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Pain after arthroplasty

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https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#1
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033152/intraoperative-infiltration-of-liposomal-bupivacaine-vs-bupivacaine-hydrochloride-for-pain-management-in-primary-total-hip-arthroplasty-a-prospective-randomized-trial
#2
Itay Perets, John P Walsh, Brian H Mu, Leslie C Yuen, Lyall Ashberg, Muriel R Battaglia, Benjamin G Domb
BACKGROUND: Pain management after total hip arthroplasty is well studied. Nevertheless, there is no consensus regarding the "cocktail" to use in periarticular infiltration (PAI). Liposomal bupivacaine (LB) is a slow release local anesthetic that can be infiltrated during surgery. In this study, we compared LB to bupivacaine hydrochloride (HCL). METHODS: Between September 2014 and March 2016, 181 patients were screened for this prospective randomized trial. A total of 107 patients were enrolled and studied...
September 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29032916/combination-of-magnesium-sulphate-and-ropivacaine-epidural-analgesia-for-hip-arthroplasty-in-dogs
#3
Elena Lardone, Bruno Peirone, Chiara Adami
OBJECTIVE: The aim of this study was to determine whether lumbosacral epidural administration of magnesium sulphate added to ropivacaine prolongs and improves perioperative analgesia, without adverse effects on motor block duration or hind limb neurological function, in dogs undergoing hip arthroplasty. STUDY DESIGN: Investigator-blind, controlled, randomized, prospective clinical trial. ANIMALS: A group of 20 client-owned dogs undergoing hip arthroplasty were allocated randomly to either group C (control, 1 mg kg(-1)epidural ropivacaine) or group M (magnesium, epidural injection of 1 mg kg(-1) ropivacaine and 2 mg kg(-1)magnesium sulphate)...
June 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29030656/-pyoderma-gangraenosum-after-implantation-of-a-shoulder-endoprothesis
#4
M A Domej, L Pauzenberger, P R Heuberer, W Anderl
Pyoderma gangrenosum is an inflammatory, ulcerative, neutrophilic dermatosis that is clinically characterized by rapidly evolving, painful, necrotic skin lesions. It is typically associated with chronic systemic inflammatory or neoplastic diseases, but may also occur secondary to cutaneous injury or surgery (pathergy). Post-surgical pyoderma gangrenosum typically develops around surgical sites within the immediate postoperative period, mimicking early wound infection. However, common treatment strategies including antibiotics and debridement fail to improve or even worsen symptoms...
October 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29030095/postoperative-rehabilitation-following-thumb-base-surgery-a-systematic-review-of-the-literature
#5
REVIEW
Robbert M Wouters, Jonathan Tsehaie, Steven E R Hovius, Burcu Dilek, Ruud W Selles
OBJECTIVE: To provide an overview of rehabilitation for patients who underwent CMC-1 arthroplasty, with emphasis on early active mobilization. DATA SOURCES/STUDY SELECTION: PubMed/MEDLINE, Embase, CINAHL and Cochrane were searched for articles written in English that described postoperative regime (including immobilization period/method and/or description of exercises/physical therapy, follow-up ≥six weeks) on CMC-1 arthroplasty. DATA EXTRACTION: The PRISMA statement was used as guidance in this review and methodological quality was assessed using the Effective Public Health Practice Project quality assessment tool...
October 10, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29028624/foot-pressure-pattern-hindfoot-deformities-and-their-associations-with-foot-pain-in-individuals-with-advanced-medial-knee-osteoarthritis
#6
Isao Saito, Kyoji Okada, Masahiko Wakasa, Hidekazu Abe, Akira Saito
This survey clarified foot pressure patterns and hindfoot deformities in individuals with advanced knee osteoarthritis (OA) and analyzed their associations with foot pain. Sixty-four individuals with unilateral knee OA who underwent total knee arthroplasty (TKA) were divided into the following groups: no foot pain (n=26; men:women, 4:22; mean age, 73.7 years), foot pain resolved after TKA (12; 2:10; 75.8), and foot pain remaining after TKA (26; 4:22; 74.7). Elderly individuals without pain or deformity in either knee (54; 10:44; 74...
