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Modalities for knee pain

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https://www.readbyqxmd.com/read/29121695/the-effect-of-preoperative-physical-status-on-pain-management-in-total-knee-arthroplasty-patients-receiving-adductor-canal-blockade
#1
Chukwuweike U Gwam, Jaydev B Mistry, Nequesha S Mohamed, Nicole E George, Jennifer I Etcheson, Sana Virani, Ryan Skalsky, Shreya Singh, Nicolas S Piuzzi, Ronald E Delanois
INTRODUCTION: Managing postoperative pain can be challenging for arthroplasty surgeons. While pain control modalities, such as adductor canal blockade (ACB), have been proven effective, the multifactorial nature of pain perception may serve as an obstacle for optimizing pain control. This study assesses the effect of patient pre-operative physical status on patient perception of pain. Specifically, we compared 1) lengths of hospital stay (LOS), 2) pain levels, and 3) opioid consumption in patients receiving total knee arthroplasty (TKA) who presented with an American Society of Anesthesiologists physical status score (ASA) of 2 and 3...
November 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29098574/immune-contributions-to-osteoarthritis
#2
REVIEW
Erika Barboza Prado Lopes, Adrian Filiberti, Syed Ali Husain, Mary Beth Humphrey
PURPOSE OF THE REVIEW: Mounting evidence supports a role of low-grade inflammation in the pathophysiology of osteoarthritis (OA). We review and discuss the role of synovitis, complement activation, cytokines, and immune cell population in OA. RECENT FINDINGS: Using newer imaging modalities, synovitis is found in the majority of knees with OA. Complement activation and pro-inflammatory cytokines play a significant role in the development of cartilage destruction and synovitis...
November 2, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/29095245/prospective-multicenter-randomized-crossover-clinical-trial-comparing-the-safety-and-effectiveness-of-cooled-radiofrequency-ablation-with-corticosteroid-injection-in-the-management-of-knee-pain-from-osteoarthritis
#3
Tim Davis, Eric Loudermilk, Michael DePalma, Corey Hunter, David Lindley, Nilesh Patel, Daniel Choi, Marc Soloman, Anita Gupta, Mehul Desai, Asokumar Buvanendran, Leonardo Kapural
BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) of the knee affects the aging population and has an associated influence on the health care system. Rigorous studies evaluating radiofrequency ablation for OA-related knee pain are lacking. This study compared long-term clinical safety and effectiveness of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain. METHODS: This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities...
November 1, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29064877/evidence-basis-for-regional-anesthesia-in-ambulatory-arthroscopic-knee-surgery-and-anterior-cruciate-ligament-reconstruction-part-ii-adductor-canal-nerve-block-a-systematic-review-and-meta-analysis
#4
Herman Sehmbi, Richard Brull, Ushma Jitendra Shah, Kariem El-Boghdadly, David Nguyen, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Adductor canal block (ACB) has emerged as an effective analgesic regional technique for major knee surgeries in the last decade. Its motor-sparing properties make it particularly attractive for ambulatory knee surgery, but evidence supporting its use in ambulatory arthroscopic knee surgery is conflicting. This systematic review and meta-analysis evaluates the analgesic effects of ACB for ambulatory arthroscopic knee surgeries. METHODS: We conducted a comprehensive search of electronic databases for randomized controlled trials examining the analgesic effects of ACB compared to control or any other analgesic modality...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29052519/circuit-training-enhances-function-in-patients-undergoing-total-knee-arthroplasty-a-retrospective-cohort-study
#5
Wei-Hsiu Hsu, Wei-Bin Hsu, Wun-Jer Shen, Zin-Rong Lin, Shr-Hsin Chang, Robert Wen-Wei Hsu
BACKGROUND: The number of patients receiving total knee arthroplasty (TKA) has been rising every year due to the aging population and the obesity epidemic. Post-operative rehabilitation is important for the outcome of TKA. METHODS: A series of 34 patients who underwent primary unilateral TKA was retrospectively collected and divided into either exercise group (n = 16) and control group (n = 18). The exercise group underwent a 24-week course of circuit training beginning 3 months after total knee arthroplasty (TKA)...
