Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2014
Randomized Controlled Trial Comparative StudySingle-injection or continuous femoral nerve block for total knee arthroplasty?
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Clin. Orthop. Relat. Res. · May 2014
ReviewCan regional anesthesia and analgesia prolong cancer survival after orthopaedic oncologic surgery?
The perioperative period of major oncologic surgery is characterized by immunosuppression, angiogenesis, and an increased load of circulating malignant cells. It is a window period in which cancer cells may seed, invade, and proliferate. Thus, it has been hypothesized that the use of regional anesthesia with the goal of reducing surgical stress and opioid and volatile anesthetic consumption would avoid perioperative immune suppression and angiogenesis and ultimately cancer recurrence. ⋯ Although basic science studies suggest a potential benefit of regional anesthesia and stress response reduction in cancer formation, we found little clinical evidence to support the theory that regional anesthesia and analgesia improve overall patient survival after oncologic surgery.
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Clin. Orthop. Relat. Res. · May 2014
Randomized Controlled Trial Comparative StudyIs L2 paravertebral block comparable to lumbar plexus block for postoperative analgesia after total hip arthroplasty?
Continuous lumbar plexus block (LPB) is a well-accepted technique for regional analgesia after THA. However, many patients experience considerable quadriceps motor weakness with this technique, thus impairing their ability to achieve their physical therapy goals. ⋯ Level I, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Comparative StudyUnicompartmental knee arthroplasty survivorship is lower than TKA survivorship: a 27-year Finnish registry study.
Balancing the relative advantages and disadvantages of unicompartmental knee arthroplasties (UKAs) against those for TKAs can be challenging. Survivorship is one important end point; arthroplasty registers repeatedly report inferior midterm survival rates, but longer-term data are sparse. Comparing survival directly by using arthroplasty register survival reports also may be inadequate because of differences in indications, implant designs, and patient demographics in patients having UKAs and TKAs. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Randomized Controlled Trial Comparative StudyIntraarticular analgesia versus epidural plus femoral nerve block after TKA: a randomized, double-blind trial.
Pain management after TKA remains challenging and the efficacy of continuously infused intraarticular anesthetics remains a controversial topic. ⋯ Level I, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.