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A randomized controlled trial of electrostimulation effects on effussion, swelling and pain recovery after anterior cruciate ligament reconstruction: a pilot study [with consumer summary]
Ediz L, Ceylan MF, Turktas U, Yanmis I, Hiz O
Clinical Rehabilitation 2012 May;26(5):413-422
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate rehabilitation results of electrostimulation especially on joint effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. DESIGN: A randomized controlled trial; the assessor was not blinded to the group allocation. SETTING: Orthopaedics-traumatology and physical medicine-rehabilitation departments. SUBJECTS: Twenty-nine consecutive patients underwent anterior cruciate ligament reconstruction. INTERVENTIONS: Both groups began the voluntary exercise protocol one day post-surgery. The intervention group (n = 15) also received 30 sessions electrostimulation treatment protocol started four days after the operation. MAIN MEASURES: Numerical bulge-dancing patella signs for effusion assessment; differences in circumferences of the mid-centre of the patella between operated and non-operated knees for swelling assessment. Aself-report of average daily resting pain assessed by visual analogue scale; Intenational Knee Documentation Committee scoring system and Tegner Activity Scale for subjective response assessment. RESULTS: Twenty-six subjects including 13 patients from the intervention group completed the study. Significantly less effusion and swelling were determined in the intervention group after seven days (1.8 +/- 1.3 versus 2.4 +/- 1.7 for effusion and 1.7 +/- 1.2 versus 3.4 +/- 1.5 for swelling) to 12 weeks (0.2 +/- 0.7 versus 0.6 +/- 0.8 for effusion and 0.2 +/- 0.8 versus 0.8 +/- 0.9 for swelling) postoperative (p < 0.05). Patients treated with electrostimulation had significantly lower pain scores from seven days up to 12 weeks after the operation (p < 0.05). CONCLUSION: Electrostimulation along with exercise therapy appears superior to exercise alone regarding knee effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. Still, there is need for further clinical studies using a radiologic method to demonstrate this effect of electrostimulation.

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