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Orthopedic pain

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https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#1
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27920572/home-peripheral-nerve-catheters-the-first-24-months-of-experience-at-a-children-s-hospital
#2
Andrew Gable, Candice Burrier, Jenna Stevens, Sharon Wrona, Kevin Klingele, Tarun Bhalla, David P Martin, Giorgio Veneziano, Joseph D Tobias
CONTEXT: Home peripheral nerve catheters (PNCs) have become common practice for adult patients after major orthopedic surgery. However, use in pediatric patients is a recent application. OBJECTIVES: The purpose of this study was to review the demographics and outcomes of pediatric patients receiving a PNC at our institution. METHODS: This retrospective study included patients from October 2012 through October 2014 undergoing orthopedic procedures with a PNC placed for postoperative pain management...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27916034/-the-mid-to-long-term-effect-of-wallis-lumbar-interspinous-dynamic-stabilization-on-the-adjacent-segment-degeneration
#3
X Yuan, C Kong, X M Chen, L B Cui, S J Xu, Y D Liu
Objective: To explore the mid- to long-term effect of Wallis interspinous dynamic stabilization system on the adjacent segment degeneration. Methods: From March 2009 to June 2010, in Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, 24 patients with L4-5 monosegmental lumbar disc herniation were treated with posterior lumbar decompression combined with Wallis interspinous dynamic fixation. Clinical outcomes were evaluated with visual analogue score (VAS) (back pain), VAS (leg pain) and oswestry disability index (ODI) score...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#4
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27907013/development-and-implementation-of-the-ebola-traveler-monitoring-program-and-clinical-outcomes-of-monitored-travelers-during-october-may-2015-minnesota
#5
Aaron DeVries, Pamela Talley, Kristin Sweet, Susan Kline, Patricia Stinchfield, Pritish Tosh, Richard Danila
BACKGROUND: In October 2014, the United States began actively monitoring all persons who had traveled from Guinea, Liberia, and Sierra Leone in the previous 21 days. State public health departments were responsible for monitoring all travelers; Minnesota has the largest Liberian population in the United States. The MDH Ebola Clinical Team (ECT) was established to assess travelers with symptoms of concern for Ebola virus disease (EVD), coordinate access to healthcare at appropriate facilities including Ebola Assessment and Treatment Units (EATU), and provide guidance to clinicians...
2016: PloS One
https://www.readbyqxmd.com/read/27906949/pulsed-compared-to-thermal-radiofrequency-to-the-medial-calcaneal-nerve-for-management-of-chronic-refractory-plantar-fasciitis-a-prospective-comparative-study
#6
Ayman M Osman, Dina H El-Hammady, Mohamed M Kotb
BACKGROUND: Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. OBJECTIVES: To evaluate the effect of applying PRF for 6 minutes vs...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27904799/a-clinical-guide-to-the-assessment-and-treatment-of-breathing-pattern-disorders-in-the-physically-active-part-2-a-case-series
#7
Jena Hansen-Honeycutt, Erin B Chapman, Alan Nasypany, Russell T Baker, Jim May
INTRODUCTION: Breathing pattern disorders (BPDs) are characterized by persistent, suboptimal breathing strategies that may result in additional musculoskeletal pain and/or dysfunction. The purpose of this case series was to examine the effects of Primal Reflex Release Technique (PRRT) and breathing exercise interventions in physically active individuals that presented with a primary complaint of musculoskeletal pain, a BPD, and startle reflexes. SUBJECTS: The assessment techniques described in Part 1 of this series were used to identify three student athletes (aged 16-22) who presented with musculoskeletal pain of the low back, mid back, and knee, BPDs, and startle reflexes...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27904792/current-concepts-and-treatment-of-patellofemoral-compressive-issues
#8
Michael J Mullaney, Takumi Fukunaga
