Improved Pain Management in Knee Osteoarthritis-related Surgeries
Condition: Knee Osteoarthritis; Total Knee Arthroplasty; Unicompartmental Knee Arthroplasty; High Tibial Osteotomy; Pain Management
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Observational

Summary: 
      In recent years, pain management coordinated with enhanced recovery after surgery (ERAS) has
      been widely applied and rapidly developed in orthopedics, showing promising prospects. Since
      2016, our hospital has used a series of continuously improved pain management schemes for
      patients with knee OA who underwent total knee arthroplasty (TKA), unicompartmental knee
      arthroplasty (UKA), and high tibial osteotomy (HTO). Here, we retrospectively analyze these
      patients' clinical data to compare the effects of different pain intervention measures during
      the perioperative period on postoperative pain, functional exercise, hospital stay, and
      prognosis of the three surgical methods in an attempt to provide a feasible solution for pain
      management of these patients.
    

Detailed description: 
      We retrospectively analyzed the clinical data of patients with knee osteoarthritis (OA) who
      received surgical treatment to provide a feasible solution for perioperative pain management
      of these patients. The medical records of 714 patients with knee OA who had undergone total
      knee arthroplasty (n=551), unicompartmental knee arthroplasty (n=92) and high tibial
      osteotomy (n=71) were retrospectively analyzed and the cases were divided into Groups A, B,
      and C, according to the continuously optimized pain management. Clinical data including
      anesthesia grade, surgery time, functional exercise, hospital stay, pain, emotion,
      complications and prognosis were compared.
    

Intervention name(s): Preoperative pain managment; Intraoperative pain managment; Postoperative pain managment
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): propaganda and education on pain; Preemptive analgesia with celecoxib (200 mg bid) 2 days before surgery; Squeeze to expel blood (tourniquet); Before skin suture, 20 mL 0.5% ropivacaine was given subcutaneously for local infiltration anesthesia;; The intravenous analgesia pump was placed until 48 h after surgery;On the second day after surgery, celecoxib (200 mg bid) was administered orally, and buprenorphine transdermal patch was applied externally until hospital discharge;FNB catheter was placed under the guidance of ultrasound and connected with an analgesic pump, the anesthesia lasted until 48 h after surgery ‡
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        The medical records of 714 patients (142 men, 40 women; mean age: 38.5 years; age range:
        18-64 years) with moderate or severe knee OA who had undergone TKA (n=551), UKA (n=92), or
        HTO (n=71) in a group of joint surgery at Sichuan Provincial People's Hospital between
        March 2016 and February 2022 were retrospectively analyzed. Clinical data, including age,
        weight, height, anesthesia grade, surgery, and time, as well as continuously improved
        perioperative pain management measures, were recorded.