Postoperative Pain After Patellar Dislocation Surgery
Conditions
Keywords
Treatment of postoperative pain after patellar dislocation surgery
Brief summary
This study is a concurrent non-randomized controlled pilot trial. We plan to recruit 80 patients following patellar dislocation surgery from Peking University Third Hospital in China, with at least 40 participants in each group. The study aims to evaluate the safety and efficacy of acupuncture for the treatment of postoperative pain after patellar dislocation. The treatment regimen (pharmacological therapy or acupuncture) will be determined by the clinician and the patient based on the patient's condition and preference. Participants will be assigned to two groups according to the treatment they receive in clinical practice: a medication group and an acupuncture group. All participants will enter a follow-up phase lasting up to 3 months. Assessments include pain intensity (Visual Analog Scale, VAS), the Lysholm Knee Score, the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, the Tegner Activity Score, a sleep score, and the degree of joint swelling. VAS pain score, sleep score, and joint swelling will be evaluated preoperatively and on postoperative days 3, 4, 7, 14, 30, and at 3 months. The remaining outcomes will be measured at 3 months postoperatively.
Interventions
PROCEDUREAcupuncture
The acupuncture points for Traditional Chinese Medicine (TCM) treatment are Quchi (LI11) and Zhisi Ma (SI4). For Quchi, the needle is inserted at the point of marked tenderness around the Quchi point on the contralateral Hand Yangming Large Intestine Meridian. For Zhisi Ma, the needle is inserted at the junction of red and white skin on the back of the hand, penetrating to the subcutaneous tissue on the palm side. Needling is manipulated every 15 minutes, while the patient is guided to gently move the affected knee joint, with the needles retained for 45 minutes. Treatment is performed once on the day of surgery and once on the day following surgery.
DRUGVoltaren
Drug therapy refers to oral or topical medication, specifically oral Voltaren sustained-release tablets at a dose of 0.5 mg/kg twice daily.
Sponsors
Peking University Third Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patients with recurrent patellar dislocation, male or female; * patients with acute patellar dislocation complicated by a tangential osteochondral fracture requiring surgical treatment; * patients who voluntarily participated in the clinical trial, signed the informed consent form, and were able to comply with clinical follow-up;
Exclusion criteria
* participation in other drug or medical device clinical trials within the past 6 months; * joint fibrosis, ankylosis, or significant limitation of movement; * contraindications to MRI examination; * other conditions that, in the physician's judgment, preclude participation in the trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| VAS | Preoperative, immediately before and after acupuncture, and then at postoperative day 3, day 4, day 7, day 14, day 30, and at 3 months. | 0-10, with 0 representing no pain and 10 representing the most severe pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lysholm Knee Function Score | 3 months after surgery | It can assess specific symptoms and functional impairments of the knee joint, and has particular advantages in reflecting instability and limitations in daily activities. It consists of 8 items, with a total score of 100. The higher the score, the better the function. Function classification (widely accepted standard): Excellent: 95 - 100 points; Good: 84 - 94 points; Average: 65 - 83 points; Poor: \< 65 points. |
| Tegner Activity Scale | 3 months after surgery | It is a one-dimensional scale ranging from 0 to 10, used to assess the activity level of patients in terms of sports and daily work. The higher the score, the higher the activity level of knee joint. High score (8-10 points): Indicates the level of competitive sports, with extremely high requirements for the knee joint. Medium score (4-7 points): Represents recreational sports and physical labor, which is the level of most active people. Low score (0-3 points): Represents daily life and sedentary work, with a lower load on the knee joint. |
| International Knee Documentation Committee (IKDC)-2000 | 3 months after surgery | It can comprehensively assess the knee joint's functionality, consisting of 18 questions, covering three dimensions: symptoms, sports activity function, and daily activity function. The higher the score, the better the knee joint's functionality and the fewer the symptoms. Generally, a score of \>90 indicates excellent function, while a score of \<70 indicates significant functional impairment. The minimum clinically important difference is approximately 10-12 points. |
| sleep score | Preoperative, immediately before and after acupuncture, and then at postoperative day 3, day 4, day 7, day 14, day 30. | The sleep score ranging from 1 to 5 was used to assess sleep quality, with 1 indicating very good sleep and 5 indicating inability to fall asleep. |
Countries
China
Outcome results
None listed