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Acute Knee Pain

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

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

2020 EvidenceUpdates

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

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

3. Femoral nerve blocks for acute postoperative pain after knee replacement surgery. (Abstract)

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

2014 Cochrane

4. Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review Full Text available with Trip Pro

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.

2017 European journal of rheumatology

5. 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

6. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018 | Journal of Orthopaedic & Sports Physical Therapy ADVERTISEMENT Journal of Orthopaedic & Sports Physical Therapy | | | | | > > > Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018 Clinical Practice Guidelines Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions (...) ) may be used to assess knee-related quality of life. Examination — Physical Performance Measures 2018 Recommendation Clinicians may administer appropriate clinical or field tests, such as single-legged hop tests (eg, single hop for distance, cross-over hop for distance, triple hop for distance, and 6-m timed hop), that can identify a patient's baseline status relative to pain, function, and disability; detect side-to-side asymmetries; assess global knee function; determine a patient's readiness

2018 American Physical Therapy Association

7. First-in-human randomized clinical trials of the safety and efficacy of tanezumab for treatment of chronic knee osteoarthritis pain or acute bunionectomy pain Full Text available with Trip Pro

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

2018 Pain Reports Controlled trial quality: uncertain

8. Patients With Total Knee Arthroplasty in the Acute Post-Operative Phase

) accelerated rehabilitation for improving ROM and walking, and (3) neurostimulation for reduction of pain in the acute care setting after TKA. | REFERENCES 1. Tian W, DeJong G, Brown M, Hsieh CH, Zamfirov ZP, Horn SD. Looking upstream: factors shaping the demand for postacute joint replacement rehabilitation. Arch Phys Med Rehabil. 2009;90(8):1260–1268. | | 2. Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative (...) in hospital after fast-track hip and knee arthroplasty? Acta Orthop. 2011;82(6):679–684. 15. Chan EY, Blyth FM, Nairn L, Fransen M. Acute postoperative pain following hospital discharge after total knee arthroplasty. Osteoarthr Cartil. 2013;21(9):1257–1263. | | 16. Lowe CJM, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ. 2007;335(7624):812. | | | 17. Shea BJ

2018 American Physical Therapy Association

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

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

10. Efficacy of different-frequency TEAS on acute pain after the total knee arthroplasty: a study protocol for a parallel group randomized trial. Full Text available with Trip Pro

Efficacy of different-frequency TEAS on acute pain after the total knee arthroplasty: a study protocol for a parallel group randomized trial. Total knee arthroplasty (TKA) is an optimal option for patients with middle-to-end-stage knee osteoarthritis. However, the management of postoperative acute pain remains inefficient. Transcutaneous electrical acupoint stimulation (TEAS) is a nonpharmacological method to manage postoperative acute pain. Different frequencies of TEAS have been tested using (...) varying parameters, but the optimal analgesic frequency remains controversial. The aim of this study was to explore the optimal analgesic frequency of TEAS for treating acute pain after the primary unilateral TKA.This is a double-blind, randomized controlled trial. A total of 156 patients are randomly assigned to: G1, 5 Hz TEAS; G2, 100 Hz TEAS; G3, mixed TEAS (alternative use of daily 5 Hz and 100 Hz TEAS) and G4, placebo TEAS. In the G1, G2 and G3 groups, TEAS is conducted at acupoints SP9 and GB34

2019 Trials Controlled trial quality: predicted high

11. Effect of Adductor Canal Block on Acute Perioperative Pain and Function in Total Knee Arthroplasty. (Abstract)

Effect of Adductor Canal Block on Acute Perioperative Pain and Function in Total Knee Arthroplasty. Multimodal pain management strategies are commonplace in perioperative management of total knee arthroplasty (TKA), although controversy remains regarding the role of adductor canal blocks (ACB) in this algorithm. The purpose of this study is to independently evaluate the effect of ACB on short-term postoperative outcomes including (1) length of stay (LOS), (2) postoperative narcotic utilization (...) , and (3) function with physical therapy in the era of modern TKA.We retrospectively identified a cohort of consecutive patients from January 2014 to January 2018 who had undergone unilateral primary TKA using a single-shot ACB in addition to a standardized multimodal pain regimen vs those who only received a multimodal pain regimen. These 2 groups were compared using independent sample t-tests with primary end points of interest being LOS, distance ambulated with therapy, and inpatient narcotic

