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Effect of Ketoprofenphonophoresis and femoral nerve block in Knee Osteoarthritis

Journal of Clinical and Nursing Research 2021年第6期5卷 72-78页

作者： Fan Fan Wei Wei Binyan He Chaonan Li Qing Yang Shuiqin Li Department of Rehabilitation Medicine the First Affiliated Hospital of Xi’an Medical UniversiyXi’an 710077Shaanxi ProvinceChina

Objective:To evaluate the effect of ketoprofenphonophoresis and femoral nerve block in knee ***:One hundred and fourteen patients with knee osteoarthritis were randomly divided into two *** control group consisted of 57 patients who were treated with only *** experimental group consisted of patients were treated with ketoprofenphonophoresis and femoral nerve *** patients were followed for more than one *** treatment effect assessed by observing their WOMAC index before and after ***:All the patients finished the *** WOMAC indexes were reduced after therapy and one month after treatment,especially in the experimental group(Pfemoral nerve block were higher than that in the control group after treatment and after one month of follow-up(Pfemoral nerve block was more appropriate in knee osteoarthritis.

关键词： Ketoprofenphonophoresis femoral nerve block Knee osteoarthritis

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Implementation science for the adductor canal block:A new and adaptable methodology process

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World Journal of Orthopedics 2021年第11期12卷 899-908页

作者： Nikhil Crain Chun-Yuan Qiu Stephen Moy Shawn Thomas Vu Thuy Nguyen Mijin Lee-Brown Diana Laplace Jennifer Naughton John Morkos Vimal Desai Bowman Gray Center for Medical Education Wake Forest School of MedicineWinston-SalemNC 27103United States Perioperative Service and Anesthesiology Kaiser Permanente Medical CenterBaldwin ParkCA 91706United States Department of Anesthesiology Baldwin Park Medical CenterSouthern California Kaiser Permanente Medical GroupBaldwin ParkCA 91706United States Johns Hopkins University The Johns Hopkins University School of MedicineBaltimoreMD 21205United States

BACKGROUND Following the successful Perioperative Surgical Home(PSH)practice for total knee arthroplasty(TKA)at our institution,the need for continuous improvement was realized,including the deimplementation of antiquated PSH elements and introduction of new *** To investigate the transition from femoral nerve blocks(FNB)to adductor canal nerve blocks(ACB)during *** Our 13-month study from June 2016 to 2017 was divided into four periods:a three-month baseline(103 patients),a one-month pilot(47 patients),a three-month implementation and hardwiring period(100 patients),and a six-month evaluation period(185 patients).In total,435 subjects were *** within 30 postoperative days were extracted from electronic medical records,such as physical therapy results and administration of oral morphine equivalents(OME).RESULTS Our institution reduced FNB application(64% to 3%)and increased ACB utilization(36% to 97%)at 10 *** in the ACB group were found to have increased ambulation on the day of surgery(4.1 vs 2.0 m)and lower incidence of falls(0 vs 1%)and buckling(5% vs 27%)compared with FNB patients(P<0.05).While ACB patients(13.9)reported lower OME than FNB patients(15.9),the difference(P=0.087)did not fall below our designated statistical threshold of P value<*** By demonstrating closure of the“knowledge to action gap”within 6 mo,our institution’s findings demonstrate evidence in the value of implementation *** education,technical support,and performance monitoring were deemed key facilitators of our program’s *** patient populations and additional orthopedic procedures are recommended for future study.

关键词： Total knee arthroplasty femoral nerve block Adductor canal block Physical therapy Oral morphine equivalent Action-related information gap

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Ultrasound-guided continuous adductor canal block for analgesia after total knee replacement

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Chinese Medical Journal 2014年第23期127卷 4077-4081页

作者： Zhang Wei Hu Yan Tao Yan Liu Xuebing Wang Geng Department of Anesthesiology Beijing Jishuitan Hospital Beijing 100035 China

Background There are several methods for postoperative analgesia for knee *** commonly utilized method is multimodal analgesia based on continuous femoral nerve *** aim of this study was to investigate the application of continuous adductor canal block for analgesia after total knee replacement and compare this method with continuous femoral nerve *** Sixty patients scheduled for total knee replacement from June 2013 to March 2014 were randomly divided into a femoral group and an adductor *** were placed under the guidance of nerve stimulation in the femoral group and under the guidance of ultrasound in the adductor *** were performed under combined spinal and epidural *** the operations,0.2％ ropivacaine was given at a speed of 5 ml/h through catheters in all *** analogue scale （VAS） pain scores at rest and while moving were noted at 4,24,and 48 hours after the operation,and quadriceps strength was also assessed at these *** parameters such as doses of complementary analgesics and side effects were also *** There were no significant differences between the groups in VAS pain scores at rest or while moving,at 4,24,or 48 hours after the operation （P ＞0.05）.At these time-points,mean quadriceps strengths in the adductor group were 3.0 （2.75-3.0）,3.0 （3.0-4.0）,and 4.0 （3.0-4.0）,respectively,all of which were significantly stronger than the corresponding means in the femoral group,which were 2.0 （2.0-3.0）,2.0 （2.0-3.0）,and 3.0 （2.0-4.0）,respectively （P ＜0.05）.There were no significant differences between the groups in doses of complementary analgesics or side effects （P ＞0.05）.X-ray images of some patients showed that local anesthetic administered into the adductor canal could diffuse upward and reach the femoral *** Continuous adductor canal block with 0.2％ ropivacaine could be used effectively for analgesia after total knee *** with

关键词： adductor canal block femoral nerve block ropivacaine total knee replacement multimodal analgesia

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Mobile Bearing Plate Dislocation in Total Knee Arthroplasty Due to Muscle Spasm:A Case Report

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Open Journal of Orthopedics 2013年第2期3卷 69-73页

作者： Jean-Damien Nicodeme Claus Locherbach Alexandre Terrier Aurélien Gallice Brigitte MJolles Department of Orthopaedic Surgery and Traumatology Centre Hospitalier Universitaire Vaudois and University of LausanneLausanneSwitzerland Laboratory of Biomechanical Orthopedics Interinstitutional Center of Translational BiomechanicsEcole Polytechnique Fédérale de LausanneLausanneSwitzerland

An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mismatch. Revision surgery reduced posterior dislocation, increased bearing plate thickness and rebalanced ligaments. A second dislocation occurred after revision surgery. The patient’s history was retaken and a hamstring spasm disease identified. A new revision utilized a more constrained design, without perioperative local nerve block. Two years following surgery, no further dislocation had occurred. A numerical musculoskeletal model of the case and implant configuration identified no trend to mobile bearing dislocation when regular muscle forces were applied. Muscle spasm is a risk factor for mobile bearing total knee arthroplasty dislocation, especially with femoral nerve block.

关键词： Dislocation femoral nerve block Mobile Bearing Prosthesis Muscle Spasm Total Knee Arthroplasty

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