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Femoral pain after arthroplasty

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https://www.readbyqxmd.com/read/28326419/bilateral-atypical-femoral-fracture-and-end-stage-arthritis-of-the-hip-treated-with-total-hip-arthroplasty
#1
Scott M Sandilands, Jesus M Villa, Carlos J Lavernia
The prolonged use of bisphosphonates has been associated with an increased rate of atypical femoral fracture. A 77-year-old woman with prolonged bisphosphonate use presented to our office with groin pain and end-stage arthritis, She was scheduled for a total hip replacement. Before the surgery and with minimal trauma, the patient then suffered a displaced atypical femoral fracture. She underwent a total hip replacement as a treatment for her fracture and her arthritis. Subsequently, the patient presented with pain in the contralateral thigh with an incomplete atypical femoral fracture...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326400/staged-total-hip-arthroplasty-in-a-patient-with-hip-dysplasia-and-a-large-pertrochanteric-bone-cyst
#2
Joseph R Langston, Alexander M DeHaan, Thomas W Huff
Hip arthroplasty in young patients requires thoughtful preoperative planning. Patients with proximal femoral bone loss complicate this planning and may require a staged procedure to optimize implant insertion. We report on a case of a 26-year-old woman with secondary hip arthritis from developmental dysplasia of the hip and a large pertrochanteric bone cyst that was treated with staged total hip arthroplasty. The cyst was decompressed and filled with an osteoconductive and osteoinductive bone graft substitute called EquivaBone...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#3
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28289001/presentation-of-calcinosis-cutis-universalis-in-mixed-connective-tissue-disorder-an-encounter-during-hip-arthroplasty
#4
Munis Ashraf, Krishnanunni Gopikrishnan, Balaji Umamahesvaran, Senthil Nathan Sambandam
A woman aged 23 years with a diagnosis of mixed connective tissue disorder presented with left groin pain extending over 6 months. Workup revealed avascular necrosis of the femoral head (Grade 3) secondary to systemic lupus erythematosus and chronic steroid intake. An uncemented total hip arthroplasty was considered as the patient was only in the third decade of life. During the preop workup, careful clinical assessment had revealed multiple subcutaneous nodules affecting the extensor musculature limited to the gluteal region, anterior and posterior aspects of the thigh...
March 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#5
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28273133/postoperative-pain-treatment-after-total-knee-arthroplasty-a-systematic-review
#6
Anders Peder Højer Karlsen, Mik Wetterslev, Signe Elisa Hansen, Morten Sejer Hansen, Ole Mathiesen, Jørgen B Dahl
INTRODUCTION: The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). METHODS: This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication-based analgesic interventions after TKA. Bias was evaluated according to Cochrane methodology. Outcomes were opioid consumption (primary), pain scores at rest and during mobilization, adverse events, and length of stay...
2017: PloS One
https://www.readbyqxmd.com/read/28261427/causes-of-aseptic-persistent-pain-after-total-knee-arthroplasty
#7
Hong-An Lim, Eun-Kyoo Song, Jong-Keun Seon, Kyung-Soon Park, Young-Joo Shin, Hong-Yeol Yang
BACKGROUND: Persistent pain after total knee arthroplasty (TKA) is dissatisfying to the patient and frustrating to the surgeon. The purpose of this study is to evaluate the aseptic causes and clinical course of intractable pain following TKA. METHODS: Of the total 2,534 cases of primary TKA reviewed, 178 cases were classified as having aseptic persistent pain that was not resolved within 1 year after surgery. Except for the cases with periprosthetic fracture (56 knees), 122 cases of aseptic painful TKA were divided into two groups: intra-articular group (83 knees) and extra-articular group (39 knees)...
March 2017: Clinics in Orthopedic Surgery
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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