WorldWideScience

Sample records for arthroscopes

  1. Arthroscopic treatment of gonarthrosis

    OpenAIRE

    Taser, Omer; Alturfan, Aziz; Pinar, Halit; Gogus, Abdullah

    2004-01-01

    59 cases, who had arthroscopic debridement or arthroscopic abrasion arthroplasty (±drilling) for gonarthrosis between June 1988 and December 1990 were evaluated. Follow-up period was 1 ,5 to 30 months (average 9,2 months) in the debridement group (Group I) and 1, 5 to 24 months (average 7,5 months) in the abrasion arthroplas group (Group II). All patients became subjectively well In the first group (39 patients in total) activity level increased in 30 patients, stayed the same in 6 patients a...

  2. Arthroscopic partial medial meniscectomy

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    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  3. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function...... and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...

  4. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical t...

  5. Discoid lateral meniscus and its arthroscopic treatment

    OpenAIRE

    Asik, Mehmet; Sen, Cengiz; Dikici, Fatih; Sozen, Yunus V.; Taser, Omer F.; Alturfan, Aziz

    2004-01-01

    Objectives: We evaluated the results of arthroscopic meniscectomy in patients with lateral discoid menisci of the knee. Methods: Lateral discoid menisci were documented in 274 patients, of whom 183 patients (110 males, 73 females; mean age 34.8 years; range 6-67 years) were clinically and arthroscopically found to be symptomatic and underwent total, subtotal, or partial meniscectomy. The most common complaints were pain, lurch, feeling of giving way, locking, limited extension, and marked ...

  6. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  7. Arthroscopic quadriceps tendon repair: two case reports.

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    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  8. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

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    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  9. Arthroscopic treatment of iliotibial band syndrome.

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    Cowden, Courtney H; Barber, F Alan

    2014-02-01

    Lateral knee pain in athletes is commonly seen in the sports medicine clinic, and the diagnosis of iliotibial band (ITB) syndrome is frequently made. Although conservative management including rest from activity, equipment modification, oral nonsteroidal anti-inflammatory drug use, and physical therapy is the mainstay of treatment initially, refractory cases do exist. Multiple surgical techniques have been described including an arthroscopic technique. Arthroscopic release of the ITB attachment to the lateral femoral epicondyle and resection of the lateral synovial recess for recalcitrant ITB syndrome comprise a valid option that can have a good outcome. This option avoids the complications associated with open surgery and allows for a complete arthroscopic knee examination. Division or lengthening of the ITB band itself is not a necessary step in this technique.

  10. Augmented virtuality for arthroscopic knee surgery.

    Science.gov (United States)

    Li, John M; Bardana, Davide D; Stewart, A James

    2011-01-01

    This paper describes a computer system to visualize the location and alignment of an arthroscope using augmented virtuality. A 3D computer model of the patient's joint (from CT) is shown, along with a model of the tracked arthroscopic probe and the projection of the camera image onto the virtual joint. A user study, using plastic bones instead of live patients, was made to determine the effectiveness of this navigated display; the study showed that the navigated display improves target localization in novice residents. PMID:22003616

  11. Open Versus Arthroscopic Tennis Elbow Release

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    Leiter, Jeff; Clark, Tod; McRae, Sheila; Dubberley, James; MacDonald, Peter B.

    2016-01-01

    Objectives: The primary objective of this study was to determine if quality of life and function are different following arthroscopic versus open tennis elbow release surgery. Based on retrospective studies, both approaches have been found to be beneficial, but no prospective randomized comparison has been conducted to date. Methods: Following a minimum six-months of conservative treatment, seventy-one patients (>16 yrs old) were randomized intraoperatively to undergo either arthroscopic or open lateral release. Outcome measures were the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), a 5-question VAS Pain Scale, and grip strength. Study assessments took place pre-, and 6-week, 3-, 6-, and 12-months post-surgery. Comparisons between groups and within groups over time were conducted using repeated measures ANOVA. A minimal clinically significant difference for the DASH had been previously identified as 15 points, and was used to compare groups as well at 12-months post-operative (Beaton et al. 2001). Results: Fifteen women and 19 men underwent the open procedure with a mean age of 47.1 years (6.7) and 13 women and 21 men were in the arthroscopic group with a mean age of 45.0 (6.9). No pre-surgery differences were found between groups based on age, sex, DASH or VAS scores. Both groups demonstrated a significant improvement in subjective measures and grip strength by 12-months post-surgery, and no significant differences were found between groups at any time point. The DASH, our primary outcome, decreased from a mean (SD) of 47.5 (14.5) pre-surgery to 21.9 (21.8) at 12-months post-surgery in the Open group and from 52.7 (16.0) to 22.6 (21.1) in the Arthroscopic group. VAS-pain scores (%) decreased in the Open group from 62.5 (17.2) pre-operatively to 30.0 (26.5) at 12-months. In the arthroscopic group, scores decreased from 63.7 (15.9) to 26.2 (24.6). Grip strength (kg) increased on the affected side from 23.6 (14.9) to 29.3 (16.3) and 21.4 (15.4) to

  12. Comparison of two arthroscopic pump systems based on image quality

    OpenAIRE

    Tuijthof, G. J. M.; van den Boomen, H.; van Heerwaarden, R. J.; Dijk, C. N. Van

    2008-01-01

    The effectiveness of arthroscopic pump systems has been investigated with either subjective measures or measures that were unrelated to the image quality. The goal of this study is to determine the performance of an automated pump in comparison to a gravity pump based on objective assessment of the quality of the arthroscopic view. Ten arthroscopic operations performed with a gravity pump and ten performed with an automated pump (FMS Duo system) were matched on duration of the surgery and sha...

  13. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Science.gov (United States)

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  14. Increased Post-Operative Stiffness after Arthroscopic Suprapectoral Biceps Tenodesis

    OpenAIRE

    Werner, Brian C.; Pehlivan, Hakan C.; Hart, Joseph M.; Carson, Eric W.; Diduch, David R.; Miller, Mark D.; Brockmeier, Stephen F.

    2014-01-01

    Objectives: Biceps tenodesis can be performed open or arthroscopically and can be positioned in a suprapectoral or subpectoral position. Suprapectoral tenodesis can be carried out arthroscopically, whereas the subpectoral tenodesis is performed as an open procedure. The goal of this study is to compare the incidence of postoperative stiffness between arthroscopic suprapectoral and open subpectoral biceps tenodesis and evaluate risk factors for its occurrence. Methods: Study Design: The charts...

  15. Outcomes after Arthroscopic Bankart Repair

    Science.gov (United States)

    Marshall, Tyler James; Vega, Jose F.; Siqueira, Marcelo BP; Gelber, Jonathan David; Cagle, Robert; Saluan, Paul M.

    2016-01-01

    Objectives: The shoulder is the most common joint dislocation effecting roughly 2% of the general population. Males are effected to a higher degree that females at a ratio of 3:1.1-2 The young, athletic population make up the largest portion of shoulder instability, and treated nonoperatively have a recurrent dislocation rate approaching 50%.3-5 Owens et. al recently published a cohort looking at 45 college athletes with an in season shoulder instability event. 73% of athletes returned to play in season. Only 36% of athletes completed the season without re-injury and 64% of athletes had a recurrent instability event.6 It is unknown how the outcomes of those who go on to have a recurrent dislocation in season are effected versus those who have a stabilization procedure after a first time dislocation. The objective of the current study is to report the postoperative outcomes of first time dislocators versus patients with recurrent dislocations prior to surgery. Methods: CPT codes were used to identify patients who had arthroscopic Bankart repair between 2003-2013. 439 patients aged 16-30 years were identified across 8 fellowship trained surgical practices. The first phase of the study was a retrospective chart review to obtain patient demographics, number of reported preoperative dislocations, review imaging, and number of anchors placed. Patients were identified as first time dislocators or as recurrent dislocators when they had more than one dislocation prior to surgical intervention. The second phase consisted of a survey to obtain a simple shoulder test score, whether they returned to sport, postoperative instability events and further surgery on the shoulder. Postoperative instability was defined as a subluxation or dislocation reported by the patient survey in the postoperative period. Of the 439 patients identified, 296 were excluded for revision surgery, open repair, posterior instability, multidirectional instability, HAGL lesion, labral tears involving the

  16. Arthroscopic anatomy of the subdeltoid space

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    Michael J. Salata

    2013-09-01

    Full Text Available From the first shoulder arthroscopy performed on a cadaver in 1931, shoulder arthroscopy has grown tremendously in its ability to diagnose and treat pathologic conditions about the shoulder. Despite improvements in arthroscopic techniques and instrumentation, it is only recently that arthroscopists have begun to explore precise anatomical structures within the subdeltoid space. By way of a thorough bursectomy of the subdeltoid region, meticulous hemostasis, and the reciprocal use of posterior and lateral viewing portals, one can identify a myriad of pertinent ligamentous, musculotendinous, osseous, and neurovascular structures. For the purposes of this review, the subdeltoid space has been compartmentalized into lateral, medial, anterior, and posterior regions. Being able to identify pertinent structures in the subdeltoid space will provide shoulder arthroscopists with the requisite foundation in core anatomy that will be required for challenging procedures such as arthroscopic subscapularis mobilization and repair, biceps tenodesis, subcoracoid decompression, suprascapular nerve decompression, quadrangular space decompression and repair of massive rotator cuff tears.

  17. Arthroscopic management of distal radius fractures.

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    Wiesler, Ethan R; Chloros, George D; Mahirogullari, Mahir; Kuzma, Gary R

    2006-11-01

    Arthroscopy has the advantage of providing a direct and accurate assessment of the articular surfaces and detecting the presence of injuries associated with distal radius fractures. Current indications, although numerous and potentially expanding, also are controversial. This report presents a global view of the current status of arthroscopy in the management of distal radius fractures. The rationale of arthroscopic treatment, the available evidence, and finally the diagnosis and treatment are discussed. PMID:17095385

  18. Stem cell procedures in arthroscopic surgery

    OpenAIRE

    Dyrna, Felix; Herbst, Elmar; Hoberman, Alexander; Imhoff, Andreas B.; Schmitt, Andreas

    2016-01-01

    The stem cell as the building block necessary for tissue reparation and homeostasis plays a major role in regenerative medicine. Their unique property of being pluripotent, able to control immune process and even secrete a whole army of anabolic mediators, draws interest. While new arthroscopic procedures and techniques involving stem cells have been established over the last decade with improved outcomes, failures and dissatisfaction still occur. Therefore, there is increasing interest in wa...

  19. Multimodal pain management after arthroscopic surgery

    DEFF Research Database (Denmark)

    Rasmussen, Sten

    Multimodal Pain Management after Arthroscopic Surgery By Sten Rasmussen, M.D. The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery. NSAID was tested against placebo after knee arthrosco...... after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid....... ankle arthroscopy. Oral NSAID reduced time to work from 17 to 14 days after knee arthroscopy. Intra-articular treatment with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after arthroscopic knee meniscectomy reduced time to work from 10 to 5 to 3 days. Intraarticular treatment...... with bupivacaine plus morphine and bupivacaine plus morphine plus steroid after diagnostic knee arthroscopy reduced time to work from 10 to 5 to 2 days. Additional analysis revealed that the surgical trauma and the use of tourniquet influenced recovery. The thesis proves a reduction in the time to return to work...

  20. All-Arthroscopic Latissimus Dorsi Transfer.

    Science.gov (United States)

    Cutbush, Kenneth; Peter, Noel A; Hirpara, Kieran

    2016-06-01

    Massive irreparable rotator cuff tears are often associated with severe functional impairment and disabling pain. One viable treatment option is a latissimus dorsi tendon transfer. We propose an all-arthroscopic technique that we believe avoids insult to the deltoid musculature while reducing morbidity from open harvest of the tendon. The operation is performed with the patient in the lateral decubitus position, by use of a combination of viewing and working portals in the axilla. The initial viewing portal is placed along the anterior belly of the latissimus muscle in the axilla. The latissimus and teres major are identified, as is the thoracodorsal neurovascular pedicle. The tendons are carefully separated, and the inferior and superior borders of the latissimus are whipstitched using a suture passer, which helps facilitate subsequent mobilization of the muscle. The interval deep to the deltoid and superficial to the teres minor is developed into a subdeltoid tunnel for arthroscopic tendon transfer. The latissimus tendon is then transferred and stabilized arthroscopically to the supraspinatus footprint with suture anchors. Our preliminary data suggest that this surgical technique results in improvement in pain, range of motion, and function. PMID:27656385

  1. Arthroscopic treatment of glenoid bone loss.

    Science.gov (United States)

    Taverna, Ettore; Garavaglia, Guido; Ufenast, Henri; D'Ambrosi, Riccardo

    2016-02-01

    Recurrent anterior instability of the glenohumeral joint has long been an arduous problem to solve surgically, owing to its difficulty to the need to restore both osseous and dynamic constraints in the unstable shoulder. Biomechanical studies have indicated that glenoid bone loss shortens the safe arc through which the glenoid can resist axial forces; in these cases, a soft tissue repair alone may be insufficient to maintain stability. Clinical studies have confirmed that major bone loss is associated with an unfavourable outcome. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions and less soft tissue dissection, better access for repair and, potentially, the maximum respect for the undamaged anatomical structures. The biggest disadvantage of arthroscopic procedures until recently was the inability to successfully treat a significant bone defect. Over the last 10 years, several new arthroscopic techniques have been developed, providing new surgical options for successfully treating soft tissues and bony lesions in anterior-inferior glenohumeral instability. Level of evidence V. PMID:26658567

  2. Arthroscopic Decompression for a Giant Meniscal Cyst.

    Science.gov (United States)

    Ohishi, Tsuyoshi; Suzuki, Daisuke; Matsuyama, Yukihiro

    2016-01-01

    The authors report the case of a giant medial meniscal cyst in an osteoarthritic knee of an 82-year-old woman that was successfully treated with only arthroscopic cyst decompression. The patient noticed a painful mass on the medial side of the right knee that had been gradually growing for 5 years. Magnetic resonance imaging showed an encapsulated large medial cystic mass measuring 80×65×40 mm that was adjacent to the medial meniscus. An accompanying horizontal tear was also detected in the middle and posterior segments of the meniscus. The medial meniscus was resected up to the capsular attachment to create bidirectional flow between the joint and the cyst with arthroscopic surgery. Magnetic resonance imaging performed 14 months postoperatively showed that the cyst had completely disappeared, and no recurrence was observed during a 2-year follow-up period. An excellent result could be obtained by performing limited meniscectomy to create a channel leading to the meniscal cyst, even though the cyst was large. Among previously reported cases of meniscal cysts, this case is the largest to be treated arthroscopically without open excision.

