The Journal of Bone and Joint Surgery, Vol 71, Issue 3 365-369, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Reflex sympathetic dystrophy of the knee. Treatment using continuous epidural anesthesia
DE Cooper, JC DeLee and S Ramamurthy
University of Texas Health Science Center, San Antonio 78284.
We retrospectively reviewed the cases of fourteen patients who had reflex
sympathetic dystrophy of the knee. All fourteen were hospitalized, and
epidural block anesthesia was instituted with an indwelling catheter for an
average of four days, during which continuous passive motion, manipulation
(as necessary), stimulation of muscles, and alternating hot and cold soaks
were used. The average length of follow-up was thirty-two months. Eleven
patients had complete resolution of the symptoms, two had sufficient
intermittent aching with changes in the weather to need medication, and one
had no relief. The diagnosis was confirmed if the symptoms were relieved by
a lumbar sympathetic block. Pain that was out of proportion to the severity
of the injury was the most consistent finding, being present in all
fourteen patients. However, variation in clinical severity is
characteristic of the syndrome. Eleven of the fourteen patients had had a
previous patellar operation. After the onset of the symptoms, nine patients
had two or more arthroscopic examinations, without notable findings. All
fourteen patients had had extensive physical therapy and medical treatment
before the epidural block was performed.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
