Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

Objective: To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears.

Design: Prospective diagnostic study.

Settings: Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling.

Initial derivation of diagnostic clusters combining history elements and physical examination tests for symptomatic knee osteoarthritis.

Introduction: The aim of the present study was to assess the validity of clusters combining history elements and physical examination tests to diagnose symptomatic knee osteoarthritis (SOA) compared with other knee disorders.

Methods: This was a prospective diagnostic accuracy study, in which 279 consecutive patients consulting for a knee complaint were assessed. History elements and standardized physical examination tests were obtained independently by a physiotherapist and compared with an expert physician's composite diagnosis, including clinical examination and imaging.

Validity of Combining History Elements and Physical Examination Tests to Diagnose Patellofemoral Pain.

Objective: To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP).

Design: Prospective diagnostic study.

Settings: Orthopedic outpatient clinics, family medicine clinics, and community-dwelling.

Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

Background: The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce.

Objective: To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders.

Design: Prospective diagnostic accuracy study.

Modeling the anesthetic effect of ropivacaine after a femoral nerve block in orthopedic patients: a population pharmacokinetic-pharmacodynamic analysis.

Background: Even though ropivacaine is frequently used during orthopedic surgery, the relationship between plasma concentrations and degree of sensory anesthesia after a peripheral nerve block is currently unknown. The aim of this study was to characterize this relation using population pharmacokinetic-pharmacodynamic modeling.

Methods: Femoral nerve block was performed by the anterior approach using a single injection (20 ml) of 0.

The reliability of the current perception threshold in volunteers and its applicability in a clinical setting.

Background: Even though current perception threshold (CPT) has been used for evaluating the effectiveness of sensory block in patients before surgery, its reliability under controlled conditions has not been investigated. Two independent investigations were performed. The primary objective of the first study was to determine the test-retest reliability of CPT measures after repeated stimulations in a group of healthy volunteers.

Total knee arthroplasty with a novel navigation system within the surgical field.

Total knee arthroplasty is a common procedure, and current navigation systems are gradually gaining acceptance for improving surgical accuracy and clinical outcomes. A new navigation system used within the surgical field, iAssist, has demonstrated reproducible accuracy in component alignment. All orientation information is captured by small electronic pods and transmitted via a local wireless network, which directs the surgical workflow automatically to the femoral and tibial resection instruments.

A population pharmacokinetic model for the complex systemic absorption of ropivacaine after femoral nerve block in patients undergoing knee surgery.

Because of its slow systemic absorption and flip-flop kinetics, ropivacaine's pharmacokinetics after a peripheral nerve block has never been thoroughly characterized. The purpose of this study was to develop a population pharmacokinetic model for ropivacaine after loco-regional administration and to identify patient characteristics that may influence the drug's absorption and disposition. Frequent plasma samples were taken up to 93 h after a 100 mg dose given as femoral block for postoperative analgesia in 15 orthopedic patients.

Psychological determinants of problematic outcomes following Total Knee Arthroplasty.

The primary objective of the present study was to examine the role of pain-related psychological factors in predicting pain and disability following Total Knee Arthroplasty (TKA). The study sample consisted of 75 (46 women, 29 men) individuals with osteoarthritis of the knee who were scheduled for TKA. Measures of pain severity, pain catastrophizing, depression, and pain-related fears of movement were completed prior to surgery.

A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.

Background: Although numerous methods of postoperative analgesia have been investigated in an attempt to improve pain control after total knee arthroplasty, parenteral narcotics still play a major role in postoperative pain management. Local anesthetics have the advantage of blocking pain conduction at its origin and minimizing the systemic side effects associated with postoperative narcotic use. This study was performed to evaluate the benefits and safety of a multimodal analgesia protocol that included periarticular injection of large doses of local anesthetics in patients undergoing total knee arthroplasty.

The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement.

Purpose: To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR).

Methods: Sixty patients were randomly allocated to receive iv patient-controlled morphine analgesia (PCA), PCA plus a continuous FEM block with 30 mL ropivacaine 0.5% and epinephrine 1:200,000 bolus followed by an infusion of ropivacaine 0.