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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Randomized Controlled Trial Clinical Trial
The efficacy of continuous bupivacaine infiltration following anterior cruciate ligament reconstruction.
The purpose of this study was to determine whether continuous infiltration of a local anesthetic into the surgical wound for 48 hours will diminish the need for narcotics and improve the postoperative pain experience for patients undergoing anterior cruciate ligament (ACL) reconstruction using a patellar tendon autograft. ⋯ This report of a new technique suggests that surgical knee patients receiving local anesthetic infusion postoperatively experience less pain and require less narcotics. The disposable pump allowed administration of the medication on an outpatient basis.
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Comparative Study Clinical Trial
The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation.
The study goal was to examine the targeting accuracy of subacromial injection to the shoulder and the influence of the location of the injected structure. ⋯ This study showed that subacromial injection was a relatively difficult procedure. A high incidence of injections that missed the subacromial bursa would be a sufficient reason to refrain from repeated usage of corticosteroids. These results also suggest that pain relief could be attained whether the injected material reached the subacromial bursa or the deltoid muscle. Successful pain relief after intradeltoid injection seems to call into question the diagnostic value of a positive Neer impingement test.
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The purpose of this study was to determine the prevalence of heterotopic ossification following knee dislocation. ⋯ HO is a common problem following knee dislocation. Of the 7 knees with severe HO, 5 developed HO medially, 4 developed HO posteriorly, 3 developed HO laterally, and only 1 had involvement anteriorly. A similar distribution was present in the patients with mild HO, with posterior and medial ossification being the most common. Five of the 7 severe HO cases involved at least 3 of the 4 sides (anterior, posterior, medial, or lateral) of the knee. Patients were evaluated for the presence of head injury and any relationship to the development of HO around the knee. There was no increased incidence of HO around the knee in our 10 patients with severe head injuries when compared with those with no head injury. There was also no increased incidence of HO in knee dislocations associated with periarticular fractures.