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Intra-articular block for knee arthroscopy: a study on 41 patients
Emami A, Farhoud Ar, Ganjealikhan Hakemi A, Ganji M, Mortazavi Seyed Mj,
Volume 67, Issue 4 (7-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: During recent three decades, parallel to the improvement of arthroscopic techniques, intra-articular block by direct injection of anesthetics into the joint has been used in knee arthroscopy. In this study the efficacy of intra- articular block by complex of bupivacaine, lidocaine and adrenaline in knee arthroscopy has been assessed.
Methods: Forty one healthy adults (age range: 18-55 years) with knee problems selected for diagnostic arthroscopy. Anesthesia was induced by direct injection of 10ml 2% bupivacaine, 10ml 0.5% lidocaine plus 1/100000 adrenaline into the knee joint.  Duration of operation and volume of serum used for irrigation during the procedure pain and analgesics requirement, during and after arthroscopy VAS (Visual Analogue Scale) score, at time of discharge from recovery and also patient's and surgeon's satisfaction were assessed.
Results: Sixty eight percent and 29% of cases reported mild and moderate degree of pain perception during arthroscopy, respectively, and only one case for which general anesthesia was performed, reported severe pain. VAS mean was 2.78. Seventy eight percent of cases and the surgeon in 80% of procedures had excellent or good satisfaction with intra-articular block.
Conclusions: Considering high level of satisfaction in both patients and surgeon and mean of VAS, complications of other modalities of anesthesisa and simplicity of the technique, intra-articular block can be used as an easy, safe and efficient method for knee arthroscopy.


Study of knee range of motion after soft tissue repair in both flexion and extension during total knee arthroplasty: a randomized clinical trial
Kiavash Hushmandi, Mohsen Heidari , Seyedeh Omolbanin Seyed Rezaei, Alireza Bahonar, Mehdi Motififard, Hamed Gholizadeh, Mehdi Raei,
Volume 79, Issue 11 (2-2022)
Abstract
Background: The patient's position during the recovery time after arthroplasty surgery can be a factor in reducing complications and improving patients’ condition. Therefore, this study was performed to compare the knee range of motion after soft tissue repair in both flexion and extension positions of total knee arthroplasty.
Methods: This study is a double-blind clinical trial. The study population was all candidates for total knee arthroplasty surgery in Al-Zahra and Kashani hospitals in Isfahan from July 2011 to September 2012. The sample size was selected using the statistical formula of 88 patients and randomly divided into two groups of flexion and extension. In the first group during the knee soft tissue repair, the knee was in flexion and in the second group it was in extension and then it was repaired. Information such as age, sex, body mass index and surgical position were recorded in the checklist. The knee range of motion was measured at the end of the first, second, fourth, eighth and twelfth weeks and recorded in a checklist. In order to compare the pattern of changes in mean knee range of motion over time in the two groups, mixed linear models and conventional marginal models to generalized estimator equations were used by STATA software.
Results: The results showed that there was no significant difference between the flexion and extension groups in knee range of motion. In both groups, the mean knee range of motion increased with time (P<0.001). The mean scores of knee function after the end of the twelfth week in the flexion and extension groups were 141.04±23.19 and 143.09±22.34, respectively, and this difference was not significant.
Conclusion: Soft tissue repair in a particular position is not so effective on the outcome that we want to institutionalize it by spending a considerable amount of budget for training surgeons.

Comparison of the analgesic effect before and after injection of hyaluronic acid in patients with knee osteoarthritis in Amir A'alam hospital
Nader Ali Nazemian, Arman Taheri , Mehdi Sanatkar,
Volume 79, Issue 11 (2-2022)
Abstract
Background: One of the most important issues for patients with osteoarthritis is reducing pain and returning them to normal life. In addition to losing weight and improving daily activities, pain management treatments may be needed. One of these treatments is the injection of hyaluronic acid gel into the knee joint, which has been studied in this study.
Methods: In this study, 61 patients with knee osteoarthritis were included and the Then, they received the injection of hyaluronic acid gel, and the intensity of pain, range of motion of the knee joint, and inflammation of the knee joint were measured. The numeric rating scale was used to measure pain intensity, and movement angle was used to measure the range of motion
Results: The mean age of patients in this study was 60.52±11.77 years. Pre-injection pain index in patients was 7.90±0.99, which decreased to 5.49±1.91 on the third day, 5.98±1.98 on the seventh day and 3.77±2.91 on the 30th day (P<0.001). The amplitude of painless movement based on the degree before injection in patients was 38.85±19.44 which increased to 60.25±21.65 on the third day to 65.25±22.65 on the seventh day and to 71.07±24.17 on the 30th day (P<0.001). Inflammation rate was reported before injection in 29 patients which decreased to 6 patients on the third day after injection (P=0.009).
Conclusion: Injection of hyaluronic acid into the joint has analgesic effects and significantly improves the function and range of motion of patients. It is recommended that hyaluronic acid could be considered as a suitable drug in the treatment process of these patients. Considering that using this method, which is a useful treatment method in reducing patients' pain and improving their function, we recommend this method, especially in the elderly and without the need for surgery.

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