Application of sensory and motor training in AIDET communication mode in patients after knee arthroplasty

BACKGROUND Patients with knee arthroplasty often have problems such as slow recovery of knee function,which may cause negative emotions and affect their postoperative rehabilitation.The application of sensory and motor training in the Acknowledge,Introduce,Duration,Evaluation,Thank You(AIDET)communication mode in patients after knee arthroplasty can provide reference for the selection of postoperative rehabilitation training measures.AIM To explore the sensory and motor training effects in AIDET communication mode on knee function recovery and resilience of patients after knee arthroplasty.METHODS One hundred patients who underwent knee arthroplasty at our hospital between January 2022 and January 2024 were randomly divided into two groups.The control group(n=50)received routine rehabilitation training.In the observation group(n=50),the AIDET communication mode was used to perform sensory and motor training,in addition to routine rehabilitation training.The rehabilitation training was administered for 8 weeks.After surgery,knee function,balance ability,walking ability,proprioception,and resilience were compared between the two groups.RESULTS The New York Hospital for Special Surgery knee scores of the observation group at the time of discharge and 8 weeks after intervention were(65.23±6.84,84.53±5.27),which was higher than those of the control group(61.03±7.15,74.92±6.52)(P<0.05).The balance ability of the observation group at the time of discharge and 8 weeks after the intervention was higher than that of the control group,the time of time up to go test was shorter than that of the control group,and proprioceptive function was higher than that of the control group(P<0.05).The resilience level in the observation group after the intervention was higher than that in the control group(P<0.05).CONCLUSION Sensory and motor training in AIDET communication mode promotes knee function recovery of patients after knee arthroplasty,improves their limb walking ability and balance function,and increases their resilience level.

Intact, pie-crusting and repairing the posterior cruciate ligament in posterior cruciate ligament-retaining total knee arthroplasty: A 5-year follow-up

BACKGROUND The posterior cruciate ligament(PCL) is important for cruciate-retaining(CR)total knee arthroplasty(TKA). Whether the entire PCL should be retained during CR-TKA is controversial.AIM To evaluate the clinical outcomes of PCL preservation in CR-TKA and the methods used to deal with the PCL during surgery.METHODS A retrospective review of patients with osteoarthritis undergoing primary CRTKA(176 patients, 205 knees) in our institution between March 2012 and March 2014 was performed. A PCL protector was used to preserve the intact PCL bone block. The status of the PCL was recorded during surgery. Intact PCL preserved,pie-crusting and repairing were used to balance the tension of the PCL. Range of motion(ROM) and the Knee Society Clinical Rating system(KSS) were evaluated preoperatively and at the endpoint of follow-up.RESULTS The mean ROM of the knee was 103.2 ± 17.2°, KSS clinical score was 47.6 ± 9.5 and KSS functional score was 46.3 ± 11.9 before surgery. The mean ROM of the knee was 117.5 ± 9.7°, KSS clinical score was 89.2 ± 3.6 and KSS functional score was 84.6 ± 9.8 at 5 years follow-up. ROM, KSS clinical scores and KSS functional scores were significantly improved after surgery(P < 0.01). Thirty-two(23.7%)TKAs involved PCL pie-crusting and 18(13.3%) involved PCL repair. Eighty-five(63.0%) TKAs applied standard operating procedures and preserved intact PCL.At 5 years follow-up, in the intact PCL group, the mean ROM of the knee was 118.0 ± 8.3°, KSS clinical score was 89.1 ± 3.7 and KSS functional score was 84.9 ±9.6. In the PCL pie-crusting group, mean ROM of the knee was 114.0 ± 13.5°, KSS clinical score was 88.8 ± 3.4 and KSS functional score was 83.8 ± 10.5. In the PCL repair group, mean ROM of the knee was 120.3 ± 7.0°, KSS clinical score was 89.0± 3.6 and KSS functional score was 89.4 ± 4.5. There were no significant differences in ROM, KSS clinical scores and KSS functional scores among the three groups(P > 0.05).CONCLUSION The clinical outcomes of preserving the PCL in CR-TKA are encouraging. Piecrusting and PCL repair do not affect the function. The PCL protector effectively protected the PCL bone block.

