小针刀配合手法在膝关节置换术后关节功能恢复中的应用

Application of small needle knife along with manipulation for rehabilitation joint function after total knee arthroplasty

目的探讨小针刀配合手法在膝关节置换术(TKA)后关节功能恢复中的应用。方法将74例TKA术后关节活动不佳、组织黏连患者随机分为治疗组和对照组,各37例。2组均行拿法、揉法、滚法、刮髌、推髌、痛点弹拨等手法按摩,治疗组在此基础上给予小针刀配合改善关节活动度。观察2组治疗前后HSS评分、关节活动度、VAS评分及不良反应的发生情况。结果治疗后4周治疗组HSS评分较对照组显著升高(P<0.05);治疗后,2组ROM、最大屈曲度及VAS评分均显著改善(P<0.05),且治疗组的改善程度优于对照组(P<0.05)。治疗期间,治疗组无局部血肿、切口感染等并发症,2组均未见假体松动移位。结论小针刀配合手法治疗TKA术后关节活动不佳,可缓解关节疼痛,改善关节活动度,促进膝关节功能的恢复。

Objective To explore clinical effect of small needle knife along with manipulation for rehabilitation joint function after total knee arthroplasty（ TKA）. Methods The 74 patients who suffered poor activity,tissue adhesion after TKA were randomly divided into treatment group（ 37 cases） and control group（ 37 cases）. All the patients were given manipulation including grasping,kneading,rolling,scraping,pushing,plucking,and treatment group was treated with manipulation combined with small needle knife additionally to improve the motion of joint. The HSS score,motion of joint,VAS score and complications were observed and compared. Results The scores of HSS at 4 weeks after treatment in treatment group were significantly higher than those in control group（ P〈0. 05）. After treatment,the ROM,maximal flexibility and VAS score was improved remarkably after treatment（ P〈0. 05）,and there were significant difference on those indicators between the two groups（ P〈0. 05）. During the treatment,treatment group was no complications such as hematoma,incision infection,prostheses flexibility and shift was not found in two groups. Conclusion Small needle knife along with manipulation for poor joint motion after TKA,can eased painful joint,improve the joint activity and function.