Methods of hamstring muscle injection of botulinum toxin type A combined with periarticular injection after total knee arthroplasty
Abstract
This study aimed to report on a method for injecting botulinum toxin type A into the hamstring muscles combined with periarticular injection in total knee arthroplasty (TKA) patients. We enrolled patients who underwent elective unilateral TKA at our hospital from February 2021 to December 2021 and administered botulinum toxin type A hamstring muscle injection combined with periarticular injection. We established and reported a detailed method for this combined approach, which could provide an alternative analgesic regimen after TKA in clinical practice.
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References
Baczkowicz D, Skiba G, Czerner M, Majorczyk E. Gait and functional status analysis before and after total knee arthroplasty. Knee. 2018; 25(5): 888–96. Doi: 10.1016/j.knee.2018.06.004
Theodoulou A, Bramwell DC, Spiteri AC, Kim SW, Krishnan J. The use of scoring systems in knee arthroplasty: a systematic review of the literature. J Arthroplasty. 2016; 31(10): 2364–70. doi: 10.1016/j.arth.2016.05.055
American Society of Anesthesiologists Task Force on Acute Pain M. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on acute pain management. Anesthesiology. 2012; 116(2): 248–73.
Chung AS, Spangehl MJ. Peripheral nerve blocks vs periarticular injections in total knee arthroplasty. J Arthroplasty. 2018; 33(11): 3383–8. doi: 10.1016/j.arth.2018.08.006
Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010; 69(3): 483–9. doi:10.1136/ard.2009.113100
Montecucco C, Molgo J. Botulinal neurotoxins: revival of an old killer. Curr Opin Pharmacol. 2005; 5(3): 274–9. doi: 10.1016/j.coph.2004.12.006
Durham PL, Cady R, Cady R. Regulation of calcitonin gene-related peptide secretion from trigeminal nerve cells by botulinum toxin type A: implications for migraine therapy. Headache: The Journal of Head and Face Pain. 2004; 44(1): 35–43 doi: 10.1111/j.1526-4610.2004.04007.x
Burstein R, Zhang X, Levy D, Aoki KR, Brin MF. Selective inhibition of meningeal nociceptors by botulinum neurotoxin type A: therapeutic implications for migraine and other pains. Cephalalgia. 2014; 34(11): 853–69. doi: 10.1177/0333102414527648
Dressler D, Saberi FA, Barbosa ER. Botulinum toxin: mechanisms of action. Arq Neuropsiquiatr. 2005; 63(1): 180–5. doi: 10.1590/S0004-282X2005000100035
Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov. 2012; 2: tre-02-85-417-1. doi: 10.5334/tohm.120
Rojewska E, Piotrowska A, Popiolek-Barczyk K, Mika J. Botulinum toxin type A-A modulator of spinal neuron-glia interactions under neuropathic pain conditions. Toxins. 2018; 10(4): 145. doi: 10.3390/toxins10040145
Manuel Munoz-Lora VR, Abdalla HB, Del Bel Cury AA, Clemente-Napimoga JT. Modulatory effect of botulinum toxin type A on the microglial P2X7/CatS/FKN activated-pathway in antigen-induced arthritis of the temporomandibular joint of rats. Toxicon. 2020; 187: 116–21. doi: 10.1016/j.toxicon.2020.08.027
Seyler TM, Jinnah RH, Koman LA, Marker DR, Mont MA, Ulrich SD, et al. Botulinum toxin type A injections for the management of flexion contractures following total knee arthroplasty. J Surg Orthop Adv. 2008; 17(4): 231–8.
Copyright (c) 2023 Xiaofeng Jiang, TaoTao Jiang, Xiaojun Qi, Pengzhou Gai, Hongliang Sun, Guangda Wang

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