Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (18): 2840-2845.doi: 10.3969/j.issn.2095-4344.3845

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Effectiveness of Tuina in the treatment of pain after total knee arthroplasty in patients with knee osteoarthritis

Xu Hui1, Kang Bingxin1, Gao Chenxin1, Zhao Chi1, Xu Xirui1, Sun Songtao1, Xie Jun1, Xiao Lianbo1, 2, Shi Qi3, 4    

  1. 1Shanghai Guanghua Integrated Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, China; 2Institute of Arthritis of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, China; 3Longhua Hospital, Shanghai University of Traditional Chinese Medicine, China; 4Institute of Spinal Diseases, Shanghai University of Traditional Chinese Medicine, China
  • Received:2020-08-15 Revised:2020-08-18 Accepted:2020-09-15 Online:2021-06-28 Published:2021-01-12
  • Contact: Xiao Lianbo, Master, Chief physician, Doctoral supervisor, Shanghai Guanghua Integrated Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200050, China; Institute of Arthritis of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai 200050, China
  • About author:Xu Hui, Doctoral candidate, Shanghai Guanghua Integrated Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200050, China
  • Supported by:
    the Shanghai Key Clinical Specialist Construction Project, No. shslczdzk04801 (to XLB); Rehabilitation Diagnosis and Treatment Ability Improvement Project of Integrated Traditional Chinese and Western Medicine of Shanghai Health and Family Planning Commission, No. ZY(2018-2020)-FWTX-6023 (to XLB)

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Abstract: BACKGROUND: The pain of patients after total knee arthroplasty seriously affects the efficacy of surgery and patient satisfaction, which is a clinical problem concerned by joint surgery experts all over the world.
OBJECTIVE: To observe the efficacy of Tuina in the treatment of pain after total knee arthroplasty in patients with knee osteoarthritis. 
METHODS: In a randomized controlled design, 134 patients with unilateral knee osteoarthritis scheduled for total knee arthroplasty were randomly divided into two groups: Tuina group (n=67) and control group (n=67). The control group was treated with routine postoperative analgesia, and the Tuina group was treated with Tuina on the basis of the control group. The intervention time was set from the first day to the seventh day after operation. The pressure pain threshold, visual analogue scale score, times of patient-controlled analgesia, additional dose of analgesics, range of motion of knee joint, Hamilton anxiety scale score, and adverse events were recorded in the two groups. The study was approved by the Ethics Committee of Shanghai Guanghua Integrated Chinese and Western Medicine Hospital on October 12, 2019, approval No. 2019-K-24. All participants gave informed consent to the trial protocol and process, and signed informed consent. This study was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/searchproj.aspx, ChiCTR1900027810) on November 29, 2019.
RESULTS AND CONCLUSION: (1) After 3 and 7 days of intervention, the pressure pain threshold in the Tuina group was higher than that in the control group (P < 0.05). (2) After 3 and 7 days of intervention, the visual analogue scale score in the Tuina group was lower than that in the control group (P < 0.05). (3) The pressing times of patient-controlled analgesia after 2 days of intervention and the additional dose of analgesics after 7 days of intervention in the Tuina group were less than those in the control group (P < 0.05). (4) After 3 and 7 days of intervention, the range of motion of knee joint in the Tuina group was better than that in the control group (P < 0.05). (5) After 3 and 7 days of intervention, the Hamilton anxiety scale score in the Tuina group was lower than that in the control group (P < 0.05). (6) There were no adverse events in both groups. (7) It is indicated that Tuina can improve the local pain threshold of knee after total knee arthroplasty in patients with knee osteoarthritis, reduce the use of analgesics, and promote the rehabilitation of knee, which is safe and reliable. 

Key words: knee joint, total knee arthroplasty, massage, postoperative pain, tenderness threshold, range of motion

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