Patellofemoral disorders, commonly encountered in sports and orthopedic rehabilitation settings, may result from dysfunction in patellofemoral joint compression. Osseous and soft tissue factors, as well as the mechanical interaction of the two, contribute to increased patellofemoral compression and pain. Treatment of patellofemoral compressive issues is based on identification of contributory impairments. Use of reliable tests and measures is essential in detecting impairments in hip flexor, quadriceps, iliotibial band, hamstrings, and gastrocnemius flexibility, as well as in joint mobility, myofascial restrictions, and proximal muscle weakness...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#9
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27903758/oprm1-and-comt-gene-gene-interaction-is-associated-with-postoperative-pain-and-opioid-consumption-after-orthopedic-trauma
#10
Heba Khalil, Susan M Sereika, Feng Dai, Sheila Alexander, Yvette Conley, Gary Gruen, Li Meng, Peter Siska, Ivan Tarkin, Richard Henker
BACKGROUND: mu-opioid receptor (OPRM1) and catechol-O-methyltransferase (COMT) contribute to the neurotransmission pathway of pain. COMT affects mu receptor expression and density in the brain. The aim of this study was to explore the OPRM1 and COMT interaction effects on postoperative pain and opioid consumption. METHODS: This cross-sectional exploratory study used genotype and clinical data from 153 postoperative patients. Using multiple regression analyses, four single-nucleotide polymorphisms of COMT (rs6269, rs4633, rs4818, and rs4680), their haplotypes, and diplotypes were considered for their interactions with A118G of OPRM1 regarding postoperative pain and opioid consumption...
November 30, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27900272/return-to-physical-activity-after-gastrocnemius-recession
#11
Camelia Tang Qian Ying, Sean Lai Wei Hong, Bing Howe Lee, Gowreeson Thevendran
AIM: To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS: Endoscopic gastrocnemius recession (EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36 (SF-36), American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score and modified Olerud and Molander (O and M) scores respectively...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27899200/-mucoadhesive-buccal-films-of-tramadol-for-effective-pain-management
#12
Xiao-Qin Li, Zhao-Ming Ye, Jian-Bing Wang, Cai-Rong Fan, Ai-Wu Pan, Cong Li, Ren-Bing Zhang
BACKGROUND AND OBJECTIVES: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. METHODS: Buccal films of tramadol hydrochloride were prepared by solvent casting method...
November 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27898256/comparative-study-of-the-physiotherapeutic-and-drug-protocol-and-low-level-laser-irradiation-in-the-treatment-of-pain-associated-with-temporomandibular-dysfunction
#13
Marcos Fernando Xisto Braga Cavalcanti, Uoston Holder Silva, Ernesto Cesar Pinto Leal-Junior, Rodrigo A B Lopes-Martins, Rodrigo Labat Marcos, Rodney Capp Pallotta, Francesca Diomede, Oriana Trubiani, Natalia De Isla, Lucio Frigo
BACKGROUND: The temporomandibular joint (TMJ) is a structure of the craniofacial complex affected by neurological diseases. Orthopedic and musculoskeletal changes can also cause temporomandibular disorders (TMD) and pain. Low-level laser (LLL) therapy has been studied in the treatment of temporomandibular jaw (TMJ) dysfunction, and controversial results were obtained. OBJECTIVE: The objective of this work was comparing the physiotherapeutic and drug protocol (PDP) to LLL therapy in the treatment of pain associated with TMD...
November 29, 2016: Photomedicine and Laser Surgery
https://www.readbyqxmd.com/read/27896037/functional-evaluation-of-patients-undergoing-multiple-joint-replacements-a-retrospective-study-of-50-patients-with-a-minimum-of-six-months-of-follow-up
#14
Shubhranshu S Mohanty, Nandan Mishra, Prateek Patil, Ajinkya Desale
INTRODUCTION:  Polyarthritis is a challenging condition that an orthopedic surgeon faces in day-to-day practice. Some of the conditions where multiple joints are affected are rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Multiple joint afflictions can cause severe impairment in the quality of life, which leads to a significant socioeconomic burden on the family and society. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by conservative management...
