Clinical application of enhanced recovery after surgery in the perioperative period of anterior cruciate ligament reconstruction / 中国组织工程研究

ABSTRACT

BACKGROUND: Anterior cruciate ligament injury, with an increasing incidence in recent years, will seriously impact the motor function of the knee joint. Rehabilitation exercise after anterior cruciate ligament reconstruction is directly related to whether the patient can obtain ideal joint function. It is of important clinical significance to introduce the concept of enhanced recovery after surgery (ERAS) into the perioperative management of arthroscopic anterior cruciate ligament reconstruction. OBJECTIVE: To explore the clinical effect of ERAS in the perioperative period of anterior cruciate ligament reconstruction. METHODS: Sixty patients with anterior cruciate ligament injury, who were treated in the Department of Orthopedics, Renmin Hospital of Wuhan University from July 2016 to July 2018, were randomly divided into ERAS group (n=30) and traditional treatment group (n=30). Postoperative Visual Analogue Scale score, recovery time of knee range of motion, Lysholm knee scoring scale score, hospitalization duration, patients’ satisfaction rating were compared between the two groups. The implementation of the study complied with the Declaration of Helsinki and the relevant ethical requirements of Wuhan University Renmin Hospital, and all the enrolled patients were fully informed of the trial process. RESULTS AND CONCLUSION: The Visual Analogue Scale scores in the ERAS group were significantly lower than those in the traditional treatment group at 1, 24 hours, 2, 3, and 7 days after surgery (P < 0.05). The time that the range of motion returned to 30°, 60°, 90° and 120° after surgery in the ERAS group was significantly less than that in the traditional treatment group (P < 0.05). The Lysholm knee scoring scale scores in 3 months and 6 months after surgery in the ERAS group were significantly higher than those in the traditional treatment group (P < 0.05). The length of hospitalization in the ERAS group was significantly lower than that in the traditional treatment group (P < 0.05). The patients’ satisfaction rating in the ERAS group was significantly higher than that in the traditional treatment group (P < 0.05). To conclude, the introduction of ERAS concept into the perioperative management of anterior cruciate ligament reconstruction has obvious merits in reducing anxiety, relieving postoperative pain, reducing postoperative complications, promoting early recovery of patients and accelerating the recovery of knee joint function.