scholarly journals The stiff total knee arthroplasty: causes, treatment modalities and results

2019 ◽  
Vol 4 (10) ◽  
pp. 602-610 ◽  
Author(s):  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Treatment Options ◽  
Patellar Ligament ◽  
Treatment Modalities ◽  
Surgical Trauma ◽  
Physical Medicine ◽  
Physical Medicine And Rehabilitation ◽  
Total Knee

It is clear that the stiff total knee arthroplasty (TKA) is a multifactorial entity associated with preoperative, intraoperative and postoperative factors. Management of the stiff TKA is best achieved by preventing its occurrence using strategies to control preoperative factors, avoid intraoperative technical errors and perform aggressive, painless postoperative physical medicine and rehabilitation; adequate pain control is paramount in non-invasive management. Careful attention to surgical exposure, restoring gap balance, minimizing surgical trauma to the patellar ligament/extensor mechanism, appropriate implant selection, pain control and adequate physical medicine and rehabilitation (physiotherapy, Astym therapy) all serve to reduce its incidence. For established stiff TKA, there are multiple treatment options available including mobilization under anaesthesia (MUA), arthroscopic arthrolysis, revision TKA, and combined procedures. Cite this article: EFORT Open Rev 2019;4:602-610. DOI: 10.1302/2058-5241.4.180105

scholarly journals A Collaborative Approach to Pain Control Reduces In-hospital Opioid Use and Improves Range of Motion following Total Knee Arthroplasty

Cureus ◽  
2019 ◽  
Author(s):  
Christopher Roberts ◽  
Devon Foster ◽  
Glen G Shi ◽  
Elizabeth R Lesser ◽  
Michael G Heckman ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Collaborative Approach ◽  
Opioid Use ◽  
Total Knee

EARLY POSTOPERATIVE QUADRICEPS POWER, MOTION RANGE, AND ANALGESIA EVALUATION FOLLOWING KNEE REPLACEMENT AFTER FEMORAL OR ADDUCTOR BLOCK: RANDOMIZED CONTROLLED STUDY

2020 ◽  
Vol 23 (03) ◽  
pp. 2050006
Author(s):  
Mahmoud Fahmy
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Femoral Nerve ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Group A ◽  
Total Knee

Purpose: Evaluate the reliability of the early functional recovery and postoperative pain control using adductor canal block (ACB) compared with that using femoral nerve block (FNB) in patients undergoing total knee replacement (TKR). Patients and Methods: A total of 80 patients scheduled for TKR were randomly and blindly distributed into two groups (40 patients each). Group A received ACB and group F received FNB. The early quadriceps strength, range of motion and pain control were assessed after surgery during the first 48[Formula: see text]h. Results: Patients in group F had significantly less quadriceps power postoperatively than those in group A. There were no significant differences between the two studied groups as regard ambulation, range of motion and pain estimation. Conclusion: Since both blocks have comparable analgesic effect and opioid consumption rates, the increased quadriceps muscle strength and ability to ambulate on the first postoperative day is the driving factor in selecting the ACB. With the findings discussed in our study and in literature, an ACB is a viable option in place of a FNB in patients undergoing a total knee arthroplasty. Additional large participant randomized controlled studies should be conducted to further discover the benefits of an ACB in patients undergoing a total knee arthroplasty.

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