October 15, 2016: Curēus
https://www.readbyqxmd.com/read/27893033/effect-of-a-decision-aid-on-access-to-total-knee-replacement-for-black-patients-with-osteoarthritis-of-the-knee-a-randomized-clinical-trial
#15
Said A Ibrahim, Marissa Blum, Gwo-Chin Lee, Pekka Mooar, Elina Medvedeva, Aliya Collier, Diane Richardson
Importance: Black patients with advanced osteoarthritis (OA) of the knee are significantly less likely than white patients to undergo surgery. No strategies have been proved to improve access to surgery for black patients with end-stage OA of the knee. Objective: To assess whether a decision aid improves access to total knee replacement (TKR) surgery for black patients with OA of the knee. Design, Setting, and Participants: In a randomized clinical trial, 336 eligible participants who self-identified as black and 50 years or older with chronic and frequent knee pain, a Western Ontario McMaster Universities Osteoarthritis Index score of at least 39, and radiographic evidence of OA of the knee were recruited from December 1, 2010, to May 31, 2014, at 3 medical centers...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27892441/a-prospective-study-of-commonly-prescribed-drugs-in-the-management-of-neuropathic-pain-and-its-medication-adherence-pattern
#16
R Shrestha, P Silwal, N Basnet, S Shakya Shrestha, R Shrestha, B R Pokharel
Background Neuropathic pain is one of the common complains of patients visiting neurology and orthopedic departments in hospitals. Management of neuropathic pain is difficult and is often symptomatic rather than being curative. Adherence to medication is necessary for pain management to be effective. However, there are various factors related to patient, physician, drug regimen and other socio-economic affecting adherence. Objective To study commonly prescribed drugs in neuropathic pain management and the medication adherence pattern including its associated factors...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27890840/infected-iliac-pseudoaneursym-after-cardiac-catheterization-complicated-by-girdlestone-pseudoarthroplasty-for-recurrent-infection-of-hip-prosthesis
#17
Christopher Horn, Victoria Wang, Michael Williams, Donald Jacobs
We report a massive infected pseudoaneurysm of the right external iliac artery in the setting of Girdlestone pseudoarthroplasty (GSA) for chronic infection. Around the time of her GSA the patient underwent cardiac catheterization with resultant pseudoaneurysm formation. Infection was likely due to spread from her previous chronic infection. Delay in presentation occurred due to attribution of her symptoms to her GSA. The patient underwent ligation of the right external iliac artery and hip disarticulation and was discharged on antibiotics...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#18
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27889883/a-randomized-clinical-trial-to-evaluate-efficacy-and-tolerability-of-trypsin-chymotrypsin-as-compared-to-serratiopeptidase-and-trypsin-bromelain-rutoside-in-wound-management
#19
Ajay Chandanwale, Deepak Langade, Dheeraj Sonawane, Piyush Gavai
INTRODUCTION: Systemic enzyme therapy can play an important role in maintaining normal inflammatory processes within the body and thereby helps support and speed up healing. In the course of the anti-inflammatory action, enzymes degrade damaged cells and necrotic material and, through the inactivation of mediators and toxic products, they restrict the edema and pain. METHOD: The study conducted at Grant Medical College, Mumbai, India was a clinical trial comparing the efficacy and tolerability of three oral enzyme treatment groups-oral tablets containing trypsin:chymotrypsin (TC) (Chymoral Forte(®)), serratiopeptidase (S) 5 mg oral tablets, and oral enzyme tablets containing trypsin 48 mg, bromelain 90 mg, and rutoside 100 mg (TBR)-to evaluate their healing potential in surgical wounds after orthopedic surgery...
November 26, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27885288/correlation-between-clinical-features-and-magnetic-resonance-imaging-findings-in-lumbar-disc-prolapse
#20
S S Thapa, R B Lakhey, P Sharma, R K Pokhrel
BACKGROUND: Magnetic resonance imaging is routinely done for diagnosis of lumbar disc prolapse. Many abnormalities of disc are observed even in asymptomatic patient.This study was conducted tocorrelate these abnormalities observed on Magnetic resonance imaging and clinical features of lumbar disc prolapse. METHODS: A This prospective analytical study includes 57 cases of lumbar disc prolapse presenting to Department of Orthopedics, Tribhuvan University Teaching Hospital from March 2011 to August 2012...
May 2016: Journal of Nepal Health Research Council
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