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Acute Knee Pain

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1. Acute postoperative pain is an independent predictor of chronic postsurgical pain following total knee arthroplasty at 6 months: a prospective cohort study. (PubMed)

Acute postoperative pain is an independent predictor of chronic postsurgical pain following total knee arthroplasty at 6 months: a prospective cohort study. Approximately 15% of patients report persistent knee pain despite surgical success following total knee arthroplasty (TKA). The purpose of this study was to determine the association of acute-postsurgical pain (APSP) with chronic postsurgical pain (CPSP) 6 months after TKA controlling for patient, surgical and psychological confounding (...) factors.Adult patients with osteoarthritis undergoing primary elective tricompartmental TKA, with the operated knee the primary source of preoperative pain, were studied between March 2011 and February 2017. Patients received standard operative management and a perioperative multimodal analgesia regimen. The primary outcome was CPSP at 6 months. The primary variable of interest was the APSP (weighted mean pain score) for 72 hours postoperatively. Patient, surgical and psychological confounders were assessed

2019 Regional Anesthesia and Pain Medicine

2. Femoral nerve blocks for acute postoperative pain after knee replacement surgery. (PubMed)

Femoral nerve blocks for acute postoperative pain after knee replacement surgery. Total knee replacement (TKR) is a common and often painful operation. Femoral nerve block (FNB) is frequently used for postoperative analgesia.To evaluate the benefits and risks of FNB used as a postoperative analgesic technique relative to other analgesic techniques among adults undergoing TKR.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2013, Issue 1, MEDLINE, EMBASE, CINAHL, Web (...) , number needed to treat for an additional harmful outcome (NNTH) four, high-quality evidence), greater knee flexion (11 RCTs, 596 participants, MD 6.48 degrees, 95% CI 4.27 to 8.69 degrees, moderate-quality evidence) and greater patient satisfaction (four RCTs, 180 participants, SMD 1.06, 95% CI 0.74 to 1.38, low-quality evidence) compared with PCA.We could not demonstrate a difference in pain between FNB (any type) and epidural analgesia in the first 72 hours post operation, including pain at 24

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2014 Cochrane

3. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty (...) observer's assessment of alertness/sedation score of 3 or 4. The cumulative amounts of fentanyl administered via intravenous patient-controlled analgesia were recorded at 24 and 48 hours postoperatively (primary outcome). The postoperative numerical rating scale for pain was assessed at 6, 12, 24, and 48 hours (secondary outcome). The postoperative use of additional rescue analgesic (ketoprofen) and antiemetic drugs was also compared between the 2 groups at 24 and 48 hours.Dexmedetomidine significantly

2018 EvidenceUpdates

4. Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review (PubMed)

Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review Acute pseudoseptic arthritis is a very rare complication that is associated with intra-articular hyaluronic acid injections, which normally involve minimal risk. The most common adverse events that are caused by hyaluronic acid injections are inflammatory reactions or flares at the injection site. In this study, we described three cases of acute (...) pseudoseptic arthritis that was caused by hyaluronic acid; the symptoms in these cases were reminiscent of acute septic arthritis. Moreover, we performed a literature review on pseudoseptic arthritis following hyaluronic acid injections to determine the manner in which this condition can be described, diagnosed, and treated.

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2017 European journal of rheumatology

5. First-in-human randomized clinical trials of the safety and efficacy of tanezumab for treatment of chronic knee osteoarthritis pain or acute bunionectomy pain (PubMed)

First-in-human randomized clinical trials of the safety and efficacy of tanezumab for treatment of chronic knee osteoarthritis pain or acute bunionectomy pain The neurotrophin nerve growth factor has a demonstrated role in pain transduction and pathophysiology.Two randomized, double-blind, placebo-controlled, phase 1 studies were conducted to evaluate safety, tolerability, and analgesic efficacy of single doses of tanezumab, a humanized anti-nerve growth factor monoclonal antibody, in chronic (...) or acute pain.In the first study (CL001), patients with moderate to severe pain from osteoarthritis (OA) of the knee received a single intravenous infusion of tanezumab (3-1000 μg/kg) or placebo in a dose-escalation (part 1; N = 42) or parallel-arm (part 2; N = 79) study design. The second study (CL002) was a placebo-controlled dose-escalation (tanezumab 10-1000 μg/kg; N = 50) study in patients undergoing bunionectomy surgery.Adverse event rates were generally similar across treatments. Most adverse

