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The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review.

Complementary therapies in medicine
October 1, 2013
Timothy Barlow et al. (3 authors)
Journal ArticleReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of Arnica in reducing post-operative pain and swelling following ambulatory knee surgery.

Results Summary

Arnica demonstrated a significant reduction in post-operative swelling but did not affect post-operative pain. The study suggests further research is needed to quantify its positive effects on swelling.

Population

Patients undergoing ambulatory knee surgery.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Acupoint pressure
decrease
pain
patients after ambulatory knee surgery
-
demonstrated reduced pain compared with placebo
#1
Arnica
decrease
swelling
patients after ambulatory knee surgery
-
demonstrating a significant reduction in swelling
#2
Arnica
no change
post-operative pain
patients after ambulatory knee surgery
-
did not affect post-operative pain
#3
Acupuncture
no change
post-operative pain
patients after ambulatory knee surgery
-
did not affect post-operative pain
#4
Acupuncture
decrease
ibuprofen use
patients after ambulatory knee surgery
-
a reduction in ibuprofen use was demonstrated
#5
Abstract

Ambulatory knee surgery is a common procedure with over 100,000 knee arthroscopies performed in the U.K. in 2010-2011. Pain after surgery can decrease patient satisfaction, delay discharge, and decrease cost effectiveness. Multi-modal therapies, including complementary therapies, to improve pain control after surgery have been recommended. However, a comprehensive review of the literature regarding the use of complementary therapies to enhance pain control after ambulatory knee surgery is lacking, and this article aims to address this deficit. CINHAL, EMBASE, MEDLINE, AMED and CENTRAL databases were searched. Only Randomised Controlled Trials were included. All eligible papers were quality assessed using the Jadad system, and data was extracted using piloted forms. Two independent reviewers performed each stage of the review. Full details of the study methodology can be found on Prospero, a systematic review register. Five studies satisfied our eligibility criteria: three reporting on acupuncture, one on homeopathy, and one on acupoints. Acupoint pressure was the only study that demonstrated reduced pain compared with placebo. This study was the least methodologically robust. Arnica, although demonstrating a significant reduction in swelling, did not affect post-operative pain. Acupuncture did not affect post-operative pain; however, a reduction in ibuprofen use was demonstrated in two studies. Before recommending complementary therapy for routine use in ambulatory knee surgery, further work is required. Two areas of future research likely to bear fruit are demonstrating robust evidence for the effect of acupoint pressure on post-operative pain, and quantifying the positive effect of homeopathic arnica on post-operative swelling.

Medical Subject Headings (MeSH)
Acupuncture TherapyClinical Trials as TopicHomeopathyHumansKnee JointPain ManagementPain, Postoperative
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality85/10
Citation Metrics
Total Citations10
Citations/Year0.8
Relative Citation Ratio0.55
NIH Percentile29.7%
Research Impact Scores
APT Score0.25
Weight Score1.50
Normalized Score0.65
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