  3. Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.

    Science.gov (United States)

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

    Arthroscopic examination of 16 dancers with dance-related knee injuries which defied conservative treatment showed 15 meniscal tears and 4 cases of chondromalacia patellae. Partial arthroscopic meniscectomy was used to treat the tears. The results were excellent, with 13 of the 16 returning to preoperative levels of dance activity. (MT)

  4. Arthroscopic treatment for chronic lateral epicondylitis

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    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC in patients with chronic lateral epicondylitis that was refractory to conservative treatment. METHODS: Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS for pain. RESULTS: A total of 15 patients (9 men and 6 women were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100. The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used ( p 0.05. CONCLUSION: Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.

  5. Arthroscopic meniscal allograft transplantation without bone plugs.

    Science.gov (United States)

    Alentorn-Geli, Eduard; Seijas Vázquez, Roberto; García Balletbó, Montserrat; Álvarez Díaz, Pedro; Steinbacher, Gilbert; Cuscó Segarra, Xavier; Rius Vilarrubia, Marta; Cugat Bertomeu, Ramón

    2011-02-01

    Partial or total meniscectomy are common procedures performed at Orthopedic Surgery departments. Despite providing a great relief of pain, it has been related to early onset knee osteoarthritis. Meniscal allograft transplantation has been proposed as an alternative to meniscectomy. The purposes of this study were to describe an arthroscopic meniscal allograft transplantation without bone plugs technique and to report the preliminary results. All meniscal allograft transplantations performed between 2001 and 2006 were approached for eligibility, and a total of 35 patients (involving 37 menisci) were finally engaged in the study. Patients were excluded if they had ipsilateral knee ligament reconstruction or cartilage repair surgery before meniscal transplantation or other knee surgeries after the meniscal transplantation. Scores on Lysholm, Subjective IKDC Form, and Visual Analogue Scale (VAS) scale for pain were obtained at a mean follow-up of 38.6 months and compared to pre-operative data. Data on chondral lesions were obtained during the arthroscopic procedure and through imaging (radiographs and MRI) studies pre-operatively. Two graft failures out of 59 transplants (3.4%) were found. Daily life accidents were responsible for all graft failures. Significant improvements for Lysholm, Subjective IKDC Form, and VAS for pain scores following the meniscal allograft transplantation were found (P lesion, there was no significant interactions for Lysholm (n.s.), Subjective IKDC Form (n.s.), and VAS for pain scores (n.s.). This study demonstrated that an arthroscopic meniscal allograft transplantation without bone plugs improved knee function and symptoms after a total meniscectomy. Improvements were observed independently of the degree of chondral lesion.

  6. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique

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    Vilá y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo

    2016-01-01

    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores. PMID:27073783

  7. Arthroscopic tibiotalar and subtalar joint arthrodesis.

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    Roussignol, X

    2016-02-01

    Arthroscopy has become indispensable for performing tibiotalar and subtalar arthrodesis. Now in 2015, it is the gold-standard surgical technique, and open surgery is reserved only for cases in which arthroscopy is contraindicated: material ablation after consolidation failure, osteophytes precluding a work chamber, excentric talus, severe malunion, bone defect requiring grafting, associated midfoot deformity, etc. The first reports of arthroscopic tibiotalar and subtalar arthrodesis date from the early 1990s. Consolidation rates were comparable to open surgery, but with significantly fewer postoperative complications: infection, skin necrosis, etc. Arthroscopy was for many years reserved to moderate deformity, with frontal or sagittal deviation less than 10°. The recent literature, however, seems to extend indications, the only restriction being the surgeon's experience. Tibiotalar arthrodesis on a posterior arthroscopic approach remains little used. And yet the posterior work chamber is much larger, and initial series showed consolidation rates similar to those of an anterior approach. The surgical technique for posterior tibiotalar arthrodesis was described by Van Dijk et al., initially using a posterior para-Achilles approach. This may be hampered by posterior osteophytes or ankylosis of the subtalar joint line (revision of non-consolidated arthrodesis, sequelae of calcaneal thalamus fracture) and is now used only by foot and ankle specialists. Posterior double tibiotalar-subtalar arthrodesis, described by Devos Bevernage et al., is facilitated by transplantar calcaneo-talo-tibial intramedullary nailing. PMID:26797006

  8. [Arthroscopic treatment of distal radius fracture].

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    Lindau, T

    2006-11-01

    The orthopaedic surgeons cannot predict the functional results after a distal intra articular radius fracture. The intra-articular incongruity of more than 1 mm is associated with the development of secondary osteoarthrosis. The wrist arthroscopy became an essential help for the reduction of these fractures. The hand is normally in an upright position with a traction of approximately 4-5 kg which facilitates the reduction of the extra-articular fracture component. It is possible to use a technique of horizontal traction. The arthroscopy allows the reduction and control of the fixing of the various fragments, but also the treatment associated lesions associated. One randomized study, which compared 34 arthroscopically treated fractures with 48 openly treated, concluded that the arthroscopy-treated group had better outcome, better reduction, better grip strength and better range of motion than the openly treated group. The treatment of intra articular distal radius fractures with arthroscopic assistance is thus the guaranteeing of the most anatomical reduction of articular surface. It allows the diagnosis and the treatment of the associated lesions, decreases the peripheral fibrous scars of soft tissues by avoiding initially extensive approaches and finally gives better functional results. PMID:17361885

  9. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release.

    Science.gov (United States)

    Arce, Guillermo

    2015-12-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  10. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    Science.gov (United States)

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter.

  11. Prognostic Factors of Arthroscopic Adhesiolysis for Arthrofibrosis of the Knee

    OpenAIRE

    Kim, Young-Mo; Joo, Yong Bum

    2013-01-01

    Purpose To assess the results of arthroscopic adhesiolysis for arthrofibrosis of the knee and to investigate possible prognostic factors. Materials and Methods Among the patients who developed arthrofibrosis after knee joint surgery, 68 patients who underwent arthroscopic adhesiolysis and were available for at least one-year follow-up were evaluated with regard to the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, patient satisfaction, and range o...

  12. Arthroscopic Reverse Remplissage for Posterior Instability.

    Science.gov (United States)

    Lavender, Chad D; Hanzlik, Shane R; Pearson, Sara E; Caldwell, Paul E

    2016-02-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a "reverse Hill-Sachs lesion." The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor-based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  13. Arthroscopical treatment of elbow joint disease

    Directory of Open Access Journals (Sweden)

    C.M.F. Rezende

    2012-02-01

    Full Text Available Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8 to fragmentation (42 of medial coronoid process (FCP of the ulna. Osteochondritis dissecans (OCD of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

  14. Arthroscopic skills assessment and use of box model for training in arthroscopic surgery using Sawbones – “FAST” workstation

    Science.gov (United States)

    Goyal, Saumitra; Radi, Mohamed Abdel; Ramadan, Islam Karam-allah; Said, Hatem Galal

    2016-01-01

    Purpose: Arthroscopic skills training outside the operative room may decrease risks and errors by trainee surgeons. There is a need of simple objective method for evaluating proficiency and skill of arthroscopy trainees using simple bench model of arthroscopic simulator. The aim of this study is to correlate motor task performance to level of prior arthroscopic experience and establish benchmarks for training modules. Methods: Twenty orthopaedic surgeons performed a set of tasks to assess a) arthroscopic triangulation, b) navigation, c) object handling and d) meniscus trimming using SAWBONES “FAST” arthroscopy skills workstation. Time to completion and the errors were computed. The subjects were divided into four levels; “Novice”, “Beginner”, “Intermediate” and “Advanced” based on previous arthroscopy experience, for analyses of performance. Results: The task performance under transparent dome was not related to experience of the surgeon unlike opaque dome, highlighting the importance of hand-eye co-ordination required in arthroscopy. Median time to completion for each task improved as the level of experience increased and this was found to be statistically significant (p 85%) of subjects across all the levels reported improvement in performance with sequential tasks. Conclusion: Use of the arthroscope requires visuo-spatial coordination which is a skill that develops with practice. This simple box model can reliably differentiate the arthroscopic skills based on experience and can be used to monitor progression of skills of trainees in institutions. PMID:27801643

  15. The Arthroscopic Ulnohumeral Arthroplasty: From Mini-Open to Arthroscopic Surgery

    Directory of Open Access Journals (Sweden)

    Ilse Degreef

    2011-01-01

    Full Text Available In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure.

  16. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  17. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

    Directory of Open Access Journals (Sweden)

    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  18. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  19. Arthroscopic treatment of bony loose bodies in the subacromial space

    Directory of Open Access Journals (Sweden)

    Wei Li

    2015-01-01

    Conclusion: The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function.

  20. An arthroscopic technique to treat the iliotibial band syndrome.

    Science.gov (United States)

    Michels, F; Jambou, S; Allard, M; Bousquet, V; Colombet, P; de Lavigne, C

    2009-03-01

    Iliotibial band syndrome (ITBS) is an overuse injury mainly affecting runners. The initial treatment is conservative. Only, in recalcitrant cases surgery is indicated. Several open techniques have been described. The purpose of this study is to evaluate the results of a standardized arthroscopic technique for treatment of a resistant ITBS. Thirty-six athletes with a resistant ITBS were treated with a standardized arthroscopic technique, limited to the resection of lateral synovial recess. Thirty-three patients were available for follow-up (mean 2 years 4 months). Thirty-two patients (34 knees) had good or excellent results. All patients went back to sports after 3 months. In two patients a meniscal lesion was found, which required treatment. One patient with only a fair result had associated cartilage lesions of the femoral condyle. Our results show that arthroscopic treatment of resistant ITBS is a valid option with a consistently good outcome. In addition, this arthroscopic approach allows excluding or treating other intra-articular pathology.

  1. Arthroscopic management of mucoid degeneration of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Chirag H Chudasama

    2012-01-01

    Conclusions: Mucoid hypertrophy of the ACL should be suspected in elderly persons presenting pain on terminal extension or flexion without preceding trauma, especially when there is no associated meniscal lesion or ligamentous insufficiency. They respond well to a judicious arthroscopic release of the ACL with notchplasty.

  2. Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation

    Directory of Open Access Journals (Sweden)

    S R Sundararajan

    2011-01-01

    Full Text Available Background: Anterior cruciate ligament (ACL avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic fixation. The aim of our study was to assess the clinical and radiological results of arthroscopic staple fixation in the management of ACL avulsion fractures. Materials and Methods: Twenty-two patients (17 males and 5 females who underwent arthroscopic staple fixation for displaced ACL avulsion fractures were analysed. The mean age was 32.2 years (15-55 years with a mean followup of 21 months (6-36 months. All patients were assessed clinically by calculating their Lysholm and International Knee Documentation Committee (IKDC scores and the radiological union was assessed in the followup radiographs. Results: The mean Lysholm score was 95.4(83-100 and the mean IKDC score was 91.1(77-100 at the final followup. In 20 patients anterior drawer′s test was negative at the end of final followup while two patients had grade I laxity. Associated knee injuries were found in seven cases. The final outcome was not greatly influenced by the presence of associated injuries when treated simultaneously. At final followup all the patients were able to return to their pre-injury occupation Conclusion: Arthroscopic staple fixation is a safe and reliable method for producing clinical and radiological outcome in displaced ACL avulsion fractures.

  3. Plate presetting arthroscopic reduction technique for the distal radius fractures.

    Science.gov (United States)

    Abe, Yukio; Tsubone, Tetsu; Tominaga, Yasuhiro

    2008-09-01

    Wrist arthroscopy for the distal radius fractures is an effective adjunct to evaluate the reduction of intraarticular fragments and soft tissue injuries. In recent years, volar locking plate fixation has become popular, and arthroscopic procedures for distal radius fracture reduction have become problematic because vertical traction has to be both on and off during surgery. We developed a plate presetting arthroscopic reduction technique to simplify the combination of plating and arthroscopy. The fracture was reduced, and anatomic alignment was regained under an image intensifier, and then the volar locking plate was preset. Wrist arthroscopy was introduced under vertical traction, and the intraarticular condition was assessed. If dislocations of the intraarticular fragments were residual, they were reduced arthroscopically, and soft tissue injuries were treated subsequently. Finally, the traction was removed, and the plate was securely fixed. Since May 2005, the authors have used this technique in more than 50 patients. This article will review the history, indications, contraindications, technique, rehabilitation, and complications for the plate presetting arthroscopic reduction technique for distal radius fractures. PMID:18776773

  4. Arthroscopically Assisted Open Reduction-Internal Fixation of Ankle Fractures: Significance of the Arthroscopic Ankle Drive-through Sign.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; Dare, David M; Drakos, Mark C

    2016-04-01

    Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2.9-mm shaver (Smith & Nephew, Andover, MA) easily through the medial ankle gutter during arthroscopy, which is not usually possible with both an intact deltoid ligament and syndesmosis. This arthroscopic maneuver indicates instability after ankle reduction and fixation and is predictive of the need for further stabilization. Furthermore, when this sign remains positive after fracture fixation, it may guide the surgeon to further evaluate the adequacy of fixation for the possible need for further fixation of the syndesmosis or deltoid. We present the case of an ankle fracture managed with arthroscopy-assisted ORIF and describe the clinical utility of the arthroscopic ankle drive-through sign. PMID:27462542

  5. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    Directory of Open Access Journals (Sweden)

    Lützner J

    2009-01-01

    Full Text Available Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, either arthroscopically in presence of an detached, but not elongated capsulolabral complex (40 or open (159. After a median time of 31 months (12 to 67 months 174 patients were contacted and agreed to follow-up, 135 after open and 39 after arthroscopic Bankart procedure. Results Re-dislocations occurred in 8% after open and 15% after arthroscopic Bankart procedure. After open surgery 4 of the 11 re-dislocations occurred after a new adequate trauma and 1 of the 6 re-dislocations after arthroscopic surgery. Re-dislocations after arthroscopic procedure occured earlier than after open Bankart repair. An external rotation lag of 20° or more was observed more often (16% after open than after arthroscopic surgery (3%. The Rowe score demonstrated "good" or "excellent" functional results in 87% after open and in 80% patients after arthroscopic treatment. Conclusion In this retrospective investigation the open Bankart procedure demonstrated good functional results. The arthroscopic treatment without capsular shift resulted in a better range of motion, but showed a tendency towards more frequently and earlier recurrence of instability. Sensitive patient selection for arthroscopic Bankart repair is recommended especially in patients with more than five dislocations.

