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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors have treated 63 knees with osteoarthritis associated with varus deformity by valgus osteotomies. The clinical and radiological state of the patello-femoral joints has been studied before and after correction of varus deformity. No correlation was found between the severity of tibio-femoral osteoarthritis and patello-femoral osteoarthritis. Medical patello-femoral discordance was found in 12 p. 100 of the cases. Clinical evidence of pain arising from the patello-femoral joint was more often found than evidence of radiological abnormality. It is concluded that pain arising from the medial compartment may be confused with patello-femoral pain. A five-year follow-up showed that the patello-femoral joint was not influenced radiologically by the valgus osteotomy but patellar pain was improved in most of the cases. Procedures to re-align the patella should not normally be associated with valgus osteotomy in cases in which patellar pain exists in association with osteoarthritis of the knee with varus deformity.
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PMID:[The patello-femoral joint in osteoarthritis of the knee with gene varum (author's transl)]. 15 54

The authors have treated 63 knees with osteoarthritis associated with varus deformity by valgus osteotomies. The clinical and radiological state of the patello-femoral joints has been studied before and after correction of varus deformity. No correlation was found between the severity of tibio-femoral osteoarthritis and patello-femoral osteoarthritis. Medial patello-femoral discordance was found in 12 p. 100 of the cases. Clinical evidence of pain arising from the patello-femoral joint was more often found than evidence of radiological abnormality. It is concluded that pain arising from the medial compartment may be confused with patellofemoral pain. A five-year follow-up showed that the patello-femoral joint was not influenced radiologically by the valgus osteotomy but patellar pain was improved in most of the cases. Procedures to re-align the patella should not normally be associated with valgus osteotomy in cases in which patellar pain exists in association with osteoarthritis of the knee with varus deformity.
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PMID:[The patello-femoral joint in osteoarthritis of the knee with genu varum (author's transl)]. 15 84

In degenerative and posttraumatic osteoarthritis of the knee joint pain is a major indication for correctional osteotomy. In additon, the degree of arthrosis, axis deviation, range of motion and derangement of ligaments must be considered. In the cases reviewed supracondylar femur osteotomy, extraligamentar and high interligamentar osteotomy of the tibial head were utilized for correction. High tibial osteotomies were performed without using stabilizing plates. Autologous as well as homologous bone implants were added as needed. From the results presented we conclude, that the different methods of correctional osteotomies are equivalent, as long as the axis deviation, which is present in most cases, is corrected into a physiological valgus position. About 3/4 of the patient operated upon were improved as far as pain, range of motion and weigthbearing are concerned. Regression of the arthrotic structural changes could be demonstrated in a few cases only.
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PMID:[Indication, technique, and results for high tibial osteotomies (author's transl)]. 42 May 54

Fifty-six consecutive knees were operated on for single compartment disease using the Marmor modular knee with a minimum follow-up of four years. The information obtained indicates that single compartment replacement is valuable in restoring function and relieving pain in a high percentage of patients. There was no evidence of late degeneration of the successful results at the time of writing. No difference in the results obtained with medial or lateral compartment replacement has been noted. Degeneration of the compartment not operated on has not been a problem. Unicompartmental replacement is an excellent procedure in the elderly patient who has osteoarthritis of the knee with varus or valgus deformity.
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PMID:Marmor modular knee in unicompartmental disease. Minimum four-year follow-up. 42 1

In a series of 280 high tibial osteotomies performed for osteoarthritis of the knee between 1969 and 1975, there were ten cases of pseudarthrosis, an incidence of 3.6 per cent. These ten knees (and an additional two that were referred to us) were reoperated on. In most cases the pseudarthrosis was resected and stabilized with the Charnley transfixation-compression method. Other procedures involved resection without compression (one knee), compression blade-plate fixation, and arthroplasty with a hinge endoprosthesis. All osteotomies healed eventually with the knee in satisfactory position. In spite of the initial non-union and repeated operation, all twelve patients eventually had satisfactory correction of the preosteotomy deformity, and none had a loss in walking ability. All but two patients had freedom from pain. We concluded that patients with non-union following high tibial osteotomy for osteoarthritis of the knee should undergo resection of the pseudarthrosis and transfixation compression as the treatment of choice. Endoprosthetic replacement then can be used as a salvage procedure if it is needed.
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PMID:Results of surgical treatment for non-union after high tibial osteotomy in osteoarthritis of the knee. 70 47

