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Modalities for knee pain

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https://www.readbyqxmd.com/read/28334196/the-effectiveness-of-prolotherapy-in-treating-knee-osteoarthritis-in-adults-a-systematic-review
#1
Fadi Hassan, Suad Trebinjac, William D Murrell, Nicola Maffulli
Introduction: Osteoarthritis (OA) often leads to symptoms such as pain, stiffness and decreased function. OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise. Sources of data: Searches of the electronic databases, PubMed, ISI web of science, PEDro and SPORTDiscus, were conducted for all Level 1-4 studies published from inception through to December 2016...
March 4, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28294528/effect-of-intraoperative-dexamethasone-on-pain-scores-and-narcotic-consumption-in-patients-undergoing-total-knee-arthroplasty
#2
Jason Samona, Carrie Cook, Kyle Krupa, Krystle Swatsell, Andrew Jackson, Chase Dukes, Sidney Martin
OBJECTIVE: To examine whether the addition of intravenous dexamethasone during total knee arthroplasty (TKA) would be effective at reducing postoperative pain scores and postoperative opioid consumption. METHODS: A total of 102 patients undergoing TKA were placed into two groups: 55 subjects received intraoperative dexamethasone 8 mg intravenously (treatment group) and 47 did not receive dexamethasone at any time during the perioperative period. Comparison was made using the 0-10 numeric pain rating scale and the amount of opioids used in each group...
March 15, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#3
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28283810/anesthetic-and-analgesic-management-for-outpatient-knee-arthroplasty
#4
REVIEW
Chris Cullom, Jonathan T Weed
PURPOSE OF REVIEW: Total knee arthroplasty traditionally has been associated with significant postoperative pain that can limit recovery and prolong hospital length of stay. Recently, however, due to financial pressures and an emphasis on improving patient satisfaction, many institutions are implementing outpatient and short-stay programs for patients undergoing this procedure. An effective perioperative anesthetic plan is an essential quality of a successful outpatient joint replacement program...
May 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28277593/pain-management-with-adductor-canal-blockade-or-multimodal-periarticular-analgesia-in-elderly-total-knee-arthroplasty-patients
#5
Chukwuweike U Gwam, Nequesha Mohamed, Jaydev B Mistry, Melbin Thomas, Morad Chughtai, Sabahat Khan, Anton Khlopas, Michael A Mont, Ronald E Delanois
INTRODUCTION: Post-operative pain management in elderly total knee arthroplasty (TKA) patients has traditionally included opioids, epidurals, and femoral nerve blocks. Although these modalities are effective, they are often associated with adverse side effects, which may have a greater impact on this population. Alternative modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA) have demonstrated great efficacy with a low side effect profile. However, it is unknown if one modality is advantageous over the other in the elderly...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28211591/magnetic-resonance-imaging-of-the-knee-an-overview-and-update-of-conventional-and-state-of-the-art-imaging
#6
Nicholas C Nacey, Matthew G Geeslin, Grady Wilson Miller, Jennifer L Pierce
Magnetic resonance imaging (MRI) has become the preferred modality for imaging the knee to show pathology and guide patient management and treatment. The knee is one of the most frequently injured joints, and knee pain is a pervasive difficulty that can affect all age groups. Due to the diverse pathology, complex anatomy, and a myriad of injury mechanisms of the knee, the MRI knee protocol and sequences should ensure detection of both soft tissue and osseous structures in detail and with accuracy. The knowledge of knee anatomy and the normal or injured MRI appearance of these key structures are critical for precise diagnosis...
