Prosthetic joint infection (PJI) remains a significant complication following joint arthroplasty, necessitating prompt recognition and intervention to optimize patient outcomes. This case report describes a 65-year-old male who presented with persistent pain, swelling, and purulent discharge from the right hip, three years post-bipolar hemiarthroplasty following a road traffic accident. Clinical examination revealed signs suggestive of PJI, prompting surgical intervention with total hip arthroplasty. Postoperatively, the patient experienced resolution of symptoms and satisfactory recovery. This case underscores the challenges associated with infected joint arthroplasty and highlights the importance of a multidisciplinary approach for effective management. Early diagnosis, appropriate surgical intervention, and comprehensive postoperative care are essential for minimizing morbidity associated with PJIs and optimizing patient outcomes.

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BACKGROUND: People with persistent pain are frequently offered a pain management programme (PMP) as part of their care plan. Cognitive behavioural therapy (CBT) principles often underpin PMPs and has a good evidence base; nevertheless, more recent systematic reviews have suggested that its effectiveness is limited. Compassion-focused therapy (CFT) is a form of \'third-wave CBT\' that offers an alternative and complementary view of pain, encouraging the person to be alongside their experience of pain and respond to it using skills of compassion they have learnt.
METHODS: The current research explored the effectiveness of a 12-week CFT group for people who experience persistent pain. Research interviews explored CFT members\' experiences of the CFT group. Feedback was collected on the facilitators\' experience of running the group and questionnaire data collected on participants\' mood, pain disability, acceptance of chronic pain and levels of self-criticism and self-reassurance.
RESULTS: Interviews were analysed using interpretative phenomenological analysis that revealed five master superordinate themes representative across all interviews. These were then triangulated with data from the questionnaires and facilitator feedback.
CONCLUSIONS: In people whose persistent pain was compounded by a significant psychological component, a CFT group approach helped reduce feelings of isolation, improve ability to self-reassure, learn new ways of coping and develop a growing acceptance of the limitations associated with their pain. The possible implications for future clinical practice are considered.

UNASSIGNED: Persistent idiopathic facial pain (PIFP) is a poorly defined and debilitating chronic pain state with a challenging and often inadequate treatment course. This is the first case report identifying the novel use of low-dose lumbar intrathecal ziconotide to successfully treat PIFP with nearly complete resolution of pain and minimal to no side effects.
UNASSIGNED: The patient was a 37 year-old female whose PIFP was refractory to multimodal medication management and multiple neurovascular surgical interventions. A single-shot lumbar intrathecal trial of ziconotide (2.5 mL, equivalent 2.5 μg) was injected when she was at her baseline pain level - VAS 7/10. She received complete resolution of her pain for about 9 hours, concordant with ziconotide\'s half-life. She was subsequently implanted with a lumbar intrathecal delivery system.
UNASSIGNED: The patient experienced complete resolution of her facial pain with a single-shot intrathecal trial of ziconotide. The intrathecal pump system has provided nearly complete (VAS 1/10) pain relief. Two flares of pain occurred 10 and 18 months after pump placement, which subsequently resolved after increasing the ziconotide dose by 0.5 μg/day on each occasion. The patient is currently maintained on a dose of 2.0 μg/day and is pain-free.
UNASSIGNED: This is the first case report describing the use of a single-shot lumbar intrathecal trial of ziconotide and subsequent placement of lumbar (as opposed to thoracic) intrathecal ziconotide pump for PIFP. A single-injection intrathecal trial is a low-risk, viable option for patients with this debilitating and frustrating pain condition. Successful trials and subsequent intrathecal pump placement with ziconotide may supplant multimodal medication management and/or invasive orofacial surgical intervention for PIFP.

We investigated the possible role of intercostal surgical neurolysis in relieving chronic neuropathic pain refractory to other nonsurgical treatments in patients with postsurgical thoracic pain.
We retrospectively collected clinical data on patients referred to the Neurosurgery Unit of Policlinic Hospital of Milan. Ten patients (age range, 20-68 years) suffering from neuropathic pain for at least 2 months after thoracic surgery underwent intercostal neurolysis.
Compared with preneurolysis, pain intensity decreased 1 month postneurolysis and remained stable 2 months postneurolysis (median score [interquartile range]: 8 [6-9] preneurolysis, 4 [3-5] 1 month after, and 3 [2-5] 2 months after, P < 0.001). Antiepileptic drugs for pain control decreased after neurolysis.
Surgical intercostal neurolysis may be a promising therapeutic option in patients with chronic neuropathic pain associated with neurological deficits. Muscle Nerve 58: 671-675, 2018.