Abstract
Objective
To evaluate the effect of wrist-ankle acupuncture (WAA) in pain and functional recovery after total knee arthroplasty (TKA).
Methods
From June to September 2020, 94 participants were included from the Second Hospital of Tangshan and randomly assigned to the WAA group (47 cases) and the sham WAA group (47 cases) by a random number table, receiving real or sham WAA treatment, respectively. The primary outcome measure involved the visual analogue scale (VAS) scores at rest and in motion. The secondary outcomes involved the range of motion (ROM) of the knee joints, straight-leg raising time, postoperative weight-bearing time, sufentanil consumption within 48 h of patient-controlled analgesia (PCA) pump, length of hospital stay, and postoperative complications.
Results
The VAS scores on the 3rd, 5th, and 7th postoperative days at rest and in motion was significantly lower in the WAA group than that of the sham WAA group (P<0.01). The ROM on the 1st, 2nd, and 3rd PODs was significantly higher in the WAA group than that of the sham WAA group (P<0.01). In comparison to the sham WAA group, the sufentanil consumption within 48 h of PCA pump was significantly less in the WAA group (156.3 ± 12.2 µg vs. 128.8 ± 9.8 µg, P<0.01). There was no significant difference in active straight-leg raising time, postoperative weight-bearing time, length of hospital stay, and postoperative complications between the two groups (P>0.05).
Conclusions
WAA could alleviate post-TKA pain, improve knee joint function, and reduce the sufentanil consumption within 48 h of PCA pump. WAA is a safe and effective treatment in the perioperative analgesic management for TKA.
Similar content being viewed by others
References
Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Horthy Traumatol Surg Res 2018;104:S41–S46.
Li JW, Ma YS, Xiao LK. Postoperative pain management in total knee arthroplasty. Orthop Surg 2019;11:755–761.
Derogatis MJ, Sodhi N, Anis HK, Ehiorobo JO, Bhave A, Mont MA. Pain management strategies to reduce opioid use following total knee arthroplasty. Surg Technol Int 2019;35:301–310.
Jung JY, Cho JH, Chung SH. Acupuncture for postoperative pain following total knee arthroplasty: a systematic review protocol. BMJ Open 2015;5:e009573.
Zhu Y, Feng Y, Peng L. Effect of transcutaneous electrical nerve stimulation for pain control after total knee arthroplasty: a systematic review and meta-analysis. J Rehabil Med 2017;49:700–704.
Yang K, Du YZ, Shi J, Wang JL, Sun YH, Xing HJ, et al. Exploration of dominant diseases and clinical application characteristics of wrist-ankle acupuncture therapy based on data mining technology. Chin Acupunct Moxibust (Chin) 2019;39:673–678.
Wang Q, Zhou Q. Theoretical origin and clinical application of wrist-ankle acupuncture therapy. Chin Acupunct Moxibust (Chin) 2017;37:509–512.
Gademan MG, Hofstede SN, Vliet Vlieland TP, Nelissen RG, Marang-van de Mheen PJ. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview. BMC Musculoskelet Disord 2016;17:463.
Goodman SM, Springer B, Guyatt G, Abdel MP, Dasa V, George M, et al. 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty. J Arthroplasty 2017;32:2628–2638.
Zhu LB, Chan WC, Lo KC, Yum TP, Li L. Wrist-ankle acupuncture for the treatment of pain symptoms: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2014;2014:261709.
Chen JS. The clinical study of wrist-ankle acupuncture in the treatment of pain after total knee arthroplasty [Dissertation]. Fuzhou: Fujian University of Traditional Chinese Medicine; 2016.
Mihalko WM, Kerkhof AL, Ford MC, Crockarell JRJr, Harkess JW, Guyton JL. Cryoneurolysis before total knee arthroplasty in patients with severe osteoarthritis for reduction of postoperative pain and opioid use in a single-center randomized controlled trial. J Arthroplasty 2021;36:1590–1598.
Huang SY, Tong PJ, Wu W, Xu F, Zhang FF, Pan FP. Evaluation of analgesia effect of wrist-ankle acupuncture on total knee arthroplasty in elderly patients. Chin Arch Tradit Chin Med (Chin) 2013;31:1014–1016.
Bian YY, Wang LC, Qian WW, Lin J, Jin J, Peng HM, et al. role of parecoxib sodium in the multimodal analgesia after total knee arthroplasty: a randomized double-blinded controlled trial. Orthop Surg 2018;10:321–327.
Kandarian BS, Elkassabany NM, Tamboli M, Mariano ER. Updates on multimodal analgesia and regional anesthesia for total knee arthroplasty patients. Best Pract Res Clin Anaesthesiol 2019;33:111–123.
Moucha CS, Weiser MC, Levin EJ. Current strategies in anesthesia and analgesia for total knee arthroplasty. J Am Acad Orthop Surg 2016;24:60–73.
Camporesi EM, Puri S, Enten G. Postoperative analgesia choices in total knee replacement. Minerva Anestesiol 2018;84:1003–1004.
Marra C, Pozzi I, Ceppi L, Sicuri M, Veneziano F, Regalia AL. Wrist-ankle acupuncture as perineal pain relief after mediolateral episiotomy: a pilot study. J Altern Complement Med 2011;17:239–241.
Chen Y, Tian S, Tian J, Shu S. Wrist-ankle acupuncture (WAA) for primary dysmenorrhea (PD) of young females: study protocol for a randomized controlled trial. BMC Complement Altern Med 2017;17:421.
Wu JL, Su HT, Liang YH, Peng JJ, Hong WW. Auxiliary analgesic effect of wrist-ankle acupuncture on patients undergoing transforaminal endoscope surgery. Chin Acupunct Moxibust (Chin) 2020;40:147–151.
Liang S, Zhang G, Li J, Zhong L, Zhang C. Wrist ankle acupuncture in the treatment of acute lumbar sprain: a protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020;99:e23420.
Author information
Authors and Affiliations
Contributions
Cao HT were responsible for design of the study. Zhang W drafted the manuscript. Cao HT, Luo C and Zhao HB performed the experiments. Liu JM participated in critical revision of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
All the authors have no possible conflicts of interest.
Supplementary material to
Rights and permissions
About this article
Cite this article
Cao, Ht., Zhang, W., Luo, C. et al. Effect of Wrist-Ankle Acupuncture on Postoperative Analgesia after Total Knee Arthroplasty. Chin. J. Integr. Med. 29, 253–257 (2023). https://doi.org/10.1007/s11655-022-3463-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11655-022-3463-5