Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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A prospective study was undertaken to evaluate the postoperative pain and analgesic profiles of a group of 50 patients undergoing outpatient anterior cruciate ligament (ACL) reconstruction and to compare their profiles with those of a group of 50 patients undergoing outpatient non-ACL arthroscopic surgery. All patients received preoperative and postoperative ketorolac, intraincisional/intra-articular bupivacaine, intraoperative ketorolac, and propofol anesthetic. The percentage of patients receiving supplemental analgesia in the recovery room was 49% (average, 2.2 mg intravenous morphine sulfate) for the ACL group and 31% (average, 1.2 mg intravenous morphine sulfate) in the non-ACL group. ⋯ All were satisfied with the outpatient nature of this surgery. Patients tolerate outpatient endoscopic ACL reconstruction with moderate pain and narcotic use. Outpatient endoscopic ACL reconstruction can be performed safely, effectively, and with considerable cost savings.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of oral ketorolac and hydrocodone for pain relief after anterior cruciate ligament reconstruction.
The analgesic effectiveness of ketorolac tromethamine was compared with hydrocodone and acetaminophen for pain from an arthroscopically assisted patellar-tendon autograft anterior cruciate ligament reconstruction. There were 125 patients evaluated in a double-blind, randomized, multicenter, and multidose study. A loading dose of parental ketorolac tromethamine was administered and subjects were later given two staged doses of the same "unknown" drug with pain evaluations conducted after each dose. ⋯ Moreover, ketorolac tromethamine was no more likely to cause digestive complaints than hydrocodone and acetaminophen. No bleeding problems were observed in either group. In the outpatient setting, ketorolac tromethamine controls postoperative pain better than hydrocodone and acetaminophen in the immediate postsurgery period.
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Hip arthroscopy is far less invasive than standard open arthrotomy and offers unparalleled visualization of the acetabulum and femoral head. Diagnostic arthroscopy is becoming increasingly accepted as therapeutic options are still evolving. We report the case of the arthroscopic removal of a .44 caliber bullet from the femoral head of a 45-year-old man. The procedure afforded the opportunity to thoroughly irrigate the joint, debride the articular surface, and remove several loose bodies.