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Femoral pain after arthroplasty

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https://www.readbyqxmd.com/read/28641968/femoral-nerve-catheters-improve-home-disposition-and-pain-in-hip-fracture-patients-treated-with-total-hip-arthroplasty
#1
Diren Arsoy, James I Huddleston, Derek F Amanatullah, Nicholas J Giori, William J Maloney, Stuart B Goodman
BACKGROUND: Opioids have been the mainstay of treatment in the physiologically young geriatric hip fracture patient undergoing total hip arthroplasty (THA). However opioid-related side effects increase morbidity. Regional anesthesia may provide better analgesia, while decreasing opioid-related side effects. The goal of this study was to examine the effect of perioperative continuous femoral nerve blockade with regards to pain scores, opioid-related side effects and posthospital disposition in hip fracture patients undergoing THA...
June 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28634320/comparison-of-2-analgesia-modalities-in-total-knee-replacement-surgery-is-there-an-effect-on-knee-function-rehabilitation
#2
Janis Zinkus, Lina Mockutė, Arūnas Gelmanas, Ramūnas Tamošiūnas, Arūnas Vertelis, Andrius Macas
BACKGROUND We compared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and adverse effects after total knee arthroplasty (TKA). MATERIAL AND METHODS We prospectively randomized 54 patients undergoing TKA into 2 groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anesthesia. All patients received patient-controlled analgesia (PCA) with morphine, diclofenac, and acetaminophen for the first 72 h postoperatively...
June 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28632587/the-clinical-outcome-of-computer-navigated-compared-with-conventional-knee-arthroplasty-in-the-same-patients-a-prospective-randomized-double-blind-long-term-study
#3
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: The available comparative studies of computer navigation-assisted and conventional knee arthroplasties have short-term follow-up periods. Therefore, the clinical benefits after long-term follow-up are not clear. The purposes of the current long-term study were to compare clinical outcomes, alignment of the knee components, prevalence of aseptic loosening of the components, implant survival, and complications of total knee arthroplasties performed with and without computer navigation...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28609644/outcomes-of-hip-arthroscopic-surgery-in-patients-with-t%C3%A3-nnis-grade-1-osteoarthritis-at-a-minimum-5-year-follow-up-a-matched-pair-comparison-with-a-t%C3%A3-nnis-grade-0-control-group
#4
Benjamin G Domb, Edwin O Chaharbakhshi, Danil Rybalko, Mary R Close, Jody Litrenta, Itay Perets
BACKGROUND: Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited. PURPOSE: To evaluate outcomes of the arthroscopic treatment of FAI and labral tears in patients with mild preoperative OA (Tönnis grade 1) at a minimum 5-year follow-up, and to perform a matched-pair comparison to a control group with Tönnis grade 0. STUDY DESIGN: Cohort study; Level of evidence, 3...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28606458/is-adductor-canal-block-better-than-femoral-nerve-block-in-primary-total-knee-arthroplasty-a-grade-analysis-of-the-evidence-through-a-systematic-review-and-meta-analysis
#5
REVIEW
Ming-Jie Kuang, Jian-Xiong Ma, Lin Fu, Wei-Wei He, Jie Zhao, Xin-Long Ma
BACKGROUND: Total knee arthroplasty (TKA) is associated with intense postoperative pain with a need for early ambulation to gain function and prevent postoperative complications. Compared with femoral nerve block (FNB), adductor canal block (ACB) can relieve postoperative pain and preserve quadriceps muscle strength. This meta-analysis was conducted to investigate which analgesic method provides better pain relief and functional recovery after TKA. METHOD: We conducted a meta-analysis to identify relevant randomized controlled trials involving ACB and FNB after TKA in electronic databases, including Web of Science, Embase, PubMed, and the Cochrane Library, up to November 2016...
