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Femoral pain after arthroplasty

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https://www.readbyqxmd.com/read/28215966/does-patient-perception-differ-following-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty-a-simultaneous-bilateral-randomized-study
#1
Hyun J Koh, In J Koh, Man S Kim, Keun Y Choi, Hyeon U Jo, Yong In
BACKGROUND: Femoral nerve block (FNB) has been used as part of the multimodal analgesia after total knee arthroplasty (TKA), but leads to weakness in the quadriceps muscles. Recently, adductor canal block (ACB) was reported to provide effective pain relief while sparing the strength of the quadriceps. This simultaneous bilateral randomized study investigated whether patients perceived differences between ACB and the FNB after same-day bilateral TKA. METHODS: We performed a prospective simultaneous bilateral randomized study in 50 patients scheduled to undergo same-day bilateral TKA...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28211285/can-local-infiltration-analgesia-increase-satisfaction-in-postoperative-short-term-pain-control-in-total-knee-arthroplasty
#2
David Barastegui, I Robert, E Palau, S Haddad, M Reverte-Vinaixa, L Lorente, M Cots
BACKGROUND: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes. OBJECTIVES: Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA. PATIENTS AND METHODS: Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28203021/-comparision-for-clinical-efficiency-of-continuous-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty
#3
M W Zhao, N Wang, L Zeng, M Li, Z K Zhao, H Zhang, H Tian
OBJECTIVE: To compare the pain control efficiency of continuous adductor canal block (ACB) and femoral nerve block (FNB) in total knee arthroplasty. METHODS: From April to September 2016, patients with severe knee osteoarthritis undergoing primary unilateral total knee arthroplasty (TKA) were prospectively observed, and all the patients were randomized received ultrasound-guided continuous ACB or FNB after surgery. Numeric pain rating scales(NPRS)pain scores in rest and activity 2, 6, 12, 24 and 48 h after surgery were collected, and the preoperative and postoperative quadriceps strength at 24 and 48 h were analyzed...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28203020/-effect-of-continuous-femoral-nerve-block-combined-with-periarticular-local-infiltration-analgesia-on-early-operative-functional-recovery-after-total-knee-arthroplasty-a-randomized-double-blind-controlled-study
#4
Y Deng, T L Jiang, X X Yang, M Li, J Wang, X Y Guo
OBJECTIVE: To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA). METHODS: In this randomized, double-blind, controlled study, 100 patients under-going primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled. All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28178436/femoral-versus-multiple-nerve-blocks-for-analgesia-after-total-knee-arthroplasty
#5
Anatoli Stav, Leonid Reytman, Roger Sevi, Michael Yohay Stav, Devorah Powell, Yanai Dor, Mickey Dudkiewicz, Fuaz Bayadse, Ahud Sternberg, Michael Soudry
BACKGROUND: The PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypothesized that preoperative blocking of all four nerves would offer superior analgesia to femoral nerve block alone...
January 30, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28164064/arthroscopic-scar-resection-for-the-treatment-of-anteromedial-knee-pain-after-oxford-unicompartmental-knee-arthroplasty-a-case-report
#6
Kohei Kawaguchi, Kazuhiko Michishita, Takeshi Manabe, Yoshiyuki Akasaka, Naoto Kaminaga
INTRODUCTION: It has been reported that the unicompartmental knee arthroplasty has good long-term outcomes for Western and Japanese patients. Alternatively, several reports have described reoperations after unicompartmental knee arthroplasty because of post-operative knee pain and sometimes it is difficult to diagnose the cause of pain. CASE REPORT: We treated a patient with anteromedial knee pain caused by intra-articular scar tissue that contained residual cement fragments on the anterior surface of a femoral implant following Oxford unicompartmental knee arthroplasty...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#7
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28155838/periprosthetic-metastatic-lesion-in-stem-region-after-tha-case-study
#8
Janusz Płomiński, Artur Pepłoński, Mateusz Jeśkiewicz
The paper describes a periprosthetic metastatic lesion in the stem region which developed 4 years after cementless total hip arthroplasty in a 64-year-old female patient. The patient underwent primary THA due to osteoarthritis in 2010. In June 2014, she presented with increasing hip pain. Diagnostic imaging revealed a periprosthetic osteolytic lesion in the stem region. The patient was referred to the Orthopaedic Department for further evaluation with a suspicion of pyogenic osteomyelitis. An open surgical biopsy was performed...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28116264/failure-of-polyethelene-insert-locking-mechanism-after-a-posterior-stabilised-total-knee-arthroplasty-a-case-report
#9
Gurava Reddy Ay, Soundar Rajan D, Chiranjeevi T, Karthik C, Krishna Kiran E
INTRODUCTION: Disengagement of polyethylene insert used in total knee arthroplasty is a rare but serious complication. Still rarer is disengagement because of failure of tibial insert locking mechanism. We report a previously unpublished complication of polyethylene insert locking mechanism failure in a 10-months-old posterior stabilized total knee arthroplasty in a 70-year-old woman with osteoarthritis for whom Attune (Depuy) knee implant was used. CASE PRESENTATION: A 70-year-old female underwent (Attune, Depuy) primary bilateral posterior stabilised total knee arthroplasty in a private hospital...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28116262/acetabular-prosthetic-protrusio-after-bipolar-hemi-arthroplasty-of-the-hip-case-report-and-review-of-the-literature
#10
Jason Bt Lim, Chia Liang Ang, Hee Nee Pang