October 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29046778/ultrasound-guided-percutaneous-cryoneurolysis-providing-postoperative-analgesia-lasting-many-weeks-following-a-single-administration-a-replacement-for-continuous-peripheral-nerve-blocks-a-case-report
#6
Brian M Ilfeld, Rodney A Gabriel, Andrea M Trescot
Cryoneurolysis entails using low temperatures to reversibly ablate nerves, with a subsequent analgesia duration measured in weeks or months. Previously, clinical applications for acute pain were limited because treatment originally required exposing the target nerve surgically. However, three developments have now made it possible to provide prolonged postoperative analgesia by cryoneurolysis: 1) new portable, hand-held cryoneurolysis devices, 2) ultrasound machine proliferation, and, 3) anesthesiologists trained in ultrasound-guided peripheral nerve block administration...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29025397/a-qualitative-study-of-patient-education-needs-for-hip-and-knee-replacement
#7
Deborah Kennedy, Amy Wainwright, Lucy Pereira, Susan Robarts, Patricia Dickson, Jennifer Christian, Fiona Webster
BACKGROUND: Quality health information is key to patient engagement, self-management and an enhanced healthcare experience. There is strong evidence to support involving patients and their families in the development and evaluation of health-related educational material. These factors were the impetus for our high volume joint replacement centre to undertake a qualitative study to elicit patient experiences to inform the development of effective strategies and education along the care continuum for hip and knee replacement...
October 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28947452/a-hospital-based-observational-cohort-study-exploring-pain-and-biomarkers-in-patients-with-hand-osteoarthritis-in-norway-the-nor-hand-protocol
#8
Marthe Gløersen, Elisabeth Mulrooney, Alexander Mathiessen, Hilde Berner Hammer, Barbara Slatkowsky-Christensen, Karwan Faraj, Thore Isaksen, Tuhina Neogi, Tore K Kvien, Karin Magnusson, Ida Kristin Haugen
INTRODUCTION: We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28942225/arthroscopic-deepening-trochleoplasty-for-chronic-anterior-knee-pain-after-previous-failed-conservative-and-arthroscopic-treatment-report-of-two-cases
#9
Lars Blønd
PURPOSE: A proportion of patients having years of chronic anterior knee pain(AKP) that have not responded to non-operative modalities. Trochlear dysplasia have been found to be a cause for AKP. By restoring the anatomy with a trochleoplasty procedure the patellofemoral joint is unloaded. This study is a prospective 2year follow-up study, based on two cases with chronic AKP for several years and having severe trochlear dysplasia and both were successfully treated by arthroscopic deepening trochleoplasty...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28927387/development-of-the-treatment-beliefs-in-knee-and-hip-osteoarthritis-toa-questionnaire
#10
Ellen M H Selten, Johanna E Vriezekolk, Henk J Schers, Marc W Nijhof, Willemijn H van der Laan, Roelien G van der Meulen-Dilling, Rinie Geenen, Cornelia H M van den Ende
BACKGROUND: Use of conservative treatment modalities in osteoarthritis (OA) is suboptimal, which appears to be partly due to patients' beliefs about treatments. The aim of this study was to develop a research instrument assessing patients' beliefs about various treatment modalities of hip and knee OA: the 'Treatment beliefs in OA (TOA) questionnaire'. METHODS: The item pool that was retrieved from interviews with patients and healthcare providers comprised beliefs regarding five treatment modalities: physical activity, pain medication, physiotherapy, injections and arthroplasty...
September 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28902603/the-utility-of-conservative-treatment-modalities-in-the-management-of-osteonecrosis
#11
Feroz Osmani, Savyasachi Thakkar, Jonathan Vigdorchik
INTRODUCTION: Osteonecrosis is an ischemic pathologic process associated with a number of conditions affecting a range of age groups. The problem faced in the management of osteonecrosis is whether conservative treatment is a viable and effective option for patients. In this systematic review, we investigated the efficacy of various nonoperative treatment modalities for hip and knee osteonecrosis, including pharmacological management and biophysical modalities. METHODS: We identified 16 studies based on electronic searches through the PubMed, Embase, CINAHL Plus, and Cochrane databases from January 2001 to November 2015...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28839448/the-disease-modifying-effects-of-hyaluronan-in-the-osteoarthritic-disease-state
#12
REVIEW
Mathew A Nicholls, Anke Fierlinger, Faizan Niazi, Mohit Bhandari
Hyaluronic acid (HA) has been a treatment modality for patients with knee osteoarthritis (OA) for many years now. Since HA was first introduced for the treatment of painful knee OA, much has been elucidated regarding both the etiology of this disease and the mechanisms by which HA may mitigate joint pain and tissue destruction. The objectives of this article are to (1) describe the etiology and pathophysiology of OA including both what is known about the genetics and biochemistry, (2) describe the role of HA on disease progression, (3) detail the antinociceptive and anti-inflammatory actions of HA in OA, and (4) present evidence of disease-modifying effects of HA in the preservation and restoration of the extracellular matrix...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28816893/periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee-arthroplasty-a-double-blinded-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Eric B Smith, Gregory S Kazarian, Mitchell G Maltenfort, Jess H Lonner, Peter F Sharkey, Robert P Good
BACKGROUND: Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. METHODS: This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104)...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28800711/getting-better-or-getting-well-the-patient-acceptable-symptom-state-pass-better-predicts-patient-s-satisfaction-than-the-decrease-of-pain-in-knee-osteoarthritis-subjects-treated-with-viscosupplementation
#14
Thierry Conrozier, Matthieu Monet, Anne Lohse, Raghu Raman
Background In the management of knee osteoarthritis (OA), patient-reported-outcomes (PROs) are being developed for relevant assessment of pain. The patient acceptable symptom state (PASS) is a relevant cutoff, which allows classifying patients as being in "an acceptable state" or not. Viscosupplementation is a therapeutic modality widely used in patients with knee OA that many patients are satisfied with despite meta-analyses give conflicting results. Objectives To compare, 6 months after knee viscosupplementation, the percentage of patients who reached the PASS threshold (PASS +) with that obtained from other PROs...
