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Skeletal Radiology Mar 2022Periarticular calcification and ossification is a frequent finding on imaging and may sometimes pose a diagnostic challenge. The differential diagnoses for this... (Review)
Review
Periarticular calcification and ossification is a frequent finding on imaging and may sometimes pose a diagnostic challenge. The differential diagnoses for this radiological finding are wide and can be classified into broad groups such as idiopathic, developmental, trauma, burns, infection, tumor, connective tissue disease, crystalline, metabolic, vascular, and foreign bodies. With careful consideration of the clinical and imaging findings as well as awareness of mimickers of periarticular mineralization, the list of differential diagnoses can be narrowed down. This article aims to review the clinical-radiologic findings of periarticular calcified or ossified lesions with relevant imaging illustrations.
Topics: Calcinosis; Diagnosis, Differential; Humans; Osteoarthritis
PubMed: 34155550
DOI: 10.1007/s00256-021-03842-4 -
BMC Musculoskeletal Disorders Jan 2022Periarticular hardware placement can be challenging and a source of angst for orthopaedic surgeons due to fear of penetrating the articular surface and causing undue... (Review)
Review
Periarticular hardware placement can be challenging and a source of angst for orthopaedic surgeons due to fear of penetrating the articular surface and causing undue harm to the joint. In recent years, many surgeons have turned to computed tomography (CT) and other intraoperative or postoperative modalities to determine whether hardware is truly extraarticular in areas of complex anatomy. Yet, these adjuncts are expensive, time consuming, and often unnecessary given the advancement in understanding of intraoperative fluoroscopy. We present a review article with the goal of empowering surgeons to leave the operating room, with fluoroscopy alone, assured that all hardware is beneath the articular surface that is being worked on. By understanding a simple concept, surgeons can extrapolate the information in this article to any joint and bony surface in the body. While targeted at both residents and surgeons who may not have completed a trauma fellowship, this review can benefit all orthopaedic surgeons alike.
Topics: Bone Screws; Fluoroscopy; Humans; Tomography, X-Ray Computed
PubMed: 34991568
DOI: 10.1186/s12891-021-04928-9 -
Singapore Medical Journal Sep 2017Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review... (Review)
Review
Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.
Topics: Adult; Bone Neoplasms; Bone and Bones; Female; Humans; Lipoma; Magnetic Resonance Imaging; Male; Middle Aged; Sacrum; Tibia
PubMed: 28948289
DOI: 10.11622/smedj.2017087 -
Journal of Orthopaedic Trauma Sep 2022Periarticular injuries of the lower extremity are known for wound healing and infection complications. The role for incisional negative pressure wound therapy for lower... (Review)
Review
Periarticular injuries of the lower extremity are known for wound healing and infection complications. The role for incisional negative pressure wound therapy for lower extremity periarticular fractures has expanded over the last 10 years in hopes of minimizing complications. To date, there is no standardized published protocol of how negative pressure wound therapy is best used in lower extremity periarticular fractures. A review of strategies to decrease complications associated with the operative management of lower extremity periarticular fractures to include the use of incisional negative pressure wound therapy is presented.
Topics: Fractures, Bone; Humans; Lower Extremity; Negative-Pressure Wound Therapy; Surgical Wound Infection; Wound Healing
PubMed: 35994306
DOI: 10.1097/BOT.0000000000002429 -
The Journal of the American Academy of... Sep 2018Plate fixation has historically been the preferred surgical treatment method for periarticular fractures of the lower extremity. This trend has stemmed from difficulties... (Review)
Review
Plate fixation has historically been the preferred surgical treatment method for periarticular fractures of the lower extremity. This trend has stemmed from difficulties with fracture reduction and concerns of inadequate fixation with intramedullary implants. However, the body of literature on management of periarticular fractures of the lower extremities has expanded in recent years, indicating that intramedullary nailing of distal femur, proximal tibia, and distal tibia fractures may be the preferred method of treatment in some cases. Intramedullary nailing reliably leads to excellent outcomes when performed for appropriate indications and when potential difficulties are recognized and addressed.
Topics: Contraindications, Procedure; Femoral Fractures; Fracture Fixation, Intramedullary; Humans; Intra-Articular Fractures; Tibial Fractures; Treatment Outcome
PubMed: 30113344
DOI: 10.5435/JAAOS-D-16-00849 -
The Orthopedic Clinics of North America Apr 2016Arthrofibrosis after periarticular fractures can create clinically significant impairments in both the upper and lower extremities. The shoulder, elbow, and knee are... (Review)
Review
Arthrofibrosis after periarticular fractures can create clinically significant impairments in both the upper and lower extremities. The shoulder, elbow, and knee are particularly susceptible to the condition. Many risk factors for the development of arthrofibrosis cannot be controlled by the patient or surgeon. Early postoperative motion should be promoted whenever possible. Manipulations under anesthesia are effective for a period of time in certain fracture patterns, and open or arthroscopic surgical debridements should be reserved for the patient for whom nonoperative modalities fail and who has a clinically significant deficit.
