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Femoral knee pain

Fatin Affas, Carl-Olav Stiller, Eva-Britt Nygårds, Niclas Stephanson, Per Wretenberg, Christina Olofsson
Pain after total knee arthroplasty (TKA) is difficult to control. A recently developed and increasingly popular method for postoperative analgesia following knee and hip arthroplasty is Local Infiltration Analgesia (LIA) with ropivacaine, ketorolac and epinephrine. This method is considered to have certain advantages, which include administration at the site of traumatized tissue, minimal systemic side effects, faster postoperative mobilization, earlier postoperative discharge from hospital and less opioid consumption...
December 29, 2017: Scandinavian Journal of Pain
Ayşe Aydemir Ekim, Hatice Hamarat, Ahmet Musmul
Objectives: This study aims to examine the association between Q-angle and clinical, radiological, and ultrasonographic findings in patients with knee osteoarthritis (OA). Patients and methods: Sixty-eight female patients (mean age 59.8±6.8 years; range 39 to 78 years) diagnosed with knee OA were included in this study and classified into two groups according to Q-angle of symptomatic knees: low Q-angle group (LQ) (n=40) and high Q-angle group (HQ) (n=28) (LQ-angle <15° and HQ-angle ≥15°, respectively)...
December 2017: Archives of Rheumatology
Andrew J Hotchen, Charis Demetriou, Dennis Edwards, Joel T K Melton
The presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed...
June 13, 2018: Journal of Knee Surgery
Hilary Koech, Joshua M Lawrenz, Daniel R Mesko, Robert M Molloy
Revision total hip arthroplasty in the setting of severe femoral bone loss can be challenging, with salvage options often limited to modular tapered stems, allograft prosthetic composites, and megaprostheses. This case highlights a 79-year-old woman with 2 years of thigh pain who is 8 years status post a revision proximal femoral allograft prosthetic composite reconstruction. Radiographs demonstrated significant stem subsidence into the femoral condyle. In an attempt to avoid a total femoral replacement and spare her functioning native knee, a tibial cone was used in conjunction with a proximal femoral replacement to structurally fill the flaring femoral canal and serve as a stable pedestal for the megaprosthesis body and provide the potential for biologic ingrowth...
June 2018: Arthroplasty Today
Seong-Eun Byun, Hyun-Chul Shon, Jai Hyung Park, Hyoung Keun Oh, Young-Ho Cho, Ji Wan Kim, Jae-Ang Sim
A femoral shaft fracture is usually a high-energy injury and, thus, is likely to be accompanied by an injury of adjacent joints such as a knee ligament injury. However, these associated injuries are often neglected because of severe pain and deformity. The purpose of the current study is to evaluate the incidence, type and risk factors of ipsilateral knee injuries associated with femoral shaft fractures. A total of 429 femoral shaft fractures were included in this study from January 2010 to September 2015. There were 320 males and 109 females, with mean age of 40...
June 4, 2018: Injury
Roberto Gabrielli, Franco Ciocca, Angelica Dante, Aldo Musilli, Maurizio Maiorano, Marco Ventura
BACKGROUND: Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection and lymphorrhea. The traditional management of occluded femoro-popliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedures are more technically demanding and require more expertise and judgment than the primary operation. We describe a case of using the ipsilateral iliac branch prosthesis of aorto-bifemoral as inflow for iliac-peroneal bypass, avoiding the previous groin incisions, to minimize the local complications related to a redo groin dissection and to decrease the operative time required to obtain an adequate inflow source...
June 7, 2018: Annals of Vascular Surgery
Rajanish R, Mohammed Jaseel, Chandhan Murugan, C M Kumaran
Proper knee kinematics depends upon the integrity of ACL at its femoral and medial tibial spine attachments. Tibial spine fractures disrupt this complex and if untreated can lead to pain, instability and functional limitation. So proper diagnosis and early treatment of tibial spine avulsion fracture is important. Tibial spine fractures are often associated with intra-articular injuries which are more common in adults. Diagnosis and treatment of these associated injuries along with proper fixation of tibial spine fractures are essential...
June 2018: Journal of Orthopaedics
A H van Houten, N M Kosse, M Wessels, A B Wymenga
BACKGROUND: The present study assessed the inter- and intra-observer reliability of tibial and femoral rotation measures after total knee arthroplasty (TKA), and evaluated the correlation between these measurement techniques and their clinical relevance. METHODS: Femoral rotation and tibial rotation were determined on 42 2D CT-scans made three-months after TKA. Reliability of the radiological measurements (including Berger's method, the anatomical tibial axis and the tibial tuberosity trochlear-groove) was assessed with 15 randomly selected patients measured twice by three observers...
June 3, 2018: Knee
Jannik Frings, Matthias Krause, Ralph Akoto, Peter Wohlmuth, Karl-Heinz Frosch
PURPOSE: Valgus deformities of the lower extremity influence patellofemoral joint kinematics. However, studies examining the clinical outcome after treatment of patellar instability and maltracking due to valgus deformity are rare in recent literature. This study's purpose is to analyze the clinical results after combined distal femoral osteotomy (DFO) for treatment of patellar instability. METHODS: From 2010 to 2016, 406 cases of patellofemoral instability and maltracking were treated...
June 4, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
John M Ibrahim, Devin Conway, Billy T Haonga, Edmund N Eliezer, Saam Morshed, David W Shearer
BACKGROUND: Little data exists on the negative impact of orthopaedic trauma on quality of life (QOL) in low- and middle-income countries (LMICs). The goal of this study is to investigate the factors associated with lower QOL after operative fixation of femoral shaft fractures in adult patients in a low-resource setting. METHODS: This prospective cohort study followed 272 factures in adults undergoing operative fixation for diaphyseal femur fractures at Tanzania...