February 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28146271/liposomal-bupivacaine-infiltration-at-the-surgical-site-for-the-management-of-postoperative-pain
#7
REVIEW
Thomas W Hamilton, Vassilis Athanassoglou, Stephen Mellon, Louise H Strickland, Marialena Trivella, David Murray, Hemant G Pandit
BACKGROUND: Despite multi-modal analgesic techniques, acute postoperative pain remains an unmet health need, with up to three quarters of people undergoing surgery reporting significant pain. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel method of sustained-release analgesia. OBJECTIVES: To assess the analgesic efficacy and adverse effects of liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141914/exercise-for-hand-osteoarthritis
#8
REVIEW
Nina Østerås, Ingvild Kjeken, Geir Smedslund, Rikke H Moe, Barbara Slatkowsky-Christensen, Till Uhlig, Kåre Birger Hagen
BACKGROUND: Hand osteoarthritis (OA) is a prevalent joint disease that may lead to pain, stiffness and problems in performing hand-related activities of daily living. Currently, no cure for OA is known, and non-pharmacological modalities are recommended as first-line care. A positive effect of exercise in hip and knee OA has been documented, but the effect of exercise on hand OA remains uncertain. OBJECTIVES: To assess the benefits and harms of exercise compared with other interventions, including placebo or no intervention, in people with hand OA...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28118736/effects-of-short-wave-therapy-in-patients-with-knee-osteoarthritis-a-systematic-review-and-meta-analysis
#9
Haiming Wang, Chi Zhang, Chengfei Gao, Siyi Zhu, Lijie Yang, Quan Wei, Chengqi He
OBJECTIVE: To evaluate the efficacy and safety of short-wave therapy with sham or no intervention for the management of patients with knee osteoarthritis. METHODS: We searched the following databases from their inception up to 26 October 2016: MEDLINE, CENTRAL, EMBASE, Physiotherapy Evidence Database, CINAHL and OpenGrey. Studies included randomized controlled trials compared with a sham or no intervention in patients with knee osteoarthritis. The results were calculated via standardized mean difference (SMD) and risk ratio for continuous variables outcomes as well as dichotomous variables, respectively...
December 1, 2016: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28096689/influence-of-exercise-on-visceral-pain-an-explorative-study-in-healthy-volunteers
#10
Laura Jgm van Weerdenburg, Christina Brock, Asbjørn Mohr Drewes, Harry van Goor, Marjan de Vries, Oliver Hg Wilder-Smith
BACKGROUND AND OBJECTIVES: Contradictory results have been found about the effect of different exercise modalities on pain. The aim of this study was to investigate the early effects of aerobic and isometric exercise on different types of experimental pain, including visceral pain, compared to an active control condition. METHODS: Fifteen healthy subjects (6 women, mean [standard deviation] age 25 [6.5] years) completed 3 interventions consisting of 20 minutes of aerobic cycling, 12 minutes of isometric knee extension and a deep breathing procedure as active control...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#11
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/28072900/efficacy-of-adductor-canal-blockade-compared-to-multimodal-peri-articular-analgesia-following-total-knee-arthroplasty
#12
Chukwuweike U Gwam, Jaydev B Mistry, Priya Jha, Anton Khlopas, Melbin Thomas, Morad Chughtai, Michael A Mont, Ronald E Delanois
INTRODUCTION: Postoperative pain after total knee arthroplasty (TKA) can be an impediment to patient recovery. Many commonly used pain control modalities are effective, but are also associated with adverse effects. Other modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA), have gained popularity due to their efficacy and high safety profile. However, to the best of our knowledge, there are no published studies indicating if a therapeutic advantage exists between the two pain control modalities...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28050818/what-is-the-accuracy-of-nuclear-imaging-in-the-assessment-of-periprosthetic-knee-infection-a-meta-analysis
#13
REVIEW
Steven J Verberne, Remko J A Sonnega, Olivier P P Temmerman, Pieter G Raijmakers
BACKGROUND: In the assessment of possible periprosthetic knee infection, various imaging modalities are used without consensus regarding the most accurate technique. QUESTIONS/PURPOSES: To perform a meta-analysis to compare the accuracy of various applied imaging modalities in the assessment of periprosthetic knee infection. METHODS: A systematic review and meta-analysis was conducted with a comprehensive search of MEDLINE and Embase(®) in accordance with the PRISMA and Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) recommendations to identify clinical studies in which periprosthetic knee infection was investigated with different imaging modalities...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28040320/semimembranosus-tenosynovitis-diagnosis-and-management-of-a-commonly-missed-cause-of-posteromedial-knee-pain
#14
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/27986370/effects-of-ethyl-chloride-spray-on-early-recovery-after-total-knee-arthroplasty-a-prospective-study
#15
Wang Rui, Gong Long, Geng Li, Yu Yang, Li Hengjin, Wang Zhenhu
BACKGROUND: Ethyl chloride spray as a common cooling modality has been widely used in acute sports injuries and joint injection procedures. Several clinical studies reported that use of ethyl chloride has positive effects on swelling, pain reduction and recovery from sports injuries. The main aim of present study was to analyze whether postoperative use of ethyl chloride spray benefits results after primary total knee arthroplasty (TKA). METHODS: Between April 1, 2014 and October 21, 2015, 306 subjects undergoing primary TKA used ethyl chloride spray for improving recovery from the damage from surgery...
