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Pain after arthroplasty

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https://www.readbyqxmd.com/read/28345414/fresh-osteochondral-allograft-transplantation-for-fractures-of-the-knee
#1
Guilherme C Gracitelli, Luis Eduardo Passarelli Tirico, Julie C McCauley, Pamela A Pulido, William D Bugbee
Objective The purpose of this study was to evaluate functional outcomes and allograft survivorship among patients with knee fracture who underwent fresh osteochondral allograft (OCA) transplantation as a salvage treatment option. Design Retrospective analysis of prospectively collected data. Setting Department of Orthopaedic Surgery at one hospital. Patients Fresh OCAs were implanted for osteochondral lesions after knee fracture in 24 males and 15 females with an average age of 34 years. Twenty-nine lesions (74%) were tibial plateau fractures, 6 (15%) were femoral condyle fractures, and 4 (10%) were patella fractures...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28343822/the-new-surgical-technique-for-improving-total-knee-and-hip-arthroplasty-outcomes-patient-selection
#2
Kevin Magone, Bernard P Kemker, Nataliya Pilipenko, Erin O'Connor, Norman Walter, Theresa Atkinson
BACKGROUND: Inclusion of patient satisfaction scores in setting reimbursements has been suggested by health care policy makers to contain cost and improve outcomes. The Short Form 36 Health Survey (SF-36) score provides a health-related quality of life (HRQoL) measure of arthroplasty outcome. Although previous work identified factors that influence this score for hip and knee arthroplasty patients, they did not focus on how a surgeon might use this information in a clinical setting. The present study examined whether relatively simple criteria might identify patients more likely to experience minimal HRQoL improvement...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343821/use-of-chronic-methadone-before-total-knee-arthroplasty
#3
Ferdinand J Chan, Andrew M Schwartz, Jason Wong, Cynthia Chen, Bharat Tiwari, Sun Jin Kim
BACKGROUND: A subset of patients who undergo total knee arthroplasty (TKA) are on methadone maintenance. They require more and often unpredictable quantities of opioids to function as effective painkillers. This study aims to compare the opioid requirements and the immediate postoperative course for patients on methadone maintenance with those who are not, after a TKA. METHODS: A retrospective, case-control study was performed. From 2005 to 2010, 36 patients, who underwent a unilateral TKA, on chronic methadone maintenance were identified...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28341878/sports-activity-is-maintained-or-increased-following-total-knee-arthroplasty
#4
Caroline Hepperger, Peter Gföller, E Abermann, Christian Hoser, Hanno Ulmer, Elmar Herbst, Christian Fink
PURPOSE: The purpose of this study was to investigate sports activities and functional abilities in patients following total knee arthroplasty (TKA). It was hypothesized that patients who had undergone TKA would return to a higher activity level as that experienced preoperatively. METHODS: Two hundred patients were included in this prospective single-cohort study. All the patients completed subjective questionnaires (Tegner Activity Level, Oxford Knee Score, Visual Analog Scale for pain) prior to surgery as well as at 6, 12, and 24 months postoperatively...
March 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28341088/the-latest-treatment-strategy-for-the-rheumatoid-hand-deformity
#5
Hajime Ishikawa
With a remarkable improvement in the pharmacotherapy of rheumatoid arthritis (RA), severely handicapped patients are very rare to see. Healing, repair and drug-free, and toward radical cure are coming to be possible. In the clinical practice, more than 50% of the patients are in remission. However, some patients are still difficult to reach remission due to comorbidities and economic burden. In the patient with clinical remission, smoldering synovitis so called "silent destructor" is often detected by ultrasonograpy or by synovial histology in the small joints of the hand...
March 22, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28340617/the-efficacy-of-pregabalin-for-the-management-of-postoperative-pain-in-primary-total-knee-and-hip-arthroplasty-a-meta-analysis
#6
REVIEW
Fei Li, Jianxiong Ma, Mingjie Kuang, Xuan Jiang, Ying Wang, Bin Lu, Xingwen Zhao, Lei Sun, Xinlong Ma
OBJECTIVE: A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy of pregabalin for the management of postoperative pain in patients undergoing primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA). METHOD: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. RevMan 5.3 software was selected to conduct the meta-analysis...
