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Pain after arthroplasty

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https://www.readbyqxmd.com/read/29931392/modified-robert-jones-bandage-can-not-reduce-invisible-blood-loss-after-total-knee-arthroplasty-a-randomized-controlled-trial
#1
Chaturong Pornrattanamaneewong, Pakpoom Ruangsomboon, Keerati Chareancholvanich, Vajara Wilairatana, Rapeepat Narkbunnam
INTRODUCTION: To compare the efficacy and safety of modified Robert Jones bandage (MRJB) and non-compressive dressing (NCD) on reducing invisible blood loss (IBL) after total knee arthroplasty (TKA). MATERIALS AND METHODS: Eighty patients who underwent unilateral TKA were randomly assigned into two groups: MRJB and NCD groups. Pre- and post-operative hematocrit levels, amount of drained blood and transfused blood were measured and calculated into IBL. Pain score, amount of morphine usage, range of motion (ROM) at discharge, blood transfusion rate, and complications were also recorded and compared between both groups...
June 22, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29931164/falls-after-total-knee-arthroplasty-frequency-circumstances-and-associated-factors-a-prospective-cohort-study
#2
Andy C M Chan, Deborah A Jehu, Marco Y C Pang
Background: Individuals with total knee arthroplasty (TKA) often experience pain and reduced balance control, which may predispose them to greater fall risk. Objective: The objective of this study was to determine the frequency and circumstance of falls and fall-related risk factors within a 6-month follow-up period in individuals after TKA. Design: This study was a prospective cohort study. Methods: Knee proprioception, the Balance Systems Evaluation Test, knee pain, knee extension and flexion muscle strength, knee range of motion, and balance confidence were evaluated in 134 individuals (39 men, 95 women; mean age = 66...
June 19, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29925479/metaphyseal-sleeves-as-the-primary-implant-for-the-management-of-bone-defects-in-total-knee-arthroplasty-after-post-traumatic-knee-arthritis
#3
Carlos Martín-Hernández, Luis Javier Floría-Arnal, Andrés Gómez-Blasco, Alberto Hernández-Fernández, Cristian Pinilla-Gracia, Luis Rodríguez-Nogué, Miguel Lizcano-Palomares, Elena Masa Lasheras
BACKGROUND: Implantation of a prosthesis after post-traumatic knee arthritis poses challenges derived from the bone defects and soft tissue damage. The objective of this study was to evaluate the clinical and radiological results of the use of metaphyseal sleeves in primary total knee arthroplasty surgery after post-traumatic arthritis. METHODS: Clinical and radiological results of 25 patients undergoing surgery for post-traumatic knee arthritis were prospectively evaluated...
June 17, 2018: Knee
https://www.readbyqxmd.com/read/29922553/trapeziectomy-with-interpositional-arthroplasty-using-acellular-dermal-matrix-description-of-technique-and-early-outcomes
#4
April C Cockcroft, Alexey M Markelov
Background: Trapeziectomy with interpositional arthroplasty using Repriza acellular dermal matrix is a novel technique to treat primary and secondary carpometacarpal joint arthritis. Early studies with nonautograft interposition indicate promising post-trapeziectomy space maintenance with results similar to ligament reconstruction with tendon interposition, without the potential risks and increased operating time of harvesting a tendon autograft. Methods: Eleven patients in a retrospective cohort were followed for a minimum of 6 weeks (mean, 12)...
May 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29917139/structural-brain-alterations-before-and-after-total-knee-arthroplasty-a-longitudinal-assessment
#5
Gwyn N Lewis, Rosalind S Parker, Sheena Sharma, David A Rice, Peter J McNair
Objective: Many studies have provided evidence of altered brain structure in chronic pain conditions, as well as further adaptations following treatment that are coincident with changes in pain. Less is known regarding how these structural brain adaptations relate to assessments of nociceptive processing. The current study aimed to investigate brain structure in people with knee osteoarthritis (OA) before and after total knee arthroplasty (TKA) and to investigate the relationships between these findings and quantitative sensory testing (QST) of the nociceptive system...
June 15, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29916935/mortality-after-total-knee-arthroplasty-a-systematic-review-of-incidence-temporal-trends-and-risk-factors
#6
James R Berstock, Andrew D Beswick, José A López-López, Michael R Whitehouse, Ashley W Blom
BACKGROUND: The capacity for total knee arthroplasty to improve pain, quality of life, and functional outcomes is widely recognized. Postoperative mortality is rare but of paramount importance, and needs to be accurately quantified and conveyed to patients in order to support decision-making prior to surgery. The purpose of this study was to determine a contemporary estimate of the risk of mortality following total knee arthroplasty, including the identification of temporal trends, common causes, and modifiable and nonmodifiable risk factors...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29914521/the-prognostic-value-of-pain-catastrophizing-in-health-related-quality-of-life-judgments-after-total-knee-arthroplasty
#7
Esther Yakobov, William Stanish, Michael Tanzer, Michael Dunbar, Glen Richardson, Michael J L Sullivan
BACKGROUND: Total knee arthroplasty (TKA) is a highly effective procedure that yields reductions in pain and disability associated with end stage osteoarthritis (OA) of the knee. Quality of life instruments are frequently used to gauge the outcomes of total knee arthroplasty (TKA). However, research suggests that post-TKA reductions in symptom severity may not be the sole predictors of quality of life post-TKA. The primary objective of the present study was to examine the prognostic value of catastrophic thinking in health-related quality of life (HRQoL) judgments in patients with severe OA after TKA...
