Grade Evidence Appraisal

In this academic journal Melanie Brown reports the benefits and experiences of using alternative and conventional methods to treat muscular skeletal pain. In this study Brown explains the methods people use to indicate what is going wrong or what is causing them problems and the methods they use in order to treat said ailment. Brown explains the methods and treatments used to treat muscular skeletal treatment, but she also shows the methods she used to collect the information. Brown used questionnaires, interviews,

In this study, a randomized and concealed method supported by a computer was conducted prospectively for patients who showed signs of radiographic knee OA. In addition, without knowing further about the clinical status of participants, knee radiographs were assessed in the study of baseline and follow ups by an experienced surgeon. The baseline characteristics of subjects such as age and BMI were not significantly different. Criteria included were the radiographically confirmed as knee OA (a score ≥ 1 out of 4 on the K/L scale), ability to walk to the site, understand and make signature on the written consent of information form and report the data required. However, the research did not include the participants

The proposed solution is to bring about change in the current practice protocol for pain reassessment and documentation. The plan of change is to:

The goals for management are to reduce joint pain and stiffness, maintain and improve joint mobility, improve muscle strength, limit subsequent joint damage and improve quality of life. Conservative treatment may include rest, range-of-motion exercises, use of assistive device to decrease weight-bearing, weight loss and glucosamine. Pharmacological treatment may include analgesics and anti-inflammatory drugs or intra-articular injections of hyaluronic acid (Ng, Heesch & Brown 2012). Alternative therapy includes acupuncture or magnetic bracelets. Surgical treatment includes artificial implants to create new joints, correction of a deformity or misalignment, and improvement of joint movement (McCance, Huether, Brashers, & Rote, 2010). The Osteoarthritis Research Society International (ORSI) has an extensive list of recommendations to manage OA that emphasizes weight reduction in the obese, exercise and educating patients (ORSI,

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

Study 1 primarily focused on functional and clinical outcomes and knee ROM. Half of the patients in this study undergoing a TKA surgery received an inflated tourniquet, whereas the other half received an un-inflated tourniquet. The primary outcome measurements were Knee Injury and Osteoarthritis Outcome Score (KOOS), a knee specific questionnaire, and knee ROM measurements. KOOS feedback evaluated functional and clinical outcomes, which were expressed as the change in the average score over the period of 12 months for each subscale: pain, symptom, activities of daily living (ADL), sport/recreation, quality of life (QOL). This review will focus on ADL, sports and recreation, and QOL, because these subscales pertain to the knee ROM.

These results and the success in reducing pain and improving function in their patients, led them to conclude that intra-articular MSC injections are an effective and safe way to treat OA of the knee.

Methods: All 60 knees (31 robotic-assisted; 29 conventional) from the initial study cohort were available for analysis. Differences in range of motion, Knee Society (KSS) knee and function scores, Oxford Knee scores (OKS), SF-36 subscale and summative

Sixteen patients (72%) in saline group had moderate to severe pain. Two patients (9%) in ondansetron group and one patient (4%) in lidocaine group had mild pain (P= 0.06). No patient in lidocaine, ondansetron and combination group had moderate to severe pain

The knee has the highest prevalence of OA of all of the joints in the human body. Knee OA regularly causes people to experience troubling pain and/or loss of physical function to varying degrees,5 and often results in total knee arthroplasty8 after years of distress and economic burden to the patient and society.9 During 2005 in Ontario, Canada, knee OA costs for an individual averaged $12,200 annually, including personal expenses as well as lost wages.10 It is estimated that as the world’s population ages and as the obesity epidemic grows, the burden of OA on the healthcare system, and therefore the economy, will continue to increase, barring improvements in knee OA management.8

This bias could potentially provide the reasoning for lack of expertise with condition with other professionals. Of the research the author was able to gather, the majority of references only demonstrated orthopedic surgeons with an increased interest in the subject. There should not be only interest in the invasive form of treatment. First and foremost, doctors are to do no harm. Skipping the necessary evaluation and conservative methods does not achieve this goal. The proper

Despite recent advances in information regarding perioperative care, postoperative pain continues to go undermanaged. Postoperative pain is the pain patients experience after a surgical procedure. According to Gan, 80% of all people who undergo surgeries experience postoperative pain, and 75% of them rate their pain at a moderate, severe, or extreme level (as cited by Cooney, 2016). Furthermore, inadequately managed pain can lead to patient dissatisfaction, decreased patient outcomes, and overall higher cost of care (Penprase, Brunetto, Dahmani, Forthoffer & Kapoor, 2015). In order to provide higher quality pain management,

The peer reviewed journal article, A Decision Tree Model for Postoperative pain Management, is an article describing postoperative pain management regimens using evidence-based practice. This article’s author has created a guide for prescribers who are managing postoperative pain levels for patients. This article is using evidence-based practice to help future patients have adequate pain relief, but not have the serious ramifications that can occur from the wrong dose or wrong medication for said patient.

According to John Hopkins Medicine (n.d.), pain is an uncomfortable feeling that tells you something may be wrong. It can be fixed, throbbing, stabbing, aching, pinching, or described in many other ways. Pain is categorized as either acute or chronic. Acute pain is usually severe and brief, and is often a signal that your body has been injured. Chronic pain can vary from mild to severe and is there for long periods of time (John Hopkins Medicine, n.d). This paper will discuss a scenario that entails which person is experiencing the most pain, how two people can have the same procedure experience different levels of pain, factors that contribute to each person’s pain level, and two complementary/alternative methods of pain control.

Osteoarthritis is the most common joint disorder, and more than half of all Americans who are older than 65 have been diagnosed with osteoarthritis. However, recent US data has revealed knee osteoarthritis does not discriminate age, and there is growing evidence that osteoarthritis affects individuals at a young age. The annual cost of osteoarthritis due to treatment and loss of productivity in the US is estimated to be more than 65 billion dollars.1 With no cure currently available for osteoarthritis, current treatments focus on management of symptoms. The primary goals of therapy include improved joint function, pain relief, and increased joint stability. Although the exact cause of osteoarthritis is unknown, many risk factors have been identified including increased age, female gender, obesity, and trauma.2 Within these risk factors, the etiology of osteoarthritis has been divided into anatomy, body mass, and gender.