[Acupuncture combined with femoral nerve block for postoperative analgesia after total knee arthroplasty and functional rehabilitation: a randomized controlled trial].

OBJECTIVE: To observe the therapeutic effects on the postoperative analgesia after total knee arthroplasty (TKA) and functional rehabilitation with acupuncture at the distal points along the affected meridians and femoral nerve block.

METHODS: A total of 60 patients with knee prosthesis were collected and randomized into an observation group and a control group, 30 cases in each one. All of the patients received the femoral nerve block before operation. The analgesia pump was used for analgesia after operation and TKA postoperative rehabilitation was adopted. Additionally, in the observation group, acupuncture was applied to Taichong (LR 3), Kunlun (BL 60), Taixi (KI 3), Shenmai (BL 62), Sanyinjiao (SP 6) and Houxi (SI 3) unilaterally on the affected side, as well as Chize (LU 5), Quchi (LI 11) and Shousanli (LI 10) bilaterally. The needles were remained for 30 min, once a day, totally for 2 weeks. Separately, 4 h, 8 h, 12 h, 24 h and 48 h in resting after operation, as well as during the passive functional exercises 12 h, 24 h, 48 h, 7 d and 14 d after operation, the scores of visual analogue score (VAS) were recorded. HSS score, ROM before operation and 7 d and 14 d after operation, the analgesia satisfaction, the analgesic dose as well as the adverse reactions were recorded.

RESULTS: Regarding the VAS scores, 8 h, 12 h, 24 h and 48 h in resting after operation, the results in the observation group were lower than those in the control group (all P <0.05). The VAS scores during the passive functional exercises 12 h, 24 h 48 h and 7 d after operation in the observation group were lower than those in the control group (all P <0.05). The analgesia satisfaction in the observation group was higher than that in the control group ( P <0.05). 72 h, 7 d and 14 d after operation, HSS scores in the observation group were better than those in the control group (all P <0.05) and the effects of ROM in the observation group were better than those in the control group (both P <0.05). Regarding the safety, the adverse reaction rate in the observation group was lower than that in the control group ( P <0.05).

CONCLUSION: The combined treatment with acupuncture along the meridians and femoral nerve block achieves the remarkably analgesia effects after TKA and definite effects of the joint function recovery. This combined therapy is favorable in safety and adverse reactions.