The Journal of Bone and Joint Surgery 78:1936-44 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.
Instructional Course Lecture |
Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Reflex Sympathetic Dystrophy and Pain Dysfunction in the Lower Extremity*
THOMAS N. LINDENFELD, M.D. , CINCINNATI, OHIO,
BERNARD R. BACH JR., M.D. , CHICAGO, ILLINOIS and
EDWARD M. WOJTYS, M.D.¶, ANN ARBOR, MICHIGAN
An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons.
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Introduction
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Most orthopaedic surgeons have faced the challenge of managing patients who have marked limitation of motion of the knee. Others have managed patients who have a disability because of sympathetically maintained painthat is, reflex sympathetic dystrophy. Both of these conditions can be difficult to treat. When sympathetically maintained pain and severe contractures occur together in the knee, the problems of diagnosis and treatment are magnified. Sympathetically maintained pain can be disproportionately severe and associated with periarticular swelling as well as with muscle inhibition23,47, which may lead to a slow and painful course in physical therapy. The relative lack of progress in rehabilitation of the knee, as well as the sympathetically maintained pain itself, frequently produce anxiety and depression in these patients, which can lead to poor compliance and worsening stiffness. Increasing stiffness in the knee often limits the ability of a patient to walk, kneel, climb, sit, work, or . . . [Full Text of this Article]

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