Long Zhao, Xiaoling Luo, Duan Wang, Jinwei Xie, Zongke Zhou
{"title":"聚焦低强度脉冲超声减轻全膝关节置换术后下肢肿胀和疼痛的疗效：一项随机研究。","authors":"Long Zhao, Xiaoling Luo, Duan Wang, Jinwei Xie, Zongke Zhou","doi":"10.1007/s00264-025-06601-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Low-intensity pulsed ultrasound (LIPUS) is a non-invasive physiotherapy that is often utilized to treat swelling and pain caused by musculoskeletal trauma. We aimed to evaluate the efficacy and safety of LIPUS in reducing lower-extremity swelling and pain following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This randomized, controlled study evaluated 116 patients undergoing primary TKA, randomly assigning them to either an LIPUS group receiving active LIPUS therapy (0.8 MHz, 1.35 W) or a control group receiving sham treatment. The LIPUS intervention was administered to the operated knee for 25-minute sessions, three times daily for three consecutive days, beginning four hours postoperatively. The primary study outcome measured lower extremity swelling during the first 14 postoperative days, while secondary outcomes included knee pain (assessed by visual analogue scale ranging from 0 to 10 points), Hospital for Special Surgery (HSS) score, range of knee motion (ROM), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), myoglobin, and complications.</p><p><strong>Results: </strong>The LIPUS (n = 55) and control (n = 56) groups showed similar baseline characteristics. LIPUS treatment significantly improved clinical outcomes compared to sham treatment, reducing calf swelling by 2.37-2.74%, thigh swelling by 2.76-4.81%, and patellar swelling by 2.30-3.28% (all p < 0.001). Patients receiving LIPUS also reported less walking pain (1.16-2.48 point reduction, p < 0.001) and showed lower inflammatory markers (CRP reduction of 2.53-13.85 mg/L, p = 0.047; IL-6 reduction of 3.64-17.27 pg/mL, p = 0.041). However, the treatment did not significantly affect resting pain, HSS scores, ROM, serum myoglobin levels, or complication rates.</p><p><strong>Conclusion: </strong>This study found that short-term LIPUS use markedly decreased lower-extremity swelling and walking pain post-TKA, with no major safety concerns. However, future studies are needed to determine the optimal protocol and long-term safety of LIPUS in TKA patients.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"2423-2431"},"PeriodicalIF":2.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of focused low intensity pulsed ultrasound in reducing lower-extremity swelling and pain after total knee arthroplasty: a randomized study.\",\"authors\":\"Long Zhao, Xiaoling Luo, Duan Wang, Jinwei Xie, Zongke Zhou\",\"doi\":\"10.1007/s00264-025-06601-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Low-intensity pulsed ultrasound (LIPUS) is a non-invasive physiotherapy that is often utilized to treat swelling and pain caused by musculoskeletal trauma. We aimed to evaluate the efficacy and safety of LIPUS in reducing lower-extremity swelling and pain following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This randomized, controlled study evaluated 116 patients undergoing primary TKA, randomly assigning them to either an LIPUS group receiving active LIPUS therapy (0.8 MHz, 1.35 W) or a control group receiving sham treatment. The LIPUS intervention was administered to the operated knee for 25-minute sessions, three times daily for three consecutive days, beginning four hours postoperatively. The primary study outcome measured lower extremity swelling during the first 14 postoperative days, while secondary outcomes included knee pain (assessed by visual analogue scale ranging from 0 to 10 points), Hospital for Special Surgery (HSS) score, range of knee motion (ROM), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), myoglobin, and complications.</p><p><strong>Results: </strong>The LIPUS (n = 55) and control (n = 56) groups showed similar baseline characteristics. LIPUS treatment significantly improved clinical outcomes compared to sham treatment, reducing calf swelling by 2.37-2.74%, thigh swelling by 2.76-4.81%, and patellar swelling by 2.30-3.28% (all p < 0.001). Patients receiving LIPUS also reported less walking pain (1.16-2.48 point reduction, p < 0.001) and showed lower inflammatory markers (CRP reduction of 2.53-13.85 mg/L, p = 0.047; IL-6 reduction of 3.64-17.27 pg/mL, p = 0.041). However, the treatment did not significantly affect resting pain, HSS scores, ROM, serum myoglobin levels, or complication rates.</p><p><strong>Conclusion: </strong>This study found that short-term LIPUS use markedly decreased lower-extremity swelling and walking pain post-TKA, with no major safety concerns. However, future studies are needed to determine the optimal protocol and long-term safety of LIPUS in TKA patients.</p>\",\"PeriodicalId\":14450,\"journal\":{\"name\":\"International Orthopaedics\",\"volume\":\" \",\"pages\":\"2423-2431\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00264-025-06601-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-025-06601-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Efficacy of focused low intensity pulsed ultrasound in reducing lower-extremity swelling and pain after total knee arthroplasty: a randomized study.
Purpose: Low-intensity pulsed ultrasound (LIPUS) is a non-invasive physiotherapy that is often utilized to treat swelling and pain caused by musculoskeletal trauma. We aimed to evaluate the efficacy and safety of LIPUS in reducing lower-extremity swelling and pain following total knee arthroplasty (TKA).
Methods: This randomized, controlled study evaluated 116 patients undergoing primary TKA, randomly assigning them to either an LIPUS group receiving active LIPUS therapy (0.8 MHz, 1.35 W) or a control group receiving sham treatment. The LIPUS intervention was administered to the operated knee for 25-minute sessions, three times daily for three consecutive days, beginning four hours postoperatively. The primary study outcome measured lower extremity swelling during the first 14 postoperative days, while secondary outcomes included knee pain (assessed by visual analogue scale ranging from 0 to 10 points), Hospital for Special Surgery (HSS) score, range of knee motion (ROM), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), myoglobin, and complications.
Results: The LIPUS (n = 55) and control (n = 56) groups showed similar baseline characteristics. LIPUS treatment significantly improved clinical outcomes compared to sham treatment, reducing calf swelling by 2.37-2.74%, thigh swelling by 2.76-4.81%, and patellar swelling by 2.30-3.28% (all p < 0.001). Patients receiving LIPUS also reported less walking pain (1.16-2.48 point reduction, p < 0.001) and showed lower inflammatory markers (CRP reduction of 2.53-13.85 mg/L, p = 0.047; IL-6 reduction of 3.64-17.27 pg/mL, p = 0.041). However, the treatment did not significantly affect resting pain, HSS scores, ROM, serum myoglobin levels, or complication rates.
Conclusion: This study found that short-term LIPUS use markedly decreased lower-extremity swelling and walking pain post-TKA, with no major safety concerns. However, future studies are needed to determine the optimal protocol and long-term safety of LIPUS in TKA patients.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