October 6, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29026333/analgesic-efficacy-and-safety-of-epidural-oxycodone-in-patients-undergoing-total-hip-arthroplasty-a-pilot-study
#7
Bogumił Olczak, Grzegorz Kowalski, Wojciech Leppert, Agnieszka Bienert, Artur Teżyk, Michał Adamski, Stanisław Rzymski, Katarzyna Wieczorowska-Tobis
BACKGROUND AND OBJECTIVES: Oxycodone is poorly studied as an adjuvant to central blockades. The aim of this pilot study was to assess the efficacy and safety of oxycodone hydrochloride in epidural blockade among patients undergoing total hip arthroplasty (THA). PATIENTS AND METHODS: In 11 patients (American Society of Anesthesiologists physical status classification system II/III, age range: 59-82 years), THA was conducted with an epidural blockade using 15 mL 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29025528/-evaluation-of-the-function-and-quality-of-life-after-total-hip-arthroplasty-by-different-approaches
#8
Paulo Araújo, Luís Machado, Duarte Cadavez, Lisete Mónaco, Filipa Januário, Lisete Luís, Mafalda Bártolo
INTRODUCTION: To assess the function and quality of life in patients undergoing total hip arthroplasty distinguishing two surgical approaches (posterior / anterolateral) used by the Orthopedics department of Centro Hospitalar de Leiria. MATERIAL AND METHODS: Retrospective study of 94 patients subject to unilateral hip replacement surgery, using the 'Hip Osteoarthritis Outcome Score' (HOOS LK 2.0) questionnaire, the Trendelenburg test and evaluation of muscle strength of the hip abductor muscles with dynamometer...
September 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29017803/increasing-perioperative-communication-with-automated-mobile-phone-messaging-in-total-joint-arthroplasty
#9
Molly A Day, Christopher A Anthony, Nicholas A Bedard, Natalie A Glass, Charles R Clark, John J Callaghan, Nicolas O Noiseux
BACKGROUND: Automated mobile phone messaging has not been reported in total joint arthroplasty (TJA). Our purpose was to compare Press Ganey (PG) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores between TJA patients who did and did not receive perioperative automated mobile phone messages. METHODS: Patients were prospectively enrolled and received messages for 1 week prior until 2 weeks after TJA. Message content included reminders, activity, and pain control...
September 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28993082/noncemented-total-hip-arthroplasty-in-sickle-cell-disease-long-term-results
#10
Imran Ilyas, Husam A Alrumaih, Samar Rabbani
BACKGROUND: Avascular necrosis of the femoral head is a well-known sequela of sickle-cell disease (SCD) requiring a surgical intervention that comes with technical challenges. METHODS: Uncemented hip arthroplasty for avascular necrosis of the femoral head due to SCD was carried out for 101 patients (133 hips) between 2000 and 2012. The duration of follow-up ranged from 5 to 17 years (mean, 14.59 years). All patients received a noncemented femoral stem and a noncemented acetabular shell...
September 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28986675/does-the-grading-of-chondromalacia-patellae-influence-anterior-knee-pain-following-total-knee-arthroplasty-without-patellar-resurfacing
#11
Guo-Chun Zha, Shuo Feng, Xiang-Yang Chen, Kai-Jin Guo
OBJECTIVES: The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing. METHODS: We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28984654/joint-denervation-in-the-digits-technique-and-patient-satisfaction
#12
Russell J Madsen, Lindsay A Stone, Jeremiah B Knapp, Joel S Solomon
BACKGROUND: Traditional approaches to treating painful osteoarthritis of the fingers include arthrodesis and arthroplasty. Although highly effective for pain control, arthrodesis sacrifices joint motion and can be complicated by nonunion, malunion, and infection.Implant arthroplasty preserves motion but is likewise subject to complications-particularly at the level of the proximal interphalangeal joint. In contrast, finger joint denervation is a simple outpatient procedure that maintains joint motion...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28984095/the-addition-of-continuous-wound-infusion-of-local-anaesthetics-to-local-infiltration-in-the-management-of-postoperative-pain-and-rehabilitation-after-total-hip-arthroplasty-a-double-blind-randomized-controlled-trial
#13
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Maurizio Fiorenzi, Giuseppe Paladini, Astrid U Behr, Battista Borghi, Stefano Flamini, Renzo Pizzoferrato, Olivo Colafarina, Alexander DI Francesco, Tito Tabacco, Stefano Necozione, Franco Marinangeli
BACKGROUND: Total hip arthroplasty is one of the most common procedures in orthopaedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anaesthetics in the first 72 h after surgery could provide more effective postoperative analgesia with better rehabilitation. METHODS: A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anaesthetics or a local infiltration analgesia and continuous wound infusion of saline solution...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28983666/assessment-of-reliability-validity-responsiveness-and-minimally-important-change-of-the-german-hip-dysfunction-and-osteoarthritis-outcome-score-hoos-in-patients-with-osteoarthritis-of-the-hip
#14
Dariusch Arbab, Johannes H M van Ochten, Christoph Schnurr, Bertil Bouillon, Dietmar König
Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability...
