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Pain after arthroplasty

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https://www.readbyqxmd.com/read/29691180/multimodal-clinical-pathway-with-adductor-canal-block-decreases-hospital-length-of-stay-improves-pain-control-and-reduces-opioid-consumption-in-total-knee-arthroplasty-patients-a-retrospective-review
#1
Terry A Ellis, Hassan Hammoud, Philip Dela Merced, Nishankkumar P Nooli, Farhad Ghoddoussi, Joshua Kong, Sandeep H Krishnan
BACKGROUND: Total knee arthroplasty volume is increasing significantly in the United States. Reducing hospital length of stay may represent the best method for accommodating expanding volume and reducing costs. We hypothesized that tailoring a clinical pathway to facilitate early ambulation would decrease costs and resource utilization. METHODS: We conducted a sequential before-and-after study of total knee arthroplasty patients after a phased implementation of a clinical pathway that includes multimodal oral analgesic protocols, adductor canal nerve block, and standardized day of surgery ambulation protocols...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29690729/-clinical-study-of-a-new-wearable-device-for-rehabilitation-after-total-knee-arthroplasty
#2
K Kang, Q Geng, H T Xu, X Z Zheng, J T Dong, T Li, Z G Zhao, S J Gao
Objective: To evaluate the effect of promoting knee joint rehabilitation after total knee arthroplasty (TKA) with a rehabilitation training instrument NEO-GAIT. Methods: Sixty patients who received TKA from January 2017 to July 2017 in the Third Hospital of Hebei Medical University were randomly assigned to receive rehabilitation training with continuous passive motion (CPM) or NEO-GAIT with random number (30 cases in CPM group, included 8 males and 22 females; 30 cases in NEO-GAIT group, included 6 males and 24 females)...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29685389/arthroplasty-for-glenohumeral-arthritis-in-shoulders-with-a-previous-bristow-or-latarjet-procedure
#3
Laurent B Willemot, Bassem T Elhassan, John W Sperling, Robert H Cofield, Joaquin Sánchez-Sotelo
BACKGROUND: Coracoid transfer has become increasingly popular for recurrent anterior shoulder instability. Despite the success, glenohumeral arthropathy develops in some patients. Arthroplasty in this population is complicated by altered anatomy, scarring, and retained hardware. This study evaluated shoulder arthroplasty in patients with a previous Latarjet or Bristow procedure. METHODS: Between 1980 and 2014, 33 patients underwent shoulder arthroplasty after coracoid transfer...
April 20, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29681582/subchondral-insufficiency-fracture-of-the-femoral-head-in-a-pregnant-woman-with-pre-existing-anorexia-nervosa
#4
Kyoko Kasahara, Tomohiro Mimura, Suzuko Moritani, Taku Kawasaki, Shinji Imai, Shunichiro Tsuji, Fuminori Kimura, Takashi Murakami
Subchondral insufficiency fracture (SIF) is a fragility fracture secondary to osteoporosis that leads to collapse of the femoral head with no evidence of osteonecrosis. SIF of the femoral head has been reported in adults of varying ages and both sexes, but it has never been reported to occur in pregnant women. Herein, we describe a 40-year-old primiparous patient with pre-existing anorexia nervosa who developed SIF of the femoral head in the third trimester. At 29 weeks of gestation, the patient complained of sudden pain on walking in both hips...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29677091/factors-associated-with-revision-surgery-after-internal-fixation-of-hip-fractures
#5
Sheila Sprague, Emil H Schemitsch, Marc Swiontkowski, Gregory J Della Rocca, Kyle J Jeray, Susan Liew, Gerard P Slobogean, Sofia Bzovsky, Diane Heels-Ansdell, Qi Zhou, Mohit Bhandari
BACKGROUND: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery...
May 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29672324/lidocaine-patch-to-treat-postoperative-tourniquet-pain-after-total-knee-replacement-a-case-report
#6
Brittney M Clark, Gabriel L Pagani-Estevez, Rebecca L Johnson
Intraoperative tourniquet-related pain is well recognized by anesthesiologists, but postoperative tourniquet-related pain has received little attention. We present a patient who underwent a total knee arthroplasty under general anesthesia and an adductor canal nerve block. She complained of intractable thigh pain postoperatively. Lidocaine 5% patches completely resolved her postoperative tourniquet-related pain.
April 17, 2018: A&A practice
https://www.readbyqxmd.com/read/29670791/self-resolution-of-a-draining-sinus-tract-in-a-patient-with-chronic-periprosthetic-hip-infection
#7
Trevor J Shelton, Alton W Skaggs, Gavin C Pereira
We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29667853/evaluation-and-management-of-subchondral-calcium-phosphate-injection-technique-to-treat-bone-marrow-lesion
#8
Diego Costa Astur, Eduardo Vasconcelos de Freitas, Pedro Barreira Cabral, Caio Carvalho Morais, Bruno Silveira Pavei, Camila Cohen Kaleka, Pedro Debieux, Moises Cohen
Purpose This study aimed to compile available data in medical literature about subchondral calcium phosphate injection, comparing results obtained with this technique, as well as indications, complications, and other important factors in treatment of bone marrow lesions. Designs A literature review using PubMed and Medline database in order to identify works with terms "subchondral calcium phosphate injection," " subchondroplasty®," "bone marrow lesion," and "knee." Eight relevant articles were found...
