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Femoral knee pain

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https://www.readbyqxmd.com/read/27924199/in-plane-three-step-needle-insertion-technique-for-ultrasound-guided-continuous-femoral-nerve-block-after-total-knee-arthroplasty-a-retrospective-review-of-488-cases
#1
Hyeon Ju Shin, Jung Sub Soh, Hyong Hwan Lim, Bumjoon Joo, Hye Won Lee, Hae Ja Lim
BACKGROUND: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. METHODS: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27923404/combined-femoral-and-sciatic-nerve-block-versus-femoral-and-local-infiltration-anesthesia-for-pain-control-after-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#2
Jian Li, Xinlian Deng, Tao Jiang
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect of combined femoral and sciatic nerve block (SNB) versus femoral and local infiltration anesthesia (LIA) after total knee arthroplasty (TKA). METHODS: The electronic databases PubMed, Embase, Cochrane Library, and Web of Science were searched from their inception to 15 June 2016. Articles comparing combined femoral and SNB versus femoral and LIA for pain control were eligible for this meta-analysis...
December 7, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27920593/slipped-capital-femoral-epiphysis-and-primary-hyperparathyroidism-a-case-report
#3
Anas A Alghamdi, Maswood M Ahmad, Mussa H Almalki
The aim of reporting this case is to highlight the association of two disorders, primary hyperparathyroidism (PHPT) and slipped capital femoral epiphysis (SCFE). They are usually seen in two different age groups and rarely together. PHPT is a rare cause of SCFE and only 10 cases have been reported in the literature worldwide. The patient in our report is a 13-year-old girl who presented to our clinic with bilateral knee pain and a waddling gait. Subsequent investigations showed that she had PHPT and SCFE with low bone mass...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#4
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/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#5
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27910257/neurostimulation-for-postsurgical-analgesia-a-novel-system-enabling-ultrasound-guided-percutaneous-peripheral-nerve-stimulation
#6
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/27909144/bone-area-provides-a-responsive-outcome-measure-for-bone-changes-in-short-term-knee-osteoarthritis-studies
#7
Michael A Bowes, Rose A Maciewicz, John C Waterton, David J Hunter, Philip G Conaghan
OBJECTIVE: To analyze the 3-D bone area from an osteoarthritis (OA) cohort demonstrating no change in cartilage thickness. METHODS: Twenty-seven women with painful medial knee OA had magnetic resonance images at 0, 3, and 6 months. Images were analyzed using active appearance models. RESULTS: At 3 and 6 months, the mean change in medial femoral bone area was 0.34% (95% CI 0.04-0.64) and 0.61% (95% CI 0.32-0.90), respectively. Forty-one percent of the subjects had progression greater than the smallest detectable difference at 6 months...
December 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27906096/biological-and-functional-evaluation-of-a-novel-pyrolytic-carbon-implant-for-the-treatment-of-focal-osteochondral-defects-in-the-medial-femoral-condyle-assessment-in-a-canine-model
#8
Samantha L Salkeld, Laura P Patron, Joan C Lien, Stephen D Cook, Deryk G Jones
BACKGROUND: Osteochondral defects continue to be a clinical treatment challenge, and when left untreated, may cause pain and functional impairment. Pyrolytic carbon is a unique isotropic biomaterial used in heart valve and small joint replacements due to its excellent wear properties and biocompatibility with bone and articular cartilage. Therefore, a proposed solution is to utilize a focal pyrolytic carbon hemiarthroplasty implant as an alternative resurfacing treatment strategy for isolated cartilage lesions...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27898194/inflammatory-cell-induced-corrosion-in-total-knee-arthroplasty-a-retrieval-study
#9
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Anna Di Laura, John A Skinner, Alister J Hart
Metal release in patients with joint replacements is associated with local tissue reactions, pain, and ultimately revision of implants. One of the causes of this metal loss is speculated to be due to a mechanism of inflammatory cell-induced corrosion (ICIC). In this knee retrieval study, we aimed to: (1) identify the extent and location of ICI corrosion patterns on our femoral and tibial components and (2) correlate our findings with implant and clinical information. We investigated 28 femoral and 9 tibial components made of polished CoCr for presence of ICIC, using macroscopic and microscopic screening and statistical analyses to identify any significant correlations between our results and clinical information...