October 5, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28979607/application-of-tranexamic-acid-in-total-knee-arthroplasty-prospective-randomized-trial
#15
Joao Paulo Fernandes Guerreiro, Bruno Scatolon Badaro, Jose Rodolfo Martines Balbino, Marcus Vinicius Danieli, Alexandre Oliveira Queiroz, Daniele Cristina Cataneo
BACKGROUND: The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has shown good results. Bleeding may cause local complications consequently greater pain and reduced function postoperatively. No study has related the use of TXA to these facts. OBJECTIVE: The aim was to evaluate the effects of TXA haemoglobin, Western Ontario and McMaster Universities Index (WOMAC), pain intensity and flexion gain after TKA. METHODS: 43 patients were randomized and then underwent TKA...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28975848/bioabsorbable-poly-l-d-lactide-96-4-scaffold-arthroplasty-regjoint%C3%A2-for-trapeziometacarpal-osteoarthritis-a-3-year-follow-up-study
#16
Simo Mattila, Mari Ainola, Eero Waris
The poly-L/D-lactide joint scaffold (RegJoint™) has recently been associated with adverse tissue reactions and osteolysis after partial trapeziectomy for trapeziometacarpal osteoarthritis. Twenty-two of 23 patients previously operated on with this scaffold were re-examined at a mean follow-up of 3.3 years (range 36-53 months). Overall, the results showed an unacceptably high rate of adverse tissue reactions related to the degradation process of the implant, resulting in a revision procedure in three patients...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28975843/long-term-follow-up-of-capsular-interposition-arthroplasty-for-hallux-rigidus
#17
Ettore Vulcano, Andy L Chang, David Solomon, Mark Myerson
BACKGROUND: Capsular interposition arthroplasty is a joint- and motion-sparing procedure that has been shown as an effective alternative to fusion. This study aimed to evaluate patient function and satisfaction after long-term follow-up. METHODS: Sixty-four patients were treated with capsular interposition arthroplasty for hallux rigidus by the senior author performed between February 1998 and July 2011. Twenty-two patients could not be reached for follow-up and were thus excluded from the analysis...
October 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28975074/cooled-radiofrequency-ablation-of-genicular-nerves-for-knee-osteoarthritis-pain-a-protocol-for-patient-selection-and-case-series
#18
Rajiv D Reddy, Zachary L McCormick, Ben Marshall, Ryan Mattie, David R Walega
BACKGROUND: Chronic knee pain from osteoarthritis (OA) is common in the aging and the obese population. Radiofrequency ablation of the genicular nerves has been introduced as a potential surgery-sparing treatment for chronic knee pain from OA, yet only two outcome studies have been published and optimal patient selection for this procedure has not been established. OBJECTIVES: We describe a standardized protocol for selecting patients for cooled radiofrequency ablation (C-RFA) of the genicular nerves, as well as the clinical outcomes of four patients ages 63-65 years...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28974398/differences-in-patellofemoral-alignment-as-a-result-of-patellar-shape-in-cruciate-retaining-total-knee-arthroplasty-without-patellar-resurfacing-at-a-minimum-three-year-follow-up
#19
Atsuo Inoue, Yuji Arai, Shuji Nakagawa, Hiroaki Inoue, Yasushi Yoshihara, Shouichi Yamazoe, Toshikazu Kubo
BACKGROUND: Although the patellofemoral (PF) joint shape of the femoral implant in a particular prosthetic design is identical, the articular surface shape of the patella varies between individuals. The present study investigated the effects of patellar shape on the postoperative PF joint in a cruciate-retaining total knee arthroplasty (CR-TKA) without patellar resurfacing and with at least three years of follow-up. METHODS: This study investigated 76 knees of 62 patients who underwent CR-TKA without patellar resurfacing for varus osteoarthritis...
September 30, 2017: Knee
https://www.readbyqxmd.com/read/28974377/persistent-opioid-use-following-total-knee-arthroplasty-a-signal-for-close-surveillance
#20
Robert S Namba, Maria C S Inacio, Nicole L Pratt, Stephen E Graves, Elizabeth E Roughead, Elizabeth W Paxton
BACKGROUND: Prolonged opioid use following total knee arthroplasty (TKA) has not been extensively studied. METHODS: A cohort study of primary TKA for osteoarthritis using an integrated healthcare system and Total Joint Replacement Registry (January 2008-December 2011) was conducted. Opioid use during the first year after TKA was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total postsurgical OME per 90-day exposure periods were categorized into quartiles...
September 13, 2017: Journal of Arthroplasty
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