June 18, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29913844/systematic-review-of-neuropathic-component-in-persistent-post-surgical-pain
#8
S Haroutiunian, L Nikolajsen, N B Finnerup, T S Jensen
Background/aim The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery. Methods We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1]...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913764/a-randomized-study-comparing-plasma-concentration-of-ropivacaine-after-local-infiltration-analgesia-and-femoral-block-in-primary-total-knee-arthroplasty
#9
Fatin Affas, Carl-Olav Stiller, Eva-Britt Nygårds, Niclas Stephanson, Per Wretenberg, Christina Olofsson
Pain after total knee arthroplasty (TKA) is difficult to control. A recently developed and increasingly popular method for postoperative analgesia following knee and hip arthroplasty is Local Infiltration Analgesia (LIA) with ropivacaine, ketorolac and epinephrine. This method is considered to have certain advantages, which include administration at the site of traumatized tissue, minimal systemic side effects, faster postoperative mobilization, earlier postoperative discharge from hospital and less opioid consumption...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913030/lateralized-center-of-rotation-and-lower-neck-shaft-angle-are-associated-with-lower-rates-of-scapular-notching-and-heterotopic-ossification-and-improved-pain-for-reverse-shoulder-arthroplasty-at-1-year
#10
Ryan Nelson, Jeremiah T Lowe, Sarah M Lawler, Megan Fitzgerald, Matthew T Mantell, Andrew Jawa
Heterotopic ossification and scapular notching are common following reverse total shoulder arthroplasty. Compared with the original Grammont-style prosthesis with a medialized center of rotation (COR) and a 155° neck-shaft angle, lateralization of COR and reduction of neck-shaft angle have been associated with decreased incidence of scapular notching. The authors hypothesized that these design features may also be effective in reducing heterotopic ossification after reverse total shoulder arthroplasty. Ninety-seven consecutive patients who underwent reverse total shoulder arthroplasty performed by a single surgeon were included in the study...
June 18, 2018: Orthopedics
https://www.readbyqxmd.com/read/29911136/multimodal-pain-management-protocol-versus-patient-controlled-narcotic-analgesia-for-postoperative-pain-control-after-shoulder-arthroplasty
#11
Thema Nicholson, Mitchell Maltenfort, Charles Getz, Mark Lazarus, Gerald Williams, Surena Namdari
Background: Our institution's traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization. Methods: Patients undergoing primary total shoulder or reverse arthroplasty were retrospectively studied...
May 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29911092/use-of-closed-suction-drainage-after-primary-total-hip-arthroplasty-a-prospective-randomized-controlled-trial
#12
Lorenzo Fagotti, Leandro Ejnisman, Helder de Souza Miyahara, Henrique de Melo Campos Gurgel, Alberto Tesconi Croci, Jose Ricardo Negreiros Vicente
Objective: This study aimed to investigate drain use in a controlled population of patients with hip osteoarthritis undergoing primary total hip arthroplasty. Methods: This prospective controlled trial evaluated 93 patients randomized into two groups: a group that received drains and a group that did not. The patients who were randomized to the drain group used a 3.2 mm drain placed under the fascia that was kept in place for 24 h. Postoperative evaluations were performed after 24 h and then three, six, and 12 weeks after total hip arthroplasty...
March 2018: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29910098/a-meta-analysis-evaluates-the-efficacy-of-intravenous-acetaminophen-for-pain-management-in-knee-or-hip-arthroplasty
#13
Hongzhang Guo, Changde Wang, Yufang He
BACKGROUND: The objective of this study was to assess whether intravenous acetaminophen for patients undergoing knee or hip arthroplasty could reduce the opioid consumption and improve pain management. METHOD: Eligible studies were searched from electronic databases including PubMed, Web of Science, Embase (Ovid interface) and Cochrane Library (Ovid interface). The quality assessments were performed according to the Cochrane systematic review method. The assessed outcomes were including opioid consumption, pain scores, length of hospital stays and total occurrence of adverse events...
June 14, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29909435/photobiomodulation-therapy-pbmt-on-acute-pain-and-inflammation-in-patients-who-underwent-total-hip-arthroplasty-a-randomized-triple-blind-placebo-controlled-clinical-trial
#14
Luciana Gonçalves Langella, Heliodora Leão Casalechi, Shaiane Silva Tomazoni, Douglas Scott Johnson, Regiane Albertini, Rodney Capp Pallotta, Rodrigo Labat Marcos, Paulo de Tarso Camillo de Carvalho, Ernesto Cesar Pinto Leal-Junior
When conservative treatments fail, hip osteoarthritis (OA), a chronic degenerative disease characterized by cartilage wear, progressive joint deformity, and loss of function, can result in the need for a total hip arthroplasty (THA). Surgical procedures induced tissue trauma and incite an immune response. Photobiomodulation therapy (PBMt) using low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) has proven effective in tissue repair by modulating the inflammatory process and promoting pain relief...