November 29, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27871547/adductor-canal-block-for-knee-surgical-procedures-review-article
#10
REVIEW
Maulin U Vora, Thomas A Nicholas, Cale A Kassel, Stuart A Grant
Adductor canal block (ACB) has recently emerged as an alternative to femoral nerve block for pain control after various knee procedures especially knee arthroplasty. In this review article, we will review the anatomy of adductor canal, sonoanatomy, and ultrasound-guided approach for ACB as well as review current evidence regarding the indications of the ACB.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27852298/assessment-of-subchondral-bone-marrow-lesions-in-knee-osteoarthritis-by-mri-a-comparison-of-fluid-sensitive-and-contrast-enhanced-sequences
#11
Flemming K Nielsen, Niels Egund, Anette Jørgensen, David A Peters, Anne Grethe Jurik
BACKGROUND: Bone marrow lesions (BMLs) in knee osteoarthritis (OA) can be assessed using fluid sensitive and contrast enhanced sequences. The association between BMLs and symptoms has been investigated in several studies but only using fluid sensitive sequences. Our aims were to assess BMLs by contrast enhanced MRI sequences in comparison with a fluid sensitive STIR sequence using two different segmentation methods and to analyze the association between the MR findings and disability and pain...
November 16, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27844117/are-advanced-three-dimensional-imaging-studies-always-needed-to-measure-the-coronal-knee-alignment-of-the-lower-extremity
#12
Jean Yves Lazennec, Quentin Chometon, Dominique Folinais, Christopher B Robbins, Aidin Eslam Pour
BACKGROUND: Coronal malalignment of the lower extremity is closely related to the onset and progression of osteoarthritis. Restoring satisfactory alignment after tibial osteotomy improves the long-term success of this conservative surgery. The purpose of our study was to determine (1) if there is a difference between two-dimensional (2D) and 3D measurements of the hip-knee-ankle (HKA) angle between the mechanical axes of the femur and the tibia, (2) which parameter most affects 2D-3D HKA measurement, and (3) the percentage of patients who are at risk of error in HKA measurement...
November 14, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27818185/validation-of-a-french-patient-reported-outcome-measure-for-patello-femoral-disorders-the-lille-patello-femoral-score
#13
S Putman, F Rémy, G Pasquier, F Gougeon, H Migaud, A Duhamel
BACKGROUND: The diagnosis of patello-femoral instability (PFI) relies chiefly on the patient's clinical findings. Nevertheless, few clinical scores specifically designed to evaluate the patello-femoral joint are available. The Lille scoring system is a 12-item self-questionnaire yielding a score from 0 to 100 that is used in France but has not been validated. We therefore conducted a validation study in a population of younger patients with PFI. HYPOTHESIS: The Lille scoring system meets validation criteria for patient-reported outcome measures (PROMs)...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27817975/long-term-result-of-arthroplasty-in-the-treatment-of-a-case-of-ochronotic-arthropathy
#14
Sinan Karaoğlu, Fatih Karaaslan, Musa Uğur Mermerkaya
Alkaptonuria is a rare metabolic disease caused by a partial or total deficiency of homogentisic acid oxidase, which results in excess homogentisic acid (HGA) levels. Homogentisic acid and its oxidation products can accumulate in hyaline cartilage, tendons, and ligaments. A 55-year-old male was admitted complaining of worsening chronic pain in his left knee. A radiographic evaluation showed tricompartmental end- stage osteoarthritis. A cemented total knee replacement was performed. At the 10-year follow-up, he had returned to full activity, had no knee pain, and was very satisfied with the outcome...