April 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29666733/clinical-results-of-total-hip-arthroplasty-in-two-patients-with-charcot-hip-joints-due-to-congenital-insensivity-to-pain-with-anhydrosis
#9
Daisuke Inoue, Tamon Kabata, Yoshitomo Kajino, Tadashi Taga, Takashi Yamamoto, Tomoharu Takagi, Takaaki Ohmori, Hiroyuki Tsuchiya
Traditionally, Charcot arthropathy has been considered an absolute contraindication for total hip arthroplasty (THA). However, some recent reports have shown that good short- to mid-term results can be achieved by improving the durability of the implant. This paper reports the mid- to long-term results of THA in two patients with Charcot hip joints caused by congenital insensivity to pain with anhydrosis. Both patients suffered multiple posterior dislocations in the six months immediately following surgery...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29666030/resection-arthroplasty-compared-with-total-hip-arthroplasty-in-treating-chronic-hip-pain-of-patients-with-a-history-of-substance-abuse
#10
William Curtis, Meir Marmor
BACKGROUND: Retrospective comparison of surgical management of severe hip pain in patients with a history of substance abuse treated by modified Girdlestone resection arthroplasty (RA) vs delayed total hip arthroplasty (THA) following yearlong sobriety pathway. METHODS: Patients were identified using charts, current procedural terminology (CPT) code query, and THA sobriety pathway registry. The primary outcome was adequate pain control following surgery, defined as visual analog scale ≤ 5 or verbal description of "moderate" or lower pain...
March 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29665717/selective-peripheral-nerve-resection-for-treatment-of-persistent-pain-around-the-knee-joint-after-total-knee-arthroplasty
#11
Guangjun Zhong, Zhu Liang, Jiang Kan, Aikeremujiang Muheremu
Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29662778/comparisons-of-slice-encoding-metal-artifact-correction-and-view-angle-tilting-magnetic-resonance-imaging-and-traditional-digital-radiography-in-evaluating-chronic-hip-pain-after-total-hip-arthroplasty
#12
Yimin Ma, Panli Zuo, Mathias Nittka, Xiaoguang Cheng, Hongyi Shao, Chen Wang
Purpose: The aims of this study were (1) to compare the areas of metal-induced artifacts and definition of periprosthetic structures between patients scanned with the slice-encoding metal artifact correction and view-angle tilting (SEMAC-VAT) turbo-spin-echo (TSE) prototype and those scanned with the standard TSE magnetic resonance (MR) sequences and (2) to further clarify the superiority of the SEMAC-VAT MR imaging technique at detecting lesions in patients after total hip arthroplasty (THA), compared with digital radiography (DR)...
January 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29658975/thumb-basal-joint-arthroplasty-prospective-comparison-of-perioperative-analgesia-and-opioid-consumption
#13
Andrew J Miller, Michael Livesey, Dennis P Martin, Jack Abboudi, William H Kirkpatrick, Frederic E Liss, Christopher M Jones, Mark L Wang, Jonas L Matzon, Asif M Ilyas
Trapeziectomy alone or in combination with a suspensionplasty technique is a common surgical treatment for symptomatic thumb basal joint arthritis. The authors undertook a prospective comparative study to test the hypothesis that peripheral nerve blocks would provide better pain control than local anesthesia with bupivacaine or liposomal bupivacaine regarding pain scores and opioid pill consumption. Patients who elected to undergo basal joint arthroplasty were allocated to 1 of 3 postoperative pain management groups: (1) peripheral nerve block, (2) local anesthesia with bupivacaine, or (3) local anesthesia with liposomal bupivacaine...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29657477/evaluation-of-the-multi-attribute-prioritisation-tool-for-total-joint-replacement
#14
Michael Nganga, Donald Bramwell, Jenifer Monaghan, Christine Doerr, Graham Mercer, Jeganath Krishnan
Rationale aims and objectives: The demand for arthroplasty is increasing and will continue to rise with an ageing population. Obesity and lengthy waiting time for Total Joint Replacement (TJR) have been associated with poorer outcomes postoperatively. This study aimed to evaluate the Multi-Attribute Prioritisation Tool (MAPT) for TJR patients. The primary objective was to explore if patients prioritised by the MAPT had an improvement in score post-operative. Further to identify any relationship between MAPT score and length of time on the waiting list or obesity...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29656980/the-recovery-curve-for-the-patient-reported-outcomes-measurement-information-system-patient-reported-physical-function-and-pain-interference-computerized-adaptive-tests-after-primary-total-knee-arthroplasty
#15
Ryland Kagan, Mike B Anderson, Jesse C Christensen, Christopher L Peters, Jeremy M Gililland, Christopher E Pelt
BACKGROUND: We sought to characterize the typical recovery in physical function (PF) and pain interference (PI) after TKA using Patient-Reported Outcomes Measurement Information System (PROMIS) patient-reported outcome (PRO) measures. METHODS: Ninety-one patients were enrolled into an institutional review board -approved prospective observational study. PROs were obtained preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 year. PROs included the PROMIS PF computerized adaptive test (CAT) and the PROMIS PI CAT...