  6. Functional outcome after open and arthroscopic Bankart repair for traumatic shoulder instability

    OpenAIRE

    Lützner J; Krummenauer F; Lübke J; Kirschner S; Günther K-P; Bottesi M

    2009-01-01

    Abstract Purpose Both open and arthroscopic Bankart repair are established procedures in the treatment of anterior shoulder instability. While the open procedure is still considered as the "golden standard" functional outcome is supposed to be better in the arthroscopic procedure. The aim of this retrospective study was to compare the functional outcome between open and arthroscopic Bankart repair. Materials and methods In 199 patients a Bankart procedure with suture anchors was performed, ei...

  7. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    OpenAIRE

    Guity MR; Sianati S

    2010-01-01

    "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instabil...

  8. Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis

    DEFF Research Database (Denmark)

    Hare, Kristoffer B; Lohmander, Stefan; Christensen, Robin;

    2013-01-01

    Arthroscopic partial meniscectomy has been shown to be of no benefit to patients with concomitant knee osteoarthritis, but the optimal treatment of a degenerative meniscus tear in patients with mild or no knee osteoarthritis is unknown. This article describes the rationale and methodology...... of a randomized sham-controlled trial to assess the benefit of arthroscopic partial meniscectomy of a medial meniscus tear in patients with mild or no knee osteoarthritis. The objective of the study is to test whether the benefit from arthroscopic partial meniscectomy in patients with knee pain, medial meniscus...... lesion and mild/no knee osteoarthritis, is greater after arthroscopic partial meniscectomy than following sham surgery....

  9. Technical tips for (dry) arthroscopic reduction and internal fixation of distal radius fractures.

    Science.gov (United States)

    Del Piñal, Francisco

    2011-10-01

    Contrary to general belief, arthroscopic assisted reduction in distal radius fractures can be done in an expeditious manner and with minimal consumption of operating room resources. This article presents the steps for a pleasant arthroscopic experience in detail. The technique proposed combines the benefits of rigid fixation with volar locking plates (for the extra-articular component) and arthroscopic control of the reduction (for the articular component). It is important that the operation be carried out using the dry arthroscopic technique. However, arthroscopy is just an addition to conventional methods. Thorough knowledge of and facility with classic techniques of distal radius fracture treatment is essential for a good result. PMID:21971058

  10. Three cases of septic arthritis following a recent arthroscopic procedure.

    Science.gov (United States)

    Rowton, Joseph

    2013-01-01

    We report three cases of septic arthritis in patients who presented with a painful, swollen and supurative knee joint following a recent arthroscopic procedure, 8-15 days prior to attendance. In all three cases, patients presented with pain and swelling of the affected knee joint with discharge from the port sites. All were sent for washout of the affected joint and received intravenous antibiotic cover. Any patient presenting within 1 month of a recent arthroscopic procedure with pain and swelling of that joint should be presumed to have septic arthritis until proven otherwise. They must have urgent treatment in the form of joint washout and intravenous antibiotics, and receive 6 weeks oral antibiotics on discharge.

  11. Evaluation of arthroscopic treatment of posterior shoulder instability

    Science.gov (United States)

    Garcia, José Carlos; Maia, Lucas Russo; Fonseca, Juliano Rocha; Zabeu, José Luís Amim; Garcia, Jesely Pereira Myrrha

    2015-01-01

    OBJECTIVE: To provide data for the analysis of arthroscopy as a method of surgical treatment for shoulder and discuss its actual indications and preliminary results. METHODS: We evaluated 15 patients submitted to reverse Bankart arthroscopic surgery. We used the UCLA (University of California at Los Angeles) score to measure the results before surgery and 12 months thereafter. RESULTS: The average UCLA score changed from 26.67±0.25 (SD 0.97) before surgery to 34.20±0.53 (SD 2.04) after surgery. The effectiveness of surgery was 93%. In five cases loose bodies were found. A patient undergoing remplissage was evaluated separately. The data did not change after 24 months post-surgery. CONCLUSION: The arthroscopic treatment of posterior shoulder instability and posterior dislocation of the shoulder has been proved feasible and results in our series followed the same trends as in the literature. Level of Evidence III, Transversal Retrospective Study. PMID:26207089

  12. Arthroscopic cartilage regeneration facilitating procedure for osteoarthritic knee

    Directory of Open Access Journals (Sweden)

    Lyu Shaw-Ruey

    2012-11-01

    Full Text Available Abstract Background The effectiveness of arthroscopic treatment for osteoarthritic knee is a controversy. This study presents the technique of a novel concept of arthroscopic procedure and investigates its clinical outcome. Method An arthroscopic procedure targeted on elimination of focal abrasion phenomenon and regaining soft tissue balance around patello-femoral joint was applied to treat osteoarthritis knees. Five hundred and seventy-one knees of 367 patients with osteoarthritis received this procedure. There were 70 (19% male and 297 (81% female and the mean age was 60 years (SD 10. The Knee Society score (KSS and the knee injury and osteoarthritis outcome score (KOOS were used for subjective outcome study. The roentgenographic changes of femoral-tibial angle and joint space width were evaluated for objective outcomes. The mean follow-up period was 38 months (SD 3. Results There were 505 knees in 326 patients available with more than 3 years follow-up and the mean follow-up period was 38 months (SD 3. The subjective satisfactory rate for the whole series was 85.5%. For 134 knees with comprehensive follow-up evaluation, the KSS and all subscales of the KOOS improved statistically. The femoral-tibial angle improved from 1.57 degrees (SD 3.92 to 1.93 degrees (SD 4.12 (mean difference: 0.35, SD 0.17. The joint space width increased from 2.02 millimeters (SD 1.24 to 2.17 millimeters (SD 1.17 (mean difference: 0.13, SD 0.05. The degeneration process of the medial compartment was found being reversed in 82.1% of these knees by radiographic evaluation. Conclusions Based on these observations arthroscopic cartilage regeneration facilitating procedure is an effective treatment for osteoarthritis of the knee joint and can be expected to satisfy the majority of patients and reverse the degenerative process of their knees.

  13. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis

    OpenAIRE

    Lui, Tun Hing

    2015-01-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus.

  14. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis.

    Science.gov (United States)

    Lui, Tun Hing

    2015-10-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus. PMID:26697294

  15. Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Benjamin D. Kuhns

    2015-12-01

    Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

  16. SLAP repair with arthroscopic decompression of spinoglenoid cyst

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    Hashiguchi Hiroshi

    2016-01-01

    Full Text Available Introduction: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. Methods: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery. There was one female and five males with a mean age of 48.5 years. SLAP lesion was found in all the patients at arthroscopy. A small tear of the rotator cuff was found in the two patients. The SLAP lesion was repaired using suture anchors, and the rotator cuff tears were repaired by suture-bridge fixation. The spinoglenoid cyst was decompressed through the torn labrum in three patients, and through the released superior to posterior portion of the capsule in the other three patients. Results: All patients showed excellent improvement in pain and muscle strength at the final follow-up examination. The mean Constant score was improved from 60.5 points preoperatively to 97.2 points postoperatively. The mean visual analog scale (VAS score decreased from 4.5 on the day of the surgery to 2.5 within one week postoperatively. Postoperative MRI showed disappearance or reduction of the spinoglenoid cyst in four and two patients, respectively. There were no complications from the surgical intervention and in the postoperative period. Discussion: The patients treated by decompression through the released capsule obtained pain relief at an early period after the surgery. Arthroscopic treatment for a spinoglenoid cyst can provide a satisfactory clinical outcome. Arthroscopic decompression of a spinoglenoid cyst through the released capsule is recommended for a safe and reliable procedure for patients with suprascapular nerve disorders.

  17. Automatic ICRS scoring of cartilage lesions using arthroscopic OCT images

    OpenAIRE

    te Moller, Nikae; Pitkanen, M; Liukkonen, J.; Puhakka, P H; Brommer, Harold; J.S. Jurvelin; van Weeren, René; Toyras, J.

    2014-01-01

    Articular cartilage injury is a common cause of chronic disability in both humans and animals. Current treatment strategies offer several possibilities and in order to select the optimal repair procedure, accurate determination of size and severity of a lesion is important [1,2]. Recently, an equine ex vivo study showed that arthroscopic optical coherence tomography (OCT) provides high resolution optical images of the cartilage layer [3]. Furthermore, in that study morphological characteristi...

  18. Arthroscopic treatment of symptomatic type D medial plica

    OpenAIRE

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N.

    2007-01-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our...

  19. Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011

    DEFF Research Database (Denmark)

    Thorlund, Jonas B; Hare, Kristoffer B; Lohmander, Stefan

    2014-01-01

    Background - Arthroscopic meniscal surgery is the most common orthopedic procedure, and the incidence has increased in Denmark over the last 10 years. Concomitantly, several randomized controlled trials have shown no benefit of arthroscopic procedures including arthroscopic partial meniscectomy in...... and 2011. Interpretation - The incidence of meniscal procedures performed in Denmark doubled from 2000 to 2011, with the largest increase in middle-aged and older patients. This increase contrasts with the mounting evidence showing no added benefit of arthroscopic partial meniscectomy over non...

  20. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears.

  1. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears. PMID:26761928

  2. ARTHROSCOPIC RECONSTRUCTION OF ANTERIO R CRUCIATE LIGAMENT TEARS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Thimma Reddy

    2015-09-01

    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  3. Use of an Irrigation Pump System in Arthroscopic Procedures.

    Science.gov (United States)

    Hsiao, Mark S; Kusnezov, Nicholas; Sieg, Ryan N; Owens, Brett D; Herzog, Joshua P

    2016-05-01

    Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization. Gravity flow systems were described first and are still commonly used today. More recently, automated pump systems with pressure or dual pressure and volume control have been developed. The advantages of automated irrigation systems over gravity irrigation include a more consistent flow, a greater degree of joint distention, improved visualization especially with motorized instrumentation, decreased need for tourniquet use, a tamponade effect on bleeding, and decreased operative time. Disadvantages include the need for additional equipment with increased cost and maintenance, the initial learning curve for the surgical team, and increased risk of extra-articular fluid dissection and associated complications such as compartment syndrome. As image quality and pump systems improve, so does the list of indications including diagnostic and treatment modalities to address intra-articular pathology of the knee, shoulder, hip, wrist, elbow, and ankle joints. This article reviews the current literature and presents the history of arthroscopy, basic science of pressure and flow, types of irrigation pumps and their functions, settings, applications, and complications. [Orthopedics. 2016; 39(3):e474-e478.].

  4. Use of an Irrigation Pump System in Arthroscopic Procedures.

    Science.gov (United States)

    Hsiao, Mark S; Kusnezov, Nicholas; Sieg, Ryan N; Owens, Brett D; Herzog, Joshua P

    2016-05-01

    Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization. Gravity flow systems were described first and are still commonly used today. More recently, automated pump systems with pressure or dual pressure and volume control have been developed. The advantages of automated irrigation systems over gravity irrigation include a more consistent flow, a greater degree of joint distention, improved visualization especially with motorized instrumentation, decreased need for tourniquet use, a tamponade effect on bleeding, and decreased operative time. Disadvantages include the need for additional equipment with increased cost and maintenance, the initial learning curve for the surgical team, and increased risk of extra-articular fluid dissection and associated complications such as compartment syndrome. As image quality and pump systems improve, so does the list of indications including diagnostic and treatment modalities to address intra-articular pathology of the knee, shoulder, hip, wrist, elbow, and ankle joints. This article reviews the current literature and presents the history of arthroscopy, basic science of pressure and flow, types of irrigation pumps and their functions, settings, applications, and complications. [Orthopedics. 2016; 39(3):e474-e478.]. PMID:27135450

  5. Arthroscopic treatment of symptomatic type D medial plica.

    Science.gov (United States)

    Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N

    2008-12-01

    We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our series were classified as fenestrated (14 knees), torn (5 knees), or reduplicated (4 knees). Fibrotic changes in the plicae and degenerative changes on the medial femoral condyle were found in 16 knees Patellofemoral chondromalacia was present in three knees Arthroscopic partial resection was performed in all patients. Comparative Lysholm Knee Scale scores before and after surgery revealed a significant clinical improvement (pre-operative status, 67.19 +/- 8.05 vs. post-operative status, 90.57 +/- 9.80; P knee pain. Arthroscopic partial resection of the plicae in symptomatic patients gives satisfactory results.

  6. Arthroscopic debridement of osteoarthritic elbow in professional athletes

    Institute of Scientific and Technical Information of China (English)

    YAN Hui; CUI Guo-qing; WANG Jian-quan; YIN Yu; AO Ying-fang

    2011-01-01

    Background Arthroscopic debridement is an appropriate procedure for osteoarthritic elbow in general populations.However,the results of arthroscopic debridement in the professional athletes,a younger and highly active patient cohort is unclear.The purposes of this study were to assess the clinical outcomes of arthroscopic debridement of osteoarthritic elbow in professional athletes and to evaluate the effect of prognostic factors on the clinical outcomes.Methods From January 1999 to January 2006,35 professional athletes with osteoarthritc elbow (36 elbows) were treated with arthroscopic debridement,consisted of osteophytes removal,loose bodies removal and fenestration of the olecranon fossa as necessary.Average patient age was (23±5) years (range 7-34 years).Average follow-up was (43±23) months (range 16-98 months).Athletic activities consisted mainly of wrestling,judo and weightlifting.Patients were evaluated preoperatively and postoperatively with the modified Hospital for Special Surgery (HSS) elbow scoring system.Results According to the modified HSS elbow scoring system,the result was excellent for 16 elbows,good for 14 and poor for 6.No case had got worse after surgery.All athletes reported an improvement in pain.After athletic training,15 elbows were not painful,16 mildly painful,3 moderately painful and 2 severely painful.The arc of flexion-extension improved from 111 ° preoperatively to 127° postoperatively.All of the athletes were able to return to their previous level of training.Five athletes won national-level championships.At follow-up,17 athletes (18 elbows) were greatly satisfied with the results,12 satisfied and 6 unsatisfied.Postoperatively,one athlete reported ulnar nerve symptoms and two others had residual loose bodies.The fenestration of the olecranon fossa was associated with a significantly increased chance of a poor outcome.The nature of the osteoarthritis,duration of symptoms,osteophytes removal and loose bodies removal did not predict

  7. Arthroscopic washout of the ankle for septic arthritis in a three-month-old boy

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2011-10-01

    Full Text Available Abstract There is no report of athroscopic treatment for septic arthritis of the ankle in infants. We report a case of successful management of septic arthritis of the ankle in a three-month-old boy by arthroscopic washout. Arthroscopic washout may be a useful treatment for septic arthritis in young infants when performed early after onset.

  8. Ultrasonography-assisted arthroscopic proximal iliotibial band release and trochanteric bursectomy.

    Science.gov (United States)

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression.

  9. Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy

    OpenAIRE

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression.

