The journal of knee surgery
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Patellar instability is a common knee disorder encountered in young athletes. Patients with normal osseous anatomy and mechanical alignment of the lower extremity are candidates for soft-tissue reconstructive procedures. ⋯ Biomechanical research demonstrates that the medial patellofemoral ligament is the primary soft-tissue restraint to lateral subluxation of the patella, and the medial patellotibial ligament is an important secondary stabilizer. We present a novel physeal-sparing surgical technique that anatomically reconstructs both the medial patellofemoral and medial patellotibial ligaments using semitendinosus autograft.
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Randomized Controlled Trial
Intraoperative music reduces perceived pain after total knee arthroplasty: a blinded, prospective, randomized, placebo-controlled clinical trial.
Patients undergoing total knee arthroplasty (TKA) often experience a difficult recovery due to severe postoperative pain. Using a multimodal pain management protocol, a blinded, randomized, placebo-controlled study was designed to evaluate the efficacy of patient-selected music on reducing perceived pain. ⋯ Postoperative pain scores, assessed with the visual analog scale, indicated the music group experienced less pain at 3 and 24 hours postoperatively than did the nonmusic group (at 3 hours: 1.47+/-1.39 versus 3.87+/-3.44, P=.01; at 24 hours: 2.41+/-1.67 versus 4.03+/-2.89, P=.04). Intraoperative music provides an inexpensive nonpharmacological option to further reduce postoperative pain.