2019 Journal of Arthroplasty

12. Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty. Full Text available with Trip Pro

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

13. 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

14. Individualized Care Plans for Acute Sickle Cell Pain Crises

Individualized Care Plans for Acute Sickle Cell Pain Crises Individualized Care Plans for Acute Sickle Cell Pain Crises | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search If you would like to view the videos from this event, please click the links below. Vignette Mr. J. is a 22 year old male presenting to your urban emergency department (...) complaining of his typical sickle cell pain in his knees, back, and shoulders for the last 2-days. he reports no recent viral of febrile illness, blunt trauma, travel history, or sock contacts. His home pain medications have been ineffective and he notes not recent change in his doses. He denies recent alcohol use or any history of intravenous or illicit substance abuse – and his screen is low risk for substance use disorder. He has been to your ED about 4-times per year over the last few years and always

2020 Washington University Emergency Medicine Journal Club

15. Chronic pain after total knee arthroplasty Full Text available with Trip Pro

Chronic pain after total knee arthroplasty Despite a good outcome for many patients, approximately 20% of patients experience chronic pain after total knee arthroplasty (TKA).Chronic pain after TKA can affect all dimensions of health-related quality of life, and is associated with functional limitations, pain-related distress, depression, poorer general health and social isolation.In both clinical and research settings, the approach to assessing chronic pain after TKA needs to be in-depth (...) and multidimensional to understand the characteristics and impact of this pain. Assessment of this pain has been inadequate in the past, but there are encouraging trends for increased use of validated patient-reported outcome measures.Risk factors for chronic pain after TKA can be considered as those present before surgery, intraoperatively or in the acute postoperative period. Knowledge of risk factors is important to guide the development of interventions and to help to target care. Evaluations of preoperative

2018 EFORT open reviews

16. Additional femoral nerve block analgesia does not reduce the chronic pain after total knee arthroplasty: A retrospective study in patients with knee osteoarthritis. Full Text available with Trip Pro

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.

2019 Medicine

17. The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty. Full Text available with Trip Pro

The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty. Pain catastrophizing contributes to acute and long-term pain after knee arthroplasty (KA), but the association between pain catastrophizing and physical function is not clear. We examined the association between preoperative pain catastrophizing and physical function one year after surgery, as well as differences in physical function, pain and general health in two (...) groups of patients with high and low preoperative pain catastrophizing score.We included 615 patients scheduled for KA between March 2011 and December 2013. Patients completed The Pain Catastrophizing Scale (PCS) prior to surgery. The Oxford Knee Score (OKS), Short Form-36 (SF-36) and the EuroQol-5D (EQ-5D) were completed prior to surgery, and 4 and 12 months after the surgery.Of the 615 patients, 442 underwent total knee arthroplasty (TKA) and 173 unicompartmental knee arthroplasty (UKA). Mean age

2019 BMC Musculoskeletal Disorders

18. Oral shea nut oil triterpene concentrate supplement ameliorates pain and histological assessment of articular cartilage deterioration in an ACLT injured rat knee osteoarthritis model. Full Text available with Trip Pro

Oral shea nut oil triterpene concentrate supplement ameliorates pain and histological assessment of articular cartilage deterioration in an ACLT injured rat knee osteoarthritis model. Osteoarthritis (OA) is a multifactorial joint disease and a common disabling condition in the elderly population. The associated pain and pathohistological changes in cartilage are common features of OA in both humans and animal models. Shea nut oil extract (SheaFlex75) contains a high triterpenoid concentration (...) and has demonstrated anti-inflammatory and antiarthritic effects in both human and animal studies. In this study, we aim to investigate the potential of SheaFlex75 to prevent articular cartilage deterioration in a rat model of chronic OA progression. By employing anterior cruciate ligament transection (ACLT) with medial meniscectomy (MMx)-induced OA, we found attenuation of both early and chronic onset OA pain and cartilage degeneration in ACLT+MMx rats receiving SheaFlex75 dietary supplementation

2019 PLoS ONE

19. Perioperative intravenous ketamine for acute postoperative pain in adults. Full Text available with Trip Pro

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

20. Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis. Full Text available with Trip Pro

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.

2017 Medicine

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