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2018 Pain Reports

6. Peri-operative steroids reduce pain, inflammatory response and hospitalisation length following knee arthroplasty without increased risk of acute complications: a meta-analysis. (PubMed)

Peri-operative steroids reduce pain, inflammatory response and hospitalisation length following knee arthroplasty without increased risk of acute complications: a meta-analysis. There is no consensus regarding the risks and benefits of peri-operative steroid supplementation in total knee arthroplasty (TKA). The aim of this meta-analysis is to compare TKA protocols implemented with or without steroids in terms of pain, inflammatory response, hospitalisation length, and complications.A systematic (...) of evidence were defined according to the Cochrane guidelines.Twenty articles were included. Steroid supplementation provides significantly lower post-operative pain from day 1 to day 4 (p < 0.05), with less opioid consumption (p = 0.05), less nausea and vomiting (p < 0.05), and greater knee range of motion (p < 0.001), thus resulting in a shorter hospitalisation length (p = 0.01). Moreover, lower C-reactive protein (p < 0.05), and IL-6 (p < 0.05) levels, but a higher blood glucose level at day 1 (p

2019 Knee Surgery, Sports Traumatology, Arthroscopy

7. Preoperative Pain, Symptoms, and Psychological Factors related to Higher Acute Pain Trajectories during Hospitalization for Total Knee Arthroplasty. (PubMed)

Preoperative Pain, Symptoms, and Psychological Factors related to Higher Acute Pain Trajectories during Hospitalization for Total Knee Arthroplasty.

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2016 PLoS ONE

8. Chronic Knee Pain

® topic on: “Osteonecrosis of the Hip” [3] for osteonecrosis, “Acute Trauma to the Knee” for acute knee injuries [4], “Imaging After Total Knee Arthroplasty” for patients with total knee arthroplasty [5], “Soft-Tissue Masses” for a patient with a suspected soft-tissue mass [6], “Primary Bone Tumors” for a patient with a suspected or known bone tumor [7], and “Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis” for patient with suspected arthritis or synovitis [8]. Special Imaging (...) imaging procedure. When associated with acute injury, recommendations are covered in the ACR Appropriateness Criteria ® topic on “Acute Trauma to the Knee” [4]. ACR Appropriateness Criteria ® 9 Chronic Knee Pain Radiography Hip An ipsilateral hip radiograph is usually not indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT Knee CT without IV contrast may be indicated to evaluate the patellofemoral anatomy in the setting of chronic knee pain related to repetitive

2018 American College of Radiology

9. The ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions

. At present, the vague and ill-defined term “subacute” pain has been used to define this time period where acute pain may or may not become chronic pain. Unique attributes of pain during this period, however, have been described. For example, in a study of 96 patients undergoing total knee arthroplasty, more patients described neuropathic pain symptoms at six weeks postoperatively when compared with the immediate postoperative setting or at later time points greater than six months [ ]. At this time (...) The ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions | Pain Medicine | Oxford Academic ') We use cookies to enhance your experience on our website.By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term

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2017 American Academy of Pain Medicine

10. Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty. (PubMed)

Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty. Pain scores are routinely reported in clinical practice, and we wanted to examine whether this routinely measured, patient-reported variable provides prognostic information, especially with regard to chronic opioid use, after taking preoperative and perioperative variables into account in a preoperative opioid user population.In 32,874 preoperative opioid users undergoing primary total knee arthroplasty at Veterans (...) Affairs hospitals between 2010 and 2015, we compared preoperative and perioperative characteristics in patients reporting lower versus higher acute pain (scores ≤4/10 vs >4/10 averaged over days 1-3). We calculated the propensity for lower acute pain based on all available data. After 1:1 propensity score matching, to identify similar patients differing only in acute pain, we contrasted rates of chronic significant opioid use (mean >30 mg/d in morphine equivalents) beyond postoperative month 3

2018 Regional Anesthesia and Pain Medicine

11. A Meta-Analysis on the Use of Gabapentinoids for the Treatment of Acute Postoperative Pain Following Total Knee Arthroplasty (PubMed)

A Meta-Analysis on the Use of Gabapentinoids for the Treatment of Acute Postoperative Pain Following Total Knee Arthroplasty Total knee arthroplasty is a painful procedure, with approximately half of patients reporting severe pain during the early postoperative period. Gabapentinoids are used as an adjunct for the management of acute pain in approximately half of enhanced recovery programs. We performed a meta-analysis to assess the effectiveness and safety of gabapentinoids for the treatment (...) of acute postoperative pain following total knee arthroplasty.Randomized controlled trials of patients undergoing elective primary total knee arthroplasty that compared the use of the gabapentinoid class of drugs (gabapentin [Neurontin; Pfizer]) or pregabalin [Lyrica; Pfizer]) with that of placebo were retrieved, with 12 studies meeting inclusion criteria. The primary outcome was pain intensity with activity at 48 hours following the surgical procedure. The secondary outcomes included pain intensity

2016 EvidenceUpdates

12. Prediction Model of Acute Postoperative Pain in Bilateral Total Knee Replacement Arthroplasty Patient

Prediction Model of Acute Postoperative Pain in Bilateral Total Knee Replacement Arthroplasty Patient Prediction Model of Acute Postoperative Pain in Bilateral Total Knee Replacement Arthroplasty Patient - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Prediction Model of Acute Postoperative Pain in Bilateral Total Knee Replacement Arthroplasty Patient The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03765723 Recruitment

2018 Clinical Trials

13. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial. (PubMed)

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial. In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty (...) observer's assessment of alertness/sedation score of 3 or 4. The cumulative amounts of fentanyl administered via intravenous patient-controlled analgesia were recorded at 24 and 48 hours postoperatively (primary outcome). The postoperative numerical rating scale for pain was assessed at 6, 12, 24, and 48 hours (secondary outcome). The postoperative use of additional rescue analgesic (ketoprofen) and antiemetic drugs was also compared between the 2 groups at 24 and 48 hours.Dexmedetomidine significantly

2018 Anesthesia and Analgesia

14. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial. (PubMed)

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial. In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty (...) observer's assessment of alertness/sedation score of 3 or 4. The cumulative amounts of fentanyl administered via intravenous patient-controlled analgesia were recorded at 24 and 48 hours postoperatively (primary outcome). The postoperative numerical rating scale for pain was assessed at 6, 12, 24, and 48 hours (secondary outcome). The postoperative use of additional rescue analgesic (ketoprofen) and antiemetic drugs was also compared between the 2 groups at 24 and 48 hours.Dexmedetomidine significantly

2018 Anesthesia and Analgesia

15. Perioperative intravenous ketamine for acute postoperative pain in adults. (PubMed)

Perioperative intravenous ketamine for acute postoperative pain in adults. Inadequate pain management after surgery increases the risk of postoperative complications and may predispose for chronic postsurgical pain. Perioperative ketamine may enhance conventional analgesics in the acute postoperative setting.To evaluate the efficacy and safety of perioperative intravenous ketamine in adult patients when used for the treatment or prevention of acute pain following general anaesthesia.We searched (...) . Studies compared ketamine with placebo, or compared ketamine plus a basic analgesic, such as morphine or non-steroidal anti-inflammatory drug (NSAID), with a basic analgesic alone.Two review authors searched for studies, extracted efficacy and adverse event data, examined issues of study quality and potential bias, and performed analyses. Primary outcomes were opioid consumption and pain intensity at rest and during movement at 24 and 48 hours postoperatively. Secondary outcomes were time to first