Tibial osteotomy proximal to the tuberosity is a successful method of treating osteoarthritis of the knee joint with a axial deformity. The clinical results of 54 osteotomies carried out between 1971 and 1975 show significant pain relief after correction of the deformity. There were only a few complications. Internal fixation by plates or other devices is superflous. A single staple is sufficient to allow early movement and weight-bearing because of the broad contact of cancellous bone at the osteotomy site. So this operation is the method of choice especially in the elderly patient with cardio-vascular disease. In the case of failure of the osteotomy other salvage procedures as well as joint replacement are still possible.
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PMID:[High tibial osteotomy for gonarthrosis (author's transl)]. 71 61

Ninety-four knee joints in 71 patients had primary gonarthrosis (osteoarthritis of the knee) for periods of 10-18 years. The course of gonarthrosis was unfavorable in that a majority of the cases became worse over the years and some also developed pain at rest. The prognosis in gonarthrosis seemed worse than in coxarthrosis (osteoarthritis of the hip). The radiographic changes in the affected knee joint progressed over the years. However, in most knees the changes remained limited to the compartment first affected so that knees with initially medial involvement had exclusively medial involvement even 10-18 years later. Varus deformity was related to poor stability and to a generally poor prognosis. An early onset of symptoms was unfavorable with regard to development of pain. The majority of otherwise healthy patients became incapable of using public transportation because of knee pain on walking.
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PMID:The natural course of untreated osteoarthritis of the knee. 85 13

This study compared the efficacy and safety of etodolac, a new nonsteroidal anti-inflammatory drug of the pyranocarboxylic class, with that of diclofenac in patients with osteoarthritis of the knee. A total of 172 patients entered this double-blind, parallel study and were randomly assigned to receive etodolac 600 mg/day (n = 85) or diclofenac 150 mg/day (n = 87) for 8 weeks. Both treatment groups showed a statistically significant reduction in pain at the second week and significant improvement (P < or = 0.05) from baseline in all efficacy assessments for the remainder of the study. Seventeen (20%) patients in the etodolac group and 21 (24%) patients in the diclofenac group reported at least one adverse event. Seven (8%) patients treated with etodolac and eight (9%) of those receiving diclofenac withdrew prematurely from the trial. One diclofenac-treated patient had a significant increase in alanine aminotransferase at the final evaluation. The results of this study indicate that etodolac was well tolerated and as effective as diclofenac in relieving the signs and symptoms of osteoarthritis.
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PMID:Comparison of etodolac and diclofenac in osteoarthritis of the knee. 128 86

We evaluated the efficacy of heparin-glucuronylglucosaminoglycane association topically used on periarticular deep tissues (subcutaneous and muscle), in 20 females divided into two homogeneous groups of 10 each, affected by painful osteoarthritis of the knee. Electrically stimulated subcutaneous and muscular pain thresholds have been assessed; ultrasound scan of subcutaneous tissue overlying articular rima and vastus medialis muscle, and ultrasound scan of vastus medialis muscle thickness have been also examined. The measurements have been done (at the beginning of the experiment) in basal conditions and respectively after one, two, and three weeks treatment with the drug or placebo administered in a double blind fashion. Subcutaneous and muscular pain thresholds have shown an important rise right from the first week of treatment; subcutaneous tissue thickness was significantly decreased after two weeks treatment and in the same period a significant increase of vastus medialis muscle was registered. No such variations have been shown after placebo treatment. The possible mechanisms of such effects have been assessed in a peripheral control action of inflammation, with decrease of nociceptive message and consequent limitation of dystrophic reflex phenomena.
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PMID:[Effects of a heparin-heparinoid combination on esthesiologic and trophic changes in deep periarticular tissues in gonarthritis]. 130 4

In this single-blind, multiple-dose study the efficacy and tolerability of flurbiprofen was compared with that of piroxicam in 60 adult patients suffering from osteoarthritis of the knee. The patients were randomly allocated to receive either flurbiprofen 100 mg twice daily or piroxicam 20 mg once daily for a period of four weeks. Clinical assessments w.r.t. pain, tenderness, stiffness, swelling and general activity of patient were carried out prior to initiation of trial therapy and thereafter at weekly intervals for four weeks. The findings were graded. Though significant improvements as compared to baseline data occurred in both the treatment groups, flurbiprofen was found to be superior to piroxicam in improving pain on movement and at rest (p < 0.05). The incidence of side effects was less in the group receiving flurbiprofen (6% compared to 47% observed with piroxicam).
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PMID:A comparative study of flurbiprofen and piroxicam in osteoarthritis. 130 85


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