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Modalities for knee pain

Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
October 14, 2016: Journal of Vascular Surgery
Lang Jia, Yan Wang, Jinyun Chen, Wenzhi Chen
The aim of this study was to investigate the effects of focused low-intensity pulsed ultrasound (FLIPUS) therapy on the functional and health status of patients with knee osteoarthritis (KOA). A total of 106 subjects with bilateral KOA were randomized sequentially into two groups. Group I received FLIPUS + diclofenac sodium, and group II received sham FLIPUS + diclofenac sodium. The therapeutic effects of the interventions were evaluated by measuring changes in VAS pain, the WOMAC scores, and the LI scores after 10 days of treatment as well as changes in LI and VAS at follow-up, 4 and 12 weeks later...
October 17, 2016: Scientific Reports
Tuğba Yeğin, Lale Altan, Meliha Kasapoğlu Aksoy
Osteoartritis (OA) is one of the most frequent causes of pain, loss of function and disability in adults. The prevalence of OA is expected to increase substantially in the future. Knee OA is the most common subset of OA. Therapeutic ultrasound (US) is one of several physical therapy modalities suggested for the management of pain and loss of function due to OA. The purpose of our study was to investigate the efficacy of US therapy in reducing pain and functional loss and improving the quality of life in patients with knee OA in comparison to sham US therapy...
October 7, 2016: Ultrasound in Medicine & Biology
Corey T Gatewood, Andrew A Tran, Jason L Dragoo
PURPOSE: There is a wide array of device modalities available for post-operative treatment following arthroscopic knee surgery; however, it remains unclear which types and duration of modality are the most effective. This systematic review aimed to investigate the efficacy of device modalities used following arthroscopic knee surgery. METHODS: A systematic search of the literature was performed on: PubMed; Scopus; MEDLINE; EMBASE; PEDro; SportDiscus; and CINAHL databases (1995-2015) for clinical trials using device modalities following arthroscopic knee surgery: cryotherapy, continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), surface electromyographic (sEMG) biofeedback and shockwave therapy (ESWT)...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
J Greene, G M O'Kane, D N Carney, E Aherne, G C O'Toole
Patients with inflammatory bowel disease (IBD) have an increased risk of developing malignancy. The use of immunosuppressive therapies and tumour necrosis factor (TNF) inhibitors in these patients may provide a further risk for the development of malignancy. We report the clinical and pathological findings of a high grade osteosarcoma in a patient with Crohns disease receiving TNF inhibitor therapy. In this case, a 32-year old female presented with a painful right knee after receiving maintenance adalimumab for Crohns disease for a period of six years...
2016: Irish Medical Journal
Khawla Achour, Eya Mersni, Bassem Krifa, Emna Bahlouli, Sonia Lebib, Catherine Dziri
OBJECTIVE: The aim of this work is to determine the epidemiological and characteristics and the therapeutic modalities of heterotopic ossification in brain injury. MATERIAL/PATIENTS AND METHODS: Retrospective study conducted between January 2010 and January 2016, including patients hospitalized for management of sequelae of an isolated head injury or associated with multiple trauma, and in whom the diagnosis of of heterotopic ossification (HO) was increased. A review of epidemiological data (including age, sex, occupation, type of neurological injury, discovering circumstances of HO), clinical data, the therapeutic choice and evolutivity...
September 2016: Annals of Physical and Rehabilitation Medicine
Stacey M Cornelson, Alicia M Yochum, Norman W Kettner
OBJECTIVE: This case report describes magnetic resonance imaging (MRI) and diagnostic ultrasound (US) findings for a patient with arthrofibrosis related to a complication of anterior cruciate ligament (ACL) reconstruction. CLINICAL FEATURES: A 25-year old man presented with right knee pain and loss of extension 5 years after ACL reconstruction. MRI and sonographic examination revealed a soft tissue mass anterolateral to the ACL graft consistent with a cyclops lesion...
