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Orthopedic pain

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https://www.readbyqxmd.com/read/28087496/digital-pills-to-measure-opioid-ingestion-patterns-in-emergency-department-patients-with-acute-fracture-pain-a-pilot-study
#1
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Rochelle K Rosen, Conall O'Cleirigh, Kenneth H Mayer, Edward W Boyer
BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy...
January 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#2
Brian M Ilfeld, Christopher A Gilmore, Stuart A Grant, Michael P Bolognesi, Daniel J Del Gaizo, Amorn Wongsarnpigoon, Joseph W Boggs
BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance for accurate introduction, and stimulators small enough to be adhered to the skin, neurostimulation may now be provided in a similar manner to continuous peripheral nerve blocks...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28079742/the-hybrid-method-for-the-treatment-of-congenital-talipes-equinovarus-preliminary-results-on-92-consecutive-feet
#3
Federico Canavese, Mounira Mansour, Guillemette Moreau-Pernet, Yannael Gorce, Alain Dimeglio
Over the past 4 years, our pediatric orthopedic unit has developed a new hybrid protocol combining the advantages of Ponseti's method and the French functional physiotherapy method. Sixty-one patients (92 feet) completed treatment. Clubfoot was unilateral in 30 (49.2%) patients and bilateral in 31 (50.8%) patients. The mean Dimeglio score at the start of treatment was 13.5/20 (range: 6/20-19/20). All patients had clinical and radiographic follow-up for at least 2 years (range: 2-4 years). If orthopedic treatment was ineffective and feet showed no improvement, further surgery was performed...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28076930/hormone-receptor-expression-in-human-fascial-tissue
#4
C Fede, G Albertin, L Petrelli, M M Sfriso, C Biz, R De Caro, C Stecco
Many epidemiologic, clinical, and experimental findings point to sex differences in myofascial pain in view of the fact that adult women tend to have more myofascial problems with respect to men. It is possible that one of the stimuli to sensitization of fascial nociceptors could come from hormonal factors such as estrogen and relaxin, that are involved in extracellular matrix and collagen remodeling and thus contribute to functions of myofascial tissue. Immunohistochemical and molecular investigations (real-time PCR analysis) of relaxin receptor 1 (RXFP1) and estrogen receptor-alpha (ERα) localization were carried out on sample of human fascia collected from 8 volunteers patients during orthopedic surgery (all females, between 42 and 70 yrs, divided into pre- and post-menopausal groups), and in fibroblasts isolated from deep fascia, to examine both protein and RNA expression levels...
November 2, 2016: European Journal of Histochemistry: EJH
https://www.readbyqxmd.com/read/28074463/importance-of-fixation-of-posterior-malleolus-fracture-in-trimalleolar-fractures-a-retrospective-study
#5
Sinan Karaca, Meriç Enercan, Güzelali Özdemir, Sinan Kahraman, Mutlu Çobanoğlu, Metin Küçükkaya
BACKGROUND: The aim of this retrospective study was to evaluate treatment effect and importance of posterior malleolus (PM) fixation in surgically treated trimalleolar fractures. METHODS: A total of 57 cases of ankle joint fracture involving PM and treated with open reduction and internal fixation technique between 2004 and 2011 were evaluated. PM fixation was performed with cannulated screws in 46 cases, and in 11 cases, PM plate was used. All patients were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, American Academy of Orthopedic Surgeons (AAOS) foot and ankle questionnaire, and Visual Analog Score (VAS) pain scale...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28068425/predictive-factors-for-pressure-ulcers-in-an-older-adult-population-hospitalized-for-hip-fractures-a-prognostic-cohort-study
#6
Paolo Chiari, Cristiana Forni, Monica Guberti, Domenica Gazineo, Sabrina Ronzoni, Fabio D'Alessandro
BACKGROUND: Older adult patients with fragility hip fractures constitute a population at high risk for complications, in particular pressure ulcers. The aim was to evaluate the incidence of pressure ulcers and potential predictive factors. METHODS AND FINDINGS: A prospective multicentric prognostic cohort study in orthopedic wards in three Italian public hospitals. Participants were all consecutive patients 65 years of age or older diagnosed with a fragility hip fracture...
