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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten adolescent patients with Charcot-Marie-Tooth disease (12 feet) were evaluated an average of 7 years, 7 months following triple arthrodesis (TA) for the treatment of cavovarus deformity. The TA was the primary or index bone procedure. At follow-up, five feet were plantigrade, asymptomatic, and radiographically fused at all three joints. Three feet were plantigrade and asymptomatic, but two had talonavicular pseudarthrosis and one had calcaneocuboid pseudarthrosis. Three feet were radiographically fused at all three joints, but in nonplantigrade positions and symptomatic. One foot required a revision TA. In general, TA offers adolescent Charcot-Marie-Tooth patients a stable plantigrade foot in the face of a progressive disorder. The residual deformity, revision, and pseudarthrosis rates are similar to those for adults. Postoperative pain was related to a nonplantigrade foot and not to the presence of pseudarthrosis. It is not known whether a nonplantigrade foot was a result of incomplete surgical correction or recurrent deformity due to progressive muscle imbalance.
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PMID:Triple arthrodesis in the treatment of fixed cavovarus deformity in adolescent patients with Charcot-Marie-Tooth disease. 157 35

Forty-nine patients with 66 GUEPAR offset knee hinge replacements followed for one to 5 1/2 years were evaluated using the American Rheumatism Association Medical Information System (ARAMIS). The series included 37 female and 12 male patients whose average age was 69 years. Postoperative pain in 92% of patients decreased by an average of three grades. Maximum walking ability improved in 43% and worsened in 14%. Fewer walking aids were used by 51% of patients, whereas 18% needed increased support. Stair-climbing ability improved in 42% and worsened in 10%. Thirty-six additional functions were evaluated. Standing, housework and shopping abilities improved significantly. Range of motion improved from 87 degrees to 103 degrees and flexion contractures decreased by 11%. Varus and valgus abnormalities were almost uniformly corrected. Complications included a 23% rate of patella dislocation or subluxation. Extensor lag occurred in 26% of patients postoperatively, averaging 11 degrees. Deep infection occurred in six knees (9.1%); five were successfully treated for infection and the sixth was successfully treated by arthrodesis. Silastic bumpers broke in all cases and were associated in some instances with significant pain and effusion. Probable loosening has occurred in only one component.
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PMID:Functional outcome of GUEPAR hinge knee arthroplasty evaluated with ARAMIS. 697 24

The reported frequency of involvement of the rheumatoid ankle and hindfoot varies between 9% and 70%. Fusion of the ankle joint, the subtalar, talonavicular, or calcaneocuboidal joint (Chopart's joint) or all of them is the preferred method of treatment for severe rheumatoid involvement causing pain, instability, and/or severe deformity. Ankle arthroplasty is indicated rarely. Pantalar arthrodesis is performed more frequently than talonavicular fusion or ankle fusion. Reported rates of fusion after compression arthrodesis of the ankle joint vary from 65% to 90%, averaging 80% to 85%. Higher success rates of as high as 95% were obtained with internal lag screw fixation as proposed by Wagner. The result of various combinations of arthrodesis (n = 54) of the ankle joint, the subtalar joint, and Chopart's joint in 43 patients with rheumatoid arthritis operated on in a 10-year period from 1984 through 1993 are presented. In all cases internal fixation by lag screws according to Wagner was used with a modified lateral approach incorporating osteotomy of the distal fibula. The technique is described in detail. Solid fusion was obtained in 21% of the cases after 8 weeks, in 9% of the cases after 12 weeks, and in 92% of the cases after 16 weeks. In 8% (3 patients) revision because of delayed union or nonunion eventually led to bony fusion. Postoperative pain, walking capacity, gait, and the subjective outcome were assessed. Complications occurred in 16%, revision was performed in 11.6% of the cases; in all cases healing was obtained. Overall patient satisfaction was 93%.
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PMID:Compression arthrodesis of the rheumatoid ankle and hindfoot. 922 42

We have carried out 25 arthroplasties of the wrist using the Swanson implant since 1976. The indications were primarily in rheumatoid arthritis. The operation was done for severe pain and deformity of the wrist. Results were analysed in 19 patients with a follow-up of 21-54 months. Post-operative pain relief is good. Although mobility is fair, the return of the balance of wrist motions has been recovered. The results of the Swanson implant arthroplasty are compared to dorsal synovectomy and wrist arthrodesis.
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PMID:First results of arthroplasty of the wrist by Swanson's implant. Twenty-five cases. 933 20

When performed appropriately, good to excellent results may be obtained with triple arthrodesis in about 80% of patients. Postoperative pain relief, a plantigrade foot, and improved ambulatory ability are the desired surgical goals. Although there is a significant incidence of degenerative or compensatory arthritis in the remaining articulations, it is rarely of clinical significance. The surgical technique of triple arthrodesis is technically demanding. Rigid attention to detail is important to reduce surgical complications. It is important to understand the local anatomy to avoid injury to nerves, vessels, and tendons. Proper exposure of the joints facilitates cartilage removal and lowers the incidence of nonunion. Rigid compression fixation in an appropriate position provides the best possibility of a successful outcome. It is crucial to remember that a triple arthrodesis is an end-stage salvage procedure. With realistic expectations, the level of satisfaction will be higher for both patient and surgeon.
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PMID:Current concepts in triple arthrodesis. 1065 52

The main complications of open tibiotalocalcaneal arthrodesis are wound healing disorders and nonunion. Our hypothesis was that arthroscopy and interlocking intramedullary nailing decrease these complications. We retrospectively reviewed six patients (mean age: 58 years; mean preoperative Kitaoka score: 51/100) having undergone arthroscopic tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing between January and November 2011 for equinus deformity of the hindfoot and subtalar instability of neurological origin. Postoperative pain disappeared completely in four cases, one patient presented some pain associated with projection of the proximal locking screw head under the skin and the remaining patient presented fibular tendinitis that resolved after infiltration of anti-inflammatory drugs. The mean postoperative Kitaoka score was 64/100. None of the patients presented any wound healing complications or nonunion. The observed incidence of wound complications and bone consolidation disorders after tibiotalocalcaneal arthrodesis was lower than the ones reported for open tibiotalocalcaneal arthrodesis. Level of clinical evidence IV: retrospective case series.
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PMID:Arthroscopic tibiotalocalcaneal arthrodesis in neurological pathologies: outcomes after at least one year of follow up. 2698 62