Traditional Chinese Massage For Tourniquet Related Injury After Total Knee Arthroplasty:A Prospective Randomized Controlled Study

Objective: To prospectively evaluate the effectiveness and safety of Traditional Chinese massage(TMC)for tourniquet related injury after Total knee arthroplasty(TKA).Methods:From October 1,2021 to January 1,2022,40 patients with knee osteoarthritis who planned to receive unilateral TKA were recruited.According to the random numbers generated by Excel,participants were assigned to the experimental group(TMC+ routine postoperative rehabilitation training)and the control group(routine postoperative rehabilitation training)according to the random number table.The knee VAS(Visual Analogue Scale)score,range of motion(ROM)and flexion contracture,and muscle strength of quadriceps femoris were compared between 2 groups before surgery,3 days,7 days,2 weeks,1 month and 3 months after surgery.The American Knee Society(AKS)score and the Western Ontario and Mc Master Universities(WOMAC)score were compared between 2 groups before surgery,1month,3 months after surgery;the patients satisfaction rate and the rate of postoperative wound complications were compared between 2 groups at 3 days,7 days,2 weeks,1 month and 3 months after surgery.Results: Thirty-five participants completed the trial,18 persons in the experimental group and 17 persons in the control group.No significant differences were seen in age,gender,Body Mass Index(BMI),tourniquet length,intraoperative blood loss,preoperative knee VAS score,preoperative knee ROM and flexion contracture,preoperative AKS score,preoperative WOMAC score,and preoperative quad muscle strength between 2groups(P > 0.05).Intra-group comparison: 3 months after surgery,knee VAS score,knee ROM and flexion contracture,AKS score and WOMAC score in 2 groups were all better than baseline values,with statistically significant differences(P < 0.05).3 months after surgery,the proportion of grade 5 muscle strength of quadriceps femoris in both groups was significantly lower than that baseline values.Comparison between groups: 3 days,7 days and2 weeks after surgery,between-groups analyses of the resting thigh VAS score indicated significant difference between groups(P < 0.05);at 1 and 3 months after surgery,no significant difference were seen in the resting thigh VAS score between-groups(P > 0.05).At3 and 7 days after surgery,between-groups analyses of knee joint activity pain VAS score indicated significant difference between groups(P < 0.05);at 2 weeks,1 month and 3 months after surgery,no significant difference were seen in VAS scores of knee joint activity pain between-groups(P > 0.05).At 3 and 7 days after surgery,between-groups analyses of knee ROM and knee flexion contracture indicated significant difference between groups(P < 0.05);no significant difference were seen in knee ROM and knee flexion contracture betweengroups at 2 weeks,1 month and 3 months after surgery(P > 0.05).Between-groups analyses of AKS knee score,functional score and WOMAC score indicated without significant difference between groups at 1 month and 3 months after surgery(P > 0.05).No significant difference were seen in the quadriceps femoris muscle strength between groups(P >0.05).Between-groups analyses of the patients satisfaction rate indicated significant difference between groups at 3 and 7 days after surgery(P < 0.05);At 2 weeks,1 month and 3months after surgery,no statistically significant difference were seen in the satisfaction rate between groups(P > 0.05).No significant difference were seen in the rate of postoperative wound complications groups(P>0.05).Conclusion: TCM can effectively improve the within1 week postoperative resting pain of thigh,knee activity pain,knee ROM and flexion contracture caused by TKA tourniquet injury,and improve patient satisfaction without increasing the rate of postoperative wound complications.