JMIR Publications

ABSTRACT

Background:

ostoperative pain following total knee arthroplasty (TKA) is a significant challenge for both physicians and patients, adversely impacting patients' quality of life and the rehabilitation of joint function post-surgery. Exploring efficient and safe therapy approaches to alleviate pain and enhance joint function recovery is of paramount importance. Transcutaneous electrical acupoint stimulation (TEAS) demonstrates significant efficacy in alleviating postoperative pain. Nevertheless, there is a paucity of studies regarding its application following total knee arthroplasty.

Objective:

This study is to assess the effectiveness of TEAS in conjunction with multimodal analgesia for reducing postoperative pain and enhancing the quality of joint function rehabilitation following TKA. The impact of TEAS in conjunction with multimodal analgesia on opioid dosage and associated adverse responses, as well as the mechanism by which it enhances postoperative analgesic efficacy, was investigated.

Methods:

This article outlines a randomized controlled clinical trial that was blinded solely to evaluators. 154 participants were randomly allocated to an experimental group and a control group, with 77 cases in each group. This experiment will consist of a baseline phase, a 1-week treatment period, and a 12-week follow-up period. The control group patients who received TKA were administered the normal multimodal analgesic protocol. Patients in the experimental group received TEAS for 30 minutes, twice daily, from postoperative days 1 to 7, alongside normal multimodal analgesic treatment. The primary outcomes included Visual Analog Scale (VAS) at 3 and 7 days after surgery and the Western Ontario and McMaster Universities (WOMAC) score at 28 days after surgery. Secondary outcomes included VAS score at baseline and 1 day after surgery, WOMAC score at baseline, 1 week, 2 weeks and 12 weeks after surgery, and Short-Form 12-Item Health Survey (SF-12) at baseline, 4 weeks and 12 weeks after surgery. Other exploratory outcome measures included: knee pain threshold, Laser speckle imaging (LSI), quadriceps femoris motor unit stability index, knee skin temperature with infrared thermography (IRT), and plasma β-endorphin (β-EP) concentration. The knee pain threshold was evaluated at baseline, 1 day, 3 days, 7 days after surgery, and the plasma β-EP concentration was evaluated at baseline, 1 day, 7 days, 14 days after surgery. Other parameters were evaluated at baseline and 2 weeks after surgery. The use of postoperative analgesics was also recorded.

Results:

Subject recruitment commenced in January 2023 and is scheduled for completion by January 2025. Currently, all participants have been recruited, and the research data is undergoing sorting and analysis.

Conclusions:

The results of this study can provide a basis for TEAS to relieve pain after TKA and accelerate joint function recovery. Clinical Trial: Chictr.org.cn identifier: ChiCTR2200063897. Registered on 20 September 2022.