Multimodal pain management and arthrofibrosis

被引:22
作者
Lavernia, Carlos [1 ,2 ]
Cardona, Diego [1 ,2 ]
Rossi, Mark D. [3 ]
Lee, David [4 ]
机构
[1] Mercy Hosp, Inst Orthopaed, Miami, FL USA
[2] Arthritis Surg Res Fdn Inc, Miami, FL USA
[3] Florida Int Univ, Dept Phys Therapy, Miami, FL 33199 USA
[4] Univ Miami, Dept Epidemiol & Publ Hlth, Miami, FL USA
关键词
pain control; manipulation; arthrofibrosis;
D O I
10.1016/j.arth.2008.03.012
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Pain control after arthroplasty has been a key concern for orthopedic surgeons. After total knee arthroplasty (TKA), a small group of patients developed a painful joint With Suboptimal range of motion. manipulation under anesthesia increases flexion and extension while decreasing pain in most cases. The objective of the present investigation is to asses the effect of a multimodal pain management protocol on arthrofibrosis in primary TKAs. A cohort of 1136 patients who underwent primary TKA was selected. Patients were divided into 2 groups: group A had 778 procedures performed using a traditional approach to pain control; group B included 358 procedures that received multimodal pain management. Group A had an incidence of manipulation of 4.75% (37/778). Of 357 patients, 8 required manipulation in group B, which is an incidence of 2.24%. We recommend that orthopedic Surgeons consider using a multimodal pain management protocol for TKA.
引用
收藏
页码:74 / 79
页数:6
相关论文
共 16 条
  • [1] Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty
    Berger, RA
    Jacobs, JJ
    Meneghini, RM
    Della Valle, C
    Paprosky, W
    Rosenberg, AG
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2004, (429) : 239 - 247
  • [2] Predicting total knee replacement pain
    Brander, VA
    Stulberg, SD
    Adams, AD
    Harden, RN
    Bruehl, S
    Stanos, SP
    Houle, T
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2003, (416) : 27 - 36
  • [3] Dahlen L, 2006, ORTHOP NURS, V25, P264
  • [4] Dennis DA, 2001, ORTHOPEDICS, V24, P901
  • [5] Manipulation of total knee replacements - Is the flexion gained retained?
    Esler, CNA
    Lock, K
    Harper, WM
    Gregg, PJ
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1999, 81B (01): : 27 - 29
  • [6] Predictive risk factors for stiff knees in total knee arthroplasty
    Gandhi, R
    de Beer, J
    Leone, J
    Petruccelli, D
    Winemaker, M
    Adili, A
    [J]. JOURNAL OF ARTHROPLASTY, 2006, 21 (01) : 46 - 52
  • [7] The failed total knee arthroplasty: Evaluation and etiology
    Gonzalez, MH
    Mekhail, AO
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2004, 12 (06) : 436 - 446
  • [8] Analgesia for total hip and knee arthroplasty: A multimodal pathway featuring peripheral nerve block
    Horlocker, TT
    Kopp, SL
    Pagnano, MW
    Hebl, JR
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2006, 14 (03) : 126 - 135
  • [9] Manipulation after total knee arthroplasty
    Keating, E. Michael
    Ritter, Merrill A.
    Harty, Leesa D.
    Haas, Gail
    Meding, John B.
    Faris, Philip M.
    Berend, Michael E.
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2007, 89A (02) : 282 - 286
  • [10] Maximizing flexion after total knee arthroplasty - The need and the pitfalls
    Kurosaka, M
    Yoshiya, S
    Mizuno, K
    Yamamoto, T
    [J]. JOURNAL OF ARTHROPLASTY, 2002, 17 (04) : 59 - 62