WOMAC scores among three groups (P>0.05). There were statistically significant differences among three groups of NRSR and NRSM scores on the 4th to 7th day after operation (P<0.05). The comparison of AROM among three groups on the 7th day after operation showed statistically significant difference (P<0.05), while there was no statistically significant difference when comparing the data from 4 to 6 days after operation (P>0.05). The comparisons of HSS and WOMAC scores on the 7th day after operation among three groups showed statistically significant differences (P<0.05). NRSR scores of pre-electroacupuncture group on the 4th to 6th days after operation were 2.0(1.0, 2.3), 1.0(1.0, 2.0), and 1.0(1.0, 2.0) respectively, which were lower than those of post-electroacupuncture group 3.0(2.0, 4.0), 2.0(1.0, 3.0), 2.0(1.0, 2.0), and the differences were statistically significant (P<0.05). NRSM of preoperative electroacupuncture group on the 4th to 5th day after operation were 3.0(2.0, 3.0) and 2.0(1.0, 2.0), which were lower than those of postoperative electroacupuncture group 4.0(3.0, 5.0) and 3.0(2.0, 3.0), and the differences were statistically significant (P<0.05). HSS score of pre-electroacupuncture group on the 7th day after operation was (76.22±3.51), which was higher than that of post-electroacupuncture group (71.54±6.36), and the difference was statistically significant (P<0.05). WOMAC score of pre-electroacupuncture group on the 7th day after operation was(19.84±3.61), which was lower than that of post-electroacupuncture group (22.37±3.81), and the difference was statistically significant (P<0.05).

Conclusion: The application giant needle electroacupuncture before operation could better alleviate acute pain after TKA and improve function of knee joint.