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Femoral pain after arthroplasty

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https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#1
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
#2
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
#3
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
#4
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.
December 28, 2016: 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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27935925/clinical-evaluation-of-fused-ankylosed-hip-with-severe-flexion-deformity-after-conversion-to-total-hip-arthroplasty
#10
S K Suwal, P Songming, L Gang, H Kui
INTRODUCTION: Fused or Ankylosed hip is late complication of chronic inflammatory disorder with progressive changes in and around articular as well as periarticular structures with alteration in bio-force line of body which later lead to severe flexion deformity of joint. This not only results decreased movements of hip, it's also increase pain around the hip, back and contralateral hip. METHODS: Retrospectively, all patients aged 18 years or older undergoing THA between June 2006 to June 2012 were reviewed with selection criteria...
April 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27932436/multifactorial-pathological-hip-subluxation-in-neurofibromatosis-type-1-nf1-due-to-intra-articular-plexiform-neurofibroma-lumbar-radiculopathy-and-neurofibromatous-polyneuropathy
#11
Waqar Waheed, Diego F Diego F Lemos, Nelms Nathaniel Nelms, Rup Tandan
Neurofibromatosis type-1 (NF1) is a multisystem disorder with very rare descriptions of hip instability. We report a case of a 37-year-old man with known NF1 and childhood-onset of left foot drop, who developed persistent left hip pain following a minor trauma. Physical examination revealed left-sided mild foot drop, hip abductor weakness, bilateral sensory loss in feet and an antalgic gait. Work-up revealed anterolateral subluxation of the left femoral head along with left hip plexiform neurofibroma (PN), dysplastic and degenerative changes, neurofibromatous neuropathy and chronic left L5 radiculopathy...
December 8, 2016: BMJ Case Reports
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
#12
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
#13
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/27871547/adductor-canal-block-for-knee-surgical-procedures-review-article
#14
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/27863919/direct-lateral-vs-posterolateral-approach-to-hemiarthroplasty-for-femoral-neck-fractures
#15
S Mukka, S Mahmood, B Kadum, O Sköldenberg, A Sayed-Noor
INTRODUCTION: Adopting the direct lateral (DL) instead of the posterolateral (PL) approach in hip arthroplasty for femoral neck fracture (FNF) patients could lower the rate of prosthetic dislocation. However, little is known about how the approach influences the functional outcome. HYPOTHESIS: We hypothesized that both approaches would give comparable results. MATERIAL AND METHODS: In a prospective cohort study, we enrolled 185 hips (183 patients, 128 women, median age 84 years) with a displaced FNF...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27857822/revision-of-metal-on-metal-hip-arthroplasty-with-well-fixed-and-positioned-acetabular-component-using-a-dual-mobility-head-and-review-of-literature
#16
Guillem Figueras, Ramón Vives Planell, Ramón Serra Fernàndez, Joan Camí Biayna
BACKGROUND: As a consequence of use of metal-on-metal hip arthroplasties some patients have precised revision for pain or metal hipersensivity reactions among other causes. We propose to salvage monoblock acetabular component and femoral component using a dual-mobility head and perform a lower morbidity operation in young patients preserving host bone stock in cases with well fixed and positioned components. OBJECTIVE: (1) What clinical problems have been reported in patients with Metal-on-metal hip arthroplasties? (2) Could the tribocorrosion potentially cause a fracture of neck femoral component? (3) Can be the dual-mobility head a recourse in metal-on-metal hip revision? METHODS: Ten patients were revised for pain or/and raised Cobalt/Chromium levels between August 2012 and December 2015...
2016: Open Orthopaedics Journal
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
#17
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...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27787383/short-stem-prostheses-in-primary-total-hip-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#18
Shao-Chuan Huo, Fan Wang, Lu-Jue Dong, Wei Wei, Jing-Qi Zeng, Hong-Xing Huang, Qing-Min Han, Rui-Qi Duan
BACKGROUND: Short-stem (SS) prostheses require less resection of the femoral neck, produce a more physiological load pattern in the proximal femur, reduce stress shielding, and aid bone conservation and are, therefore, beneficial for young patients. Conventional cementless implants in total hip arthroplasty (THA) have shown excellent clinical results; however, it is unclear whether SS prostheses can obtain the same clinical and radiological outcomes. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate whether SS prostheses are superior to conventional implants after primary THA...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27752378/delayed-femoral-nerve-palsy-associated-with-iliopsoas-hematoma-after-primary-total-hip-arthroplasty
#19
Sandeep Kumar, Gerald Pflueger
Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27749351/optimizing-pain-and-rehabilitation-after-knee-arthroplasty-a-two-center-randomized-trial
#20
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
November 2016: Anesthesia and Analgesia
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