  10. Deep vein thrombosis and thromboprophylaxis in arthroscopic anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Raviraj Adala

    2011-01-01

    Conclusion: In our study the incidence of deep vein thrombosis in patients undergoing arthroscopic ACL reconstruction is 1.78%. We do not recommend routine thromboprophylaxis in patients, who are not high risk candidates for thrombosis and are of less than 45 years, in patients undergoing arthroscopic ACL reconstruction, with early postoperative rehabilitation.

  11. Arthroscopic isolated posterior labral repair in rugby players

    Directory of Open Access Journals (Sweden)

    Badge Ravi

    2009-01-01

    Full Text Available Background: The shoulder is the second most frequently injured joint after the knee in rugby players and labral tears appear to be common. There is limited data available in the literature regarding the mechanisms of posterior labral injury in rugby players and the management of these injuries. Objective: The aim of this study is to report the clinical presentation, arthroscopic findings, surgical technique for repair, and the functional outcome in elite English rugby players with isolated posterior labral injuries. Study Design: Case series (level IV evidence Materials and m0 ethods: Over a 5-year period we surgically treated 142 elite rugby players, of whom 11 (7.8% had isolated posterior labral injuries.All these 11 patients had significant contact injury. Only three (24% patients had a true posterior shoulder dislocation. Pre- and postoperative assessment included Constant score, Oxford shoulder score, and Oxford instability score. We also assessed the time taken to return to preinjury level of fitness and the complications of surgery. Results: Average follow-up was for 32 months (range 17-54 months. The mean Constant score improved from 66 to 99. The Oxford score indicated improvement, decreasing from 33 to 18; similarly, the Oxford instability score also decreased from 52.2 to 12.3. Return to playing rugby at peak level was at a mean of 4.3 months after arthroscopic repair. Conclusion: Successful clinical results and rapid return to play can be achieved by appropriate early arthroscopic repair and supervised accelerated rehabilitation for posterior labral tears in elite rugby players.

  12. The thrower's elbow: arthroscopic treatment of valgus extension overload syndrome.

    Science.gov (United States)

    O'Holleran, James D; Altchek, David W

    2006-02-01

    Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications

  13. Arthroscopic laser in intra-articular knee cartilage disorders

    Science.gov (United States)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

    Different assemblies have endeavored to develop arthroscopic laser surgery. Various lasers have been tried in the treatment of orthopaedic problems, and the most useful has turned out to be the Hol-YAG laser 2.1 nm which is a near- contact laser. By using the laser as a powerful tool, and cutting back on the power level, one is able to better achieve the desired treatment effect. Clinical studies to evaluating the role of the laser in different arthroscopic knee procedures, comparing to conventional techniques, showed that the overall outcome attains a momentous confidence level which is shifted to the side of the laser versus the conventional for all maneuvers, barring meniscectomy where there is not perceiving disparity between laser versus the conventional. Meniscectomy continues to be one of the most commonly performed orthopaedic procedures. Laser provides a single tool which can ablate and debride meniscal rims with efficiency and safety. Chondroplasty can also be accomplished with ease using defocused laser energy. Both lateral release and soft tissue cermilization benefit from the cutting effect of laser along with its hemostatic effect. Synovial reduction with a defocused laser is also easily accomplished. By one gadget, one can cut, ablate, smooth, coagulate, congeal and with authentic tissue depth control The future of laser arthroscopic surgery lies in its ability to weld or repair tissues. Our research study has shown that laser activated photoactive dyes can produce a molecular bonding of collagen fibers, and therefore a repair 'weld' can be achieved with both meniscal tissues and with articular cartilage lesions.

  14. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Science.gov (United States)

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J

    2016-06-01

    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  15. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Brody A Flanagin

    2016-01-01

    Full Text Available Purpose: Arthroscopic transosseous (TO rotator cuff repair has recently emerged as a new option for surgical treatment of symptomatic rotator cuff tears. Limited data is available regarding outcomes using this technique. This study evaluated midterm clinical outcomes following a novel arthroscopic TO (anchorless rotator cuff repair technique. Materials and Methods: A consecutive series of 107 patients and 109 shoulders underwent arthroscopic TO (anchorless rotator cuff repair for a symptomatic full-thickness tear. Pre and postoperative range of motion (ROM was compared at an average of 11.8 months. Postoperative outcome scores were obtained at an average of 38.0 months. Statistical analysis was performed to compare pre and postoperative ROM data. Univariate analysis was performed using Student′s t-test to compare the effect of other clinical characteristics on final outcome. Results: Statistically significant improvements were noted in forward flexion, external rotation and internal rotation (P < 0.0001. Average postoperative subjective shoulder value was 93.7, simple shoulder test 11.6, and American Shoulder and Elbow Surgeons (ASES score 94.6. According to ASES scores, results for the 109 shoulders available for final follow-up were excellent in 95 (87.1%, good in 8 (7.3%, fair in 3 (2.8%, and poor in 3 (2.8%. There was no difference in ROM or outcome scores in patients who underwent a concomitant biceps procedure (tenodesis or tenotomy compared with those who did not. Furthermore, there was no significant difference in outcome between patients who underwent either biceps tenodesis or tenotomy. Age, history of "injury" preceding the onset of pain, tear size, number of TO tunnels required to perform the repair, and presence of fatty infiltration did not correlate with postoperative ROM or subjective outcome measures at final follow-up. Two complications and four failures were noted. Conclusions: Arthroscopic TO rotator cuff repair technique

  16. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

    Science.gov (United States)

    Petri, Maximilian; Greenspoon, Joshua A; Millett, Peter J

    2015-12-01

    Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability. Promising clinical results have been reported in 1 case series of 23 patients, indicating that superior capsular reconstruction may be a promising tool to manage massive irreparable rotator cuff tears. This article describes our preferred technique for arthroscopic superior capsule reconstruction. PMID:27284506

  17. Arthroscopic Management of Complications Following Total Ankle Replacement.

    Science.gov (United States)

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  18. Arthroscopic Trans-osseous Suture of Peripheral Triangular Fibrocartilage Complex Tear.

    Science.gov (United States)

    Jegal, Midum; Heo, Kang; Kim, Jong Pil

    2016-10-01

    The importance of foveal repair of the triangular fibrocartilage complex (TFCC) on stability of the distal radioulnar joint (DRUJ) has been emphasized with increasing knowledge of the anatomy and biomechanics of the TFCC and DRUJ. Although both open and arthroscopic techniques have been described for improving DRUJ stability, there has been a marked evolution of arthroscopic TFCC repair technique with successful clinical outcome. Recently, an arthroscopic trans-osseous technique has been described to repair foveal tears of the TFCC. The advantage of the technique is that it allows for anatomical repair of both the superficial and deep layers. This article describes the details of this novel technique. PMID:27595945

  19. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

    Directory of Open Access Journals (Sweden)

    Takeshi Kokubu

    2012-01-01

    Full Text Available We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint.

  20. Arthroscopic Fixation of Glenoid Rim Fractures After Reduction by Labral Repair.

    Science.gov (United States)

    Voleti, Pramod B; Camp, Christopher L; Sinatro, Alec L; Dines, Joshua S

    2016-04-01

    Surgical fixation of displaced, intra-articular glenoid fractures represents a clinical challenge. These fractures have traditionally been treated through open approaches to the glenohumeral joint; however, the morbidity associated with open surgery may be reduced with arthroscopic techniques. Previously described arthroscopic methods commonly use clamps and/or Kirschner wires to obtain and maintain provisional fixation. We describe our technique for minimally invasive, arthroscopic fixation of glenoid rim fractures using labral repair as an indirect reduction maneuver, followed by final fixation with an extra-articular screw. This method is safe, efficient, and reliable, and it can be used to approach a variety of intra-articular glenoid fractures. PMID:27462537

  1. Development of Atomic Force Microscope for Arthroscopic Knee Cartilage Inspection

    Science.gov (United States)

    Imer, Raphaël; Akiyama, Terunobu; de Rooij, Nicolaas F.; Stolz, Martin; Aebi, Ueli; Friederich, Niklaus F.; Koenig, Uwe; Wirz, Dieter; Daniels, A. U.; Staufer, Urs

    2006-03-01

    A recent study, based on ex vivo unconfined compression testing of normal, diseased, and enzymatically altered cartilage, revealed that a scanning force microscope (SFM), used as a nano-intender, is sensitive enough to enable measurement of alterations in the biomechanical properties of cartilage. Based on these ex vivo measurements, we have designed a quantitative diagnosis tool, the scanning force arthroscope (SFA), able to perform in vivo measurements during a standard arthroscopic procedure. For stabilizing and positioning the instrument relative to the surface under investigation, a pneumatic system has been developed. A segmented piezoelectric tube was used to perform the indentation displacement, and a pyramidal nanometer-scale silicon tip mounted on a cantilever with an integrated deflection sensor measured the biomechanical properties of cartilage. Mechanical means were designed to protect the fragile cantilever during the insertion of the instrument into the knee joint. The stability of the pneumatic stage was checked with a prototype SFA. In a series of tests, load-displacement curves were recorded in a knee phantom and, more recently, in a pig’s leg.

  2. Evaluation of pain after arthroscopically assisted anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Brown, D W; Curry, C M; Ruterbories, L M; Avery, F L; Anson, P S

    1997-01-01

    Pain after arthroscopically assisted anterior cruciate reconstruction was examined during the first 5 postoperative days to evaluate its intensity and duration. One hundred consecutive patients who underwent arthroscopically assisted anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft were examined. During surgery, ketorolac (60 mg) was given intravenously and 0.25% bupivicaine (1 ml/kg total) was injected into the joint space and the graft donor site. After surgery, all patients received scheduled doses of oral acetaminophen (650 mg) and ketorolac (10 mg) four times a day, and they were allowed to take oral oxycodone (5 to 10 mg) every 2 hours as needed. Pain scores at rest and with activity reached a maximum on the 2nd postoperative morning. Oxycodone consumption also peaked on the 2nd postoperative day. Eighty-nine (89%) patients reported overall pain as mild or moderate, and 95 patients (95%) reported either excellent or good overall relief of pain. The 5-day cumulative mean of visual analog scale pain scores for attempting straight leg raises was significantly higher for patients unable to successfully perform that activity than for patients who were able to perform it. The association between elevated pain scores and diminished ability to perform straight leg raises suggests that pain may inhibit function and therefore early rehabilitation. PMID:9079170

  3. Change in Driving Performance following Arthroscopic Shoulder Surgery.

    Science.gov (United States)

    Hasan, S; McGee, A; Weinberg, M; Bansal, A; Hamula, M; Wolfson, T; Zuckerman, J; Jazrawi, L

    2016-08-01

    The current study aimed to measure perioperative changes in driving performance following arthroscopic shoulder surgery using a validated driving simulator.21 patients who underwent arthroscopic surgery for rotator cuff or labral pathology were tested on a driving simulator preoperatively, and 6 and 12 weeks postoperatively. An additional 21 subjects were tested to establish driving data in a control cohort. The number of collisions, centerline crossings, and off-road excursions were recorded for each trial. VAS and SPADI scores were obtained at each visit.The mean number of collisions in the study group significantly increased from 2.05 preoperatively to 3.75 at 6 weeks (p<0.001), and significantly decreased to 1.95 at 12 weeks (p<0.001). Centerline crossings and off-road excursions did not significantly change from preoperative through 12 weeks, although centerline crossings were statistically different from the controls at each time point (p<0.001). Surgery on the dominant driving arm resulted in greater collisions at 6 weeks than surgery on the non-dominant driving arm (p<0.001).Preliminary data shows that driving performance is impaired for at least 6 weeks postoperatively, with a return to normal driving by 12 weeks. Driving is more profoundly affected in conditions that require avoiding a collision and when the dominant driving arm is involved. PMID:27487432

  4. Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

    Science.gov (United States)

    Mihata, Teruhisa; Lee, Thay Q.; Itami, Yasuo; HASEGAWA, Akihiko; Ohue, Mutsumi; Neo, Masashi

    2016-01-01

    Objectives: An arthroscopic superior capsule reconstruction, in which the fascia lata autograft attached medially to the superior glenoid and laterally to the greater tuberosity, restores shoulder stability and muscle balance in patients with irreparable rotator cuff tears; consequently, it improves shoulder function specifically deltoid muscle function and relieves pain. We assessed the clinical outcome of arthroscopic superior capsule reconstruction (Figure 1) in 100 consecutive patients with irreparable rotator cuff tears. Specifically, we focused on the rates of return to sport and work. Methods: From 2007 to 2014, we performed arthroscopic superior capsule reconstruction on 107 consecutive patients (mean 66.7 years; range, 43 to 82) with irreparable rotator cuff tears that had failed conservative treatment. Seven patients were lost to follow-up because of other medical problems or reasons. In the remaining 100 patients there were 56 supraspinatus and infraspinatus tears; 39 supraspinatus, infraspinatus, and subscapularis tears; 3 supraspinatus, infraspinatus, teres minor, and subscapularis tears; and 2 supraspinatus, infraspinatus, and teres minor tears. Physical examination, radiography, and MRI were performed before surgery; at 3, 6, and 12 months after surgery; and yearly thereafter. Rates of return to sport and work were also investigated in those patients who had been employed (34 patients: 21 manual workers, 10 farmers, 1 butcher, 1 cook, and 1 athletic trainer) or played sport (26 patients: 6 golf, 4 table tennis, 4 swimming, 3 martial arts, 2 baseball, 2 yoga, 1 tennis, 1 badminton, 1 skiing, 1 mountain-climbing, and 1 ground golf) before injury. Results: The average preoperative American Shoulder and Elbow Surgeons (ASES) score was 31.6 points (range, 3.3 to 63.3 points) and the average Japanese Orthopaedic Association (JOA) score was 51.6 points (26.5 to 68.5 points). Average postoperative clinical outcome scores all improved significantly at final

  5. All-arthroscopic iliotibial band autograft harvesting and labral reconstruction technique.

    Science.gov (United States)

    Deshmane, Prashant P; Kahlenberg, Cynthia A; Patel, Ronak M; Han, Brian; Terry, Michael A

    2013-02-01

    The labrum is essential for stability, movement, and prevention of arthritis in the hip. In cases of labral damage where repair of a labral tear is not possible, reconstruction can be a useful alternative. Several different autografts have been used, including the iliotibial band (ITB), the ligamentum teres capitis, and the gracilis tendon. Authors have reported both open and arthroscopic techniques for reconstruction with good preliminary results. However, an all-arthroscopic labral reconstruction technique including the graft harvest and reconstruction portions of a labral reconstruction procedure using an ITB autograft has not been previously described. We describe a technique for an all-arthroscopic labral reconstruction performed using a novel method for arthroscopic harvest of the ITB. The decreased invasiveness of our described technique for labral reconstruction may potentially minimize scarring, bodily disfigurement, infection, and postoperative pain associated with the graft harvesting incision.

