The Orthopedic clinics of North America
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Patellar instability is a common problem, and medial patellofemoral ligament (MPFL) injury is inherent with traumatic patellar dislocations. Initial nonoperative management is focused on reconditioning and strengthening the dynamic stabilizers of the patella. ⋯ A technique of MPFL reconstruction is outlined. This procedure may also be performed in combination with other realignment procedures.
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Orthop. Clin. North Am. · Jan 2015
ReviewPeriarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique.
Postoperative pain control after total knee arthroplasty may be insufficient, resulting in insomnia, antalgic ambulation, and difficulty with rehabilitation. Current strategies, including the use of femoral nerve catheters, may control pain but have been associated with falls, motor blockade, and quadriceps inhibition. Periarticular infiltration using the appropriate technique and knowledge of intraarticular knee anatomy may increase pain control and maximize rehabilitation.
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Patellar instability is a common injury that can result in significant limitations of activity and long-term arthritis. There is a high risk of recurrence in patients and operative management is often indicated. ⋯ However, techniques such as MPFL reconstruction are technically demanding and may result in significant complication. The role of trochleoplasty remains unclear.
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Injuries to the flexor tendons remain among the most difficult problems in hand surgery. Historically, lacerations to the intrasynovial portion of the flexor tendons were thought to be unsuitable for primary repair. Despite continuing advances in our knowledge of flexor tendon biology, repair, and rehabilitation, good results following primary repair of flexor tendons remain challenging to achieve.