August 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28741321/-articular-fractures-of-the-distal-femur-comparative-analysis-of-three-surgical-treatments
#15
F Souki-Chmeit, E Zambrano-Sanguinetti, A Sandia-Briceño, A Souki-Chmeit, M Brito-Velásquez
INTRODUCTION: The distal articular femur fracture is a serious injury that for years has been a problem in traumatology. It is often believed that produced varying degrees of permanent disability in the knee and that the fate of the joint was determined by the injury rather than treatment. OBJECTIVES: Present the results of surgical treatment of articular distal femur fractures type C2 with three treatment modalities: dynamic condylar screw (TDC), condylar buttress plate (PSC) and periarticular plate (PPA)...
January 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#16
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
November 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28704746/a-case-report-of-an-anterior-tibial-artery-pseudo-aneurysm-open-surgical-management-a-rare-complication-post-total-knee-arthroplasty
#17
Kang Lie Darius Aw, Choon Chieh Tan, Jack Kian Ch'ng, Siew Ping Chng
INTRODUCTION: Complications involving injury to neurological and vascular structures are infrequently reported after total knee arthroplasty (TKA). They are associated with significant morbidity and can be limb threatening. PRESENTATION OF CASE: We present a patient with an anterior tibial artery (ATA) aneurysm post total knee arthroplasty. A 69-year-old female was referred for a swelling over her left antero-lateral aspect of her leg 4 years post TKA. Radiological investigations showed an ATA pseudo aneurysm...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28699499/effectiveness-of-argan-oil-on-knee-osteoarthritis-symptoms-a-randomized-controlled-clinical-trial
#18
Jamila Essouiri, Taoufik Harzy, Nadia Benaicha, Mourad Errasfa, Fatima Ezzahra Abourazzak
BACKGROUND: Knee osteoarthritis (KOA) is a common chronic degenerative disorder. It causes joints pain, walking difficulties and a decline of general physical function. Many pain drugs and treatment modalities can be prescribed for KOA. Among traditional medicine in Morocco, Argan oil has been used in the treatment of knee osteoarthritis to reduce pain and improve physical activity, though there have been no medical-based evidence for such treatment. Argan oil is known to have anti-oxidant and lipid modulatory properties due to its content of many substances, such as tocopherols, phytosterols, saturated and unsaturated fatty acids...
July 10, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28699498/is-the-addition-of-a-polyol-to-hyaluronic-acid-a-significant-advance-in-the-treatment-of-osteoarthritis
#19
Thierry Conrozier
Viscosupplementation with intra-articular injections of hyaluronic acid is recommended as a second line treatment for knee OA, after failure of non-pharmacological modalities and usual pain killers. Nevertheless there is still controversies regarding clinical relevance of its effects. Research is looking at the best means to improve the performance of viscosupplementation in order to obtain a faster, more sustainable and more marked effect. Antioxidants have been assessed in combination with hyaluronic acid because the injected hyaluronate is rapidly degraded by the reactive oxygen species present in large amounts in the OA synovial fluid, limiting its residence time into the joint...
July 10, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28664420/treatment-beliefs-underlying-intended-treatment-choices-in-knee-and-hip-osteoarthritis
#20
Ellen M H Selten, Rinie Geenen, Henk J Schers, Frank H J van den Hoogen, Roelien G van der Meulen-Dilling, Willemijn H van der Laan, Marc W Nijhof, Cornelia H M van den Ende, Johanna E Vriezekolk
PURPOSE: Patients' beliefs about treatment modalities for knee and hip osteoarthritis (OA) will underlie their treatment choices. Based on the Theory of Planned Behavior, it is hypothesized that patients' beliefs, subjective norm, and perceived behavioral control guide their treatment choices. Also, symptom severity and one's inherent tendency to approach or avoid situations are assumed to play a role. The objective of this study was to test whether these variables were associated with intended treatment choices in knee and hip OA...
June 29, 2017: International Journal of Behavioral Medicine
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