Journal of Yeungnam Medical Science

Communication

Algorithm for multimodal medication therapy in patients with complex regional pain syndrome: Min Cheol Chang, Donghwi Park; Received April 3, 2023 Accepted May 15, 2023 Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00360 [Epub ahead of print]

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Abstract PDF: Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Review article

Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; Received April 3, 2023 Accepted May 19, 2023 Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367 [Epub ahead of print]

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Abstract PDF: Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Communication

Some suggestions for pain physicians working in real-world clinical settings: Jung Hwan Lee, Min Cheol Chang; Received March 14, 2023 Accepted April 5, 2023 Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00255 [Epub ahead of print]

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Abstract PDF: Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.

Original article

Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study: Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo; J Yeungnam Med Sci. 2023;40(2):172-178. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00500

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Abstract PDF: Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.

Resident fellow section: Teaching images

A 40-year-old man with neuropathic pain in the entire left foot: Jae Hwa Bae, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2023;40(2):223-224. Published online August 30, 2022; DOI: https://doi.org/10.12701/jyms.2022.00486

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Case report

Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report: Myeong Geun Jeong, Bum Soon Park, Eun-Seok Son, Jang Hyuk Cho; J Yeungnam Med Sci. 2023;40(3):289-292. Published online August 5, 2022; DOI: https://doi.org/10.12701/jyms.2022.00388

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Abstract PDF: We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

Review articles

Pain in amyotrophic lateral sclerosis: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2022;39(3):181-189. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00332

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5 Citations

Abstract PDF

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

Citations

Citations to this article as recorded by

Likely Pathogenic Variants of Cav1.3 and Nav1.1 Encoding Genes in Amyotrophic Lateral Sclerosis Could Elucidate the Dysregulated Pain Pathways
Zsófia Flóra Nagy, Balázs Sonkodi, Margit Pál, Péter Klivényi, Márta Széll
Biomedicines.2023; 11(3): 933. CrossRef
Palliative Care in Amyotrophic Lateral Sclerosis
Sebastiano Mercadante, Lou'i Al-Husinat
Journal of Pain and Symptom Management.2023; 66(4): e485. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef
Synucleinopathy in Amyotrophic Lateral Sclerosis: A Potential Avenue for Antisense Therapeutics?
Bradley Roberts, Frances Theunissen, Francis L. Mastaglia, P. Anthony Akkari, Loren L. Flynn
International Journal of Molecular Sciences.2022; 23(16): 9364. CrossRef
Herbal medicine and acupuncture relieved progressive bulbar palsy for more than 3 years: A case report
Siyang Peng, Weiqian Chang, Yukun Tian, Yajing Yang, Shaohong Li, Jinxia Ni, Wenzeng Zhu
Medicine.2022; 101(45): e31446. CrossRef

The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review: Aung Chan Thu; J Yeungnam Med Sci. 2022;39(3):206-215. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00290

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4 Citations

Abstract PDF

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

Citations

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Injectable Lyophilized Chitosan-Thrombin-Platelet-Rich Plasma (CS-FIIa-PRP) Implant to Promote Tissue Regeneration: In Vitro and Ex Vivo Solidification Properties
Fiona Milano, Anik Chevrier, Gregory De Crescenzo, Marc Lavertu
Polymers.2023; 15(13): 2919. CrossRef
Systematic Review of Platelet-Rich Plasma for Low Back Pain
Edilson Silva Machado, Fabiano Pasqualotto Soares, Ernani Vianna de Abreu, Taís Amara da Costa de Souza, Robert Meves, Hans Grohs, Mary A. Ambach, Annu Navani, Renato Bevillaqua de Castro, Daniel Humberto Pozza, José Manuel Peixoto Caldas
Biomedicines.2023; 11(9): 2404. CrossRef
Restraint stress-associated gastrointestinal injury and implications from the Evans blue-fed restraint stress mouse model
Der-Shan Sun, Te-Sheng Lien, Hsin-Hou Chang
Tzu Chi Medical Journal.2023;[Epub] CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

Case report

Prolonged oral sildenafil use-induced Mondor disease: a case report: Han Sol Chung, You Ho Mun; J Yeungnam Med Sci. 2022;39(3):262-265. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00220

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Abstract PDF: Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.

Review articles

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):190-199. Published online April 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00192

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1 Citations

Abstract PDF

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Citations

Citations to this article as recorded by

The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

2,798 View
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5 Citations

Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Citations

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Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain
Shao‐jun Li, Dan Feng
CNS Neuroscience & Therapeutics.2023; 29(7): 1881. CrossRef
Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka, Pavel Ryska
Journal of Personalized Medicine.2023; 13(7): 1054. CrossRef
Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
Healthcare.2023; 11(16): 2355. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef
Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study
Min Cheol Chang, Donghwi Park, Yoo Jin Choo
Journal of Pain Research.2022; Volume 15: 4065. CrossRef

Case report

Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report: Mathieu Boudier-Revéret, Min Cheol Chang; Yeungnam Univ J Med. 2021;38(4):371-373. Published online April 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.00948

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Abstract PDF Supplementary Material: Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.