  6. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    Science.gov (United States)

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  7. A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

    OpenAIRE

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five ...

  8. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

    OpenAIRE

    Ee, Gerard WW; Mohamed, Sedeek; Tan, Andrew HC

    2011-01-01

    Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008). Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture ...

  9. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

    OpenAIRE

    Amit Mishra; Pulak Sharma; Deepak Chaudhary

    2012-01-01

    Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 yea...

  10. Lipoma arborescens of the knee: report of a case managed by arthroscopic synovectomy.

    Science.gov (United States)

    Franco, Michel; Puch, J M; Carayon, M J; Bortolotti, D; Albano, Laetitia; Lallemand, A

    2004-01-01

    We report a case of lipoma arborescens treated with an arthroscopic procedure. Lipoma arborescens is an uncommon pseudo-tumoral synovial lesion usually located in the suprapatellar pouch of the knee. This diagnosis should be considered, particularly in patients with chronic joint effusion. Magnetic resonance imaging confirms the lipomatous nature of the synovial proliferation. When limited to the anterior compartment of the knee, lipoma arborescens can be treated by arthroscopic synovectomy. PMID:14769527

  11. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

    Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.

  12. Arthroscopic excision of heterotopic calcification in a chronic rectus femoris origin injury: a case report

    OpenAIRE

    El-Husseiny, M; Sukeik, M.; Haddad, FS

    2012-01-01

    Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of ...

  13. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    OpenAIRE

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; te Moller, Nikae; Puhakka, Pia H; Jurvelin, Jukka S.; Tulamo, R M; Töyräs, Juha

    2014-01-01

    Background: Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. Arthroscopic optical coherence tomography (OCT) imaging is a promising tool introduced for quantitative detection of cartilage degeneration and scoring of the severity of chondral lesions. The aim o...

  14. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

    OpenAIRE

    Lee, Kwang Won; Seo, Dong Wook; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up per...

  15. Arthroscopic rotator cuff repair in elite rugby players

    Directory of Open Access Journals (Sweden)

    Tambe Amol

    2009-01-01

    Full Text Available Background: Rugby is an increasingly popular collision sport. A wide spectrum of injuries can be sustained during training and match play. Rotator cuff injury is uncommon in contact sports and there is little published literature on the treatment of rotator cuff tears in rugby players. Aims: We therefore reviewed the results and functional outcomes of arthroscopic rotator cuff repair in elite rugby players. Materials and Methods: Eleven professional rugby players underwent arthroscopic rotator cuff repair at our hospital over a 2-year period. We collected data on these patients from the operative records. The patients were recalled for outcome scoring and ultrasound scans. Results: There were seven rugby league players and four rugby union players, including six internationals. Their mean age was 25.7 years. All had had a traumatic episode during match play and could not return to the game after the injury. The mean time to surgery was 5 weeks. The mean width of the cuff tear was 1.8 cm. All were full- thickness cuff tears. Associated injuries included two Bankart lesions, one bony Bankart lesion, one posterior labral tear, and two 360° labral tears. The biceps was involved in three cases. Two were debrided and a tenodesis was performed in one. Repair was with suture anchors. Following surgery, all patients underwent a supervised accelerated rehabilitation programme. The final follow-up was at 18 months (range: 6-31 months post surgery. The Constant scores improved from 44 preoperatively to 99 at the last follow-up. The mean score at 3 months was 95. The Oxford shoulder score improved from 34 to 12, with the mean third month score being 18. The mean time taken to return to full match play at the preinjury level was 4.8 months. There were no complications in any of the patients and postoperative scans in nine patients confirmed that the repairs had healed. Conclusion: We conclude that full-thickness rotator cuff tears in the contact athlete can

  16. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft.

  17. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft. PMID:25973378

  18. All-inside arthroscopic suturing technique for meniscal ruptures.

    Science.gov (United States)

    Darabos, Nikica; Dovzak-Bajs, Ivana; Bilić, Vide; Darabos, Anela; Popović, Iva; Cengić, Tomislav

    2012-03-01

    The most frequent indication for surgical treatment of the knee is lesion of the meniscus. The "all inside" arthroscopic technique with bioresorptive material for meniscus lesion is becoming the most popular treatment. This prospective study included 10 patients with posterior meniscal horn lesion operatively treated at Sports Traumatology Department. The "all inside" technique was performed by intra-articular application of bioresorptive pins-Darts sticks or Meniscus Viper and bioresorptive string. Patients were followed up for 2-6 months postoperatively and graded according to the IKDC 2000 scale. All surgical treatments showed satisfactory results. Young patients with acute longitudinal peripheral lesion-posterior horn lesions, in the red-red or red-white meniscal zone, 1-2 centimeters long are most appropriate for this type of treatment. In these patients, this technique proved to be superior and free from the risk of neurovascular damage. For better authentication of this conclusion, additional prospective randomized studies should be performed.

  19. [Arthroscopic distal ulna resection after post traumatic ulno carpal abutment].

    Science.gov (United States)

    Mathoulin, C; Pagnotta, A

    2006-11-01

    Ulno carpal abutments secondary to the sequels of a fracture of the radius are often due to the inversion of the distal radio ulnar index by shortening relative to the radius. This positive ulnar variance eventually leads to an abutment between the head of the ulnar and the proximal articular face of the lunate with alteration of the cartilaginous carpal surfaces. The wrist arthroscopy makes diagnosis and treatment possible in a less invasive way. The patients are operated on as outpatients under local regional anaesthetic using a pneumatic tourniquet. The arthroscope is positioned using the 3-4 radio carpal opening permitting exploration of the joint. The surgical treatment is performed by arthroscopy using a burr and going in through the 6R radio carpal opening. In this way we use the technique of partial resection of the distal ulna. We have a series of 62 patients who have benefited from the technique of partial resection of the ulnar head by arthroscopy. There were 30 men and 32 women. The average age was 66 years old (between 45 and 82). Our average follow-up is 32 months (between 12 and 60 months). Recovery of mobility was immediate in all cases with persistent pain in the radio ulnar joint in 8 cases. Arthroscopic treatment of ulno carpal abutment has proved itself effective and innocuous. It should nevertheless be reserved for operations on small sized inversions of the distal radio ulnar index (less than 5 mm). In the event of larger ulnar variances we prefer ulnar shortening osteotomy. The other techniques will be restricted to cases where the distal radio ulnar joint has been impaired. PMID:17361890

  20. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    Directory of Open Access Journals (Sweden)

    G R Arun

    2016-01-01

    Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair.

  1. Lateral Decubitus All-Arthroscopic Latarjet Procedure for Treatment of Shoulder Instability

    Science.gov (United States)

    Lewington, Matthew R.; Urquhart, Nathan; Wong, Ivan H.

    2015-01-01

    Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid. We use the cannulated Bristow-Latarjet Instability Shoulder System (DePuy Mitek, Raynham, MA). After a diagnostic arthroscopic evaluation, we use multiple arthroscopic anterior portals to debride the rim of the glenoid. The coracoid is prepared and taken down arthroscopically, and the cannulated guide is attached and advanced through an arthroscopically created subscapularis split. With the shoulder held in a reduced position, we are then able to drill and anchor the graft to the native glenoid. The patient is able to begin gentle range-of-motion exercises immediately postoperatively. PMID:26258032

  2. Lateral Decubitus All-Arthroscopic Latarjet Procedure for Treatment of Shoulder Instability.

    Science.gov (United States)

    Lewington, Matthew R; Urquhart, Nathan; Wong, Ivan H

    2015-06-01

    Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid. We use the cannulated Bristow-Latarjet Instability Shoulder System (DePuy Mitek, Raynham, MA). After a diagnostic arthroscopic evaluation, we use multiple arthroscopic anterior portals to debride the rim of the glenoid. The coracoid is prepared and taken down arthroscopically, and the cannulated guide is attached and advanced through an arthroscopically created subscapularis split. With the shoulder held in a reduced position, we are then able to drill and anchor the graft to the native glenoid. The patient is able to begin gentle range-of-motion exercises immediately postoperatively.

  3. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    Science.gov (United States)

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in professional tennis players. Methods: The records of all female tennis players on the Women’s Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Details of the surgery including date, procedures performed, and complications were recorded. The primary outcomes were ability and time to return to professional play, and if they were able to return to their previous level of function, as determined by singles ranking. Pre and post-operative singles rankings were used to determine rate and completeness of return to preoperative function. Their highest ranking pre-injury, post operatively, and the time to return to pre-injury ranking were evaluated. Results: During the study period eight professional women tennis players from the WTA underwent shoulder surgery on their dominant arm. All surgery was performed arthroscopically, 7 out of 8 players had more than one procedure performed during the surgery. In total, 3 players underwent debridement of a partial rotator cuff tear and 2 players underwent repair of a complete supraspinatus tear. Three players had an anterior labral repair or reconstruction for anterior instability, and one player underwent repair of a SLAP lesion. Two players underwent neurolysis of a suprascapular nerve, and three players in total underwent a subacromial decompression. All players (100%) returned to professional play. The mean

  4. Cartilage change after arthroscopic repair for an isolated meniscal tear.

    Science.gov (United States)

    Soejima, Takashi; Murakami, Hidetaka; Inoue, Takashi; Kanazawa, Tomonoshin; Katouda, Michihiro; Nagata, Kensei

    2005-01-01

    To investigate the direct effect to the cartilage caused by the meniscal repair, we examined patients who underwent an isolated meniscal repair without any other abnormalities by arthroscopic examination. A total of 17 patients were examined by second-look arthroscopy after an average interval of 9 months from the meniscal repair, and have been evaluated the status of the repaired meniscus and of the relative femoral condylar cartilage. Changes in the severity of the cartilage lesion between at the time of meniscal repair and the time of the second-look arthroscopy were considered based on the status of the repaired meniscus. Regardless of the healing status of the repair site, it was possible to prevent degeneration in the cartilage in 9 of the 10 patients who demonstrated no degeneration in the meniscal body. Of the 7 patients who demonstrated degeneration in the meniscal body, progression in cartilage degeneration was noted as 1 grade in 2 patients and 2 grades in another 3 patients. Even in those in which stable fusion of the repair site was achieved, the condition of the inner meniscal body was not necessarily maintained favorably in all cases, indicating that degeneration in the meniscal body was a risk factor for cartilage degeneration. It was concluded that recovery could not be expected even at 9 months after the repair if the lesion had already demonstrated degeneration in the meniscal body at the time of repair.

  5. Review of Arthroscopic and Histological Findings Following Knee Inlay Arthroplasty.

    Science.gov (United States)

    Markarian, Gregory G; Kambour, Michael T; Uribe, John W

    2016-01-01

    The phenomenon of cartilage rim loading in defects exceeding the threshold diameter of 10 mm is well documented. Contoured defect fill off-loads the perimeter and counteracts further delamination and progression of defects. When biological procedures have failed, inlay arthroplasty follows these concepts. The human biological response to contoured metallic surface implants has not been described. Four patients underwent non-implant-related, second-look arthroscopy following inlay arthroplasty for bi- (n=3) and tricompartmental (n=1) knee arthrosis without subchondral bone collapse. Arthroscopic probing of the implant-cartilage interface of nine prosthetic components did not show signs of implant-cartilage gap formation, loosening, or subsidence. The implant periphery was consistently covered by cartilage confluence leading to a reduction of the original defect size diameter. Femoral condyle cartilage flow appeared to have more hyaline characteristics. Trochlear cartilage flow showed greater histological variability and less organization with fibrocartilage and synovialized scar tissue. This review reconfirmed previous basic science results and demonstrated effective defect fill and rim off-loading with inlay arthroplasty.

  6. Arthroscopic assisted fixation for the distal radius fractures

    International Nuclear Information System (INIS)

    Anatomic reduction of the articular surface of the distal radius is still the main goal when treating fractures in the young population. Appropriate assessment of intra-articular reduction is difficult when performing open reduction and internal fixation without having to open the joint capsule. This preliminary report focuses on the description of the surgical technique, philosophy, indications and advantages of using wrist arthroscopy to assist fixation of distal radius fractures. Twenty-seven patients (16 males and 11 females) underwent arthroscopic assisted fixation for intra-articular distal radius fractures between March of 1999 and august of 2002. According to the AO classification there were 9 C1, 12 C2, 2 C3, 3 B1 and 1 B2. Average age was 41 years old (range: 18-48). Average follow up was 6 months. Patients were evaluated at final follow-up for wrist motion, pain and grip strength. Radiographic studies were also obtained to evaluate final position of the distal radius

  7. Postoperative pain control after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Uquillas, Carlos A; Capogna, Brian M; Rossy, William H; Mahure, Siddharth A; Rokito, Andrew S

    2016-07-01

    Arthroscopic rotator cuff repair (ARCR) can provide excellent clinical results for patients who fail to respond to conservative management of symptomatic rotator cuff tears. ARCR, however, can be associated with severe postoperative pain and discomfort that requires adequate analgesia. As ARCR continues to shift toward being performed as an outpatient procedure, it is incumbent on physicians and ambulatory surgical centers to provide appropriate pain relief with minimal side effects to ensure rapid recovery and safe discharge. Although intravenous and oral opioids are the cornerstone of pain management after orthopedic procedures, they are associated with drowsiness, nausea, vomiting, and increased length of hospital stay. As health care reimbursements continue to become more intimately focused on quality, patient satisfaction, and minimizing of complications, the need for adequate pain control with minimal complications will continue to be a principal focus for providers and institutions alike. We present a review of alternative modalities for pain relief after ARCR, including cryotherapy, intralesional anesthesia, nerve blockade, indwelling continuous nerve block catheters, and multimodal anesthesia. In choosing among these modalities, physicians should consider patient- and system-based factors to allow the efficient delivery of analgesia that optimizes recovery and improves patient satisfaction. PMID:27079219

  8. Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

    Directory of Open Access Journals (Sweden)

    Nevres Hurriyet Aydogan

    2013-01-01

    Full Text Available Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.

  9. ARTHROSCOPIC TREATMENT FOR DISCOID LATERAL MENISCUS INJURY OF THE KNEE IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    蒋垚; 赵金忠; 翟伟韬; 曾炳芳

    2001-01-01

    Objective To study the arthroscopic treatment results.for discoid lateral meniscus injury of the knee in children. Methods 74 children patients, including 98 knees underwent arthroscopic treatment due to discoid lateral meniscus injury were followed up. By Watanabe classification, incomplete discoid meniscus was seen in 34 knees, complete in 42 and Wrisberg type in 22. The methods of treatment were partial, subtotal or total meniscectomy. The follow-up time ranged from 3 to 24 months, averaged 8 months. The results were analyzed according to Lysholm knee evaluation method. Results By Lysholm evaluation the results were excellent in 68 knees (69.4 % ) and good in 30 (30.6%). Conclusion Arthroscopic treatment is a reliable way for discoid lateral meniscus injury in children.