March 24, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28340610/the-importance-of-informational-clinical-and-personal-support-in-patient-experience-with-total-knee-replacement-a-qualitative-investigation
#7
Laurie J Goldsmith, Nitya Suryaprakash, Ellen Randall, Jessica Shum, Valerie MacDonald, Richard Sawatzky, Samar Hejazi, Jennifer C Davis, Patrick McAllister, Stirling Bryan
BACKGROUND: Total knee arthroplasty (TKA) is the most frequently performed joint replacement surgery in North America. Patient perspectives on TKA have been investigated in various ways, including finding as many as 20% of TKA patients are dissatisfied with their surgical outcomes. Understanding the patient experience with TKA broadly and in relation to patient satisfaction is a key gap in existing literature. METHODS: We report on the qualitative component of a mixed methods prospective cohort study examining patient experience and satisfaction post-TKA for adults in British Columbia, Canada...
March 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28339430/comparative-effectiveness-review-of-cooled-versus-pulsed-radiofrequency-ablation-for-the-treatment-of-knee-osteoarthritis-a-systematic-review
#8
Anita Gupta, Daniel P Huettner, Matthew Dukewich
BACKGROUND: Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. OBJECTIVE: This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337729/adjacent-level-disease-background-and-update-based-on-disc-replacement-data
#9
REVIEW
I David Kaye, Alan S Hilibrand
PURPOSE OF REVIEW: The precise etiology of adjacent segment disease following cervical spine surgery is controversial. Theories for development include inevitable changes secondary to the natural progression of the degenerative cascade and changes secondary to altered biomechanics of the fused cervical spine. Motion preserving techniques, such as cervical disc arthroplasties (CDA), have been introduced with the hopes of reducing the rates of adjacent segment pathology. Recently, 7-year data from the investigational device exemption (IDE) studies have been published...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#10
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28328836/the-efficacy-of-periarticular-drug-infiltration-for-postoperative-pain-after-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#11
Yanyang Wang, Fuqiang Gao, Wei Sun, Bailiang Wang, Wanshou Guo, Zirong Li
BACKGROUND: The ability of intraoperative periarticular drug infiltration (PDI) to control pain after total hip arthroplasty (THA) has been studied for many times, but it still remains controversial. Therefore, we undertook a meta-analysis to evaluate the efficacy and safety of PDI on postoperative pain after THA. METHODS: Databases, including Pubmed, Medline, Embase, Web of Science, and Cochrane library, were searched to identify randomized controlled trials concerning PDI for pain management in patients undergoing THA...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28327167/optimal-release-timing-of-temporary-drain-clamping-after-total-knee-arthroplasty
#12
Yoon Sang Jeon, Jun Sung Park, Myung Ku Kim
BACKGROUND: Bleeding control is critical after total knee arthroplasty (TKA). The purpose of this study was to evaluate the optimal time to release the clamped drain after TKA. METHODS: We performed unilateral TKA in 120 patients using three methods of drainage. Group A (N = 40) had a 3-hour clamp applied, and group B (N = 40) had a 4-hour clamp applied. Group C (N = 40) underwent conventional negative drainage. We evaluated the drainage volume, as well as the hemodynamic markers, transfusion volume, visual analog scale (VAS) scores, and range of motion (ROM)...