May 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28592324/comparison-of-local-infiltration-analgesia-and-sciatic-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#6
Li-Ping Ma, Ying-Mei Qi, Dong-Xu Zhao
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after total knee arthroplasty (TKA). METHODS: A systematic search was performed in MEDLINE (1966-2017.04), PubMed (1966-2017.04), Embase (1980-2017.04), ScienceDirect (1985-2017.04), and the Cochrane Library. Only high-quality studies were selected...
June 7, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28574123/orthogonal-plating-of-vancouver-b1-and-c-type-periprosthetic-femur-fracture-nonunions
#7
Christopher E Birch, Michael Blankstein, Jesse D Chlebeck, Craig S Bartlett Rd
BACKGROUND: Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). METHODS: A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28574117/combined-anteversion-technique-in-total-hip-arthroplasty-for-crowe-iv-developmental-dysplasia-of-the-hip
#8
Biao Zhu, Changzheng Su, Yeteng He, Xingyu Chai, Zhen Li, Zhenyang Hou, Tengteng Lou, Xinfeng Yan
BACKGROUND: A high rate of postoperative dislocation in total hip arthroplasty (THA) for Crowe IV developmental dysplasia of the hip (DDH) has been reported, 1 of the main reasons being higher true acetabular anteversion. If the cup is fixed with normal anteversion, the anterior rim will be excessively exposed, which reduces the contact areas of the cup and bone, affects prosthesis stability, and leads to iliopsoas tendinitis and persistent hip pain after THA. The aim of this study was to demonstrate that when cup anteversion is larger, adjusting femoral anteversion to bring the combined anteversion (CA) into the "safe zone" might prevent dislocation...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28571921/variability-in-static-alignment-and-kinematics-for-kinematically-aligned-tka
#9
Willy Theodore, Joshua Twiggs, Elizabeth Kolos, Justin Roe, Brett Fritsch, David Dickison, David Liu, Lucy Salmon, Brad Miles, Stephen Howell
BACKGROUND: Total knee arthroplasty (TKA) significantly improves pain and restores a considerable degree of function. However, improvements are needed to increase patient satisfaction and restore kinematics to allow more physically demanding activities that active patients consider important. The aim of our study was to compare the alignment and motion of kinematically and mechanically aligned TKAs. METHODS: A patient specific musculoskeletal computer simulation was used to compare the tibio-femoral and patello-femoral kinematics between mechanically aligned and kinematically aligned TKA in 20 patients...
May 29, 2017: Knee
https://www.readbyqxmd.com/read/28566779/pain-management-in-total-knee-arthroplasty-by-intraoperative-local-anesthetic-application-and-one-shot-femoral-block
#10
Aykut Sigirci
BACKGROUND: Pain after total knee arthroplasty (TKA) is a big problem in orthopaedic surgery. Although opioids and continuous epidural analgesia remain the major options for the postoperative pain management of TKA, they have some undesirable side effects. Epidural analgesia is technically demanding, and the patient requires close monitoring. Different types of local anesthetic applications can successfully treat TKA pain. Local anesthetics have the advantage of minimizing pain at the source...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28553448/multicentric-disappearing-bone-disease-treated-with-arthroplasty
#11
C K Chan, Razif-Ma Mohamed, A A Azlina, M M Azhar
Multicentric disappearing bone disease, or Gorham disease, is a rare entity. A middle age woman, presented to us with left sided antalgic gait and severe bony deformity of her left knee. Radiograph revealed massive bone defect of the medial condyle of the left tibia with subluxation of the knee joint. She was scheduled for knee replacement in six months. However, she developed another lesion over the right hip that typically mimicked the disease progression of disappearing bone disease. The right femoral head vanished progressively within three months without significant history of infection or trauma...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#12
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28537354/the-use-of-transcutaneous-electrical-nerve-stimulation-after-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#13
Deepak Ramanathan, Anas Saleh, Alison K Klika, Carlos A Higuera, Wael K Barsoum
INTRODUCTION: Multimodal pain management is used after total knee arthroplasty (TKA) to reduce opioid intake. Transcutaneous electrical nerve stimulation (TENS) has generated much interest as a non-pharmacologic, patient-controlled therapy. The aims of this study were to evaluate the efficacy of TENS in reducing opioid intake and improving recovery after TKA. MATERIALS AND METHODS: This was a prospective, parallel-group, double-blinded, randomized trial of patients receiving femoral nerve catheter block with allocation to either active or placebo TENS device groups...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28530120/osteochondral-allograft-transplantation-and-opening-wedge-tibial-osteotomy-clinical-results-of-a-combined-single-procedure
#14
Albert C Hsu, Luis E P Tirico, Abraham G Lin, Pamela A Pulido, William D Bugbee
Objective To evaluate the outcome of patients who have undergone simultaneous osteotomy and osteochondral allograft (OCA) transplantation. Our hypothesis is that use of high tibial osteotomy and fresh OCA in a combined procedure is safe and effective without increasing morbidity in comparison to OCA alone. Design A case series of 17 patients underwent tibial osteotomy and simultaneous OCA during a single surgery. Osteotomy was indicated when axial alignment was within the affected compartment. Patients had a minimum of 2 years of follow-up after surgery...
