Purpose Of Review: Chronic pain after total joint replacement (TJA), specifically total knee replacement (TKA), is becoming more of a burden on patients, physicians, and the healthcare system as the number of joint replacements performed increases year after year. The management of this type of pain is critical, and therefore, understanding the various modalities physicians can use to help patients with refractory pain after TJA is essential.
Recent Findings: The modalities by which chronic pain can be successfully managed include genicular nerve radioablation therapy (GN-RFA), neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and peripheral subcutaneous field stimulation (PSFS). Meta-analyses and case reports have demonstrated the effectiveness of these treatment options in improving pain and functional outcomes in patients with chronic pain after TKA. The purpose of this paper is to review and synthesize the current literature investigating the different ways that refractory pain is managed after TJA, with the goal being to provide treatment recommendations for providers treating these patients.
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http://dx.doi.org/10.1007/s11916-021-00956-1 | DOI Listing |
Int J Gynaecol Obstet
January 2025
Effective Care Research Unit, University of the Witwatersrand and Walter Sisulu University, East London, South Africa.
Objective: To compare low-cost "Suction Tube Uterine Tamponade" (STUT) treatment for refractory postpartum hemorrhage (PPH) with uterine balloon tamponade (UBT) using a randomized feasibility study.
Methods: After verbal assent, we allocated participants with refractory PPH by randomly ordered envelopes to STUT or routine UBT at 10 hospitals in South Africa and one tertiary referral center in Colombia between January 10, 2020, and May 3, 2024. In the STUT group, we inserted a 24 FG Levin stomach tube into the uterine cavity and applied suction.
J Cardiovasc Dev Dis
January 2025
Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Refractory angina pectoris (RAP) is a clinical syndrome characterized by persistent chest pain caused by myocardial ischemia that is unresponsive to optimal pharmacological therapy and revascularization procedures. Spinal cord stimulation (SCS) has emerged as a promising therapeutic option for managing RAP, offering significant symptom relief and improved quality of life. A systematic literature review was conducted to evaluate the clinical effectiveness, mechanisms of action, and safety profile of SCS in treating RAP.
View Article and Find Full Text PDFWorld J Gastrointest Endosc
January 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Lukang Christian Hospital, Changhua 505002, Taiwan.
Background: Gastric bezoars are indigestible masses that can lead to gastrointestinal obstruction and ulceration. Standard treatments include endoscopic mechanical lithotripsy with a polypectomy snare and Coca-Cola dissolution therapy or a combination of both approaches. However, giant bezoars frequently require multiple treatment sessions and extended hospital stays.
View Article and Find Full Text PDFSAGE Open Med Case Rep
January 2025
Faculty of Medicine, Division of Dermatology, University of Ottawa, Ottawa, ON, Canada.
Acrodermatitis continua of Hallopeau is a rare form of pustular psoriasis affecting the acral fingers and toes, characterized by recurrent eruptions of sterile pustules that lead to significant pain and potentially irreversible destruction of the nail apparatus. Symptoms are often refractory to topical and systemic therapies for psoriasis. This case report presents a healthy 23-year-old female with severe acrodermatitis continua of Hallopeau, destructing all 10 fingernails.
View Article and Find Full Text PDFCureus
December 2024
Neurosurgery, Fluminense Federal University, Niterói, BRA.
Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by significant sensory, motor, and autonomic dysfunction, often following trauma or nerve injury. Historically known as causalgia and reflex sympathetic dystrophy, CRPS manifests as severe, disproportionate pain, often accompanied by hyperalgesia, allodynia, trophic changes, and motor impairments. Classified into type I (without nerve injury) and type II (associated with nerve damage), CRPS exhibits a complex pathophysiology involving peripheral and central sensitization, neurogenic inflammation, maladaptive brain plasticity, and potential autoimmune and psychological influences.
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