Therapeutic Effect Analysis of Sodium Aescinate Tablets on Knee Osteoarthritis Combined with Synovitis

Objective:To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis.Methods:86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospital Affiliated to Xi’an Jiaotong University from January 2018 to December 2019 were randomly divided into control group and intervention group,with 43 cases in each group.The control group was given routine treatment,and the intervention group was given sodium aescinate Tablets orally on the basis of routine treatment,twice a day,2 tablets each time.The curative effect was evaluated after 2 weeks of treatment.The knee pain and joint function of the two groups were evaluated by Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Arthritis Index(WOMAC),and the clinical effects of the two groups were compared.Results:Before treatment,there was no significant difference in general information,VAS and WOMAC scores between the two groups(P>0.05).After treatment,the VAS and WOMAC scores of the two groups were both lower than those before treatment,and the difference was statistically significant(P<0.05).The vas and WOMAC scores of the intervention group were lower than those of the control group(VAS,1.87±0.79 vs 3.38±0.81).In this study,sodium aescinate tablets were applied to the treatment of KOA combined with synovitis.The results showed that the intervention group was better than the control group in alleviating knee pain,improving joint function and improving clinical efficacy,and the difference was statistically significant.The total effective rate of the intervention group was higher than that of the control group(100%vs 86.05%),and the difference was statistically significant(P<0.05).Conclusion:Sodium aescinate tablet in the treatment of knee osteoarthritis combined with synovitis can effectively alleviate knee pain,improve joint function and improve clinical efficacy.

Efficacy and safety of flurbiprofen cataplasms versus loxoprofen sodium cataplasms in knee osteoarthritis:a randomized controlled trial

Background:Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs(NSAIDs)for treating knee osteoarthritis(OA).We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms(FPC)with loxoprofen sodium cataplasms(LSC)in treating patients with knee OA.Methods:This is an open-label,non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital.Overall,250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio.Both medications were administered to patients for 28 days.The primary outcome was the change of pain measured by visual analog scale(VAS)score from baseline to day 28(range,0-10 points;higher score indicates worse pain;non-inferiority margin:1 point;superiority margin:0 point).There were four secondary outcomes,including the extent of pain relief,the change trends of VAS scores,joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC),and adverse events.Results:Among 250 randomized patients(One patient without complete baseline record in the flurbiprofen cataplasms was excluded;age,62.8±10.5 years;61.4%[153/249]women),234(93.6%)finally completed the trial.In the intention-to-treat analysis,the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior,and also superior to that in the LSC group(differences and 95%confidence interval,0.414(0.147-0.681);P<0.001 for non-inferiority;P=0.001 for superiority).Similar results were observed of the VAS scores for the current pain and pain during exercise.WOMAC scores were also lower in the FPC group at week 4(12.50[8.00-22.50]vs.16.00[11.00-27.00],P=0.010),mainly driven by the dimension of daily activity difficulty.In addition,the FPC group experienced a significantly lower incidence of adverse events(5.6%[7/124]vs.33.6%[42/125],P<0.001),including irritation,rash and pain of the skin,and sticky hair uncovering pain.Conclusions:This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief,joint function improvement,and safety profile.Trial Registration:ChiCTR.org.cn,ChiCTR2100054822.

Clinical Application of Direct Skin Grafting Repair in Popliteal Scar Contracture after Burn in Children

Objective To observe the clinical application of direct skin grafting in repairing popliteal scar contracture after burn in children.Methods From April 2017 to January 2019,30 children with popliteal scar contracture after burn were selected as the research objects.The scar status,knee joint function and quality of life of the patients before and after the operation were compared by direct skin grafting after medium thickness skin removal.Results 30 patients were treated with skin grafting to repair popliteal scar contracture,27 patients healed well,and the survival rate of skin grafting reached 90.00%.The scores of postoperative scar and knee joint function scale(WOMAC)were lower than those before the operation,and the scores of concise health status scale(SF-36)were higher than those before the operation,with statistical significance(P<0.05).Conclusion Scar contracture of popliteal fossa after burn in children can be repaired by direct skin grafting in the skin extraction area after medium thickness skin cutting,which can effectively improve scar condition,restore knee joint function and significantly improve quality of life.

Design and Evaluation of an Exergame System of Knee with the Azure Kinect

Timely and effective knee function evaluation and knee exercises promote the prevention and self-management of knee diseases.In this paper,aKinectbased exergame system is proposed to assess and train the knee function.Azure Kinect was used to capture and generate 3D models of the user and immerse them in an interactive virtual environment.The software included three functional modules:knee function evaluation,Knee exercises game,and Comprehensive evaluation.The stand,step,leg lift,and squat were selected for knee function evaluation and exercises.Twenty volunteers participated in the experiment.Intraclass correlation coefficients(ICCs)were calculated to assess the reliability of kinematic measurements of knee angles during the movements.The ICC of these movements were stand(ICC=0.987),step(ICC=0.997),left leg lift(ICC=0.981),right leg lift(ICC=0.990),stand(ICC=0.998).The results show that the test-retest reliability is high.It means that the motion capture data is effective and the data obtained by Kinect is stable.