Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing.
In total knee arthroplasty, surgical navigation systems provide tibio-femoral joint (TFJ) tracking for relevant bone preparation, disregarding the patello-femoral joint (PFJ). Therefore, the important intra-operative assessment of the effect of component positioning, including the patella, on the kinematics of these two joints is not available. The objective of this study is to explore in vivo whether accurate tracking of the patella can result in a more physiological TFJ and PFJ kinematics during surgery. ⋯ Patella tracking results in nearly physiological TFJ and PFJ kinematics in navigated knee arthroplasty with resurfacing. The intra-operative availability also of PFJ kinematics can support the positioning not only of the patellar component in case of resurfacing, but also of femoral and tibial components.
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Knee Surg Sports Traumatol Arthrosc · Jul 2014
Review Meta AnalysisSingle-dose intra-articular bupivacaine after knee arthroscopic surgery: a meta-analysis of randomized placebo-controlled studies.
The purpose of this meta-analysis was to examine the efficacy and safety of single-dose intra-articular bupivacaine in the management of pain after knee arthroscopic surgery. ⋯ On the basis of the currently available literature, single-dose intra-articular bupivacaine was shown to be significantly better than placebo at relieving pain after knee arthroscopic surgery. More high-quality randomized controlled trials with long follow-up are highly required for examining the safety of single-dose intra-articular bupivacaine. Besides, routine use of single-dose intra-articular bupivacaine is still an effective way for pain management after knee arthroscopic surgery.
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Knee Surg Sports Traumatol Arthrosc · Jul 2014
Randomized Controlled TrialReduced morphine consumption and pain severity with transdermal fentanyl patches following total knee arthroplasty.
To determine the effects of transdermal fentanyl patches (TFPs) for postoperative analgesia in patients undergoing total knee arthroplasty (TKA) surgery. ⋯ Transdermal fentanyl patches provide effective pain relief and decrease total rescue morphine consumption during the first 72 h after operation without additive side effects in patients undergoing TKA surgery.
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Knee Surg Sports Traumatol Arthrosc · Jul 2014
Randomized Controlled TrialEffects of dexamethasone on local infiltration analgesia in total knee arthroplasty: a randomized controlled trial.
Intraoperative local infiltration analgesia has gained increasing popularity in joint replacement surgery. Because there is considerable variation among drug combinations, analgesic effects of each drug are not well understood. The purpose of this study was to clarify the efficacy of the addition of steroid to local anaesthetics in local infiltration analgesia during total knee arthroplasty. ⋯ Adding steroid to local anaesthetics in local infiltration analgesia reduced inflammation both locally and systemically, resulting in significant early pain relief and rapid recovery in total knee arthroplasty.
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Knee Surg Sports Traumatol Arthrosc · Jul 2014
Medial tibial pain pressure threshold algometry in runners.
Pressure algometry (PA) may provide an objective and standardised tool in assessing palpation pain over the tibia. The purpose of this study was to analyse the intra-rater repeatability of PA and to determine whether tibial tenderness in healthy runners differ from runners with medial tibial stress syndrome (MTSS). ⋯ Pain pressure threshold algometry can be incorporated into MTSS clinical assessment to objectively assess pain and monitor progress. The presence of reduced medial tibial PPT in asymptomatic runners suggests that clinicians may not need to await resolution of medial tibia tenderness before allowing return to sport in MTSS patients.