2017: PloS One
https://www.readbyqxmd.com/read/28066745/deep-gluteal-space-problems-piriformis-syndrome-ischiofemoral-impingement-and-sciatic-nerve-release
#7
Luis Perez Carro, Moises Fernandez Hernando, Luis Cerezal, Ivan Saenz Navarro, Ana Alfonso Fernandez, Alexander Ortiz Castillo
BACKGROUND: Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome", a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28063477/evaluation-of-serum-cytokines-in-cats-with-and-without-degenerative-joint-disease-and-associated-pain
#8
Margaret E Gruen, Kristen M Messenger, Andrea E Thomson, Emily H Griffith, Lauren A Aldrich, Shelly Vaden, B Duncan X Lascelles
Degenerative joint disease is common in cats, with signs of pain frequently found on orthopedic examination and radiographs often showing evidence of disease. However, understanding of the pathophysiology of degenerative joint disease and associated pain remains limited. Several cytokines have been identified as having a role in pain in humans, but this has not been investigated in cats. The present study was performed to use a multiplex platform to evaluate the concentration of 19 cytokines and chemokines in serum samples obtained from cats with and without degenerative joint disease and associated pain...
January 2017: Veterinary Immunology and Immunopathology
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#9
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28057095/-comparison-of-curative-effect-and-prognosis-analysis-of-patients-with-spinal-metastases-treated-by-percutaneous-vertebroplasty-combined-with-postoperative-radiotherapy-and-radiotherapy-alone
#10
X Y Cao, Y S Liu, M X Lei, S B Liu, S G Zhou, Y C Cao, W G Jiang
Objective: To evaluate the efficacy of percutaneous vertebroplasty(PVP) combined with postoperative radiotherapy and radiotherapy alone in the treatment of spinal metastatic tumors and to evaluate the prognostic factors for survival. Methods: From December 2011 to December 2015, according to the choice of treatment, patients in group A(60 cases) were treated with PVP combined with postoperative radiotherapy and those in group B(50 cases) underwent radiotherapy alone, age, sex, primary tumor type , and other basic characteristics were analyzed in both groups in department of orthopedics and radiotherapy department, 307 Hospital of the People's Liberation Army...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28057012/clinical-results-of-arthroscopic-surgery-in-patients-over-50%C3%A2-years-of-age-what-viability-does-it-have-as-a-joint-preservative-surgery
#11
Mitsutoshi Moriya, Kensuke Fukushima, Katsufumi Uchiyama, Naonobu Takahira, Takeaki Yamamoto, Yojiro Minegishi, Masashi Takaso
BACKGROUND: To identify whether hip arthroscopy is a suitable option for treating hip pain in elderly patients and investigate the clinical outcomes of hip arthroscopic surgery for labrum tear and/or osteoarthritis in patients over 50 years of age. METHODS: Between August 2009 and May 2014, a series of 23 patients (6 men and 17 women) with a mean age of 59 years underwent arthroscopy. We retrospectively examined the clinical records, radiographs, and outcome questionnaires from all patients...
January 6, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28056158/mycobacterium-avium-complex-septic-arthritis-presenting-as-osteonecrosis-of-the-femoral-head-in-a-patient-with-systemic-lupus-erythematosus
#12
Alexander B Christ, Elena V Zininberg, Kethy M Jules-Elysee, Michael L Parks
Mycobacterium avium complex is a rare cause of musculoskeletal infection, usually occurring in patients with compromised immune systems. Obtaining the diagnosis requires a high index of suspicion, and treatment can be delayed because of difficulty with isolating the organism. Treatment involves prolonged, targeted combination antibiotic therapy, and it is unclear whether eradication of the infection can occur in the presence of a foreign body, such as antibiotic spacers. The authors report a case of M avium infection presenting as presumed osteonecrosis of the femoral head in a young woman with systemic lupus erythematosus...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28053554/postoperative-opioid-sparing-with-injectable-hydroxypropyl-%C3%AE-cyclodextrin-diclofenac-pooled-analysis-of-data-from-two-phase-iii-clinical-trials
#13
Tong J Gan, Neil Singla, Stephen E Daniels, Douglas A Hamilton, Peter G Lacouture, Christian Rd Reyes, Daniel B Carr
PURPOSE: Use of nonopioid analgesics (including nonsteroidal anti-inflammatory drugs) for postoperative pain management can reduce opioid consumption and potentially prevent opioid-related adverse events. This study examined the postoperative opioid-sparing effect of repeated-dose injectable diclofenac formulated with hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac. PATIENTS AND METHODS: Pooled data from two double-blind, randomized, placebo- and active comparator-controlled Phase III trials were analyzed...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28043311/acromion-types-and-role-of-corticosteroid-with-shoulder-impingement-syndrome
#14
Muhammad Akram, Syed Faraz Ul Hassan Shah Gillani, Faheem Mubashir Farooqi, Syed Muhammad Awais
OBJECTIVE: To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28040320/semimembranosus-tenosynovitis-diagnosis-and-management-of-a-commonly-missed-cause-of-posteromedial-knee-pain
#15
Joel K Melton, Arman Memarzadeh, William H Dunbar, Mervyn J Cross
BACKGROUND: In orthopedic and sports medicine literature there is minimal information regarding accurate diagnosis and the treatment options for tenosynovitis of the distal semimembranosus tendon. After reviewing the literature, the authors question both the etiology and treatment of this condition. Previous descriptions have associated the condition primarily with the endurance athlete but we have noted multiple cases in which this is a condition common to the 'sprinter' as well. There has been very little mention of this condition in recent literature but the most recent complete description of operative treatment for this condition recommends both tendon transfer and concomitant arthroscopy...
