Objective To investigate the relative factors of sleep disorders in patients after arthroscopic knee surgery.MethodsThe clinical data of 155 patients undergoing arthroscopic knee surgery in West China Hospital of Sichuan University from October 1st 2017 to April 1st 2018 were analyzed. The sleep quality index was assessed by the Pittsburgh Sleep Quality Index. According to the scores, the patients were divided into two groups: the sleep disorder group and the non-sleep disorder group. Mindfulness level were evaluated by Mindful Attention Awareness Scale (MAAS). The binary logistic regression was used to assess the relationship between MAAS and sleep disorders.ResultsAmong the enrolled cases, there were 135 males and 20 females, with an average age of (34.12±12.13) years; 64 patients had poor sleep quality. The results of univariate analysis showed that the payment method, single or bilateral lesions, and MAAS score were the factors affecting sleep (P<0.05). The results of multivariate analysis indicated that with medical insurance [odds ratio (OR)=0.118, 95% confidence interval (CI) (0.021, 0.671), P=0.016], postoperative pain [OR=3.379, 95%CI (1.164, 9.812), P=0.025], bilateral lesions [OR=3.842, 95%CI (1.040, 14.191), P=0.044], and MAAS score ≥68 [OR=0.046, 95%CI (0.018, 0.121), P<0.001] were independent predictive factors for sleep disorders (P<0.05). Conclusion Postoperative pain reduction and mindfulness training may improve the patients’ sleep quality and reduce the incidence of sleep disorders.
ObjectivesTo systematically review the complications of knee arthroscopic surgeries in China.MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and VIP databases to collect cross-sectional studies on the complications of knee arthroscopic surgeries in China from inception to March 1st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 36 studies involving 20 740 cases were included. The results of meta-analysis showed the incidence rate of complication in knee arthroscopic surgeries in China was 9.71% (95%CI 8.20% to 11.23%). Subgroup analysis showed that the complication incidence rates in the eastern, central and western regions were 10.04% (95%CI 8.00% to 12.14%), 9.67% (95%CI 6.57% to 12.76%) and 7.47% (95%CI 6.20% to 8.73%). The complication incidence rates in the upper first-class and non-upper first-class hospitals were 9.50% (95%CI 7.83% to 11.17%) and 10.95% (95%CI 6.75% to 15.14%). The top 3 complication types with highest incidence rate included joint effusion［2.16% (95%CI 1.44% to 2.87%)］, accidental injury of native structures［1.49% (95%CI 0.96% to 2.03%)］ and hemorrhage［1.43% (95%CI 1.01% to 1.84%)］. Other severe complications including neurovascular injury, thrombosis diseases and infection were 0.06% (95%CI 0.02% to 0.11%), 0.33% (95%CI 0.19% to 0.48%) and 0.08% (95%CI 0.03% to 0.13%).ConclusionsCurrent evidence shows that the complication incidence rate of arthroscopic surgeries in China is relatively high and the complication type is complex and varied. Due to the quantity and quality of the included studies, more high-quality studies are required to verify the above conclusions in future.
ObjectiveTo investigate the effect of different saline irrigation volume under arthroscopy on early postoperative pain and swelling of the knee.MethodsThe clinical data of 539 patients with meniscus injury treated by arthroscopic menisci reformation who met the selection criteria between July 2016 and February 2020 were retrospectively analyzed. They were divided into three groups according to the continuous saline irrigation volume during the operation: 176 patients in the non-irrigation group (group A), 183 patients in the 1 liter-irrigation group (group B), and 180 patients in the 3 liters-irrigation group (group C). There was no significant difference in gender, age, cause of injury, sides of injury, body mass index, disease duration, smoking history, and classification of meniscus injury among 3 groups (P>0.05). At 6, 12, 24, 48, and 72 hours after operation, the patient’s pain level was evaluated by the visual analogue scale (VAS) score, and the knee swelling situation was evaluated by the swelling ratings (the difference between both sides in circumference of the 2 cm upper patella of the knee). Knee skin temperature (the difference of the skin temperature between both sides) and the C-reactive protein (CRP) level in serum were measured at the 1st and 3rd days after operation. Range of motion of the knee was measured at the 1st, 3rd, and 5th days after operation.ResultsAll incisions healed by first intention without any complication after operation. The VAS scores of each group showed a slow increase trend after operation, and gradually decreased to less than the VAS score of 6 hours at 48 hours after operation. There was no significant difference in VAS scores among the 3 groups at each time point after operation (P>0.05). The swelling ratings of the knee in each group showed a gradually decrease trend after operation. There was no significant difference in the swelling ratings of the knee among the 3 groups at each time point after operation (P>0.05). The skin temperature of the knee in each group decreased at the 3rd day after operation than the 1st day, and there was no significant difference in the skin temperature of the knee among the 3 groups at each time point after operation (P>0.05). There was no significant difference in CRP level within the group and among the 3 groups at each time point after operation (P>0.05). Range of motion of the knee in each group increased gradually at the 1st, 3rd, and 5th days after operation, and there was no significant difference among the 3 groups at each time point after operation (P>0.05).ConclusionThe different continuous saline irrigation volume would not affect the early postoperative pain, swelling, and inflammation of the knee during the arthroscopic menisci plasty.