Abstract【Objective】 To investigate the effect of local drug phonophoresis on pain relief and functional exercise at the early stage after total knee arthroplasty (TKA). 【Methods】 Forty-one patients with unilateral TKA from June 2016 to May 2017 were randomly divided into observation group (n=21) and control group (n=20).Two groups of patients were given the same basic analgesia regimen. From 2 weeks after operation, the patients in the observation group received local ultrasound penetration (lidocaine + betamethasone) for 10 times in 4 weeks. The patients in the two groups were followed up to 3 months after operation. The preoperative activity and AKS scores were recorded respectively. The average activity,visual analogue score (VAS) and AKS score at 2 weeks, 6 weeks and 3 months after operation were recorded respectively. 【Results】 ① There was no significant difference between the two groups in preoperative activity, AKS score, activity at 2 weeks after exercise and VAS score after exercise (P>0.05);② At 6 weeks after operation, the activity of the observation group was (110.0±12.3)°, the VAS score was (2.0±1.0) points, the control group was (102.3±10.4)°,the VAS score was (2.9 ±1.3) points, the difference between the two groups was statistically significant (P<0.05).③ Three months after operation, the activity of the observation group was (116.4±10.7)°, the score of AKS function was (84.0±10.6), the activity of the control group was (111.0±10.9)°, the score of AKS function was (76.0±12.4). The observation group was superior to the control group(P<0.05).【Conclusion】 Ultrasound phonophoresis therapy with lidocaine and betamethasone can effectively relieve postoperative pain after TKA and is helpful to functional rehabilitation of patients with obvious early pain after TKA.
[1] 彭周全,张卫, 李丽伟,单次股神经阻滞对膝关节置换术老年患者术后早期镇痛和恢复的影响[J].中华实验外科杂志,2015,32(8):2016-2018. [2] Bruun-Olsen V, Heiberg KE, Mengshoel AM. Continuous passive motion as an adjunct to active exercises in early rehabilitation following total knee arthroplasty - a randomized controlled trial[J].Disabil Rehabil,2009,31(4):277-283. [3] Kim TK, Park KK, Yoon SW,et al.Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2009,17(10):1152-1158. [4] Peters CL, Shirley B, Erickson J. The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty[J].J Arthroplasty,2006,21(suppl 2):132-138. [5] Fu P, Wu Y, Wu H,et al.Efficacy of intra-articular cocktail analgesic injection in total knee arthroplasty - a randomized controlled trial[J].Knee,2009,16(4):280-284. [6] Moore C, Promes SB. Ultrasound in pregnancy[J].Emerg Med Clin North Am,2004,22(3):697-722. [7] Lindner JR .Microbubbles in medical imaging: current applications and future directions[J].Nat Rev Drug Discov,2004,3(6):527-532. [8] Mitragotri S Healing sound: the use of ultrasound in drug delivery and other therapeutic applications[J].Nat Rev Drug Discov,2005,4(3):255-260. [9] Voigt J, Wendelken M, Driver V,et al.Low-frequency ultrasound (20-40 kHz) as an adjunctive therapy for chronic wound healing: a systematic review of the literature and meta-analysis of eight randomized controlled trials[J].Int J Low Extrem Wounds,2011,10(4):190-199. [10] Michailidis L,Williams CM,Bergin SM,et al.Comparison of healing rate in diabetes-related foot ulcers with low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised trial protocol[J].J Foot Ankle Res,2014,7(1):1. [11] Loyola-Sánchez A, Richardson J, MacIntyre NJ. Efficacy of ultrasound therapy for the management of knee osteoarthritis: a systematic review with meta-analysis[J].Osteoarthritis Cartilage,2010,18(9):1117-1126. [12] Cross SE, Roberts MS. Physical enhancement of transdermal drug application: is delivery technology keeping up with pharmaceutical development[J].Curr Drug Deliv,2004,1(1):81-92.
2018, Vol. 35 