INTRODUCTION: Bipolar hemi-arthroplasty of the hip is a commonly performed procedure in elderly patients with intra-capsular fracture of the neck of the femur with good short-term results for pain relief, return to activity and morbidity. The incidence of intra-pelvic prosthesis migration or protrusion is rare and one of the inciting factors is chronic low-grade sepsis. Acetabular prosthesis protrusion poses a difficult and challenging surgical problem due to surrounding neurovascular structures...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28106354/adding-dexmedetomidine-to-ropivacaine-for-femoral-nerve-block-inhibit-local-inflammatory-response
#11
Jing Li, Hanghui Wang, Buhuai Dong, Jianbing Ma, Xucai Wu
BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#12
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/28079176/adductor-canal-block-versus-femoral-nerve-block-for-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#13
Duan Wang, Yang Yang, Qi Li, Shen-Li Tang, Wei-Nan Zeng, Jin Xu, Tian-Hang Xie, Fu-Xing Pei, Liu Yang, Ling-Li Li, Zong-Ke Zhou
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28073138/-long-term-complications-due-to-polyethylene-wear-in-total-knee-arthroplasty-a-case-report
#14
Matthias Aurich
This is the case of an 84-year-old patient 18 years after total knee replacement. Regular follow-up examinations did not take place beyond 10 years of implantation, so that subsequent wear of the polyethylene insert was not detected. The patient presented because of knee pain, swelling of the calf, and a drop foot. Examination showed a large ganglion with pressure on the peroneal nerve, and a loose knee replacement with severe inlay wear and extensive osteolysis around the tibial and femoral implants. This rare case demonstrates the importance of regular clinical and radiological follow-up examinations after total joint replacements, particularly in the long term...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28040319/fracture-of-the-femoral-component-after-a-lightning-strike-injury-a-case-report
#15
Xavier Lizano-Díez, Eduard Alentorn-Geli, Alfonso León-García, Fernando Marqués-López
A fracture of the stem in a total hip arthroplasty (THA) is an uncommon complication. We report a case of femoral stem fracture in a 55-year-old male patient after a lightning strike. A revision was conducted using a Wagner osteotomy and a revision prosthesis. Dall-Milles cerclages were used to close the osteotomy. The postoperative evolution was satisfactory, with an immediate partial weight bearing, consolidation of the osteotomy after three months and return to daily activity without pain.
January 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28031500/acetabular-revision-with-bone-grafting-and-cementation-for-aseptic-loosening-after-primary-charnley-low-friction-hip-arthroplasty-with-structural-bulk-autografts
#16
Riazuddin Mohammed, Efstathios Drampalos, Paul Siney, Bodo Purbach, Peter Kay
PURPOSE: To review the outcome of acetabular revision with bone grafting and cementation for aseptic loosening after primary Charnley low-friction hip arthroplasty with structural bulk autografts in 15 patients. METHODS: Records were reviewed for 3 men and 12 women aged 31 to 72 (mean, 53) years who underwent acetabular revision with bone grafting and cementation for aseptic loosening at a mean of 12.4 (range, 6.6-20.3) years after primary Charnley low-friction hip arthroplasty with superolateral structural bulk autografts from the femoral head for dysplastic hip (n=14) or bone loss secondary to acetabular fracture (n=1)...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28031498/distal-femoral-cortical-hypertrophy-after-hip-arthroplasty-using-a-cementless-doubletapered-femoral-stem
#17
Yoon Je Cho, Young Soo Chun, Kee Hyung Rhyu, Jong Hun Baek, Hu Liang
PURPOSE: To review 437 hips in 404 patients who underwent total hip arthroplasty (THA) or hemiarthroplasty using the Accolade TMZF stem to determine the incidence and risk factors of distal femoral cortical hypertrophy (DFCH). METHODS: Records of 437 hips in 169 men and 235 women aged 26 to 100 (mean, 65.7) years who underwent THA (n=293) or hemiarthroplasty (n=144) using the Accolade TMZF femoral stem by 2 senior surgeons and were followed up for a mean of 54.7 months were reviewed...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28028570/comparable-outcomes-after-total-knee-arthroplasty-in-patients-under-55%C3%A2-years-than-in-older-patients-a-matched-prospective-study-with-minimum-follow-up-of-10%C3%A2-years
#18
Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Francisco A Miralles-Muñoz, Luis Marco-Gómez, Fernando A Lopez-Prats
PURPOSE: To compare outcomes after TKA for osteoarthritis between patients younger than 55 years and older patients. METHODS: A cohort of 61 patients aged 55 years or younger was prospectively matched for gender, body mass index and knee function with patients with median age of 66 (range 60-70) years. Clinical evaluation was performed by the Knee Society scores (KSS), reduced Western Ontario and McMasters Universities (WOMAC) and Short-Form 12 (SF12) questionnaires...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28005142/no-correlation-between-coronal-alignment-of-total-knee-arthroplasty-and-clinical-outcomes-a-prospective-clinical-study-using-3d-ct
#19
Omer Slevin, Felix Amsler, Michael T Hirschmann
PURPOSE: The aim of this study was to evaluate femoral and tibial as well as whole leg coronal TKA alignment using 3D-reconstructed CTs and to assess the relationship of coronal TKA alignment and clinical outcome in a large prospective series of patients. It was hypothesized that a coronal deviation of TKA position and leg alignment from the mechanical axis is correlated with poorer patients' outcome after TKA. METHODS: A total of 81 consecutive patients who underwent primary TKA were prospectively included...
December 22, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28005122/opioid-sparing-pain-control-in-outpatient-total-joint-arthroplasty
#20
John W Barrington
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks...
November 2016: American Journal of Orthopedics
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