  10. [Arthroscopic management of intra-articular fractures of the distal radius].

    Science.gov (United States)

    Cognet, J-M; Martinache, X; Mathoulin, C

    2008-09-01

    The use of arthroscopy in the management of intra-articular fractures of the distal radius has become established over the last ten years, but the operative technique is not yet standardised. We report our experience with this technique and give a stage by stage description of the operative procedure. The arthroscopic part of the procedure consists firstly of an evaluation of the bony, cartilaginous and ligamentous injuries and secondly direct visual control of the reduction. The choice of bone fixation depends on the individual preferences of the surgeon but may be influenced by the configuration of the fracture. A literature review reiterates the advantages of arthroscopic assistance in managing these fractures without revealing any disadvantages. However, mastery of the arthroscopic techniques is vital before the full advantages of this type of management can be realised. PMID:18774328

  11. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Science.gov (United States)

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection.

  12. Arthroscopic Release of Adhesive Capsulitis of the Shoulder Complicated With Shoulder Dislocation and Brachial Plexus Injury.

    Science.gov (United States)

    Nunez, Fiesky A; Papadonikolakis, Anastasios; Li, Zhongyu

    2016-01-01

    The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation. PMID:27518297

  13. Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope.

    Science.gov (United States)

    Gáspár, Levente; Szekanecz, Zoltán; Dezso, Balázs; Szegedi, Gyula; Csernátony, Zoltán; Szepesi, Kálmán

    2003-01-01

    We demonstrate the technique, advantages, and disadvantages of metacarpophalangeal joint examination with needle arthroscope. We evaluated our experience from biopsies of 10 metacarpophalangeal joints of eight rheumatoid women aged 41-45 years. The procedures were performed using a 1-mm needle arthroscope. The synovium biopsy was taken with a microforceps. The procedure was performed under local anesthesia. The tight tension of the joint and traction of the finger is necessary for good visualization, but despite this visibility can be difficult. Needle biopsy is a useful method for the early diagnosis of rheumatoid arthritis. PMID:12548452

  14. FUNCTIONAL OUTCOME OF ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT TEARS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-02-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament (ACL tear is the most common serious ligamentous injury to the knee joint. Anterior Cruciate Ligament (ACL injury is quite common among young active population, athletes and contact sports. The exact incidence of anterior cruciate ligament tears is not known as the cases are being under reported. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. MATERIALS AND METHODS Between November 2012 to October 2014, 34 consecutive patients who underwent arthroscopic assisted ACL reconstructions in the Department of Orthopedics and Traumatology, King George Hospital, Visakhapatnam were the material in our study. Age groups between 18 to 45 years considered. We utilised both BPTB and Quadrupled hamstring graft depending on the patient’s age, outcome testing in all cases was performed at the latest follow-up (at least 6 months. Post-operative physiotherapy rehabilitation protocol followed for 06 months. RESULTS Standard protocol of Lysholm and IKDC knee scoring system were used for evaluation of the results of the surgery during followup. Patients were evaluated periodically at preop, 3 months, 6 months, 12 months, 18 months and 24 months. CONCLUSION Patients with isolated ACL injury had better outcome compared to patients who underwent associated meniscectomy. Most common mechanism of injury was activity of sports in 20 patients. Postoperatively at 3 months, anterior drawer’s was 1+ in 6, 29 (85.2% patients had normal range of motion; 29 (85.29% patients had 5/5 quadriceps power (MRC grading 94% of them had 5/5 power at latest followup. No significant difference between outcomes of BPTB and Hamstrings graft. Functional outcome of our study were similar to the previously published studies.

  15. Editorial Commentary: Arthroscopic Rotator Cuff Repair--Infection Rate After Rotator Cuff Repair With Arthroscopic, Open, and Mini-open Techniques.

    Science.gov (United States)

    Brand, Jefferson C

    2016-03-01

    In "Risk Factors for Infection After Rotator Cuff Repair," B. G. Vopat et al. report a lower rate of postoperative infection with an arthroscopic rotator cuff repair than with an open or mini-open approach. Although there were only 14 infections (infection rate of 0.77%), the reason for the preponderance of male patients, 13 of the 14 infections, needs further research to determine effective preventive strategies.

  16. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    Directory of Open Access Journals (Sweden)

    Rambani Rohit

    2009-06-01

    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  17. Arthroscopic bursectomy with concomitant iliotibial band release for the treatment of recalcitrant trochanteric bursitis.

    Science.gov (United States)

    Farr, Derek; Selesnick, Harlan; Janecki, Chet; Cordas, Daniel

    2007-08-01

    Trochanteric bursitis with lateral hip pain is a commonly encountered orthopaedic condition. Although most patients respond to corticosteroid injections, rest, physical therapy (PT), stretching, and anti-inflammatory medications, those with recalcitrant symptoms may require operative intervention. Studies have explored the use of the arthroscope in the treatment of these patients. However, these reports have not addressed the underlying pathology in this chronic condition. We believe that the iliotibial band must be addressed and is the main cause of pain, inflammation, and trochanteric impingement leading to the development of bursitis. We report a new technique for arthroscopic trochanteric bursectomy with iliotibial band release. Our technique involves 2 incisions--one 4 cm proximal to the greater trochanter along the anterior border of the iliotibial band, and the other 4 cm distal and along the posterior border. The 30 degrees arthroscope is introduced through the inferior portal, and a cannula is introduced through the superior portal. A 5.5-mm arthroscopic shaver is inserted through the superior cannula to clear off the surface of the iliotibial band, so that it may be adequately visualized. A hooked electrocautery probe is then used to longitudinally incise the iliotibial band until it no longer rubs, causing impingement over the greater trochanter.

  18. Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery

    DEFF Research Database (Denmark)

    Espelund, M; Grevstad, U; Jaeger, P;

    2014-01-01

    BACKGROUND: The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial pain relief to patients responding with moderate to severe pain after arthroscopic knee surgery. METHODS: Fifty...

  19. Analgesic efficacy of intra-articular morphine after arthroscopic knee surgery in sport injury patients

    Directory of Open Access Journals (Sweden)

    Mitra Yari

    2013-07-01

    Full Text Available BACKGROUND: Anterior Cruciate Ligament (ACL tearing is a common injury among football players. The present study aims to determine the best single-dose of intra-articular morphine for pain relief after arthroscopic knee surgery that, in addition to adequate and long-term analgesia, leads to fewer systemic side effects. METHODS: This clinical trial was conducted on 40 ASA-I athletes. After surgery, all participants received an injection of 20cc of 0.5% intra-articular bupivacaine. In addition, the first control group received a saline injection and 5, 10 and 15 mg of morphine were respectively injected into the joints of the second, third and fourth groups by use of Arthroscopic equipment before the Arthroscopic removal. The amount of pain based on VAS at 1, 2, 4, 6 and 24 hours after surgery, duration of analgesia and the consumption of narcotic drugs were recorded. RESULTS: The VAS scores in the fourth, sixth and twenty-fourth hours after surgery showed a significant difference between the study groups. The average time to the first analgesic request from the bupivacaine plus 15 mg morphine group was significantly longer than other groups and total analgesic requests were significantly lower than other groups. No drowsiness complications were observed in any of the groups in the first 24 hours after injection. CONCLUSION: Application of 15 mg intra-articular morphine after Arthroscopic knee surgery increases the analgesia level as well as its duration (IRCT138902172946N3 .

  20. The efficacy of adductor canal blockade after minor arthroscopic knee surgery

    DEFF Research Database (Denmark)

    Espelund, M; Fomsgaard, J S; Haraszuk, J;

    2014-01-01

    BACKGROUND: Adductor canal blockade (ACB) has been demonstrated to be effective in the treatment of post-operative pain after major knee surgery. We hypothesised that the ACB would reduce pain and analgesic requirements after minor arthroscopic knee surgery. METHODS: Seventy-two patients schedule...

  1. Arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years

    NARCIS (Netherlands)

    Roerdink, WH; Oskam, J; Vierhout, PAM

    2001-01-01

    Purpose: To evaluate the end results of arthroscopically assisted osteosynthesis of tibial plateau fractures in patients older than 55 years of age. Type of Study: Case series. Methods: Over a 5-year period, 201 consecutive patients presented with tibial plateau fracture; 131 of these patients were

  2. Editorial Commentary: Arthroscopic Hip Preservation Is Critical for Preserving Health and Function in Adolescents and Adults.

    Science.gov (United States)

    Martin, Hal David

    2016-09-01

    Hip health is a critical factor in preserving daily life activities and wellbeing for both adults and adolescents. There are several potential economic influences in developing arthroscopic hip techniques for the evaluation and treatment of hip pathology in patients of all ages. PMID:27594331

  3. Application of optical coherence tomography enhances reproducibility of arthroscopic evaluation of equine joints

    NARCIS (Netherlands)

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; te Moller, Nikae; Puhakka, Pia H.; Jurvelin, Jukka S.; Tulamo, R.M.; Töyräs, Juha

    2014-01-01

    Background: Arthroscopy is widely used in various equine joints for diagnostic and surgical purposes. However, accuracy of defining the extent of cartilage lesions and reproducibility in grading of lesions are not optimal. Therefore, there is a need for new, more quantitative arthroscopic methods. A

  4. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction?

    Science.gov (United States)

    Varitimidis, S E; Basdekis, G K; Dailiana, Z H; Hantes, M E; Bargiotas, K; Malizos, K

    2008-06-01

    In a randomised prospective study, 20 patients with intra-articular fractures of the distal radius underwent arthroscopically- and fluoroscopically-assisted reduction and external fixation plus percutaneous pinning. Another group of 20 patients with the same fracture characteristics underwent fluoroscopically-assisted reduction alone and external fixation plus percutaneous pinning. The patients were evaluated clinically and radiologically at follow-up of 24 months. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and modified Mayo wrist score were used at 3, 9, 12 and 24 months postoperatively. In the arthroscopically- and fluoroscopically-assisted group, triangular fibrocartilage complex tears were found in 12 patients (60%), complete or incomplete scapholunate ligament tears in nine (45%), and lunotriquetral ligament tears in four (20%). They were treated either arthroscopically or by open operation. Patients who underwent arthroscopically- and fluoroscopically-assisted treatment had significantly better supination, extension and flexion at all time points than those who had fluoroscopically-assisted surgery. The mean DASH scores were similar for both groups at 24 months, whereas the difference in the mean modified Mayo wrist scores remained statistically significant. Although the groups are small, it is clear that the addition of arthroscopy to the fluoroscopically-assisted treatment of intra-articular distal radius fractures improves the outcome. Better treatment of associated intra-articular injuries might also have been a reason for the improved outcome. PMID:18539672

  5. Results of Latarjet Coracoid Transfer to Revise Failed Arthroscopic Instability Repairs

    Science.gov (United States)

    Nicholson, Gregory P.; Rahman, Zain; Verma, Nikhil N.; Romeo, Anthony A.; Cole, Brian J.; Gupta, Anil Kumar; Bruce, Benjamin

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ♀, 11♂) that underwent Latarjet coracoid transfer for the revision of failed previous arthroscopic instability repair. The avg. age was 32.6 yrs (16-58). All patients had recurrent symptomatic anterior instability after previous arthroscopic surgery, and avg. time from arthroscopic repair to Latarjet was 13 months (4-40 mn). All had either CT or MRI that revealed suture anchor material in the glenoid, labral and capsular stripping, and anteroinferior glenoid bone loss or erosion. Advanced bone loss percentage analysis was not performed for this study. We excluded all patients that had a previous open repair, a seizure disorder, or if the Latarjet was a primary procedure. Outcome scores pre-operatively avg: SST: 6.7 (1-12); VAS: 3 (0-8); ASES: 63 (32-89). Coracoid transfer was performed thru a subscapularis split in 38, and with tendon takedown in 13. The coracoid was osteotomized along its long axis parallel to the undersurface of the lateral aspect. This provided at least 2.5 to 3.5 cm of graft with the conjoined tendon attached. The coracoacromial (CA) ligament was incised leaving a 1 cm. stump. The transfer was affixed flush with the articular surface but not lateral to it, with two 3.5 mm cortical screws in lag fashion overdrilling the coracoid with the CA ligament directed laterally. The capsule was then repaired to the CA ligament to make the transfer extra-articular. Results: At avg. 4 yr (2-7 yrs) follow-up stability had been maintained in 51 (100%).without further instability surgery. There were no

  6. ARTHROSCOPIC DEBRIDEMENT IN OSTEOARTHROSIS OF KNEE JOINT - ANALYSIS OF SHORT TERM BENEFITS

    Directory of Open Access Journals (Sweden)

    Jayakrishnan

    2015-08-01

    Full Text Available BACKGROUND: Many studies have reported symptomatic relief after arthroscopic debridement of knee for osteoarthrosis. The purpose of the study is to find out the outcome of arthroscopic debridement in osteoarthrosis of knee and to arrive at a consensus regarding the subsets of patients with osteoarthrosis who will benefit from the procedure. MATERIALS AND METHODS : 30 patients with osteoarthrosis were subjected for arthroscopic debridement. Patients included were of age greater than 50 years. Standard antero - posterior and lateral radiographs of knee were taken and grading was done using Kellegren and Lawrence system. Arthroscopic grading was done using the Outer bridge classification. Outcomes were assessed at multiple intervals over a 12 month period with a knee score and a functional score. RESULTS: Results were analyzed based on Knee society clinical rating system (1989. At the end of 1month 86.6% had excellent to good results. At the end of 6 months 60% had excellent to good results. At the end of 1 year 37.6% had excellent to good results. At six months follow up results was also evaluated based on different variables - varus deformity, radiographic and arthroscopic grading. Patients with malalignment more than 10 degrees and those with radiographic grading 3 or more were associated with poor results. CONCLUSION: Patients with mild to moderate osteoarthrosis benefitted with excellent to good results from the procedur e. Results were good and long lasting particularly if there was minimal or no malalignment of knee or there was associated mechanical restriction of movement due to meniscal tear or loose bodies.

  7. MRI assessment of tibial tunnel and its relation to complication following arthroscopic reconstruction of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Nadia F. El Ameen

    2014-09-01

    Conclusion: Anterior cruciate ligament reconstruction is one of the most commonly performed sports medicine procedures. MRI proved as an accurate method for post arthroscopic reconstruction evaluation that can help predict post ACL reconstruction complication.

