The Role of Auricular Point Diagnosis and Treatment in ERAS During TKA

Active range of motion (AROM) is defined as the degree of knee flexion achieved without assistance. It is closely related to lower limb pain, kinesiophobia and swelling, and better reflects the early functional recovery of the knee joint after surgery.

The Face Visual Analogue Scale (VAS-F) is a tool used to assess subjective experiences such as pain, discomfort, or emotional states. It utilizes a visual scale with facial expressions ranging from "very happy" to "very sad" or "no pain" to "worst pain imaginable," allowing patients to self-report their feelings or symptoms.

Measurement Procedure:

Scale Presentation:The patient is presented with a horizontal line (typically 10 cm in length) accompanied by a series of facial expressions at each end.On the left end, a "very happy" or "no pain" face is displayed, representing the best possible condition (score: 0).On the right end, a "very sad" or "worst pain imaginable" face is displayed, representing the worst possible condition (score: 10).

The SAS score is a tool used to assess an individual's anxiety status, typically used in adults and adolescents. The cut-off value of the standard score is 50 points. A score below this indicates no anxiety problems, while a score above this may indicate varying degrees of anxiety problems.

According to the increase in anxiety level, SAS scores can be divided into mild (50-59 points), moderate (60-69 points), and severe (over 70 points) anxiety. This study evaluated the perioperative anxiety of patients using this scale.

Measure the electrical measurement values of acupoints in corresponding parts of the body through a meridian analyzer.

Including the dosage of non steroidal anti-inflammatory drugs and the number of times the pain pump is pressed.

Including wish days during acute and recovery periods

The HSS knee joint scoring system is a scoring system proposed by the Hospital for Special Surgery in the United States in 1976 to evaluate preoperative and postoperative knee joint function. It mainly includes six aspects: pain, function, joint range of motion, muscle strength, knee flexion deformity, knee instability, etc., with a maximum score of 100 points. The clinical efficacy classification is excellent>85, good 70-84, medium 60-69, and poor<59. Use this scale to comprehensively evaluate the postoperative functional recovery of the knee joint.

The leg circumference measurement method is mainly used to evaluate the swelling of lower limbs after TKA.

Use this scale to evaluate patients' postoperative kinesiology. This scale has 17 items in total, with a total score of 17 to 68 points. A score of >37 can be diagnosed as kinesiphobia. The higher the score, the higher the degree of kinesiphobia after TKA.

This indicator was collected through review of medical records

This indicator was collected through review of medical records.

Investigate patients' satisfaction with auricular acupuncture diagnosis and treatment mainly through telephone follow-up.

This indicator was collected through review of medical records

The demand rate calculation formula is the total number of patients who require ear acupuncture treatment/included in this study, while the satisfaction rate calculation formula is the final patient who provides ear acupuncture treatment/patient who requires ear acupuncture treatment.

Adverse events related to auricular acupuncture diagnosis and treatment

This indicator was collected through review of medical records

This scale assesses some of the patient's conditions related to surgery, and then selects the appropriate option among the 5 options based on the actual situation during the few days of hospitalization, and circles the corresponding number. The higher the score, the more severe the patient's preoperative anxiety.This scale consists of 7 questions, with a total score of 28 points. The higher the score, the more severe the patient's preoperative anxiety level is

This indicator was collected through review of medical records

To accommodate the short treatment duration and unique ward environment of hospitalized patients, this study modified the Pittsburgh Sleep Quality Index (PSQI) to develop an adapted version (M-PSQI) for short-term sleep assessment. The scale consists of 24 items (19 self-rated + 5 caregiver-rated), with scoring based on the 19 self-rated items, which assess the following dimensions:

• Sleep Process Metrics: Sleep latency, total sleep duration, wake time
• Sleep Disturbance Manifestations: Difficulty falling asleep, nocturnal awakening frequency, environmental/physiological sleep disruptions
• Subjective Sleep Quality: Patients' overall evaluation of sleep quality
• Medication Use: Frequency of sedative-hypnotic drug use
• Daytime Functional Impairment: Difficulty maintaining wakefulness, reduced task performance efficiency The scale adopts a 7-factor structure, with each factor scored on a 0-3 scale. The total score ranges from 0 to 21, with higher scores indicating more severe sleep

The Visual Analogue Scale for Satisfaction (VAS-Satisfaction) is a simple, validated tool used to measure a patient's subjective satisfaction with their pre-operative preparation. It consists of a 100-mm horizontal line anchored by two extreme statements: Left anchor (0 mm): "Not satisfied at all"; Right anchor (100 mm): "Completely satisfied".

The patient marks a point on the line corresponding to their level of satisfaction with the pre-operative process (This includes the information provided before surgery, the attitude of the medical staff, the arrangement of the preoperative process, and the overall experience of preoperative preparation). The score is quantified by measuring the distance (in mm) from the left anchor to the patient's mark, yielding a numerical value between 0 (lowest satisfaction) and 100 (highest satisfaction).

The 5-point Verbal Rating Scale (VRS-5) is a simple method for assessing pain intensity, typically involving the following steps:

Ask the patient to describe their pain using one of the following five predefined categories:

0: No pain - No discomfort or pain at all.

• Mild pain - Pain is noticeable but easily tolerated.
• Moderate pain - Pain is more pronounced and may interfere with daily activities.
• Severe pain - Pain is intense and difficult to tolerate, significantly impacting daily life.
• Very severe pain - Pain is excruciating and unbearable, often requiring immediate relief.

Record the patient's response as a numerical value (0 to 4) based on their description.