December 13, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27973952/accuracy-of-estimating-unicondylar-knee-replacement-implant-varus-valgus-angles-from-antero-posterior-radiographs
#16
Rahul Khare, Branislav Jaramaz
Unicondylar Knee Replacement (UKR) is an orthopedic surgical procedure to reduce pain and improve function in the knee. Load-bearing long-standing antero-posterior (AP) radiographs are typically used postoperatively to measure the leg alignment and assess the varus/valgus implant orientation. However, implant out-of-plane rotations, user variability, and X-ray acquisition parameters introduce errors in the estimation of the implant varus/valgus estimation. Previous work has explored the accuracy of various imaging modalities in this estimation...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27939833/orthoses-for-osteoarthritis-a-narrative-review
#17
REVIEW
Johann Beaudreuil
Orthoses for osteoarthritis represent splints, taping, sleeves, unloading knee braces and insoles. This review of the effectiveness of these orthoses involved a search for articles published up to 2015 in MEDLINE via PubMed, with a focus on Osteoarthritis Research Society International, American College of Rheumatology and European League Against Rheumatology international recommendations. Evidence for splinting effectiveness in patients with thumb-base osteoarthritis is now provided. Splints for thumb-base osteoarthritis decrease pain and functional disability...
December 6, 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#18
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean-Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French society of anaesthesia and intensive care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation periopératoire de l'anesthésie en chirurgie ambulatoire). From among all of the ambulatory surgery centres listed by the Agences régionales de santé (Regional health agencies, France), 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27910257/neurostimulation-for-postsurgical-analgesia-a-novel-system-enabling-ultrasound-guided-percutaneous-peripheral-nerve-stimulation
#19
Brian M Ilfeld, Stuart A Grant, Christopher A Gilmore, John Chae, Richard D Wilson, Amorn Wongsarnpigoon, Joseph W Boggs
While neurostimulation-stimulation of the nervous system using electrical current-has been used to treat chronic pain, its use treating postsurgical pain has been limited. Here, we report on the clinical application of a novel investigational lead to provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously using ultrasound guidance within 0.5 to 3.0 cm of the femoral and/or sciatic nerve(s). With the delivery of current, pain decreased an average of 63% at rest, with 4 of 5 subjects having relief of > 50%...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27886697/nonsurgical-management-of-osteoarthritis-knee-pain-in-the-older-adult
#20
REVIEW
Nora Taylor
Symptomatic knee osteoarthritis is a common complaint of many elderly patients in primary care offices. For those unable or unwilling to undergo knee replacement, the primary practitioners' understanding of the strengths and weaknesses of the available treatment modalities for pain relief is critical to successful in-office counseling and expectation management. Treatment requires a multimodal approach of nonpharmacologic and pharmacologic therapies to achieve a maximal clinical benefit. The focus of this review is on the nonsurgical options for treatment of knee osteoarthritis in patients aged 65 and older...
February 2017: Clinics in Geriatric Medicine
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