  8. Modified arthroscopic double row repair of partial thickness tear of the rotator Cuff involving articular and bursal side

    Directory of Open Access Journals (Sweden)

    Kwon Oh

    2008-01-01

    Full Text Available Partial thickness of rotator cuff tears is considered as a common cause of shoulder disability. Various techniques for arthroscopic repair of partial thickness tear of rotator cuff have been reported in the literature. These techniques have addressed the articular side partial thickness cuff tear. We present an arthroscopic repair of partial thickness tear of rotator cuff involving both articular and bursal surfaces without converting into a full thickness tear. Each side of the tear was repaired with suture anchors separately.

  9. COMPREHENSIVE POST‐ARTHROSCOPIC MANAGEMENT OF A MIDDLE‐AGED ADULT WITH GLENOHUMERAL OSTEOARTHRITIS: A CASE REPORT

    OpenAIRE

    Hagen, Nicholas D.; Olson, Thomas; Millett, Peter

    2013-01-01

    Comprehensive Arthroscopic Management (CAM) is a new glenohumeral debridement procedure developed as a joint preserving alternative to total shoulder arthroplasty (TSA). The procedure consists of several arthroscopic components including: A. scar tissue and chondral debridement, B. synovectomy, C. inferior humeral osteoplasty, D. capsular release, E. axillary nerve decompression, and F. tenodesis of the long head of the biceps. In this case, an active, middle age patient who failed physical t...

  10. Early Clinical Results of Arthroscopic Remplissage in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

    OpenAIRE

    Hamid Reza Aslani; Zohreh Zafarani; Adel Ebrahimpour; Shahin Salehi; Ali Moradi; Soheil Sabzevari

    2014-01-01

    Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion...

  11. Effects of interscalene brachial plexus block to intra-operative hemodynamics and postoperative pain for arthroscopic shoulder surgery

    OpenAIRE

    Lee, Hyun-Young; Kim, Sang Hun; So, Keum Yung; Kim, Dong Jun

    2012-01-01

    Background Although arthroscopic shoulder surgery is less invasive and painful than open shoulder surgery, it can often cause intra-operative hemodynamic instability and severe post-operative pain. This study was conducted to investigate the efficacy of the interscalene brachial plexus block (IBPB) on intra-operative hemodynamic changes and post-operative pain during arthroscopic shoulder surgery. Methods After institutional review board approval, 50 consecutive patients that had undergone ar...

  12. No evidence of long-term benefits of arthroscopic acromioplasty in the treatment of shoulder impingement syndrome

    OpenAIRE

    Ketola, S.; Lehtinen, J.; Rousi, T.; Nissinen, M.; Huhtala, H.; Konttinen, Y T; Arnala, I.

    2013-01-01

    Objectives To report the five-year results of a randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. Methods A total of 140 patients were randomly divided into two groups: 1) supervised exercise programme (n = 70, exercise group); and 2) arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). Results The main outcome measure was self-reported pain as mea...

  13. Effect of continuous passive motion on functional recovery after senile arthroscope operation of knee joint%持续被动活动对老年膝关节镜术后功能恢复的作用

    Institute of Scientific and Technical Information of China (English)

    李泓

    2003-01-01

    @@ INTRODUCTION With popularit and development of arthroscope technique, it has been broadly ursed in treatment of disease of knee joint. Rehabilitation after arthroscope operation especially after senile arthxoscope operation of knee joint is very important.

  14. Arthroscopic lysis of adhesions for the stiff total knee: results after failed manipulation.

    Science.gov (United States)

    Tjoumakaris, Fotios Paul; Tucker, Bradfords Chofield; Post, Zachary; Pepe, Matthew David; Orozco, Fabio; Ong, Alvin C

    2014-05-01

    Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student's t test. Pre- to postoperative increase in range of motion was significant (Psurgery.

  15. Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Roos, Ewa M; Nissen, Nis;

    2016-01-01

    meniscus surgery were too optimistic regarding their recovery time and postoperative participation in leisure activities. This highlights the need for shared decision making which should include giving the patient information on realistic expectations of recovery time and regarding participation in leisure......Background and purpose - Patients' expectations of outcomes following arthroscopic meniscus surgery are largely unknown. We investigated patients' expectations concerning recovery and participation in leisure-time activities after arthroscopic meniscus surgery and the postoperative fulfillment...... their expectations of recovery time and postoperative participation in leisure activities. 3 months after surgery, the patients completed questionnaires on their actual level of leisure activity and their degree of satisfaction with their current knee function. We analyzed differences between the expected outcome...

  16. Arthroscopic Conjoint Tendon Transfer: A Technique for Revision Anterior Shoulder Stabilization.

    Science.gov (United States)

    Tennent, Duncan; Colaço, Henry B; Arnander, Magnus; Pearse, Eyiyemi

    2016-02-01

    Revision anterior stabilization of the shoulder presents a challenge to the surgeon and carries a higher risk of recurrent dislocation than primary repair. The Latarjet procedure may be more reliable than revision soft-tissue repair but may not be indicated in patients without significant glenoid bone loss. We describe an arthroscopic technique of conjoint tendon transfer using a combination of suspensory and interference screw fixation for patients without significant glenoid bone loss (tendon, accurate bone tunnel placement, and subsequent labral repair. It avoids the additional steps of bone block preparation and the larger portals required for arthroscopic Latarjet techniques, in addition to eliminating potential complications due to coracoid bone block resorption. PMID:27274454

  17. A Simplified Approach for Arthroscopic Repair of Rotator Cuff Tear with Dermal Patch Augmentation

    Directory of Open Access Journals (Sweden)

    Anthony C. Levenda

    2015-01-01

    Full Text Available Here, we describe an arthroscopic method specifically developed to augment rotator cuff repair using a flexible acellular dermal patch (ADP. In this method, an apparently complex technique is simplified by utilizing specific steps to augment a rotator cuff repair. In this method, using a revised arthroscopic technique, rotator cuff repair was performed. This technique allowed easy passage of the graft, excellent visualization, minimal soft tissue trauma, and full four-corner fixation of an ADP. Twelve patients underwent rotator cuff repair with augmentation using the combination of this method and ADP. Due to the technique and biomechanical characteristics of the material, the repairs have been stable and with high patient satisfaction.

  18. Osteoid osteoma (OO of the coracoid: a case report of arthroscopic excision and review of literature

    Directory of Open Access Journals (Sweden)

    Goyal Saumitra

    2015-01-01

    Full Text Available Osteoid osteoma (OO of the coracoid is a rare entity that may present with variable symptoms from shoulder leading to delay in diagnosis and treatment. We present the clinical and radiological findings and management of one such case along with a review of similar cases reported in the literature. There was a delay of 2 years in diagnosis, which was later confirmed by computed tomography in addition to magnetic resonance imaging (MRI. The lesion was accessed arthroscopically and excised by unroofing and curettage. “OO” should be included in the differential diagnosis of shoulder pain in young patients not responding to long-term conservative treatment. Arthroscopic excision and curettage provide a good choice for management, with low morbidity and rapid recovery.

  19. Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty : A randomized clinical trial

    OpenAIRE

    Holmgren, Theresa; Öberg, Birgitta; Sjöberg, Irene; Johansson, Kajsa

    2012-01-01

    Objective: To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group). Design: A randomized, single-blinded, clinically controlled study. Patients: Thirty-six patients entered the study. Thirteen in the PT-group and 16 in the H-group fulfilled all the assessments. Methods: For 12 weeks follo...

  20. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Directory of Open Access Journals (Sweden)

    Tae-Soo Park

    2016-01-01

    Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.

  1. Eikenella corrodens septic hip arthritis in a healthy adult treated with arthroscopic irrigation and debridement.

    Science.gov (United States)

    Gowda, Ashok L; Mease, Samuel J; Dhar, Yasmin

    2014-09-01

    We present the case of a seemingly spontaneous septic hip arthritis in a patient with no pertinent medical history. Our patient presented with persistent and worsening sharp lower back pain and underwent arthrocentesis of the hip joint, yielding purulent fluid positive for Eikenella corrodens. Our patient's treatment consisted of arthroscopic irrigation with debridement and limited synovectomy that used a supine 2-incision technique. To our knowledge, this is the first reported case of an E corrodens septic hip arthritis.

  2. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques.

  3. Systematic Review of Arthroscopic Versus Open Repair for Recurrent Anterior Shoulder Dislocations

    OpenAIRE

    Godin, Jonathan; Sekiya, Jon K.

    2011-01-01

    Context: It remains unknown if arthroscopic repair of recurrent anterior shoulder instability is as effective as open repair. Objective: The purpose of this study is to analyze the literature to provide clinical recommendations regarding the most appropriate therapeutic intervention for recurrent anterior shoulder instability. Study Design: Systematic review of level I and II studies. Data Sources: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and secondary references from 1967...

  4. Arthroscopic treatment for osteochondral lesions of the talus: analysis of outcome predictors

    Institute of Scientific and Technical Information of China (English)

    GUO Qin-wei; HU Yue-lin; JIAO Chen; YU Chang-long; AO Ying-fang

    2010-01-01

    Background Compared with traditional arthrotomy procedures, arthroscopic treatment for osteochondral lesions of the talus has some advantages. However, there has been considerable debate about the outcome predictors for this surgical technique. This study aimed to investigate the outcomes of arthroscopic treatment for osteochondral lesions of the talus, and analyze its outcome predictors.Methods Clinical data of 48 patients with osteochondral lesions of the talus who underwent ankle arthroscopy were studied. Arthroscopic debridement was performed on all patients, and microfracture was also performed in 36 cases. Scores on a subjective satisfaction questionnaire, visual analog scale (VAS) for pain, and the American Orthopedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores were obtained before and after surgery.Results Five patients lost to follow up. The other forty-three patients, 8 of whom were athletes, were followed up for an average of 23.9 months. The average AOFAS post-operative score was 90.16±9.96, compared with 70.81±6.96 before surgery (t=9.353, P <0.001). The VAS pain score after the operation (2.51±9.45) was significantly lower than that before the operation (6.95±1.40) (t=8.647, P<0.001). Of the 43 patients, 35 (81.4%) had good or excellent results. There was no significant difference in outcome between the medial and lateral groups (z=0.205, P=0.838), while a better outcome was found with lesions smaller than 10 mm than those with larger lesions (z=2.199, P=0.028). Age, sex, athletic profession and location of the lesion did not significantly correlate with outcomes.Conclusions Arthroscopic treatment is effective and safe for osteochondral lesions of the talus. A strong correlation was found between the size of the lesion and successful outcome.

  5. Preoperative interscalene brachial plexus block aids in perioperative temperature management during arthroscopic shoulder surgery

    Science.gov (United States)

    Lim, Se Hun; Lee, Wonjin; Park, JaeGwan; Kim, Myoung-hun; Cho, Kwangrae; Lee, Jeong Han; Cheong, Soon Ho

    2016-01-01

    Background Hypothermia is common during arthroscopic shoulder surgery under general anesthesia, and anesthetic-impaired thermoregulation is thought to be the major cause of hypothermia. This prospective, randomized, double-blind study was designed to compare perioperative temperature during arthroscopic shoulder surgery with interscalene brachial plexus block (IBPB) followed by general anesthesia vs. general anesthesia alone. Methods Patients scheduled for arthroscopic shoulder surgery were randomly allocated to receive IBPB followed by general anesthesia (group GB, n = 20) or general anesthesia alone (group GO, n = 20), and intraoperative and postoperative body temperatures were measured. Results The initial body temperatures were 36.5 ± 0.3℃ vs. 36.4 ± 0.4℃ in group GB vs. GO, respectively (P = 0.215). The body temperature at 120 minutes after induction of anesthesia was significantly higher in group GB than in group GO (35.8 ± 0.3℃ vs. 34.9 ± 0.3℃; P < 0.001). The body temperatures at 60 minutes after admission to the post-anesthesia care unit were 35.8 ± 0.3℃ vs. 35.2 ± 0.2℃ in group GB vs. GO, respectively (P < 0.001). The concentrations of desflurane at 0, 15, and 120 minutes after induction of anesthesia were 6.0 vs. 6.0% (P = 0.330), 5.0 ± 0.8% vs. 5.8 ± 0.4% (P = 0.001), and 3.4 ± 0.4% vs. 7.1 ± 0.9% (P < 0.001) in group GB vs. GO, respectively. Conclusions The present study demonstrated that preoperative IBPB could reduce both the intraoperative concentration of desflurane and the reduction in body temperature during and after arthroscopic shoulder surgery.

  6. Editorial Commentary: Iliotibial Band Allograft Shows Promise for Arthroscopic Hip Labral Reconstruction.

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

    Arthroscopic hip labral reconstruction using iliotibial band allograft in a modified front-to-back technique results in improved outcomes after 2-year follow-up. The authors' reasoning for reconstruction are reminiscent of similar arguments for restoring hoop stresses in knee meniscal surgery. Results are comparable to reported outcomes of labral repair, and allograft is particularly indicated for severe labral damage when repair is not possible. Don't miss the related technical note with video in Arthroscopy Techniques. PMID:26743407

  7. Perioperative Rehabilitation Using a Knee Extension Device and Arthroscopic Debridement in the Treatment of Arthrofibrosis

    OpenAIRE

    Biggs-Kinzer, Angie; Murphy, Brian; Shelbourne, K. Donald; Urch, Scott

    2010-01-01

    Background: Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement. Hypothesis: Patients who achieve greater knee range of motion will have better subjective scores. Study Design: Retrospective case series analysis. Methods: A review of records was performed for 33 patients with arthrofibrosis w...