September 2016: Journal of Chiropractic Medicine
Verónica A Trivillin, Leandro J Bruno, David A Gatti, Mariela Stur, Marcela A Garabalino, Andrea Monti Hughes, Jorge Castillo, Emiliano C C Pozzi, Luis Wentzeis, Hugo Scolari, Amanda E Schwint, Sara Feldman
Rheumatoid arthritis is a chronic autoimmune pathology characterized by the proliferation and inflammation of the synovium. Boron neutron capture synovectomy (BNCS), a binary treatment modality that combines the preferential incorporation of boron carriers to target tissue and neutron irradiation, was proposed to treat the pathological synovium in arthritis. In a previous biodistribution study, we showed the incorporation of therapeutically useful boron concentrations to the pathological synovium in a model of antigen-induced arthritis (AIA) in rabbits, employing two boron compounds approved for their use in humans, i...
August 27, 2016: Radiation and Environmental Biophysics
Ayako Hirata, Takehisa Ogura, Norihide Hayashi, Sayaka Takenaka, Hideki Ito, Kennosuke Mizushina, Yuki Fujisawa, Naoko Yamashita, Sumie Nakahashi, Munetsugu Imamura, Rie Kujime, Hideto Kameda
OBJECTIVE: Ultrasonography has been prevalently used as a valid and objective modality for joint examination in patients with rheumatoid arthritis (RA). This study aimed to examine and compare the concordance between ultrasound, clinical, and patient-reported assessment of joint synovitis in RA. METHODS: Fifty patients with RA (84% female; median age, 69 years; disease duration, 2.6 years; disease activity score of 28 joints, 3.8) completed the self-evaluation of joint symptoms including pain and considerable stiffness in the (proximal) interphalangeal, metacarpophalangeal, wrist, elbow, shoulder, knee, and ankle joints...
August 26, 2016: Arthritis Care & Research
Sinem Sarı, Osman N Aydın, Yasemin Turan, Pınar Özlülerden, Ufuk Efe, İmran Kurt Ömürlü
OBJECTIVES: To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain. METHODS: Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis...
August 12, 2016: International Journal of Rheumatic Diseases
Banu Sarifakioglu, Sevgi Ikbali Afsar, Seniz Akcay Yalbuzdag, Kubra Ustaömer, Meral Bayramoğlu
[Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients' visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured...
July 2016: Journal of Physical Therapy Science
John M Hardcastle, David H So, Gwo-Chin Lee
BACKGROUND: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are important markers in the evaluation and treatment of painful total knee arthroplasty (TKA). Elevation of both markers usually occurs with infected TKAs while a normal ESR and CRP usually point to aseptic causes for failure. The purpose of this study is to compare (1) rate of revision, (2) infection, and (3) reason for reoperation in a group of patients undergoing revision TKA with a single abnormality in either ESR or CRP in an otherwise negative conventional infection work-up compared to patients with normal preoperative ESR and CRP...
July 5, 2016: Journal of Arthroplasty
H Evren Eker, Oya Yalcin Cok, Anis Aribogan, Gulnaz Arslan
BACKGROUND: Intra-articular injections for the treatment of knee pain due to osteoarthritis are performed when conservative therapies have failed. The intra-articular injection of lidocaine may be an effective treatment modality due to its neuronal membrane-stabilizing effect and long-lasting anti-inflammatory action. In this study, we compared the efficacy of intra-articular 0.5% lidocaine versus saline injection on pain, stiffness and physical function in patients with osteoarthritis...
July 30, 2016: Anaesthesia, Critical Care & Pain Medicine
C Cyteval
Various types of knee arthroplasty implants are available depending on the number of knee compartments to be replaced and ligament stability. Unlike unicompartmental arthroplasty, the aim of total knee replacement is to maintain normal knee alignment. EOS X-ray imaging in the coronal and sagittal planes is the best modality for measuring the reference axes of the knee, but may by complemented by CT scans in the transverse plane. In addition to implant-related complications such as loosening and polyethylene wear, complications of the knee extensor mechanism are sometimes observed...
July 2016: Diagnostic and Interventional Imaging
Josue S Cardoso, Joseph L Riley, Toni Glover, Kimberly T Sibille, Emily J Bartley, Burel R Goodin, Hailey W Bulls, Matthew Herbert, Adriana S Addison, Roland Staud, David T Redden, Laurence A Bradley, Roger B Fillingim, Yenisel Cruz-Almeida
Pain among individuals with knee osteoarthritis (OA) is associated with significant disability in older adults, and recent evidence demonstrates enhanced experimental pain sensitivity. Although previous research showed considerable heterogeneity in the OA clinical pain presentation, less is known regarding the variability in responses to experimental pain. The present study included individuals with knee OA (n = 292) who participated in the Understanding Pain and Limitations in Osteoarthritic Disease study and completed demographic and psychological questionnaires followed by a multimodal quantitative sensory testing (QST) session...
