Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2024; 12(4): 721-728
Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.721
Rehabilitation care for pain in elderly knee replacement patients
Li Liu, Qiao-Zhen Guan, Li-Fang Wang
Li Liu, Li-Fang Wang, Wuhan Fourth Hospital, Wuhan 430033, Hubei Province, China
Qiao-Zhen Guan, Department of Orthopaedics, Wuhan Third Hospital, Wuhan 430074, Hubei Province, China
Co-first authors: Li Liu and Qiao-Zhen Guan.
Author contributions: Liu L and Guan QZ contributed equally to this work as co-first authors equally to this work. Liu L and Guan QZ designed the research; Liu L, Guan QZ, and Wang LF contributed new reagents/analytic tools, and analyzed the data; Liu L and Guan QZ wrote the paper; and all authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Liu L and Guan QZ as co-first authors are threefold. First, Liu L and Guan QZ designed and conceptualized the study. Second, Liu L and Guan QZ participated in discussion development and provided expert guidance. Third, Liu L and Guan QZ put in the same effort throughout the study, and in summary, we believe that Guan QZ can be tagged as co-first author in our manuscript.
Institutional review board statement: This study protocol was approved by Wuhan Fourth Hospital.
Informed consent statement: All the families have voluntarily participated in the study and have signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data generated from this investigation are available upon reasonable quest from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Fang Wang, Nurse, Wuhan Fourth Hospital, No. 473 Hanzheng Street, Qiaokou District, Wuhan 430033, Hubei Province, China. lifangwang2023@126.com
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 8, 2023
Revised: December 4, 2023
Accepted: January 8, 2024
Article in press: January 8, 2024
Published online: February 6, 2024
Processing time: 94 Days and 5.5 Hours
Abstract
BACKGROUND

Total knee arthroplasty (TKA) is recognized as the most effective surgical intervention for relieving pain and improving joint mobility and deformity in patients with knee osteoarthritis and other synovial diseases. The application of accelerated postoperative rehabilitation (enhanced recovery after surgery) has demonstrated its efficacy in improving patient outcomes, and early postoperative joint function exercise has become a key prognostic factor in knee replacement. The unexpected appearance of limb pain and swelling hindered the patient’s tendency for early mobilization, leading in prolonged hospitalization, delayed functional recovery and negative psychological responses.

AIM

To investigate the impact of incorporating programmed pain nursing with collaborative nursing on elderly patients undergoing knee replacement surgery.

METHODS

A retrospective analysis was conducted on a cohort of 116 patients who underwent TKA at our hospital between July 2019 and July 2021. The patients were divided into two groups: A control group (n = 58) receiving programmatic nursing, and an observed group (n = 58) receiving programmed nursing combined with a collaborative nursing model. A pain management team consisting of attending physicians, head nurses, and responsible nurses was established. Outcome measures included visual analogue scale (VAS) scores, activities of daily living (ADL) scale scores, and functional scores.

RESULTS

The ADL scores of patients in both groups exhibited a continuous increase. However, there was no statistically significant difference in the ADL scores between the two groups at 48 h and the 7th d post-surgery (P > 0.05). Upon reexamination at the 3rd mo, the observation group demonstrated higher ADL scores compared to the control group (67.48 ± 14.69 vs 59.40 ± 16.06, P < 0.05). The VAS scores of both groups significantly decreased, with no significant difference observed between the groups at each time point (P > 0.05). The functional status of patients in both groups exhibited a gradual increase prior to intervention and at the 1st, 2nd, and 3rd month following discharge (P < 0.05). There was no statistically significant difference in knee joint function scores between the two groups at the 1st month after discharge (47.52 vs 45.81, P > 0.05). However, the knee joint function scores of patients in the observation group were significantly higher than those in the control group at the 2nd (59.38 vs 53.19, P < 0.05) and 3rd month (71.92 vs 64.34, P < 0.05) following discharge.

CONCLUSION

The utilization of programmed pain nursing in conjunction with collaborative nursing for out-of-hospital care of TKA patients has demonstrated favorable outcomes, encompassing pain reduction, enhanced prognosis, and improved nursing quality for patients.

Keywords: Programmed pain nursing, Collaborative nursing, Total knee arthroplasty

Core Tip: Total knee replacement is considered to be the most effective surgical treatment for reducing pain caused by knee osteoarthritis and other synovial diseases, and improving joint mobility limitations and deformities. A total of 116 total knee arthroplasty patients treated in our hospital from July 2019 to July 2021 were retrospectively analyzed. A programmed pain management team consisting of the bed doctor, the head nurse and the responsible nurse was established. The combination of programmed pain care and collaborative care can reduce patients’ pain, improve patients’ prognosis and improve nursing quality.