Should Pre-Operative Fascia Iliaca Block Be Used for Hip Arthroscopic Labral Repair and Femoroacetabular Impingement Treatment? A Prospective Single Blinded Randomized Study
The purpose of this investigation was to evaluate the analgesic effect of preoperative fascia iliaca block (FIB) on postoperative morphine equivalent dose (MED), pain level, and patient satisfaction for patients electing to undergo primary hip arthroscopic labral repair with osteochondroplasty.
We describe a technique using a fascia lata autograft to reconstruct the rotator cuff in the setting of a massive cuff tear. This is of particular importance in centers that lack the funding or institutional approval to use acellular dermal allografts that have been popularized to date.
ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR.
J Knee Surg DOI: 10.1055/s-0039-1700978To improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] =&...
ConclusionThe findings suggest that patients undergoing shoulder surgery have high overall preoperative expectations, which were significantly associated with ethnicity, surgical history, opioid use, and employment status, and with multiple patient-reported outcome measures including physical function, pain interference, fatigue, and depression. Nevertheless, by discussing expectations preoperatively, orthopaedic surgeons can help patients develop high but realistic expectations to improve outcomes and satisfaction.Level of evidenceIV.
Discussion: We hypothesize that patients who receive a supervised early exercise program in combination with standard treatment will benefit more in respect to shoulder function, pain reduction, and range of motion than those who receive a standard exercise program. If this is confirmed, our study can be used clinically to enhance the recovery of patients with arthroscopic RC repair. Trial registration: Brazilian registry of clinical trials UTN number U1111-1224-4143. Registered December 18, 2018.
Abstract Factors motivating patients to undergo rotator cuff repair (RCR) have not been thoroughly investigated. The purpose of this study was to investigate patient and surgeon decision-making factors for RCR, as well as the use of conservative treatment, and their relationship with shoulder function. A total of 144 adult patients undergoing arthroscopic RCR completed a 13-item questionnaire assessing the importance of surgical decision-making factors. Preoperative conservative treatments were also recorded. Surgeons also completed a similar 5-item questionnaire assessing surgeon decision-making factors preoperat...
To evaluate the analgesic effect of preoperative fascia iliaca block on postoperative morphine equivalent dose, pain level, and patient satisfaction for patients electing to undergo primary hip arthroscopic labral repair with osteochondroplasty.
MRI is the advanced imaging modality of choice for the evaluation and diagnosis of full thickness rotator cuff tears (RCT). Tear size progression has been correlated with increasing pain. However, there is little data on tear size progression in symptomatic RCT with regard to time from MRI to actual rotator cuff repair (RCR). The purpose of the study was to evaluate the effect of time (from date of MRI measured tear dimensions to date of RCR measured intraoperative tear dimensions) on tear size progression.
Hip abductor tendon tears or tears of the gluteus medius and minimus is a common etiology of lateral hip pain, especially in females between the fourth and sixth decade. Abductor tears are often associated with severe functional impairment including hip abduction weakness and Trendelenburg gait. Excellent outcomes have been demonstrated using open repair with an increasing interest in endoscopic management. The purpose of this study is to add to the growing body of evidence by prospectively evaluating the short-term outcomes of endoscopic repair of full and partial abductor tendon tears, with a minimum of 1-year follow-up.
Post-operative pain following rotator cuff repair is commonly managed through the use of opioid medications; however, these medications are associated with serious adverse effects. Relaxation exercises represent a potential non-pharmacologic method of pain management that can be easily implemented without significant adverse effects. The purpose of this investigation was to evaluate the effects of relaxation exercises on post-operative pain and narcotics use after ARCR.