Effect of a Perioperative Intra-Articular Injection on Pain Control and Early Range of Motion Following Bilateral TKA

Fajardo, Marc; Collins, Jason H.; Landa, Joshua; Adler, Edward M.; Meere, Patrick; Cesare, Paul E. Di

doi:10.3928/01477447-20110317-11

Cited by 31 publications

(20 citation statements)

References 12 publications

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“…The dogs in “MSCs group” received in a blinded fashion 10 × 10 6 MSCs in the operated stifle joint by a single injection in the arthroscopic portal site before closure of the joint, according to Nganvongpanit et al (35) and Fajardo et al (36). Dogs receiving MSCs were prescribed them from the day after surgery and for 1 month thereafter, with an “A” treatment corresponding to an AINS placebo with no claim for any anti-inflammatory or an OA management in the product datasheet.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Effect of a Single Intra-articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells Compared to Oral Non-Steroidal Anti-inflammatory Treatment on the Postoperative Musculoskeletal Status and Gait of Dogs over a 6-Month Period after Tibial Plateau Leveling Osteotomy: A Pilot Study

Taroni

Cabon

Febre³

et al. 2017

Front. Vet. Sci.

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ObjectiveCompare the clinical and pressure walkway gait evolution of dogs after a tibial plateau leveling osteotomy (TPLO) for a cranial cruciate ligament rupture (CrCLR) and treatment with either a 1-month course of non-steroidal anti-inflammatory drugs (NSAIDs) or a single postoperative intra-articular (IA) injection of allogeneic neonatal mesenchymal stromal cells (MSCs).Study designProspective, double-blinded, randomized, controlled, monocentric clinical study.AnimalsSixteen client-owned dogs.Materials and methodsDogs with unilateral CrCLR confirmed by arthroscopy were included. Allogeneic neonatal canine MSCs were obtained from fetal adnexa retrieved after C-section performed on healthy pregnant bitches. The dogs were randomly allocated to either the “MSCs group,” receiving an IA injection of MSCs after TPLO, followed by placebo for 1 month, or the “NSAIDs group,” receiving IA equivalent volume of MSCs vehicle after TPLO, followed by oral NSAID for 1 month. One of the three blinded evaluators assessed the dogs in each group before and after surgery (1, 3, and 6 months). Clinical score and gait and bone healing process were assessed. The data were statistically compared between the two groups for pre- and postoperative evaluations.ResultsFourteen dogs (nine in the MSCs group, five in the NSAIDs group) completed the present study. No significant difference was observed between the groups preoperatively. No local or systemic adverse effect was observed after MSCs injection at any time point considered. At 1 month after surgery, bone healing scores were significantly higher in the MSCs group. At 1, 3, and 6 months after surgery, no significant difference was observed between the two groups for clinical scores and gait evaluation.ConclusionA single IA injection of allogeneic neonatal MSCs could be a safe and valuable postoperative alternative to NSAIDs for dogs requiring TPLO surgery, particularly for dogs intolerant to this class of drugs.

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Section: Methodsmentioning

confidence: 99%

Evaluation of the Effect of a Single Intra-articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells Compared to Oral Non-Steroidal Anti-inflammatory Treatment on the Postoperative Musculoskeletal Status and Gait of Dogs over a 6-Month Period after Tibial Plateau Leveling Osteotomy: A Pilot Study

Taroni

Cabon

Febre³

et al. 2017

Front. Vet. Sci.

