ABSTRACT
OBJECTIVE: To observe the effect of warming needle combined with rehabilitation training on chondromalacia patellae in a randomized controlled trial. METHODS: The 92 cases were randomly divided into a treatment group treated by warming needle plus rehabilitation training (47 cases) and a control group treated by medication plus rehabilitation training (45 cases), and the therapeutic effect was compared after 20 sessions. RESULTS: The pain was relieved more obviously in the treatment group than in the control group (P < 0.05), and the total effective rate was 91.8% and 71.1% respectively (P < 0.01). CONCLUSION: Warming needle plus rehabilitation training was superior in the therapeutic effect and duration of producing relief of pain to medication plus rehabilitation training in treating chondromalacia patellae.
Subject(s)
Acupuncture Therapy/methods , Chondromalacia Patellae/rehabilitation , Chondromalacia Patellae/therapy , Medicine, Chinese Traditional/methods , Acupuncture Therapy/adverse effects , Adult , Aged , Analgesics/therapeutic use , Chondromalacia Patellae/drug therapy , Female , Humans , Male , Medicine, Chinese Traditional/adverse effects , Middle Aged , Treatment OutcomeABSTRACT
INTRODUCTION: During arthroscopy for the treatment of patellofemoral lateral hyper-pressure syndrome (LHS), intra-articular morphine or its derivatives (fentanyl) may reduce postoperative pain when combined with anesthetics. We therefore decided to determine whether adding fentanyl to epinephrine and bupivacaine produced an increased analgesia. MATERIAL AND METHODS: We randomly distributed 40 patients into two groups. The experimental group (n=20) was given 0.5% bupivacaine (2 mg/kg), epinephrine (100 microg) and fentanyl (2.5 microg/kg). The control group (n=20) received 0.5% bupivacaine (2 mg/kg) and epinephrine (100 microg). Patients underwent chondroplasty and retinacular release, and we assessed pain, time of analgesia and postoperative range of motion at postoperative hours 6 and 24. RESULTS: The age and the grade of patellofemoral chondromalacia (PFC) were similar in both groups (p > 0.05). No differences were found in pain and ranges of motion intraoperatively and at postoperative hours 6 and 24 (p > 0.05) between both groups. The postoperative analgesia time was similar (p > 0.05). CONCLUSIONS: Adding intra-articular fentanyl to the combination of epinephrine plus bupivacaine did not decrease pain, and did not increase neither the analgesia time nor the range of motion in patients with LHS undergoing knee arthroscopy.
Subject(s)
Arthroscopy , Chondromalacia Patellae/drug therapy , Fentanyl/therapeutic use , Knee Joint/surgery , Pain, Postoperative/drug therapy , Adult , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/therapeutic use , Anesthetics, Local/administration & dosage , Anesthetics, Local/therapeutic use , Bupivacaine/administration & dosage , Bupivacaine/therapeutic use , Chondromalacia Patellae/surgery , Controlled Clinical Trials as Topic , Data Interpretation, Statistical , Double-Blind Method , Epinephrine/administration & dosage , Epinephrine/therapeutic use , Female , Fentanyl/administration & dosage , Humans , Injections, Intra-Articular , Male , Middle Aged , Prospective Studies , Statistics, Nonparametric , Sympathomimetics/administration & dosage , Sympathomimetics/therapeutic use , Time FactorsABSTRACT
Hyaluronic Acid (HA) is an alternative method for the treatment of osteoarthritis (OA), which acts on pain through a double action: anti-inflammatory and synovial fluid (SF) visco-supplementation. Magnetic Resonance Imaging (MRI), utilizing specific sequences, is a valid method for studying the initial phase of chondral damage. The analysis of the data, obtained through the intensity of values taken by positioning Region of Interest (ROIs) within the lesion, determining the differences before and after treatment with HA injected into the knee. The results obtained after six months and one year from the injection were statistically different in respect to those taken before, immediately and after three months of treatment. MRI represents a valid tool to evaluate the grade of chondromalacia patellae and also to follow the cartilage modification induced by HA therapy.
