Application of Iced Normal Saline Combined with Cocktail Perfusion in Total Knee Arthroplasty: randomized controlled trial

Objective: The present study was designed to investigate the safety and effectiveness of iced normal saline combined with cocktail perfusion during total knee arthroplasty (TKA). This was a random, double-blind, parallel-group study conducted in China. Methods: Seventy patients undergoing unilateral total knee replacements were assessed in the present study. Among them, sixty patients with confirmed primary knee osteoarthritis in stage IV were recruited and divided into three groups randomly, three different intro-operative articular cavity perfusion treatments were given according to the randomized and controlled rule. One way ANOVA analysis on visual analogue scale (VAS) score, functional recovery, drainage, and edema of the affected limb were performed to assess the efficiency of the treatment in the following three days after the operation. The participants, care givers, and those assessing the outcomes were blinded to group assignment. Results: Postoperative drainage in group A (n = 20) and B (n = 20) reduced significantly (P < 0.05). The IHC scores of the surgical limbs were markedly lower comparing with the control group (n = 20) (P < 0.05). No differential postoperative edema was observed and the patient acquired better rehabilitation in group A and B than control group. Compared with group A, no differential postoperative drainage, edema or other side effects were seen in group B (P > 0.05). The VAS score of group B was significantly lower than in group A(P < 0.05). Postoperative recovery of the surgical limb function in group B was better than in group A (P < 0.05). Conclusions: Intra-operation articular cavity perfusion therapy with iced normal saline combined with cocktail perfusion therapy can greatly reduce the early inflammation, contributing to the better rehabilitation of TKA.