September 2016: Pain
John W Barrington, Roger H Emerson, Scott T Lovald, Adolph V Lombardi, Keith R Berend
BACKGROUND: Opioid analgesics have been a standard modality for postoperative pain management after total knee arthroplasty (TKA) but are also associated with increased risk of nausea, pruritus, vomiting, respiratory depression, prolonged ileus, and cognitive dysfunction. There is still a need for a method of anesthesia that can deliver effective long-term postoperative pain relief without incurring the high cost and health burden of opioids and nerve blocks. QUESTIONS/PURPOSES: (1) Is liposomal bupivacaine-based periarticular injection (PAI) more effective than morphine-based spinal anesthesia or ropivacaine-based PAI in controlling postoperative pain after TKA? (2) Do patients treated with liposomal bupivacaine-based PAI experience fewer opioid-related adverse events compared with patients treated with morphine-based spinal anesthesia or ropivacaine-based PAI in controlling postoperative pain after TKA? METHODS: This multicenter, blind trial randomized 119 patients undergoing TKA with spinal anesthesia to receive spinal anesthesia plus periarticular injection with liposomal bupivacaine (40 patients), spinal anesthesia with bupivacaine plus intrathecal morphine (41 patients) but no liposomal bupivacaine injection, or spinal anesthesia with bupivacaine (38 patients) and no liposomal bupivacaine injection...
June 23, 2016: Clinical Orthopaedics and related Research
Faisal Johandi, Zackary Chua, Rishi Malhotra, Wilson Wang
We report a case of a 51-year-old man, presenting with non-specific symptoms of unilateral knee pain and swelling, who had experienced a 1-year period of multiple misdiagnoses. He was finally diagnosed with lipoma arborescens only after a MRI of the knee was performed, with postoperative histological confirmation after treatment with joint replacement surgery. The possible pathophysiology, diagnostic modalities and treatment of lipoma arborescens are discussed. The authors hope that our experience with this rare condition can be of learning value to fellow clinicians who frequently encounter patients with arthritis, as an accurate diagnosis and management of lipoma arborescens can give rise to a better clinical outcome for the patient...
2016: BMJ Case Reports
Alireza Saied, Mohsen Ostovar, Alia Ayatollahi Mousavi, Fateme Arabnejhad
BACKGROUND: Tibial fracture without concomitant fibular fracture is an injury that has long attracted notice for the fact that it sometimes heals cleanly, other times causes various problems when the bone does not heal, or misaligns. In this randomized clinical trial, we assessed two treatment modalities plating and intramedullary nailing for treatment of closed, noncomminuted tibial fractures with intact fibulae. MATERIALS AND METHODS: During the three year period, 1470 patients with leg fractures were treated and out of which, 114 were eligible to enter the study...
May 2016: Indian Journal of Orthopaedics
Nopmanee Tantivesruangdet
Acupuncture is an ancient medical treatment that is increasingly attracting the interest of the public. It is a complementary therapy that is widely used for management of pain, especially chronic discomfort caused by migraine, low-back pain and osteoarthritis of the knee(¹⁻³). The evidence base for the effectiveness of acupuncture and its clinical applications is controversial, and although its efficacy and safety in the management of acute pain have been demonstrated, the quality of this modality is still questionable...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
H B Vaegter, M Hoeger Bement, A B Madsen, J Fridriksson, M Dasa, T Graven-Nielsen
BACKGROUND: Exercise causes an acute decrease in the pain sensitivity known as exercise-induced hypoalgesia (EIH), but the specificity to certain pain modalities remains unknown. This study aimed to compare the effect of isometric exercise on the heat and pressure pain sensitivity. METHODS: On three different days, 20 healthy young men performed two submaximal isometric knee extensions (30% maximal voluntary contraction in 3 min) and a control condition (quiet rest)...
June 5, 2016: European Journal of Pain: EJP
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