May 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28508765/a-comparison-of-outcomes-of-treatment-with-resection-prosthesis-of-the-hip-in-revision-and-oncological-surgery
#15
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Jerzy Mirosław Jaworski, Bogusław Frańczuk
INTRODUCTION: The introduction of resection prostheses paved the way for the development of limb-sparing surgery in patients with primary or metastatic bone tumours. After some time, the developing possibilities of treatment of extensive bone defects allowed for the use of resection prostheses as an emergency procedure in patients undergoing revision surgery due to hip implant loosening. The aim of this paper is to compare treatment outcomes in patients receiving the Modular Universal Tumour and Revision System (MUTARS) resection prosthesis during arthroplasty performed for different indications: treatment of a tumour metastasis and revision surgery in cases of implant loosening...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#16
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28497104/stress-fracture-of-the-lateral-femoral-condyle-after-total-knee-arthroplasty
#17
Mohammad M Sarzaeem, Mahmood Jabalameli
BACKGROUND: This is to assess one of the rare complications after total knee replacement and to assess risk factors of failure. METHODS: 11 patients with varus knee and an average age of 67 years underwent TKA between 2005 and 2013. All patients returned with a sudden sharp knee pain, disability to walk and significant decrease in ROM about 4 to 8 weeks after surgery. Radiographic examination revealed a lateral femoral condylar stress fracture. RESULTS: After analyzing the images, we found common characteristics among all patients, which might be attributable to the later fracture including varus deformity>25, femoral component lateralization, and valgus correction...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#18
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28493040/stability-of-capsule-closure-and-postoperative-anterior-knee-pain-after-medial-parapatellar-approach-in-tka
#19
Armin Keshmiri, Fabian Dotzauer, Clemens Baier, Günther Maderbacher, Joachim Grifka, Ernst Sendtner
PURPOSE: Anterior knee pain after total knee arthroplasty (TKA) remains a widely discussed postoperative complication. In contrast to sports traumatology, the role of the dissected medial patellofemoral ligament (MPFL) using a medial parapatellar approach in TKA has not been discussed so far. In the present study, it was hypothesized that the attempted repair of the MPFL in TKA by simple closure of the joint capsule may not be successful in some cases, causing anterior knee pain. Furthermore, it was hypothesized, that the success of repair might be influenced by femoral component rotation...
May 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28489762/comparison-of-local-infiltration-analgesia-and-sciatic-nerve-block-as-an-adjunct-to-femoral-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#20
REVIEW
Zhi Zhang, Qing Yang, Wenqi Xin, Yixuan Zhang
BACKGROUND: To perform a meta-analysis to assess the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) for pain control following total knee arthroplasty (TKA). METHODS: We systemically searched the following electronic databases for potentially relevant articles: Embase (1980-2017.01), Medline (1966-2017.01), PubMed (1966-2017.01), ScienceDirect (1985-2017.01), web of science (1950-2017...
May 2017: Medicine (Baltimore)
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