Prolonged Epidural Infusion Improves Functional Outcomes Following Knee Arthroscopy in Patients with Arthrofibrosis after Total Knee Arthroplasty: A Retrospective Evaluation
J Knee SurgDOI: 10.1055/s-0034-1394163A total of 20 consecutive patients with knee stiffness post total knee arthroplasty (TKA) underwent arthroscopic lysis of adhesions and manipulation plus indwelling epidural were evaluated retrospectively. Epidural catheters were placed preoperatively for an intended 6 weeks of postoperative analgesia to facilitate intensive physical therapy. The mean loss of knee extension immediately before incision was 13.5 ± 9.1 degrees (range, 0–35 degrees) and flexion was 77.65 ± 19.2 degrees (range, 45–125 degrees). At the 6-week and final (mean, 0.47 years) follow-up, the loss of extension was 1.5 ± 5.1 degrees (range, −10 to +7 degrees) and 5.4 ± 4.7 degrees (range, 0–15 degrees), respectively, and flexion was 99.7 ± 12.3 degrees (range, 75–120 degrees) and 98.5 ± 16.1 degrees (range, 75–130 degrees), respectively. Of the 20 patients, 2 missed their 6-week clinic visit. Improvements in motion immediately preoperative to 6-week and final follow-up were each significant (p
We describe a case of an acetabular fracture and ipsilateral open tibia/fibula fracture with osteochondral loose bodies in the hip joint inhibiting physical therapy potential, treated successfully with arthroscopic removal using an adjusted skeletal traction method.
We recently read with interest the article titled, “Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes”1. The authors conducted a meta-analysis of patient-reported outcomes of both treatment strategies, and they concluded that patients with femoroacetabular impingement (FAI) s yndrome treated with hip arthroscopy have superior hip-related outcomes in the short term compared with patients receiving physical therapy. This letter to the editor contains some queries about the statistical methods and interpretation of those pooled analysis results.
Conclusions: This systematic review and meta-analysis of high-quality literature provides relatively strong evidence that APM did not improve functional activity or reduce pain compared with the results with conservative treatment or sham operation in knees with mild or no osteoarthritis.
Imagine you’re walking along and suddenly experience excruciating knee pain. Though it initially seems stuck in one position, after a minute or two you can limp along home, but just barely. At your doctor’s visit, an x-ray is normal but symptoms continue for weeks. An MRI is performed and now you have an explanation: a torn meniscus. (Two menisci — rubbery cartilage pads that act as shock absorbers — separate the bottom of your knee bone from the top of your shin bone.) A month later, you’re no better despite rest, pain medicines, and physical therapy. It’s time for surgery to fix it, ri...
CONCLUSIONS: Degenerative meniscal tears, without symptoms of locking and catching, can be successfully managed by a proper regimen of physical therapy as a first line treatment. Surgical approach might be considered in case of poor response after conservative treatment. PMID: 32271405 [PubMed - as supplied by publisher]
CONCLUSIONS: Surgical outcome studies do not provide sufficient detail or consistency for practicing clinicians to replicate a postoperative rehabilitation protocol for patients with FAI syndrome/labral tear. J Orthop Sports Phys Ther, Epub 9 Apr 2020. doi:10.2519/jospt.2020.9189. PMID: 32272028 [PubMed - as supplied by publisher]
Meniscal tears are commonly observed on MRIs obtained in middle-aged and older adults, with some studies suggesting a 35% prevalence in the 50-and-older population (1). Not all tears are symptomatic, but patients with these tears often seek treatment when they experience pain, swelling, or interference with valued activities. Physical therapy (PT) and arthroscopic partial meniscectomy (APM) are among the treatment options available to these patients, with clinical trials showing similar benefits in terms of pain and functional improvement for both (2).
Conclusion: In the treatment of degenerative meniscus tears, APM yielded better functional and pain outcomes compared with physical therapy in the short term until 12 months, but there were comparable results for pain and functional outcomes between the groups at the 24 months follow-up time point. PMID: 32190650 [PubMed - in process]
This article was corrected online.
Abstract The glenohumeral joint is prone to instability. Patients with instability should have a physical examination. Imaging studies can provide additional information. Classification schemes that into account soft tissue pathology, neuromuscular control, bone loss, and activity level. An arthroscopic Bankart repair is the mainstay for unidirectional instability. Bone block procedures are indicated for patients with bone loss or a failed attempt at stabilization surgery. The arthroscopic Latarjet is a promising option for these patients. For patients with multidirectional instability, prolonged rehabilitation is...