Journal of surgical orthopaedic advances
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This case study reviews the pathophysiology of scapholunate advanced collapse (SLAC), which is the most common etiology of degenerative arthritis in the wrist. The scapholunate ligament serves a critical role in stability of the carpus. Disruption of the scapholunate ligament, its sequela, and the magnetic resonance imaging evaluation are discussed, with review of the defining features of this disease and its progression.
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Total hip arthroplasty (THA) has been shown to improve long-term quality of life, although the immediate postoperative period can be associated with intense postoperative pain that hampers rehabilitation. Effective postoperative analgesia is paramount in the recovery period. ⋯ Appropriate pain management can reduce the associated total direct medical costs for lower extremity joint replacement surgeries by reducing hospital stays and the services needed during hospitalization. Factors contributing to the shorter lengths of stay include homogenous entities such as regular staff and continuity of nursing care, the use of timely and up-to-date information including expectations on a short stay, functional discharge criteria, early mobilization, and the use of a multimodal analgesia approach centered on opioid sparing.
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of a single-dose, extended-release epidural morphine formulation for pain control after lumbar spine surgery.
DepoDur, an extended-release epidural morphine, has been used effectively for postoperative pain control following many orthopaedic and general surgery procedures and has provided prolonged analgesia when compared with Duramorph. The goal of this article was to compare the safety and analgesic efficacy of DepoDur versus Duramorph after lumbar spine surgery. A prospective, randomized, double-blind clinical study was completed at a single extended-stay ambulatory surgery center. ⋯ The control group received DepoDur before surgery, while the treatment group received Duramorph. Although results show no significant differences between the two groups in postoperative visual analog pain scale scores, use of pain medication, and adverse events, subjects receiving DepoDur were less likely to receive Naloxone and oxygen supplementation, experience nausea or fever, and were more likely to experience hypotension. DepoDur proved to be safe and effective, offering similar prolonged analgesic activity when compared with Duramorph.
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Total ankle arthroplasty is a procedure that has been shown to greatly improve patient quality of life. However, it is associated with moderate to severe postoperative pain. ⋯ Nerve blocks in particular afford high-quality relief from pain while avoiding many of the side effects of traditional systemic therapies. This review highlights the state-of-the-art practice for providing postoperative analgesia following total ankle arthroplasty.