Objective: Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain.
Design: A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management.
Setting: The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012.
Subjects: Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients.
Methods: Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10).
Results: Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture.
Conclusions: Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR.
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http://dx.doi.org/10.1111/pme.12685 | DOI Listing |
Arthroplast Today
December 2024
Rush University Medical Center, Chicago, IL, USA.
Avascular necrosis (AVN) of the femoral head accounts for up to 10% of all total hip arthroplasties performed annually. Typically associated with intravascular coagulation, AVN is extremely rare in patients with bleeding disorders such as hemophilia B. In this report, we describe the therapeutic management of a 46-year-old male with hemophilia B, presenting with chronic left hip pain and AVN of the femoral head.
View Article and Find Full Text PDFArthroplast Today
December 2024
Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.
Background: Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to provide surgeons with virtual preoperative planning and intraoperative information to achieve the desired surgical goals in an effort to improve patient outcomes. The purpose of this study was to compare clinical outcomes and patient-reported outcome measures following primary TKA using RA-TKA vs manual instrumentation.
Methods: This was a retrospective cohort review study comparing 393 primary RA-TKAs vs 312 manual TKAs at a minimum 2-year follow-up.
Arthroplast Today
December 2024
Hospital Pavia Arecibo, Arecibo Orthopedic Institute, Arecibo, PR, USA.
Synovial fistula of the knee occurs when a defect in the joint capsule creates a connection between skin, bursa, and a near tissue, manifesting as an opening with continuous draining fluid or a cyst. This is a case of an 80-year-old male who developed a synovial fistula with cystic presentation 6 years after the primary total knee arthroplasty. Management included a total knee arthroplasty revision surgery with intraoperative identification of the fistula with methylene blue, and using a gelatin-thrombin matrix for closure.
View Article and Find Full Text PDFJSES Int
November 2024
Faculty of Health Sciences, Hokkaido University, Sappro, Japan.
Background: Understanding factors associated with improvements in subjective shoulder function after arthroscopic rotator cuff repair (ARCR) helps clinicians identify targets for postoperative rehabilitation. The aim of this study was to investigate the factors associated with subjective shoulder function after ARCR.
Methods: Patients who underwent ARCR for rotator cuff tear with at least 12 months of follow-up were included.
JSES Int
November 2024
Department of Orthopaedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Background: The incidence of primary reverse total shoulder arthroplasty (rTSA) and the prevalence of obesity have increased in the United States. Despite this, the literature assessing the effect of morbid obesity (body mass index≥40 kg/m) on perioperative surgical outcomes remains inconsistent.
Methods: A retrospective review of consecutive elective primary rTSA cases from January 2016 through September 2023 at a single tertiary referral center was performed.
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