The Orthopedic clinics of North America
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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.
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Non-neoplastic soft tissue masses may mimic soft tissue sarcoma in a wide variety of clinical settings. Systematic and thorough review of patient history, physical examination, imaging, laboratory results, and biopsy will allow the clinician to differentiate between the two in most cases. We describe several common non-neoplastic entities that may mimic soft tissue sarcoma in case presentation format along with the characteristics that help distinguish them.