The Journal of arthroplasty
-
Randomized Controlled Trial Clinical Trial
Continuous local cooling for pain relief following total hip arthroplasty.
This study is the first to evaluate whether continuous cryotherapy can relieve pain soon after total hip arthroplasty (THA). Patients who had undergone THA for osteoarthritis were divided into 2 prospective, randomized groups: the cryotherapy group was fitted with a computer-controlled cooling device for 4 days, and the control group was not. ⋯ Furthermore, postoperative analgesic use by the cryotherapy group was significantly lower than by the control group. The results of this study support the potential benefit of a cold compressive device for pain reduction during the postoperative recovery of patients undergoing THA.
-
Tibial tubercle osteotomy was used in the surgical exposure of 67 knees in 64 patients undergoing revision total knee arthroplasty. The clinical and radiographic results were reviewed retrospectively. The mean follow-up time was 30 months (range, 5-60 months). ⋯ The procedure was particularly effective in 2-stage exchanges for infected total knee arthroplasty, in which infection was eradicated in 9 of 10 cases, with a mean KSS of 82. In this series, no patellofemoral complications, no component malalignments, and no avulsions of the patellar tendon occurred. Serious complications directly related to the tibial tubercle osteotomy occurred in 5 patients (7%).
-
Randomized Controlled Trial Clinical Trial
Transcutaneous electrical nerve stimulation for postoperative pain relief after total knee arthroplasty.
Transcutaneous electrical nerve stimulation (TENS) has been used to treat chronic pain syndromes and has been reported to be of some utility in the treatment of postsurgical pain. A randomized, blinded, placebo-controlled trial was designed to evaluate the utility of TENS after total knee arthroplasty. ⋯ There was no significant reduction in the requirement for patient-controlled analgesia with or without TENS. We conclude that there is no utility for TENS in the postoperative management of pain after knee arthroplasty.
-
Clinical Trial
Celecoxib versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty.
A cyclo-oxygenase (COX)-1 and COX-2 inhibitor (indomethacin) and a selective COX-2 inhibitor (celecoxib) were compared in the prevention of heterotopic ossification after total hip arthroplasty. In 250 patients receiving indomethacin and in 150 patients receiving celecoxib for 20 days after surgery, an overall incidence of heterotopic ossification of 17.5% and 14.3% was seen, respectively (difference not statistically significant: P > .05). ⋯ Twenty-one patients in the indomethacin group (8.4%) and 3 patients in the celecoxib group (2.0%) required treatment discontinuation, because of side effects (P < .05). Celecoxib, a selective COX-2 inhibitor, shows the same efficacy as indomethacin in the prevention of heterotopic ossification after hip prosthesis with significantly fewer side effects.