The Knee
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Randomized Controlled Trial
A prospective double blinded randomized study of anterior cruciate ligament reconstruction with hamstrings tendon and spinal anesthesia with or without femoral nerve block.
Current literature supports the thought that anesthesia and analgesia administered perioperatively for an anterior cruciate ligament (ACL) reconstruction have a great influence on time to effective rehabilitation during the first week after hospital discharge. ⋯ Randomized Clinical Trial Level I.
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Comparative Study Clinical Trial
Assessment of the lateral patellar facet in varus arthritis of the knee.
Lateral patellar arthritis has been associated with poor outcomes in unicompartmental knee arthroplasty. The current study correlates intraoperative findings with MRI imaging, skyline radiographs and the presence of anterior knee pain. ⋯ Diagnostic study, Level II.
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Complex symptomatic ganglion cysts arising from the proximal tibio-fibular joint (PTJ) are not an uncommon presentation in specialist knee clinics and can be managed by aspiration or excision. There is, however, a high rate of recurrence and often there is progressive involvement of the common peroneal nerve (CPN) and its branches, and permanent nerve damage may result. ⋯ IV.
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Randomized Controlled Trial Comparative Study
Comparison of peripheral nerve block with periarticular injection analgesia after total knee arthroplasty: a randomized, controlled study.
Pain after total knee arthroplasty (TKA) is usually severe. Recently, the usefulness of local periarticular injection analgesia (PAI) and peripheral nerve block (PNB) has been reported. We report a prospective blinded randomized trial of PAI versus PNB in patients undergoing primary TKA, in accordance with the CONSORT statement 2010. ⋯ Therapeutic Level 1.
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Isolated unicompartmental knee arthritis is less common laterally than medially. Lateral unicompartmental knee arthroplasty (UKA) constitutes only 1% of all knee arthroplasty performed. Use of medial UKA is supported by several published series showing good long-term survivorship and patient satisfaction, in large patient cohorts. Results of lateral UKA however have been mixed. We present the short and mid-term survivorship and 5-year clinical outcome of 101 lateral UKAs using a single prosthesis. ⋯ The mid-term survivorship and outcome scores at 5-years suggest that lateral unicompartmental knee arthroplasty provides a valuable alternative to total joint replacement in selected patients with isolated lateral tibio-femoral arthritis at mid-term follow-up. Level II evidence.