The Knee
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Review Meta Analysis
Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis.
To examine the safety and efficacy of topical use of tranexamic acid (TA) in total knee arthroplasty (TKA). ⋯ I, II.
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Randomized Controlled Trial Comparative Study
Pain control after primary total knee replacement. A prospective randomised controlled trial of local infiltration versus single shot femoral nerve block.
We report a prospective blinded randomised trial of local infiltration versus femoral nerve block in patients undergoing primary total knee replacement (TKR), in accordance with the CONSORT statement 2010. ⋯ Intraoperative local infiltration gives superior pain relief compared to single shot femoral nerve block over the first 24h following primary TKR and minimises post-operative opiate use.
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Comparative Study
Inflammatory predictors of ongoing pain 2 years following knee replacement surgery.
The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial. ⋯ Prognosis study, Level 2.
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To compare the patient-reported outcomes and arthroscopic findings between drilling and autologous osteochondral grafting (AOG) for the treatment of articular cartilage defects combined with anterior cruciate ligament (ACL) injuries. ⋯ Case-control study (LEVEL III).
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Local infiltration analgesia (LIA) is a relatively novel technique developed for effective pain control following total knee arthroplasty (TKA), reducing requirements for epidural or parenteral postoperative analgesia. This study investigated the anatomical spread of an LIA used in TKA to identify the nerve structures reached by the injected fluid. ⋯ These results support the positive clinical outcomes with this LIA technique. However, the lack of infiltration into the lower popliteal fossa suggests more fluid or a different injection point could be used. The solution reaching the extensor muscles of the lower leg is likely to have no beneficial analgesic effect for a TKA patient. The LIA technique is already used in clinical practice following total knee arthroplasty. Results from this study show there may be scope to optimise the injection sites in LIA technique.