In this series highlighting hospital award winners, we’re celebrating medical institutions that are using innovative and advanced methods in patient care.
Nancy Hulton spent a decade dealing with knee pain, and after a particularly challenging two-mile walk in Pittsburgh’s February weather, she felt it was time to change. She wanted to regain the ability to travel and enjoy activities with her husband, so she decided to explore knee replacement surgery and began searching for a suitable surgeon.
Hulton chose Dr. Elizabeth Gausden at the Hospital for Special Surgery (HSS) but was unaware that Dr. Gausden collaborated with Dr. Stephanie Cheng, an anesthesiologist and certified medical acupuncturist. On the day of her surgery, Dr. Cheng introduced herself and explained her plan to use acupuncture during Hulton’s operation.
Dr. Cheng uses a technique called intraoperative electro-auricular acupuncture, rooted in the auricular trauma protocol (ATP) originally developed for military settings to address post-traumatic stress disorder. These acupuncture points relate to emotions like fear and anxiety and aim to improve the body’s overall feeling. Additional points target inflammation and pain. Once patients are sedated, she carefully inserts eight needles in the ear, away from where the surgery is happening. Dr. Cheng prefers using the ear as she is familiar with these points and can work without interrupting the surgical process.
To enhance the acupuncture effect, Dr. Cheng often applies electricity, and she mentions that about 99% of her patients receive this treatment, which intensifies the benefits for the hour-long duration the needles are in place.
Dr. Cheng’s program at HSS kicked off in October 2018, and she has treated about 1,000 patients since. The approach is unique as acupuncture is rarely part of surgical procedures in the U.S. Her goal is to aid recovery using acupuncture, given her role as an anesthesiologist in the operating room.
Patients and surgeons working with Dr. Cheng report noticing differences in recovery, and Hulton was no different. After her surgery, she experienced no pain and was able to walk and go home the same day. Additionally, she required less oxycodone than usual and transitioned to Tylenol within three days.
However, during her second knee surgery, when Dr. Cheng wasn’t available, Hulton’s experience differed significantly. She woke up in immediate pain, and oxycodone was less effective in managing her discomfort, needing more than during her first surgery.
While more research is needed to fully understand how acupuncture helps during surgery, Dr. Cheng and her team at HSS are studying the technique. Dr. Cheng conducted research involving patients undergoing total knee replacement surgery, aiming to measure acupuncture’s effects on pain and opioid consumption. The study included 41 patients at the Hospital for Special Surgery, revealing that 65% of those who received acupuncture used fewer opioid pills in the following 30 days compared to only 9% who hadn’t received acupuncture.
Dr. Michael Ast, an adult reconstruction and joint replacement expert at HSS, has collaborated with Dr. Cheng for over three years and observed noticeable differences in patient recovery with acupuncture. In his decade of performing hip and knee surgeries, he notes that patients who received acupuncture seemed significantly better post-operation. While most patients typically appear sleepy or nauseated in recovery, those who had acupuncture were more alert and cheerful, as if they hadn’t undergone surgery.
For Nancy Hulton, if she ever needs surgery again, she would definitely request acupuncture. She felt much more comfortable and relaxed after her first surgery compared to the subsequent one that was far more painful for her.
This article was fact-checked by Morgan Mullings.
