Increase in Outpatient Knee Arthroscopy in the United States: A Comparison of National Surveys of Ambulatory Surgery, 1996 and 2006

Kim, Sunny H; Bosque, Jose; Meehan, John P.; Jamali, Amir A.; Marder, Richard A.

doi:10.2106/jbjs.i.01618

Cited by 544 publications

(410 citation statements)

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“…18 Arthroscopic knee surgery is a very common procedure in the United States with over 900,000 cases performed in 2006 alone. 19 In Ontario, the rate of knee arthroscopies 20 With this large number of arthroscopic knee surgeries being performed annually, even small improvements in these clinical metrics have the potential to result in major improvements in efficiency of resource utilization. Our results show that the sham group had higher PACU pain scores despite receiving over 50% more intraoperative fentanyl, which highlights the analgesic efficacy of this nerve block.…”

Section: Discussionmentioning

confidence: 99%

Bloc échoguidé du canal adducteur pour une méniscectomie médiale par arthroscopie: une étude randomisée à double insu

Hanson

Derby

Auyong

et al. 2013

Can J Anesth/J Can Anesth

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Purpose The saphenous nerve block using a landmarkbased approach has shown promise in reducing postoperative pain in patients undergoing arthroscopic medial meniscectomy. We hypothesized that performing an ultrasound-guided adductor canal saphenous block as part of a multimodal analgesic regimen would result in improved analgesia after arthroscopic medial meniscectomy. Methods Fifty patients presenting for ambulatory arthroscopic medial meniscectomy under general anesthesia were prospectively randomized to receive an ultrasoundguided adductor canal block with 0.5% ropivacaine or a sham subcutaneous injection of sterile saline. Our primary outcome was resting pain scores (numerical rating scale; NRS) upon arrival to the postanesthesia care unit (PACU). Secondary outcomes included NRS at six hours, 12 hr, 18 hr, and 24 hr; postoperative nausea; and postoperative opioid consumption.Results There was a statistically significant difference in mean NRS pain scores upon arrival to the PACU (P = 0.03): block group NRS = 1.71 (95% confidence interval [CI] 0.73 to 2.68) vs sham group NRS = 3.25 (95% CI 2.27 to 4.23). Cumulative opioid consumption (represented in oral morphine equivalents) over 24 hr was 71.8 mg (95% CI 56.5 to 87.2) in the sham group vs 44.9 mg (95% CI 29.5 to 60.2) in the block group (P = 0.016). Conclusions An ultrasound-guided block at the adductor canal as part of a combined multimodal analgesic regimen significantly reduces resting pain scores in the PACU following arthroscopic medial meniscectomy. Furthermore, 24-hr postoperative opioid consumption and pain scores were also reduced. RésuméObjectif Le bloc du nerf saphène à l'aide d'une approche par repères anatomiques s'est avéré prometteur pour réduire la douleur postopératoire chez les patients subissant une méniscectomie médiale par arthroscopie. Nous avons émis l'hypothèse qu'en réalisant un bloc échoguidé du canal adducteur du nerf saphène dans le cadre d'un régime analgésique multimodal, l'analgésie serait plus efficace après une méniscectomie médiale par arthroscopie. Méthode Cinquante patients devant subir une méniscectomie médiale par arthroscopie en ambulatoire sous anesthésie générale ont été randomisés de façon prospective à recevoir un bloc échoguidé du canal adducteur avec de la ropivacaïne 0,5 % ou une injection sous-cutanée fictive de solution saline stérile. Notre critère d'évaluation principal était les scores de douleur au repos (échelle d'évaluation numérique; É É N) à l'arrivée en salle de réveil. Les critères d'évaluation secondaires comprenaient l'É É N à six heures, 12 h, 18 h et 24 h; les nausées Author contributions Neil A. Hanson and Francis V. Salinas were involved in the study design.

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Section: Discussionmentioning

confidence: 99%

Bloc échoguidé du canal adducteur pour une méniscectomie médiale par arthroscopie: une étude randomisée à double insu

Hanson

Derby

Auyong

et al. 2013

Can J Anesth/J Can Anesth

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“…This procedure, in which the surgeon trims the torn meniscus back to a stable rim, is performed for a range of indications in more than 465,000 persons annually in the United States. 5 The high prevalence of meniscal tears in patients with osteoarthritis of the knee and the observation that these lesions are often asymptomatic challenge the ability of clinicians to determine whether symptoms are caused by the tear, osteoarthritis, or both. Clinicians who suspect that the tear is symptomatic may refer the patient to a surgeon for arthroscopic partial meniscectomy.…”

Section: Discussionmentioning

confidence: 99%

Surgery versus Physical Therapy for Meniscal Tear and Osteoarthritis

Holzer¹,

Leithner²,

Holzer³

2013

N Engl J Med

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“…Arthroscopy of the knee is one of the most common orthopedic procedures performed in the United States [1][2][3] and has resulted in significant reduction in patient pain and improvement in function. However, some conditions and symptoms, such as pain osteoarthritis in the absence of mechanical symptoms such as locking, catching, and giving-way, have not been found to improve following arthroscopy [4][5][6][7][8][9][10][11][12].…”

Section: Commentarymentioning

confidence: 99%