May 23, 2018: Injury
Peilong Dong, Xiaobo Tang, Rongrong Cheng, Jian Wang
BACKGROUND AND AIM: The severe pain after total knee arthroplasty (TKA) brings many patients more suffering, longer hospital stay and higher expenses. This study was designed to assess the relative efficacy of several clinical treatments for postoperative analgesia of TKA through network meta-analysis (NMA) based on multiple published randomized controlled trials. METHODS: Embase and PubMed were utilized to conduct this network meta-analysis from inception until 2016...
June 2, 2018: Clinical Journal of Pain
Simon Marmor, Eric Renault, Jeremy Valluy, Mo Saffarini
PURPOSE: Numerous studies demonstrated that prosthetic overhang and over-sizing cause pain and stiffness following total knee arthroplasty (TKA), but none considered volume changes within the joint capsule. This study was designed to investigate differences in volumes of resected bone compared to implanted components in TKA, and to determine the incidence and factors related to 'over-voluming'. METHODS: Three-dimensional reconstructions were created from 100 magnetic resonance imaging scans taken to design patient-specific instruments for TKA...
June 2, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Bart Kowalczyk, Anna Kuźnik-Buziewicz
This study presents outcomes of rotation-plasty for unilateral proximal femoral focal deficiency in the adolescent population. The function, timing of knee fusion, and complications were presented as well as patients' assessment of their function and appearance. Eight patients, aged 8.37 years (range: 3-16 years) during surgery, were evaluated. The mean follow-up duration was 9.25 years (range: 6-12 years). At follow-up, all the patients were pain free and able to ambulate outdoors. Complications included derotation of the foot in five patients, necessitating a re-rotation osteotomy in two...
May 30, 2018: Journal of Pediatric Orthopedics. Part B
Xiaojian Li, Zhanli Fu, Changwei Lü
Objective: To investigate the effectiveness of the arthroscopic lateral retinacular release combined with medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation. Methods: Between January 2016 and March 2017, 28 cases (32 knees) with patellar dislocation were treated by arthroscopic lateral retinacular release and MPFL reconstruction. There were 6 males (6 knees) and 22 females (26 knees) with an average age of 21 years (range, 17-29 years)...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
M D Liu, X K Yang, F Han, Z Q Fang, Y Zhang, D H Hu, K Tao
Objective: Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. Methods: From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Wound debridement was operated on 1 to 3 days after admission...
May 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
C Runge, S Bjørn, J M Jensen, N D Nielsen, M Vase, C Holm, T F Bendtsen
INTRODUCTION: An obturator nerve block (ONB) and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA) without impeding the ambulation, although the ONB produces motor blockade of the hip adductor muscles. The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating intraarticular genicular structures and the posterior capsule of the knee. We hypothesised that a popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa...
May 24, 2018: Acta Anaesthesiologica Scandinavica
Thomas Wiesmann, Ivo Hüttemann, Nora Schilke, Thomas Heyse, Turgay Efe, Daphne Eschbach, Hinnerk Wulf, Thorsten Steinfeldt, Carsten Feldmann
BACKGROUND: Combining continuous femoral nerve blockade with single injection sciatic nerve blockade is standard peripheral nerve block practice for total knee arthroplasty (TKA) during the first 24 postoperative hours. OBJECTIVES: To assess the analgesic benefits and mobilisation capability of continuous sciatic blockade in conjunction with continuous femoral nerve blockade for 72 h after arthroplasty. DESIGN: Randomised, triple-blinded controlled trial...
May 21, 2018: European Journal of Anaesthesiology
Chenxi Cao, Zhengming Cao, Guangyu Liu, Songyang Liu, Yanqi Ye, Tiezheng Sun
BACKGROUND: Angioleiomyoma is a very rare benign solitary soft tissue neoplasm originating from smooth muscle layer of blood vessels. The tumor is usually located in the subcutis or the superficial fasciae, but less often in the deep fasciae, especially rare in the knee joint cavity. Diagnosis is frequently delayed or misdiagnosed as loose body or anterior knee pain because of its rare occurrence and poor awareness of physicians. Few studies have presented intra-articular angioleiomyoma and such cases become rarer and more difficult to diagnose when it presents as loose body...
May 24, 2018: BMC Musculoskeletal Disorders
Jan Rechsteiner, Michael T Hirschmann, Milos Dordevic, Anna L Falkowski, Enrique A Testa, Felix Amsler, Anna Hirschmann
OBJECTIVES: To assess the relationship of subchondral bone tracer uptake (BTU) on SPECT/CT and meniscal pathologies on MRI in patients with painful knees. METHODS: Twenty-five patients who had MRI and SPECT/CT within 3 months without knee surgery or grade ≥3 cartilage lesions were prospectively included. Maximum values of each subchondral femorotibial area were quantified and a ratio was calculated in relation to a femoral shaft reference region, which represented the BTU background activity...
May 22, 2018: European Radiology
J Beckmann, C Merz, J Huth, B Rath, C Schnurr, E Thienpont
PURPOSE: With the growing interest in resurfacing procedures, several new implants have been recently introduced for isolated patello-femoral joint arthroplasty (PFA). However, not much data are available for these new techniques or about the right indications for each type of implant. METHODS: Out of a retrospective cohort of 20 inlay PFA, 11 PFA with an elevated Insall-Salvati index and an increased patello-femoral congruence angle showed an initial satisfactory result, but presented thereafter with recurrent pain and "clunk" phenomena...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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