Early postoperative pain between the first and second staged bilateral total knee arthroplasty:a retrospective comparative analysis / 中国组织工程研究

ABSTRACT

BACKGROUND:Total knee arthroplasty solves a great pain for patients with severe knee joint disease, and its clinical curative effects have been general y accepted. In the clinic, the formulation of clinical analgesic program of the two surgeries in patients undergoing double knee prosthesis lacks of the support of evidence-based medicine. OBJECTIVE:To compare the differences in pain during early stage of primary and secondary surgeries in bilateral total knee arthroplasty, and to provide evidence for clinical analgesic programs. METHODS:A total of 87 patients receiving staged bilateral total knee arthroplasty from January 2009 to January 2013 were retrospectively analyzed. Visual analogue scale was compared at 24, 48 and 72 hours after first and second staged total knee arthroplasty, including seating and maximum flexion position. In addition, the difference in early pain score was compared between second and first total knee arthroplasty in different intervals (less than 6 months, 6-12 months, more than 12 months). RESULTS AND CONCLUSION:The visual analogue scale scores at seating and maximum flexion position at 24 and 48 hours after second total knee arthroplasty were significantly higher than the first surgery. No significant difference in visual analogue scale scores was detected between 72-hour seating and maximum flexion position. Visual analogue scale scores were significantly higher in the interval of less than 6 months than in the 6-12 month group and more than 12 month group in the 24-hour seating and maximum flexion position after second total knee arthroplasty. No significant difference in visual analogue scale scores was detected between the 6-12 month group and more than 12 month group at seating and maximum flexion position. Results suggested that the pain of second surgery was obviously higher than the first surgery within 48 hours after staged bilateral total knee arthroplasty, and this can provide a clinical evidence to enhance the analgesic strategy in the second staged bilateral total knee arthroplasty. The interval between two surgeries also affected the early pain after second surgery. Considered the aspect of postoperative pain, it is better to suggest the interval between first and second surgeries in staged total knee arthroplasty should be more than 6 months. This can reduce pain after second surgery, elevate patient’s satisfaction and accelerate the speed of recovery.