Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Author's Articles

3 result(s) for: David Sadigursky

Patellar denervation for Anterior Knee Pain Management in Knee Arthroplasty

David Sadigursky; Felipe Magalhães Sampaio; Eron Silva Andrade; Perseu Ribeiro Almeida; Magda Leão Pinheiro; Matheus Vasconcelos Goes Mendes; Gustavo Castro de Queiroz

MEDICALEXPRESS 2017;4(1):M170103 - ORIGINAL RESEARCH

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OBJECTIVE: To compare the effectiveness of patellar denervation versus non-patellar denervation in reducing anterior knee pain on a follow-up period of at least one year after total knee arthroplasty.
METHOD: Data from 84 patients, who underwent total knee arthroplasty were analyzed. Participants were divided into 2 groups; group A: 42 patients who previously underwent total knee arthroplasty with patellar denervation; and group B: 42 patients who previously underwent total knee arthroplasty without patellar denervation. Results were evaluated using WOMAC and KSS questionnaires, and the VAS pain measurement. Knee ranges of motion were measured. Preoperative clinical conditions of both groups were similar.
RESULTS: Postoperatively, the following results were observed. (a), the WOMAC scores for group A were significant better when compared to group B (27.95 ± 5.89 vs. 33,55 ± 6.23; (b) better results were also found in KSS scores for group A vs. group B (86.19 ± 7.10 vs. 83,07 ± 4.88); (c) the range of knee flexion was smaller than in group A vs. group B (119.0 ± 10.7 vs 125.5 ± 11.0 degrees); (d) there was no significant difference between the mean of range of knee extension between the two groups groups; (e) in terms pain referred by the patient, no difference was observed according to VAS pain.
CONCLUSION: Patellar denervation does not show better effect in pain reduction compared with TKA with non-patellar denervation. However, it had a better beneficial effect on knee function score, as measured through the KSS and WOMAC questionnaires.



Keywords: Patella, Knee Arthroplasty, Joint Pain.

Customized footwear for motion control to treat anterior knee pain among runners

David Sadigursky; Natallia Andrade Mota Santos; Gustavo Castro de Queiroz; Leandro Oliveira; Marcio Pinheiro de Souza; Rogério Jamil Fernandes Carneiro; Paulo Oliveira Colavolpe

MEDICALEXPRESS 2017;4(2):M170202 - ORIGINAL RESEARCH

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BACKGROUND: Street running is extremely popular worldwide. Despite its benefits, there is evidence that stressful physical activity contributes to the development of lesions on the patellofemoral joint, leading, to anterior knee pain. As an attempt to attain pain control and to improve performance, specific footwear is being developed, aiming to suit particular types of foot strike, and therefore to reduce the risk of injury.
OBJECTIVE: To evaluate the effectiveness of the use of customized shoes, based on baropodometric test, for the remission of anterior knee pain among amateur street runners.
METHODS: This is a cross-sectional study, using questionnaires based on anthropometric and anatomical data of the runner, type of training, individualized footwear based on baropodometric test and diagnosis of anterior knee pain. In total, 40 athletes were studied, which were divided into two groups: Group 1, with 19 athletes who wore specific shoes for their activity, according to the type of foot strike, and, Group 2, with 21 athletes who used neutral shoes, not prescribed by healthcare professionals. All athletes practiced at the same running field.
RESULTS: Most of the athletes were female (70%), The pain remission had no overall statistically significant difference between the two groups. However, significant differences were found between groups A and B regarding the time of occurrence and the extent of AKP.
CONCLUSION: The data analysis showed that the use of customized running shoes, based exclusively on baropodometric exams, does not reduce anterior knee pain in amateur street runners, which is consistent with current literature. The improvement of pain with customized shoes, when present, appeared to have a short duration of around three month.



Keywords: Running; Knee; Anterior Knee Pain Syndrome.

Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty

David Sadigursky; Mariana de Castro Oliveira; João Gilberto Gomes Macedo; Francisco Roque Paim Costa Junior; Matheus Lemos Azi; Daniel Figueiredo Alencar

MEDICALEXPRESS 2017;4(6):M170603 - ORIGINAL RESEARCH

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BACKGROUND: Effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical outcomes. The current trend is to use multimodal treatment, in which the use of patches with lidocaine as adjuvant therapy has an increasingly relevant role.
OBJECTIVE: To investigate the potential benefits of lidocaine patch association with the basic analgesia regimen for pain relief during the postoperative period of total knee arthroplasty.
METHOD: A retrospective cohort study was performed , with a total of 24 patients in each group, who underwent total knee arthroplasty. Pain levels using a visual analogue scale and opioid intake were controlled from the immediate postoperative to the end of a 28-day interval.
RESULTS: During the postoperative period, pain was less intense in patients who used lidocaine patches. In these same patients, the doses of opioids needed to control pain were lower in 15 of the 28 days analyzed. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Patients older than 70 years and females predominated.
CONCLUSION: Adjuvant treatment after total knee arthroplasty using lidocaine patches was effective in reducing pain and decreasing the use of opioids in the period analyzed, and represents a good addition to multimodal analgesic therapy.



Keywords: Knee Arthroplasty; Analgesia; Lidocaine.