November 3, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27813019/knee-donor-site-morbidity-after-mosaicplasty-a-systematic-review
#15
REVIEW
Renato Andrade, Sebastiano Vasta, Rogério Pereira, Hélder Pereira, Rocco Papalia, Mustafa Karahan, J Miguel Oliveira, Rui L Reis, João Espregueira-Mendes
BACKGROUND: Mosaicplasty has been associated with good short- to long-term results. Nevertheless, the osteochondral harvesting is restricted to the donor-site area available and it may lead to significant donor-site morbidity. PURPOSE: Provide an overview of donor-site morbidity associated with harvesting of osteochondral plugs from the knee joint in mosaicplasty procedure. METHODS: Comprehensive search using Pubmed, Cochrane Library, SPORTDiscus and CINAHL databases was carried out through 10(th) October of 2016...
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27811526/prospective-double-blind-randomized-study-to-evaluate-single-injection-adductor-canal-nerve-block-versus-femoral-nerve-block-postoperative-functional-outcomes-after-total-knee-arthroplasty
#16
George I Macrinici, Carol Murphy, Lori Christman, Michelle Drescher, Brittany Hughes, Victor Macrinici, Gloria Diab
BACKGROUND AND OBJECTIVES: Despite multiple clinical trials comparing the adductor canal block (ACB) with femoral nerve block (FNB) for total knee arthroplasty, none looked at the aforementioned nerve blocks from early functional results to up to 6 months after surgery. METHODS: For this prospective, double-blind, randomized, single-center trial, we enrolled 98 patients set to undergo total knee arthroplasty. The patients were randomized, with 93 patients included in the intention-to-treat analysis...
November 2, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27802795/femoral-fracture-following-acute-trauma-in-a-female-collegiate-swimmer
#17
Jonathan Hernandez, Seth Gamradt, Drew Morcos
The patient was a 20-year-old Division I female collegiate swimmer who presented to the athletic training room following a traumatic onset of right knee pain. She was immediately transferred to the hospital for diagnostic imaging. Knee radiographs revealed a minimally displaced fracture of her right distal femur that extended from her intercondylar notch to the lateral aspect of her distal femoral metaphysis, while computed tomography and magnetic resonance imaging scans revealed the intra-articular nature of the fracture...
November 2016: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#18
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27789021/nasal-chondrocyte-based-engineered-autologous-cartilage-tissue-for-repair-of-articular-cartilage-defects-an-observational-first-in-human-trial
#19
Marcus Mumme, Andrea Barbero, Sylvie Miot, Anke Wixmerten, Sandra Feliciano, Francine Wolf, Adelaide M Asnaghi, Daniel Baumhoer, Oliver Bieri, Martin Kretzschmar, Geert Pagenstert, Martin Haug, Dirk J Schaefer, Ivan Martin, Marcel Jakob
BACKGROUND: Articular cartilage injuries have poor repair capacity, leading to progressive joint damage, and cannot be restored predictably by either conventional treatments or advanced therapies based on implantation of articular chondrocytes. Compared with articular chondrocytes, chondrocytes derived from the nasal septum have superior and more reproducible capacity to generate hyaline-like cartilage tissues, with the plasticity to adapt to a joint environment. We aimed to assess whether engineered autologous nasal chondrocyte-based cartilage grafts allow safe and functional restoration of knee cartilage defects...
October 22, 2016: Lancet
https://www.readbyqxmd.com/read/27782936/the-lateral-wedge-augmentation-trochleoplasty-in-a-pediatric-population-a-5-year-follow-up-study
#20
Sébastien Pesenti, Benjamin Blondel, Gregory Armaganian, Sébastien Parratte, Gérard Bollini, Franck Launay, Jean-Luc Jouve
Patellofemoral instability in children requires surgery when recurrent dislocation occurs. The aim of this study is to report the 5-year clinical and radiographic outcomes following lateral wedge augmentation trochleoplasty of the femoral trochlea. This is a review of 23 (mean age: 12.5 years) patients who underwent surgery for recurrent patellar dislocations related to a flat trochlea. In every case, a lateral wedge augmentation trochleoplasty was performed with preservation of the growth plate. This surgery was consistently associated with a soft tissue procedure...
October 25, 2016: Journal of Pediatric Orthopedics. Part B
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