Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2017
Randomized Controlled Trial Multicenter Study Comparative StudyNo Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA.
Opioid analgesics have been a standard modality for postoperative pain management after total knee arthroplasty (TKA) but are also associated with increased risk of nausea, pruritus, vomiting, respiratory depression, prolonged ileus, and cognitive dysfunction. There is still a need for a method of anesthesia that can deliver effective long-term postoperative pain relief without incurring the high cost and health burden of opioids and nerve blocks. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Jan 2017
Multicenter StudyWhat Is the Frequency of Noise Generation in Modern Knee Arthroplasty and Is It Associated With Residual Symptoms?
Prior investigations have recognized the presence of patient-perceived noise generation after total knee arthroplasty (TKA). However, questions remain regarding its overall frequency after both TKA and unicompartmental knee arthroplasty (UKA) as well as with respect to its association with demographic and prosthesis-related factors and its association with patient-reported outcomes. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jan 2017
Comparative StudyPain Control and Functional Milestones in Total Knee Arthroplasty: Liposomal Bupivacaine versus Femoral Nerve Block.
Although pain management after total knee arthroplasty (TKA) affects rehabilitation, length of stay, and functional outcomes, pain management for patients undergoing TKA has yet to be standardized. Femoral nerve blocks (FNBs) are commonly used as an adjunct; however, these can result in transient quadriceps weakness and have been associated with in-hospital falls. Periarticular infiltration of liposomal bupivacaine has been recently introduced as a long-acting analgesic that can be administered without affecting motor function. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jan 2017
Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?
Despite the overall effectiveness of total knee arthroplasty (TKA), a subset of patients do not experience expected improvements in pain, physical function, and quality of life as documented by patient-reported outcome measures (PROMs), which assess a patient's physical and emotional health and pain. It is therefore important to develop preoperative tools capable of identifying patients unlikely to improve by a clinically important margin after surgery. ⋯ Level III, prognostic study.