March 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28327133/improved-knee-biomechanics-among-patients-reporting-a-good-outcome-in-knee-related-quality-of-life-one-year-after-total-knee-arthroplasty
#13
Josefine E Naili, Per Wretenberg, Viktor Lindgren, Maura D Iversen, Margareta Hedström, Eva W Broström
BACKGROUND: It is not well understood why one in five patients report poor outcomes following knee arthroplasty. This study evaluated changes in knee biomechanics, and perceived pain among patients reporting either a good or a poor outcome in knee-related quality of life after total knee arthroplasty. METHODS: Twenty-eight patients (mean age 66 (SD 7) years) were included in this prospective study. Within one month of knee arthroplasty and one year after surgery, patients underwent three-dimensional (3D) gait analysis, completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), and rated perceived pain using a visual analogue scale...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28326419/bilateral-atypical-femoral-fracture-and-end-stage-arthritis-of-the-hip-treated-with-total-hip-arthroplasty
#14
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: Arthroplast Today
https://www.readbyqxmd.com/read/28326407/instability-of-the-proximal-tibiofibular-joint-associated-with-total-knee-arthroplasty
#15
Martin Bédard, Simon Corriveau-Durand
To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA). We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis. The patient's history includes a fracture of the left lateral tibial plateau in 2008 and removal of osteosynthesis material in 2009. TKA with a lateral metal augment and intramedullary stem was performed in 2010...
September 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28326400/staged-total-hip-arthroplasty-in-a-patient-with-hip-dysplasia-and-a-large-pertrochanteric-bone-cyst
#16
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: Arthroplast Today
https://www.readbyqxmd.com/read/28326397/fracture-of-an-uncemented-tantalum-patellar-component
#17
Nathan L Grimm, Robert A Henderson, Joseph J Kavolus, Patrick D Millikan, Paul F Lachiewicz
A 62-year-old man presented with the acute, atraumatic onset of pain 3 years after uncemented right total knee arthroplasty. He complained of new mechanical locking with the knee held in extension on examination and unable to flex the knee. On the plain radiographs, the patellar component peg was fractured and the plate was dislocated. The knee was immobilized, and revision to a cemented 3-peg component was performed. Fracture of a single-peg, tantalum-backed uncemented patellar component has not been described...
June 2016: Arthroplast Today
https://www.readbyqxmd.com/read/28323139/inflammation-and-post-operative-recovery-in-patients-undergoing-total-knee-arthroplasty-secondary-analysis-of-a-randomized-controlled-trial
#18
Anne Langkilde, Thomas Linding Jakobsen, Thomas Quaade Bandholm, Jesper Eugen-Olsen, Thomas Blauenfeldt, Janne Petersen, Ove Andersen
OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial of physical rehabilitation +/- progressive strength training (PST). We aimed to investigate whether A) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; B) PST affects inflammation, and the inflammatory state over time; C) baseline or surgery-induced inflammation modifies the effect of rehabilitation +/- PST on change in 6-minute walk test (Δ6MWT); and D) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA...
March 16, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28320421/effectiveness-of-a-physiotherapist-delivered-cognitive-behavioral-patient-education-for-patients-who-undergoes-operation-for-total-knee-arthroplasty-a-protocol-of-a-randomized-controlled-trial
#19
Sara Birch, Maiken Stilling, Inger Mechlenburg, Torben Bæk Hansen
BACKGROUND: Total Knee Arthroplasty (TKA) is a common and generally effective procedure performed mainly due to advanced osteoarthritis, pain, physical disability and reduced quality of life. However, approximately 20% of the patients respond poorly to the surgery and chronic pain and disability following TKA remains a major health burden for many patients. Among the most well documented and powerful psychological predictors of poor outcome following TKA is pain catastrophizing. Recent research has shown that patients with these thoughts are at higher risk of having persistent pain and lower physical function after the operation than patients with low levels of pain catastrophizing before TKA...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28318865/anterior-vs-posterior-periarticular-multimodal-drug-injections-a-randomized-controlled-trial-in-simultaneous-bilateral-total-knee-arthroplasty
#20
Artit Laoruengthana, Piti Rattanaprichavej, Supachok Rasamimongkol, Monton Galassi
BACKGROUND: Currently, various techniques are used to overcome postoperative pain after total knee arthroplasty. A local analgesic infiltration with periarticular multimodal drug injection (PMDI) is favorable because of its simplicity, safety, and efficacy. The present study compared the efficacy of a PMDI at the anterior vs posterior compartments. METHODS: Forty-six patients were randomized to receive the PMDI at either the anterior or posterior compartment, with the contralateral knee receiving the PMDI at the opposite compartment...
February 24, 2017: Journal of Arthroplasty
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