March 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656979/reducing-length-of-stay-does-not-increase-emergency-room-visits-or-readmissions-in-patients-undergoing-primary-hip-and-knee-arthroplasties
#16
Andrea H Stone, Leah Dunn, James H MacDonald, Paul J King
BACKGROUND: Total hip and total knee arthroplasty (total joint arthroplasty [TJA]) are 2 of the most common elective surgeries. Identifying which patients are at highest risk for emergency room (ER) visits or readmissions within 90 days of surgery and the reasons for return are crucial to formulate ways to decrease these visits and improve patient outcomes. METHODS: This is a retrospective review of a consecutive series of 7466 unilateral primary TJA performed from July 2013 to June 2017; any patients who had an ER visit or readmission in the first 90 days after surgery were identified, and a detailed chart review was performed...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656978/high-rate-of-early-revision-after-iuni-custom-made-unicondylar-knee-arthroplasty
#17
Carl T Talmo, Marie C Anderson, Eliot S Jia, Claire E Robbins, Jason D Rand, Brian P McKeon
BACKGROUND: There has been a recent interest in custom-made partial knee arthroplasties to provide patient-specific instrumentation and better fit of the prosthesis. While unicondylar knee arthroplasties (UKAs) have demonstrated good outcomes and durable results in many studies, there is little evidence on outcomes of these custom-made implants. METHODS: We performed a retrospective review of all custom-made UKAs performed at our institution by one surgeon from 2008 to 2015...
March 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656977/liposomal-bupivacaine-vs-plain-bupivacaine-in-periarticular-injection-for-control-of-pain-and-early-motion-in-total-knee-arthroplasty-a-randomized-prospective-study
#18
Jason P Zlotnicki, Brian R Hamlin, Anton Y Plakseychuk, Timothy J Levison, Scott D Rothenberger, Kenneth L Urish
BACKGROUND: The use of multimodal pain regimens has been shown to be an effective technique for the treatment of postoperative pain after total knee arthroplasty. Periarticular injections, of both short-acting and long-acting anesthetics, have emerged as an additional method of providing significant improvement in postoperative pain relief. The purpose of this study is to compare the efficacy of periarticular injection using long-acting vs short-acting preparations. METHODS: A randomized, prospective study of 80 consecutive patients was performed comparing liposomal bupivacaine vs plain bupivacaine periarticular injection...
March 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656971/long-term-outcomes-after-metal-on-metal-total-hip-arthroplasty-with-a-28-mm-head-a-17-to-23-year-follow-up-study-of-a-previous-report
#19
Jun-Ki Moon, Yeesuk Kim, Kyu-Tae Hwang, Jae-Hyuk Yang, Young-Ha Oh, Young-Ho Kim
BACKGROUND: Second-generation, metal-on-metal total hip arthroplasty (MoM THA) using a 28-mm head has shown favorable results compared with large head MoM THA. The purpose of this study is to evaluate the long-term outcomes of cementless primary MoM THA with a 28-mm head and the incidence of osteolysis using computed tomography. METHODS: A total of 92 patients (53 men and 39 women) who underwent primary cementless MoM THA (114 hips) with a 28-mm head were enrolled in this study...
March 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29656965/total-hip-arthroplasty-for-periacetabular-metastatic-disease-an-original-technique-of-reconstruction-according-to-the-harrington-classification
#20
Julien Wegrzyn, Matthieu Malatray, Turki Al-Qahtani, Vincent Pibarot, Cyrille Confavreux, Gilles Freyer
BACKGROUND: Periacetabular metastatic disease requires complex acetabular reconstruction. The complication rate for these frail patients is high. Various cement-rebar reinforced techniques allowing cemented total hip arthroplasty (THA) have been described. The optimal procedure has not yet been identified. METHODS: A continuous series of 131 THAs performed in 126 patients with periacetabular metastatic disease was prospectively included in this study. After bone metastasis curettage and cementation, an original technique of acetabular reconstruction was performed using a dual mobility cup cemented into an acetabular reinforcement device (ie, Kerboull cross-plate or Burch-Schneider antiprotrusio cage) according to the Harrington classification...
March 17, 2018: Journal of Arthroplasty
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