December 28, 2016: Knee
https://www.readbyqxmd.com/read/28028648/expansive-open-door-laminoplasty-versus-laminectomy-and-instrumented-fusion-for-cases-with-cervical-ossification-of-the-posterior-longitudinal-ligament-and-straight-lordosis
#16
Xiaowei Liu, Yu Chen, Haisong Yang, Tiefeng Li, Bin Xu, Deyu Chen
PURPOSE: To identify whether expansive open-door laminoplasty (Lam) is more appropriate than laminectomy and instrumented fusion (LIF) for cases with ossification of the posterior longitudinal ligament (OPLL) and straight cervical lordosis. METHODS: A total of 67 cases were included and divided into Group Lam (n = 32) and Group LIF (n = 35), and the mean follow-up periods were 38 and 42 months, respectively. The cervical lordosis was elevated by C2-7 Cobb angle and cervical sagittal balance by C2-C7 sagittal vertical axis (SVA)...
December 27, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28027828/prognosis-and-adjacent-segment-disease-after-lumbar-spinal-fusion-surgery-for-destructive-spondyloarthropathy-in-long-term-hemodialysis-patients
#17
Keishi Maruo, Tokuhide Moriyama, Toshiya Tachibana, Shinichi Inoue, Fumihiro Arizumi, Kazuki Kusuyama, Shinichi Yoshiya
BACKGROUND: Lumbar destructive spondyloarthropathy (DSA) is a serious complication in long-term hemodialysis patients. There have not been many reports regarding the surgical management for lumbar DSA. In addition, the adjacent segment pathology after lumbar fusion surgery for DSA is unclear. The objective of this study was to assess the clinical outcome and occurrence of adjacent segmental disease (ASD) after lumbar instrumented fusion surgery for DSA in long-term hemodialysis patients...
December 24, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28027386/paresis-of-the-peroneal-nerve-a-rare-but-severe-long-term-complication-of-polyethylene-wear-in-knee-arthroplasty
#18
Matthias Aurich, Mark Lenz, Norman Best
One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027385/a-novel-screening-technique-for-ulnar-sided-carpometacarpal-dislocations
#19
Vishnu C Potini, Peter D Gibson, Kaicheng Wu, Kang Li, Virak Tan
Diagnosing ulnar-sided carpometacarpal joint dislocation is difficult, and more than half of injuries are missed on initial examination. The authors hypothesized that measuring the angle between the capitate and the metacarpals (capitate-metacarpal angle) on a plain radiograph would provide a simple, reliable tool to aid in the diagnosis of ulnar-sided carpometacarpal dislocation. This study retrospectively reviewed patients who underwent surgery for ulnar-sided carpometacarpal dislocation (study group). Two authors identified the contour of the capitate and the second, fourth, and fifth metacarpals on plain radiographs...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28025372/a-pooled-analysis-evaluating-renal-safety-in-placebo-and-active-comparator-controlled-phase-iii-trials-of-multiple-dose-injectable-hp%C3%AE-cd-diclofenac-in-subjects-with-acute-postoperative-pain
#20
Stephen E Daniels, Tong J Tj Gan, Douglas A Hamilton, Neil Singla, Peter G Lacouture, Olufunmibi Johnson, Lauren H Min, Christian R D Reyes, Daniel B Carr
OBJECTIVE : While injectable nonsteroidal anti-inflammatory drugs (NSAIDs) are a key component of postoperative multimodal analgesia, renal safety concerns may limit use in some patients. This study examined the renal safety of injectable HPβCD-diclofenac when given for ≤ 5 days following orthopedic or abdominal/pelvic surgery. METHODS : Pooled analysis of data from two randomized, placebo- and active comparator-controlled phase III trials in 608 total patients was conducted. Renal safety was assessed by examining treatment-emergent adverse events (AEs) and postoperative blood urea nitrogen (BUN) and serum creatinine shifts...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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