Effect of electroacupuncture stimulation combined with the enhanced recovery after surgery regimen on motor function recovery following total knee arthroplasty.
Shiqiang Ma, Jun Dong, Zhengxin Meng and 3 others
PMID 40671006WHAT IT FOUND
After total knee replacement, patients receiving electroacupuncture plus enhanced recovery measures had lower pain, shorter hospital stay, and better knee function.
The care also included analgesia and exercise, so electroacupuncture alone cannot be credited.
Key findings
01The combined group had lower 72-hour morphine equivalent consumption (12.5 ± 3.2 mg vs 25.8 ± 5.6 mg), shorter hospitalisation (5.72 ± 1.88 days vs 8.82 ± 2.09 days), and lower reported rates of intermuscular thrombosis (4% vs 20%) and infection (4% vs 16%).
02On a 0-to-10 pain scale, static and dynamic VAS scores were lower in the combined group at several time points; at one week static VAS was 2.72 ± 0.70 vs 4.06 ± 1.42 and dynamic VAS was 1.76 ± 0.59 vs 3.50 ± 1.11.
03Range of motion and AKS function scores were higher in the combined group; at six months ROM was 120.24 ± 1.15 vs 100.62 ± 2.28 and AKS function score was 95.12 ± 1.00 vs 85.02 ± 1.15.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
It was done in one hospital department with 100 patients, so generalisability is limited. The intervention was a bundle: electroacupuncture, advanced ERAS measures such as tranexamic acid, routine analgesia and exercise therapy were given together, so the independent effect of electroacupuncture cannot be isolated. The authors state the study cannot distinguish independent effects of electroacupuncture, ERAS and robotic surgery. The paper does not report dropouts or loss to follow-up, despite planning for at least 10% dropout. The randomisation description is unclear: it says random numbers were generated, but also that the first 50 patients were assigned to the study group and the other 50 to the control group in admission order. The paper does not report whether patients or rehabilitation therapists were blinded, and the authors note possible subjective error in knee angle measurement and scoring.
The easy way to misread this
Do not read these results as proof that electroacupuncture alone improves recovery after total knee replacement. The study group also received an enhanced ERAS regimen with advanced measures such as tranexamic acid, routine analgesia, and exercise therapy timed around electroacupuncture. The authors state that the independent effects of electroacupuncture, ERAS and robotic surgery cannot be separated.