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“…Theoretically, if administered close enough to surgery the anti-inflammatory effects of the corticosteroid could provide increased pain relief to allow for earlier and increased post-operative rehabilitation. The concept of administering peri-operative local anesthetic injections in order to improve post-operative results is well-documented in hip and knee surgery [11][12][13][14][15][16][17] but to our knowledge nothing has been written on a similar approach to RCT repair. The purpose of this study was to examine whether…”

Section: Introductionmentioning

confidence: 99%

Computerized tomographic assessment and clinical evaluation in shoulder instability treated with the Latarjet-Patte procedure using one screw and washer

Cautiero

Russo

Pietto

et al. 2019

Muscle Ligaments and Tendons J

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Background: Subacromial corticosteroid injections (CSI's) are a common non-surgical treatment for rotator cuff tears. Few studies have assessed the effects of pre-operative CSI's on postoperative functional outcomes. Methods: A retrospective analysis was conducted of 132 patients with high-grade, partial-thickness rotator cuff tears (PTRCT's). The subjects were divided into two groups based on whether they received a CSI or not. The CSI group was further divided into three subgroups based on when they received a pre-operative injection: 0-3 months, 3-6 months, >6 months before surgery. The Visual Analog Scores (VAS), American Shoulder and Elbow Surgeon scores (ASES), and Constant scores were recorded prior to surgery and at a one-year post-operative follow-up appointment for each subject. stant score (p=0.019 and 0.014, respectively) compared to the other two subgroups, but the VAS score decrease only trended toward significance (p=0.091). The sample as a whole experienced significant improvement in all three outcome measures. Conclusion: Patients undergoing arthroscopic re-pair of a high-grade PTRCT may benefit from a pre-operative CSI 0-3 months before surgery. Level of evidence: IIb. Results: Patients who received a pre-operative CSI (n=92) improved significantly more than the non-injection group (n=40) in all outcome measures. The 0-3 months injection subgroup experienced a significant increase in ASES and Con

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“…Advances in postoperative pain management after knee arthroplasty have improved short-term pain relief, earlier return of ROM, and in some cases earlier discharge from the hospital [12,13,25,35]. Over the last decade multimodal pain management techniques have become an increasingly common alternative to opioids alone in the management of perioperative pain after knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

The Chitranjan Ranawat Award: Periarticular Injections and Femoral & Sciatic Blocks Provide Similar Pain Relief After TKA: A Randomized Clinical Trial

Spangehl

Clarke

Hentz

et al. 2015

Clinical Orthopaedics &Amp; Related Research

129

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Background Two of the more common methods of pain management after TKA are peripheral nerve blocks and intraarticular/periarticular injections. However, we are not aware of any study directly comparing the commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection after TKA. Questions/purposes This randomized clinical trial compared a combined femoral and sciatic nerve block with periarticular injection as part of a multimodal pain protocol after total knee arthroplasty with respect to (1) pain; (2) narcotic use; (3) quadriceps function and length of stay; and (4) peripheral nerve complications. Methods One hundred sixty patients completed randomization into two treatment arms: (1) peripheral nerve blocks (PNB; n = 79) with an indwelling femoral nerve catheter and a single shot sciatic block; or (2) periarticular injection (PAI; n = 81) using ropivacaine, epinephrine, ketorolac, and morphine. All patients received standardized general anesthesia and oral medications. The primary outcome was postoperative pain, on a 0 to 10 scale, measured on the afternoon of postoperative day 1 (POD 1). Secondary outcomes were narcotic use, quadriceps function, length of stay, and peripheral nerve complications. Results Mean pain scores on the afternoon of POD 1 were not different between groups (PNB group: 2.9 [SD 2.4]; PAI group: 3.0 [SD 2.2]; 95% confidence interval, À0.8 to 0.6; p = 0.76). Mean pain scores taken at three times points on POD 1 were also similar between groups. Hospital length of stay was shorter for the PAI group (2.44 days [SD 0.65] versus 2.84 days [SD 1.34] for the PNB group; p = 0.02). Narcotic consumption was higher the day of surgery for the PAI group (PAI group: 11.7 mg morphine equivalents [SD 13

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Effect of a Perioperative Intra-Articular Injection on Pain Control and Early Range of Motion Following Bilateral TKA

Cited by 31 publications

References 12 publications

Computerized tomographic assessment and clinical evaluation in shoulder instability treated with the Latarjet-Patte procedure using one screw and washer

The Chitranjan Ranawat Award: Periarticular Injections and Femoral & Sciatic Blocks Provide Similar Pain Relief After TKA: A Randomized Clinical Trial

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