Review articles

Updates on the treatment of adhesive capsulitis with hydraulic distension: Jang Hyuk Cho; Yeungnam Univ J Med. 2021;38(1):19-26. Published online August 31, 2020; DOI: https://doi.org/10.12701/yujm.2020.00535

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8 Citations

Abstract PDF

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

Citations

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Frozen Shoulder: Diagnosis and Management
Sean R. Wise, Paul Seales, Alex P. Houser, Chase B. Weber
Current Sports Medicine Reports.2023; 22(9): 307. CrossRef
Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder
Huajun Xu, Yingchun Zhang, Caishan Wang
Journal of Back and Musculoskeletal Rehabilitation.2022; 35(5): 1153. CrossRef
Impact of capsular preservation on patient-reported outcomes and complication rates in total hip arthroplasty using the direct anterior approach
Vincent A. Stadelmann, Hannes A. Rüdiger, Selina Nauer, Michael Leunig
The Bone & Joint Journal.2022; 104-B(7): 826. CrossRef
Management of Patients with Adhesive Capsulitis via Ultrasound-Guided Hydrodilatation without Concomitant Intra-Articular Lidocaine Infusion: A Single-Center Experience
Yung-Chieh Chen, Shu-Huei Shen, Hong-Jen Chiou, Yung-Liang Wan
Life.2022; 12(9): 1293. CrossRef
Role of Platelet-Rich Plasma in the Treatment of Adhesive Capsulitis: A Prospective Cohort Study
Syed Imran Haider, Muhammad Zarak Awais, Muhammad Tahir Iqbal
Cureus.2022;[Epub] CrossRef
Musculoskeletal complications in patients with diabetes mellitus
Jong Han Choi, Hae-Rim Kim, Kee-Ho Song
The Korean Journal of Internal Medicine.2022; 37(6): 1099. CrossRef
Comparison of the spread pattern of medial-to-lateral and lateral-to-medial rotator interval injections: A cadaveric study
Benjamin J. Kozlowski, John Tran, Philip W.H. Peng, Anne M.R. Agur, Nimish Mittal
Interventional Pain Medicine.2022; 1(4): 100164. CrossRef
Updates on Intra-articular Corticosteroid Injection for the Treatment of Adhesive Capsulitis
Ju Heon Oh, In Ho Jung, Eun Woo Park, Jang Hyuk Cho
Keimyung Medical Journal.2022; 41(2): 51. CrossRef

Effectiveness of orthoses for treatment in patients with spinal pain: Yoo Jin Choo, Min Cheol Chang; Yeungnam Univ J Med. 2020;37(2):84-89. Published online March 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00150

7,083 View
162 Download
11 Citations

Abstract PDF

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients’ lifestyle.

Citations

Citations to this article as recorded by

Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
Healthcare.2023; 11(16): 2355. CrossRef
Effectiveness and Safety of Inelastic Versus Elastic Lumbosacral Orthoses on Low Back Pain Prevention in Healthy Nurses
Jianzhong Hu, Liyuan Jiang, Yong Cao, Jin Qu, Hongbin Lu
Spine.2022; 47(9): 656. CrossRef
The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review
Donghwi Park, Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 200. CrossRef
Effectiveness of pulsed radiofrequency on the medial cervical branches for cervical facet joint pain
Min Cheol Chang, Seoyon Yang
World Journal of Clinical Cases.2022; 10(22): 7720. CrossRef
The Effectiveness of Facet Joint Injection with Steroid and Botulinum Toxin in Severe Lumbar Central Spinal Stenosis: A Randomized Controlled Trial
Sang Lee, Hyun Choi, Min Chang
Toxins.2022; 15(1): 11. CrossRef
Use of Pulsed Radiofrequency for the Treatment of Discogenic Back Pain: A Narrative Review
Seoyon Yang, Mathieu Boudier‐Revéret, Min Cheol Chang
Pain Practice.2021; 21(5): 594. CrossRef
YouTube as a Source of Information on Epidural Steroid Injection
Min Cheol Chang, Donghwi Park
Journal of Pain Research.2021; Volume 14: 1353. CrossRef
Comparison of Physical Activity Levels of Individuals Using Orthosis Without Pain and Kinesiophobia with Healthy Controls and within Themselves
Melek VOLKAN-YAZICI, Fatmagül VAROL
Ergoterapi ve Rehabilitasyon Dergisi.2021; 9(3): 79. CrossRef
The role of assistive devices in frail elderly people with fragility fractures: a narrative review
Giovanni Iolascon, Carla Michini, Robin Kuruvila Sentinella, Milena Aulicino, Antimo Moretti
International Journal of Bone Fragility.2021; 1(2): 53. CrossRef
Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review
Min Cheol Chang
Cureus.2020;[Epub] CrossRef
Association between Chronic Pain and Alterations in the Mesolimbic Dopaminergic System
Seoyon Yang, Mathieu Boudier-Revéret, Yoo Jin Choo, Min Cheol Chang
Brain Sciences.2020; 10(10): 701. CrossRef

Original article

Correlation between anterior thigh pain and morphometric mismatch of femoral stem: Haksun Chung, So Hak Chung; Yeungnam Univ J Med. 2020;37(1):40-46. Published online September 16, 2019; DOI: https://doi.org/10.12701/yujm.2019.00325

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120 Download

Abstract PDF: Background
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
Methods
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Results
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Conclusion
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

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