2018 Cochrane

16. Acute pain

practice guideline from the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-30. [184 references 2017 7. Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. BACKGROUND: Topical analgesic drugs are used for a variety of painful conditions. Some are acute , typically strains or sprains, tendinopathy, or muscle aches. Others are chronic, typically osteoarthritis of hand or knee, or neuropathic pain . OBJECTIVES: To provide an overview (...) Acute pain Top results for acute pain - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3

2018 Trip Latest and Greatest

17. Treatment for Acute Pain: An Evidence Map (Draft)

Treatment for Acute Pain: An Evidence Map (Draft) Draft Comparative Effectiveness Review Number XX Treatment for Acute Pain: An Evidence Map Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. xxx-xx-xxxx Prepared by: Evidence-based Practice Center Investigators: First and Last Names, X.X. First and Last Names, X.X. AHRQ Publication No. xx-EHCxxx This information is distributed (...) Messages Purpose of review The purpose of this evidence map is to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. We map the evidence for several acute pain conditions including postoperative pain, dental pain, neck pain, back pain, renal colic, acute migraine, and sickle cell crisis. Improved understanding of the interventions studied for each of these acute pain conditions will provide insight on which

2019 Effective Health Care Program (AHRQ)

18. Additional femoral nerve block analgesia does not reduce the chronic pain after total knee arthroplasty: A retrospective study in patients with knee osteoarthritis. (PubMed)

Additional femoral nerve block analgesia does not reduce the chronic pain after total knee arthroplasty: A retrospective study in patients with knee osteoarthritis. Femoral nerve block analgesia was deemed to the gold standard for acute pain management after total knee arthroplasty (TKA). But effect on chronic pain management is not investigated fully. We conducted a retrospective study to explore the effect of single-injection femoral nerve block on postsurgical chronic pain.All medical (...) (motion, P < .001). The rescued anesthesia rate reduced significantly in group N + P in POD 1 (P = .001), whereas no difference was found in POD 2 (P = .864). No difference was found at 3, 6, and 12 months after surgery (all P > .05).The single-injection femoral nerve block could relieve the acute postsurgical pain in a short period of time. But no evidence was found that it could reduce the chronic pain between 3 and 12 months after TKA.

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2019 Medicine

19. Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. (PubMed)

Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. Topical analgesic drugs are used for a variety of painful conditions. Some are acute, typically strains or sprains, tendinopathy, or muscle aches. Others are chronic, typically osteoarthritis of hand or knee, or neuropathic pain.To provide an overview of the analgesic efficacy and associated adverse events of topical analgesics (primarily nonsteroidal anti-inflammatory drugs (NSAIDs), salicylate (...) is good evidence that some formulations of topical diclofenac and ketoprofen are useful in acute pain conditions such as sprains or strains, with low (good) NNT values. There is a strong message that the exact formulation used is critically important in acute conditions, and that might also apply to other pain conditions. In chronic musculoskeletal conditions with assessments over 6 to 12 weeks, topical diclofenac and ketoprofen had limited efficacy in hand and knee osteoarthritis, as did topical high

2017 Cochrane

20. Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis. (PubMed)

Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis. The ability of preoperative intravenous glucocorticoids to control pain after total knee arthroplasty (TKA) has been examined in many studies, but it remains controversial. Therefore, we undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of preoperative intravenous glucocorticoids for postoperative pain management (...) , intravenous glucocorticoids were also associated with increased blood glucose with no clinical importance at 6 hours after TKA. No significant difference was found in the occurrence of infection or in blood glucose at 24 hours after TKA.Preoperative intravenous glucocorticoids are an effective and safe method to reduce postoperative pain and PONV in patients following TKA. More studies are necessary to identify the optimal dose and type of glucocorticoids for maximal pain control.

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2017 Medicine

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