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BackgroundThe adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group.MethodsPatients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured.ResultsPostoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were 0.14 ± 0.37, 4.57 ± 2.37, 6.00 ± 1.63, and 4.28 ± 1.49, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB.ConclusionsIn this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

Nonoperative treatment in patients with acute calcific tendinitis of the hip joint might be successful in most patients. Surgical treatment is of value for patients experiencing prolonged severe pain, solid type, and large size.

The navigation-assisted TKA with measured gap resection technique could be a useful technique with regard to restoration of the joint line.

Purpose:To explore the healing process of the injured posterior cruciate ligament (PCL) by evaluating instability measurements and magnetic resonance imaging (MRI) findings. Materials and Methods:A retrospective cross-sectional study of 46 cases of complete PCL tear who obtained MRI more than two months after injury.Results: A total of 13 cases (28%) showed nearly normal PCL contour, 20 cases (44%) showed continuity but deformed PCL contour, and 13 cases (28%) showed discontinuity. The duration from injury to MRI was not directly correlated with continuity. However, the group that obtained MRI more than six months after injury showed more continuity than the group that obtained MRI within six months of the injury (P Ͻ 0.01). The group with nearly normal continuity showed better stability results in the KT-1000 arthrometer and stress radiographs than the group with discontinuity (P Ͻ 0.05). The presence of other combined ligament injuries had a negative effect on regaining PCL continuity (P Ͻ0.05). Conclusion:More than two-thirds (72%) of chronic PCL injury cases showed ligamentous continuity on MRI, especially when the injury had occurred more than six months before. Stability may improve as continuity is regained. The presence of other combined ligament injuries appears to prohibit spontaneous PCL healing.