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Background: The impact of periarticular corticosteroid injection for pain control after total joint arthroplasty (TJA) is controversial. The present study aimed to investigate this controversy in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Methods: A total of 42 THA and 42 TKA patients were included in this study. The patients of each group were randomly allocated into group A (cocktail+Depo-Medrol) and group B (cocktail alone). The outcome measures were a Visual Analog Scale (VAS) for pain at five different time points for both THA and TKA, as well as the knee range of motion (ROM) and straight leg raise (SLR) for the TKA group only. Patients were followed for three months to observe infection, wound complications, and any venous thromboembolic event.
Results: In the THA group, the preoperative VAS, 12, 24, 48, and 72h postoperative VAS were not statistically different between groups A and B (, , , , and , respectively). In the TKA group, the preoperative VAS, 12, 24 48h, and 72h postoperative VAS were not statistically different between groups A and B (, , , , , respectively). The mean scores of knee range of motion and ability to perform SLR were not significantly different between TKA patients in the steroid and non-steroid groups ( and , respectively). The only observed complication was one surgical site infection in the non-steroid group of the TKA.
Conclusion: The obtained results did not support the benefit of including a steroid (Depo-Medrol) in the periarticular injection cocktail for pain control after the THA and TKA.
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http://dx.doi.org/10.22038/ABJS.2022.50610.2509 | DOI Listing |
Eur J Gastroenterol Hepatol
August 2025
Department of Medical and Surgical Sciences, University of Bologna.
Background: Gastric cancer epidemiology evolved rapidly in the last century, shifting from being one of the main causes of cancer-related death to the sixth in high-income countries.
Methods: We conducted a narrative review on gastric cancer epidemiology. Our review focused on trends of gastric cancer and its relationship with Helicobacter pylori infection; cardia and noncardia gastric cancer risk factors; early onset gastric cancer; second primary cancers in patients with gastric cancer; and implementation of gastric cancer prevention strategies.
Pain Med Case Rep
December 2023
Department of Anesthesiology, UNC School of Medicine, Chapel Hill, NC.
Background: Centrally mediated abdominal pain syndrome (CAPS) is a condition that has traditionally been treated with first-line agents, such as tricyclic anti-depressants and serotonin and norepinephrine reuptake inhibitors. However, in the setting of pain refractory to these primary agents, there is little evidence in support of alternative regimens, especially opioid analgesics.
Case Report: This case examines the utility of weekly 10 mcg transdermal buprenorphine patches as an additional treatment modality for CAPS, specifically in the setting of a 27-year-old woman with intractable abdominal pain following a cholecystectomy.
Pain Med Case Rep
December 2023
University of Central Florida College of Medicine, Orlando, FL.
Background: An intrathecal (IT) pump is an effective drug delivery system that assists patients with chronic pain management. However, due to the invasive nature of the procedure, a complication that could arise is cerebrospinal overdrainage or leak, which could lead to adverse effects.
Case Report: The patient underwent an IT morphine pump implant for treatment of his chronic, intractable low back pain.
Pain Med Case Rep
December 2023
Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA.
Background: Spinal cord stimulation (SCS) is a minimally invasive neuromodulation treatment modality primarily used for failed back surgery syndrome (FBSS), complex regional pain syndrome, and diabetic neuropathy. Specifically, when utilized for the treatment of FBSS, placement can be complicated by the excessive scarring, adhesions, and altered anatomy limiting the access to the epidural space and advancement of the leads.
Case Report: Our patient is a 58-year-old woman with a history of scoliosis and severe lumbar spinal stenosis who presented for trial of an SCS for FBSS.
Pain Med Case Rep
November 2023
Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA.
Background: Spinal cord stimulation (SCS) is a minimally invasive neuromodulation treatment modality primarily indicated for failed back surgery syndrome (FBSS). When FBSS occurs in the setting of spinal cord injury (SCI) it can often be refractory to treatment with opioids and anticonvulsants; in such cases, SCS has demonstrated promising results. Here, we present a case series of 2 patients with FBSS in the setting of SCI who received pain relief with SCS therapy.
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