Topics: Fibrosis; Fracture Fixation, Internal; Humans; Intra-Articular Fractures; Joint Diseases; Range of Motion, Articular
PubMed: 26772943
DOI: 10.1016/j.ocl.2015.09.003 -
Knee Surgery, Sports Traumatology,... Aug 2014A systematic review and meta-analysis based on randomized controlled trials (RCTs) were conducted to evaluate the efficiency and safety of periarticular multimodal drug... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
A systematic review and meta-analysis based on randomized controlled trials (RCTs) were conducted to evaluate the efficiency and safety of periarticular multimodal drug injection in total knee arthroplasty (TKA).
METHODS
Periarticular injection with the use of multimodal drugs is an efficient alternative for postoperative analgesia in TKA. A systematical electronic search was performed to identify the eligible RCTs in the databases of PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and the Chinese Biomedical Literature Database. Two independent reviewers completed data collection and assessment of methodological quality. The quality of evidence of outcomes was judged using GRADE criteria. Meta-analysis was performed for the outcomes of pain, straight leg raise, operating time, hospital stay and complications.
RESULTS
Ten RCTs including eight studies with 1,216 TKAs in 835 patients met the inclusion criteria. Periarticular injection with multimodal drugs in TKA was associated with short-term benefits in terms of pain relief, straight leg raise, narcotic consumption, and the rates of nausea, vomiting, rash and pruritus. There were no statistically significant differences in operating time, hospital stay, wound complications and deep vein thrombosis between both groups.
CONCLUSIONS
The current evidence suggests that periarticular multimodal drug injection in TKA provides short-term advantages in pain relief, straight leg raise and postoperative complications.
Topics: Analgesics, Opioid; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Arthroplasty, Replacement, Knee; Epinephrine; Glucocorticoids; Humans; Injections, Intra-Articular; Pain Management; Pain, Postoperative; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 23783531
DOI: 10.1007/s00167-013-2566-0 -
The Journal of Arthroplasty Nov 2018In patients undergoing surgery, optimal pain management is associated with improved perioperative outcomes, patient satisfaction with surgery, and a more rapid... (Comparative Study)
Comparative Study Review
In patients undergoing surgery, optimal pain management is associated with improved perioperative outcomes, patient satisfaction with surgery, and a more rapid functional recovery. In recent years, the employment of multimodal pain management strategies has become increasingly widespread. In particular, there has been an explosion in the use of peripheral nerve blockade and periarticular injections in total knee arthroplasty. However, there is significant variability in the administration of either modality of anesthesia. As such, a critical evaluation of the current literature is warranted to elucidate the advantages and disadvantages of each technique with the ultimate goal of further refining current pain control strategies. In this symposium, we review each of these modalities and their association with pain management, narcotic consumption, length of hospital stay, and adverse events.
Topics: Anesthesia, Conduction; Anesthetics, Local; Arthroplasty, Replacement, Knee; Bupivacaine; Humans; Injections, Intra-Articular; Length of Stay; Narcotics; Nerve Block; Pain Management; Pain, Postoperative; Patient Satisfaction; Recovery of Function
PubMed: 30197218
DOI: 10.1016/j.arth.2018.08.006 -
Sports Medicine and Arthroscopy Review Mar 2013Periarticular osteotomies, either a high tibial osteotomy for a varus deformity or a distal femoral osteotomy for a valgus deformity, are performed for symptomatic... (Review)
Review
Periarticular osteotomies, either a high tibial osteotomy for a varus deformity or a distal femoral osteotomy for a valgus deformity, are performed for symptomatic unicompartmental degenerative joint disease (DJD) of the knee. These procedures provide pain relief by realigning the mechanical axis and unloading the degenerative compartment. Although arthroplasty has become a reliable procedure for DJD, premature wear and revision remain a concern for younger individuals as well as for individuals who desire to participate in high impact activities. Long-term follow-up studies have shown good results for osteotomy at over 10 years of follow-up. Periarticular osteotomies are a reliable and durable way to provide symptomatic relief for these younger and more active patients with symptomatic DJD of the knee.
Topics: Humans; Knee Joint; Osteoarthritis, Knee; Osteotomy; Treatment Outcome
PubMed: 23314267
DOI: 10.1097/JSA.0b013e31826d2f5d -
The Orthopedic Clinics of North America Oct 2013Orthopedic surgeons frequently provide weight-bearing recommendations to guide patient recovery following lower extremity fractures. This article discusses the available... (Review)
Review
Orthopedic surgeons frequently provide weight-bearing recommendations to guide patient recovery following lower extremity fractures. This article discusses the available literature regarding the effects of early weight bearing on fracture healing, patient compliance with weight bearing restrictions, and the effect of different weight bearing protocols following acetabular, tibial plateau, tibial plafond, ankle, and calcaneus fractures.
Topics: Acetabulum; Ankle Fractures; Calcaneus; Cartilage, Articular; Humans; Intra-Articular Fractures; Patient Compliance; Tibial Fractures; Weight-Bearing
PubMed: 24095067
DOI: 10.1016/j.ocl.2013.06.005