Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Jan 2020
How Does Perioperative Ketorolac Affect Opioid Consumption and Pain Management After Ankle Fracture Surgery?
The investigation of nonnarcotic drug regimens for postoperative pain management is important in addressing the opioid epidemic. NSAIDs can be a powerful adjunct in managing postoperative pain, but the possibility of delayed bone healing is a major concern for orthopaedic surgeons. Our recent retrospective study on ketorolac administration demonstrated that the NSAID is not associated with an increased risk of delayed union or nonunion after ankle fracture surgery. ⋯ Level I, therapeutic study.
-
Clin. Orthop. Relat. Res. · Dec 2019
Prediction of Autograft Hamstring Size for Anterior Cruciate Ligament Reconstruction Using MRI.
Hamstring autografts with a diameter of less than 8 mm for ACL reconstruction have an increased risk of failure, but there is no consensus regarding the best method to predict autograft size in ACL reconstruction. ⋯ Level II, diagnostic study.
-
Clin. Orthop. Relat. Res. · Dec 2019
Which Psychological Variables Are Associated With Pain and Function Before Surgery for de Quervain's Tenosynovitis? A Cross-sectional Study.
Depression, anxiety, and pain catastrophizing have been associated with worse pain and function in studies of patients with de Quervain's tenosynovitis. Illness perceptions are the patient's thoughts and feelings about their illness. More negative perceptions of the illness such as the illness having a long duration or serious consequences are associated with worse physical function in patients with hand osteoarthritis. It is currently unknown whether these psychological factors play a similar role in de Quervain's. We chose to study patients who have tried nonoperative management and have chosen surgical decompression due to persistent symptoms. Psychological factors may be associated with their ongoing pain and impaired function, so it is particularly important to investigate the role of psychosocial factors that may be targeted with non-invasive interventions. ⋯ III, therapeutic study.
-
Clin. Orthop. Relat. Res. · Dec 2019
Patient Position Is Related to the Risk of Neurovascular Injury in Clavicular Plating: A Cadaveric Study.
Fixation of clavicle shaft fractures with a plate and screws can endanger the neurovascular structures if proper care is not taken. Although prior studies have looked at the risk of clavicular plates and screws (for example, length and positions) to vulnerable neurovascular structures (such as the subclavian vein, subclavian artery, and brachial plexus) in the supine position, no studies to our knowledge have compared these distances in the beach chair position. ⋯ The surgeon should be careful while making the first medial and second medial screw holes. Superior plating is safer to perform in the beach chair position, while anteroinferior plating is more safely performed in the supine position.
-
Clin. Orthop. Relat. Res. · Dec 2019
Randomized Controlled TrialThe "Cough Trick" Reduces Pain During Removal of Closed-suction Drains after Total Knee Arthroplasty: A Randomized Trial.
Drain removal after TKA can be painful. Prior research suggests that the "cough trick," in which a patient coughs at the same time she or he receives an injection, effectively decreases pain. To our knowledge, this intervention has not been evaluated as a way to reduce pain during other brief but painful interventions, such as removal of closed-suction drains after orthopaedic surgery. ⋯ Level I, therapeutic study.