June 16, 2018: Lasers in Medical Science
https://www.readbyqxmd.com/read/29908355/medial-acetabular-wall-breach-in-total-hip-arthroplasty-is-full-weight-bearing-possible
#15
Filippo Mandelli, Simon Tiziani, Jürgen Schmitt, Clément M L Werner, Hans-Peter Simmen, Georg Osterhoff
BACKGROUND: A breach of the medial acetabular wall is a phenomenon seen frequently due to over-reaming during total hip arthroplasty (THA). The consequences of this issue are not fully understood particularly in cementless THA. A retrospective study was performed to answer whether: 1) immediate postoperative full-weight bearing in the presence of a medial acetabular wall breach after THA results in more short-term revisions of the acetabular component, 2) increases the risk for migration of the acetabular component? HYPOTHESIS: Immediate full-weight bearing in the presence of a medial breach is not associated with an increased likelihood for acetabular-related revision surgery or migration of the cup...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29903459/single-injection-adductor-canal-block-with-multiple-adjuvants-provides-equivalent-analgesia-when-compared-with-continuous-adductor-canal-blockade-for-primary-total-knee-arthroplasty-a-double-blinded-randomized-controlled-equivalency-trial
#16
James D Turner, Sean W Dobson, Daryl S Henshaw, Christopher J Edwards, Robert S Weller, Jon W Reynolds, Gregory B Russell, Jonathan D Jaffe
BACKGROUND: Peripheral nerve blockade is used to provide analgesia for patients undergoing total knee arthroplasty. This study compared a single-injection adductor canal block (SACB) with adjuvants to continuous adductor canal blockade (CACB). The hypothesis was that the 2 groups would have equivalent analgesia at 30 hours after neural blockade. METHODS: This was a double-blinded, randomized, controlled, equivalency trial. Sixty patients were randomized to either the SACB group (20 mL of 0...
May 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29896558/are-reinfusion-drains-safe-to-use-with-periarticular-liposomal-bupivacaine-an-analysis-of-systemic-bupivacaine-toxicity
#17
Marc R Angerame, Gavin P Hart, Susan M Odum, Bryan D Springer
Background: Intraoperative periarticular injection (PAI) with local anesthetic is an important component of multimodal pain control in total joint arthroplasty (TJA). A potential risk of this practice is serum anesthetic toxicity resulting from the autotransfusion of blood collected from a reinfusion drain. The purpose of this study is to evaluate the levels of bupivacaine in blood collected in an autotransfusion system after use of a PAI in TJA. Methods: In this prospective study, each TJA patient had an identical PAI consisting of 20 cc of liposomal bupivacaine, 30 cc of 0...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896554/association-of-rapidly-destructive-osteoarthritis-of-the-hip-with-intra-articular-steroid-injections
#18
Shane R Hess, Robert S O'Connell, Christopher P Bednarz, Andrew C Waligora, Gregory J Golladay, William A Jiranek
Background: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections. Methods: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-articular hip injection to treat pain associated with primary osteoarthritis. Radiographic measurements from preinjection and postinjection imaging were evaluated with Luquesne's classification of RDOA to determine diagnosis (greater than 50% joint space narrowing or greater than 2 mm of cartilage loss in 1 year with no other forms of destructive arthropathy)...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896547/early-aseptic-loosening-of-the-tritanium-primary-acetabular-component-with-screw-fixation
#19
William J Long, Samir Nayyar, Kevin K Chen, David Novikov, Roy I Davidovitch, Jonathan M Vigdorchik
Ultraporous acetabular components were developed to improve osseointegration and fit for increased longevity and better outcomes after total hip arthroplasty. There is a paucity of literature detailing this acetabular component's clinical performance, with even less detailing those with screw fixation. We identify 5 patients at our institution who underwent revision total hip arthroplasty for early aseptic acetabular cup loosening of an ultraporous acetabular component known as the Tritanium primary cup with secondary screw fixation...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896542/tibial-tray-fracture-in-a-modern-prosthesis-with-retrieval-analysis
#20
John J Callaghan, David E DeMik, Nicholas A Bedard, Andrew N Odland, William M Kane, Steven M Kurtz
Fracture of the tibial tray is a rarely observed complication of total knee arthroplasty (TKA), predominately in implants placed greater than a decade ago. This case highlights a case of baseplate fracture in a contemporary prosthesis. The patient presented 1 year after TKA with medial knee pain consistent with pes bursitis. The implant-cement-bone construct was intact and she was managed with corticosteroids. She had persistent pain, acutely developed new varus deformity, and presented with a tibial tray fracture...
June 2018: Arthroplasty Today
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