  8. Arthroscopic lysis of adhesions for the stiff total knee: results after failed manipulation.

    Science.gov (United States)

    Tjoumakaris, Fotios Paul; Tucker, Bradfords Chofield; Post, Zachary; Pepe, Matthew David; Orozco, Fabio; Ong, Alvin C

    2014-05-01

    Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student's t test. Pre- to postoperative increase in range of motion was significant (P<.001) (average, 62° preoperatively to 98° postoperatively). Average preoperative extension deficit was 16°, which was reduced to 4° at final follow-up. This value was also found to be statistically significant (P<.0001). With regard to ultimate flexion attained, average preoperative flexion was 79°, which was improved to 103° at final follow-up. This improvement in flexion was statistically significant (P<.0001). Patients can reliably expect an improvement after arthroscopic lysis of adhesions for a stiff TKA using a standardized arthroscopic approach; however, patients achieved approximately half of the improvement that was obtained at the time of surgery. PMID:24810826

  9. Prevention of arthrofibrosis after arthroscopic screw fixation of tibial spine fracture in children and adolescents.

    Science.gov (United States)

    Parikh, Shital N; Myer, David; Eismann, Emily A

    2014-01-01

    Arthrofibrosis is a major complication of tibial spine fracture treatment in children, potentially resulting in knee pain, quadriceps weakness, altered gait, decreased function, inability to return to sports, and long-term osteoarthritis. Thus, prevention rather than treatment of arthrofibrosis is desirable. The purpose of this study was to evaluate an aggressive postoperative rehabilitation and early intervention approach to prevent permanent arthrofibrosis after tibial spine fracture treatment and to compare epiphyseal and transphyseal screws for fixation. A consecutive series of 24 patients younger than age 18 with displaced type II and III tibial spine fractures who underwent arthroscopic reduction and screw fixation between 2006 and 2011 were retrospectively reviewed. Final range of motion was compared between patients with epiphyseal (n=12) and transphyseal (n=9) screws. One-third (4 of 12) of patients with epiphyseal screws underwent arthroscopic debridement and screw removal approximately 3 months postoperatively; 3 patients lacked 5° to 15° of extension, 1 experienced pain with extension, and 1 had radiographic evidence of screw pullout, loss of reduction, and resultant malunion. In the transphyseal screw group, 3 patients had 10° loss of extension, and all corrected after arthroscopic debridement and screw removal. The two groups did not significantly differ in time to hardware removal or return to sports or final range of motion. No growth disturbances were identified in patients after transphyseal screw removal. An aggressive approach of postoperative rehabilitation and early intervention after arthroscopic reduction and screw fixation of tibial spine fractures in children was successful in preventing permanent arthrofibrosis. PMID:24683658

  10. Arthroscopic Knotless, Double-Row, Extended Linked Repair for Massive Rotator Cuff Tears.

    Science.gov (United States)

    Greenspoon, Joshua A; Petri, Maximilian; Millett, Peter J

    2016-02-01

    The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct. PMID:27330944

  11. Effect of arthroscopic rotator cuff surgery in patients with preoperative restricted range of motion

    OpenAIRE

    Razmjou, Helen; Henry, Patrick; Costa, Giuseppe; Dwyer, Tim; Holtby, Richard

    2016-01-01

    Background The purpose of this study was to examine the impact of rotator cuff (RC) decompression and/or repair on post-operative ROM in patients with pre-operative restricted passive motion who had undergone arthroscopic subacromial debridement and/or rotator cuff repair. Potential predictors of ROM recovery such as age, sex, mechanism of injury, type of surgery, presence of an endocrine illness and having an active Worker Compensation claim related to the shoulder were explored. Methods A r...

  12. Arthroscopic management of recalcitrant stiffness following rotator cuff repair: A retrospective analysis

    OpenAIRE

    Sanjeev Bhatia; Mather, Richard C.; Hsu, Andrew R.; Ferry, Amon T; Romeo, Anthony A.; Nicholson, Gregory P.; Cole, Brian J.; Verma, Nikhil N.

    2013-01-01

    Background : Rotator cuff repair surgery is one of the most commonly performed procedures in the world but limited literature exists for guidance of optimal management of post-operative arthrofibrosis following cuff repair. The purpose of this study is to report the results of arthroscopic capsular release, lysis of adhesions, manipulation under anesthesia, and aggressive physical therapy in patients with recalcitrant postoperative stiffness after rotator cuff repair. Materials and Method...

  13. Suprascapular nerve palsy after arthroscopic Latarjet procedure: a case report and review of literature.

    Science.gov (United States)

    Sastre, Sergi; Peidro, Lluis; Méndez, Anna; Calvo, Emilio

    2016-02-01

    The Bristow and Latarjet procedures have become popular among orthopaedic surgeons thanks to the development of new instruments that allow the use of arthroscopic techniques to treat cases of glenohumeral instability with bone defects or capsular deficiency. Nonetheless, several complications have been reported after Latarjet procedures, including neurological injuries. This report describes surgical damage to the suprascapular nerve, an unusual complication. Level of evidence Expert opinion, Level V.

  14. A Comparison of Functional Outcomes After Metallic and Bioabsorbable Interference Screw Fixations in Arthroscopic ACL Reconstructions

    OpenAIRE

    Hegde, Atmananda S; Rai, Deepak K; Kannampilly, Antony J

    2014-01-01

    Introduction: Anterior Cruciate Ligament (ACL) is as one of the most frequently injured ligaments in the modern contact sports scenario. Graft fixations can be achieved during anterior cruciate ligament (ACL) reconstructions by using either bioabsorbable screws or metal screws. The objective of this study was to compare the functional outcomes after bioabsorbable and metallic interference screw fixations in arthroscopic anterior cruciate ligament reconstructions done by using hamstring grafts.

  15. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    OpenAIRE

    Santosh Kumar; Anant Kumar; Sanjay

    2015-01-01

    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  16. The outcome study of arthroscopic repair with anchor suture for anterior shoulder instabilities

    Directory of Open Access Journals (Sweden)

    Guity MR

    2010-10-01

    Full Text Available "nBackground: Anterior glenohumeral instabilities can be corrected with open and arthroscopic surgery. The purpose of this study was to evaluate retrospectively the surgical outcomes of arthroscopic repair of anterior glenohumeral instabilities with use of suture anchors in a series of patients who were followed for twenty to fifty months."n "nMethods: The results of arthroscopic Bankart repair with use of suture anchors in 30 patients with traumatic recurrent anterior instability of the shoulder were evaluated. At the time of follow-up (mean of thirty-three months, the patients were assessed with two outcome measurement tools (the Rowe score, the Constant score. The recurrence rate, range of motion, and risk factors for postoperative recurrence were evaluated."n "nResults: According to the Rowe scale, 12 patients (40% had an excellent score; 13 (43%, a good score; 4 (13%, a fair score; and 1 (4%, a poor score. The mean ROWE score was 81.8 and the mean CONSTANT score was 85.5. Overall, the rate of postoperative recurrence of instability was 10% (two dislocations, one subluxation. The mean delay to recurrence was 20 months. Loss of external rotation in regard to uninvolved extremity was less than 10 degrees in 30% and more than 10 degrees in 10% of patients. The average number of anchors used was 3.2 which follow-up radiographs showed all of them in the osseous glenoid without pullout. In preoperative studies, shoulder 3D CT scan was not performed routinely. Radiographic signs of degenerative changes were noted in one shoulder."n "nConclusion: Arthroscopic capsulolabral repair with use of suture anchors can provide satisfactory outcomes in terms of recurrence rate, activity, and range of motion.

  17. Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures

    OpenAIRE

    Katerina Katerina Kasapinova; Viktor Kamiloski

    2014-01-01

    AIM: The aim of this study was to analyze the frequencies of these soft-tissue injuries and to describe the arthroscopic technique used for their diagnosis. METHODS: The prospective study included 85 patients with operatively treated distal radius fracture. Wrist arthroscopy was used to identify the associated lesions of triangular fibrocartilage complex (TFCC), scapholunate ligament (SL) and lunitriquetral ligament (LT), extrinsic ligaments, and chondral lesions. RESULTS: Wrist arthr...

  18. Massive Bone Loss from Fungal Infection after Anterior Cruciate Ligament Arthroscopic Reconstruction

    OpenAIRE

    Muscolo, D. Luis; Carbo, Lisandro; Aponte-Tinao, Luis A.; Ayerza, Miguel A.; Makino, Arturo

    2009-01-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in th...

  19. Concurrent arthroscopic bicruciate ligament reconstruction using Achilles tendon-bone allografts: experience with 15 cases

    Institute of Scientific and Technical Information of China (English)

    Shi De-hai; CAI Dao-zhang; WANG Kun; RONG Li-min; XU Yi-chun

    2008-01-01

    Objective: To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achil-les tendon-bone allografts. Methods: Associated meniscus injuries were treated according to established methods prior to ligament recon-structions during arthroscopic surgery. Thirty Achilles ten-don-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (>3-8 weeks), 3 for acute ligamentous deficien-cies (≤ 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the differ-ence was statistically significant (t- test, P<0.001) before and after operation. Conclusions: Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

  20. Analysis of the functional results of arthroscopic Bankart repair in posttraumatic recurrent anterior dislocations of shoulder

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    Amit Mishra

    2012-01-01

    Full Text Available Background: The Bankart lesion represents the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder leading to shoulder instability. We report the clinical outcome of arthroscopic repair of Bankart lesion in 50 patients. Materials and Methods: Sixty five patients with posttraumatic anterior dislocation of shoulder were treated by arthroscopic repair from Jan 2005 to Nov 2008. Fifty patients, with an average age of 26.83 years (range 18-45 years, were reviewed in the study. The average followup period was 27 months (range 24-36 months. University of California Los Angeles shoulder rating scale was used to determine the outcome after surgery. The recurrence rates, range of motion, as well as postoperative function and return to sporting activities were evaluated. Results : Thirty six patients (72.0% had excellent results, whereas seven patients (14.0% had good results. The mean pre- and postoperative range of external rotation was 80.38° and 75.18°, respectively. Eighty-six percent patients had stability compared with the normal sided shoulder and were able to return to sports. There were no cases of redislocation observed in this study; however, three cases had mild laxity of the joint. Conclusion: Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent postoperative shoulder motion and low recurrence rates.

  1. Outcomes of arthroscopic "Remplissage": capsulotenodesis of the engaging large Hill-Sachs lesion

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    Mayo Lee

    2011-06-01

    Full Text Available Abstract Background A Hill-Sachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon ("remplissage" to seal a large engaging Hill-Sachs lesion in an unstable shoulder. Methods This was a prospective follow-up study of patients who underwent arthroscopic surgery for recurrent shoulder instability with a large engaging Hill-Sachs lesion from 2007 to 2009. The clinical results were measured preoperatively and postoperatively with the Simple Shoulder test (SST and the Rowe score for instability. Results Eleven patients met the inclusion criteria of this study. The mean follow-up time was 30 months (range 24 to 35 months. At the last follow-up, significant improvement was observed in both scores with no recurrent dislocations. The mean SST improved from 6.6 to 11 (p Conclusions Arthroscopic remplissage for shoulder instability is an effective soft tissue technique to seal a large engaging Hill-Sachs lesion with respect to recurrence rate, range of motion and shoulder function.

  2. ARTHROSCOPIC RELEASE OF THE SUPRASCAPULAR NERVE: SURGICAL TECHNIQUE AND EVALUATION OF CLINICAL CASES

    Science.gov (United States)

    Garcia Júnior, José Carlos; Paccola, Ana Maria Ferreira; Tonoli, Cristiane; Zabeu, José Luis Amin; Garcia, Jesely Pereira Myrrha

    2015-01-01

    To describe a specific surgical technique for arthroscopic decompression of the suprascapular nerve (SSN) and evaluate its preliminary results. Methods: Ten shoulders of nine patients were operated using a technique with portals differing from the already-known techniques, which did not use traction and made use of materials available within the public healthcare system. Results: Among the ten shoulders of nine patients, eight were right shoulders and two were left shoulders. The mean age was 69.5 years. The UCLA score increased from 11.7 to 26.1 points over the postoperative follow-up of 16.6 months. The SF-36 questionnaire score was 122.9 and the raw pain scale value was 88%. Conclusion: Arthroscopic decompression of the SSN in accordance with the described technique is reproducible and less traumatic than the open techniques. The patients achieved improvements in many of the parameters evaluated, particularly with regard to pain. Arthroscopic decompression of the SSN may be a therapeutic option for pathological compression of the SSN. PMID:27027028

  3. Long term results of arthroscopic bankart repair for traumatic anterior shoulder instability

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    Tan Andrew HC

    2011-06-01

    Full Text Available Abstract Background The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder. Methods Data from 79 shoulders in 74 patients were collected over 4 years (2004 - 2008. Each patient was followed-up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA shoulder rating scale and the Simple Shoulder Test (SST score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated. Results SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p Conclusion Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

  4. Intraligamentous ganglion cysts of the anterior cruciate Ligament: MR findings with clinical and arthroscopic correlations

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    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)

    1996-01-01

    Magnetic resonance findings with clinical and arthroscopic correlation of intraligamentous cysts of the anterior cruciate ligament (ACL) are presented. Three cases of intraligamentous cysts of the ACL were identified out of 681 knee MRI examinations over a 2-year period. Arthroscopy and postoperative MRI were performed in all three patients, each of whom experienced knee pain with extreme flexion and extension. In all three cases the intraligamentous cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Two of the three ACL cysts required a 70{degrees} scope for adequate visualization and establishment of posteromedial and posterolateral portals for arthroscopic treatment. One cyst could not be visualized arthroscopically and probing of the ACL from the anterior portal resulted in drainage of the cyst. No patient had presence of ACL cyst on follow-up MRI or recurrence of symptoms at a mean of 24 months. Intraligamentous cyst of ACL is a rare cause of knee pain. It should be suspected in patients having chronic pain with extremes of motion. Magnetic resonance findings are diagnostic and help to guide arthroscopy. 14 refs., 3 figs.

  5. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Science.gov (United States)

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  6. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

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    Satish Shervegar

    2015-09-01

    Full Text Available Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively.Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26 .Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation

  7. Periarticular osteoid osteoma of the ankle: a report of nine arthroscopically treated patients.

    Science.gov (United States)

    Dimnjaković, Damjan; Bojanić, Ivan; Smoljanović, Tomislav; Mahnik, Alan

    2015-01-01

    Periarticular osteoid osteoma often presents with unspecific clinical symptoms, mimicking other clinical conditions. This can lead a clinician to a ''diagnostic side path'' and a delayed or missed diagnosis compared with extra-articular osteoid osteoma. We report the cases of 9 patients with a mean age of 22 (range 14 to 32) years who were diagnosed with periarticular osteoid osteoma of the ankle and were surgically treated in our department during a 12-year period. The diagnostic difficulties associated with periarticular osteoid osteoma must be resolved by obtaining a detailed patient history and performing a thorough physical examination. Computed tomography is the ultimate imaging method to confirm the suspicion of osteoid osteoma. Arthroscopic removal of the osteoid osteoma was performed in all 9 patients in the present case series, with synovectomy performed when indicated. Under arthroscopic visualization, a specimen was obtained for histopathologic analysis to confirm the diagnosis, followed by tumor excision. All the patients were pain free at the final follow-up visit after a mean duration of 6 years (range 6 months to 12.7 years) postoperatively. We suggest arthroscopic removal of periarticular osteoid osteomas of the ankle as an effective treatment method, because it allows complete tumor excision, synovectomy when needed, a short postoperative rehabilitation period, and satisfactory functional results.

  8. INTRAARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROSCOPIC LAVAGE OF THE KNEE: LONG-TERM RESULTS

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    Lidia Vladimirovna Luchikhina

    2013-01-01

    Full Text Available Objective: to evaluate the efficiency of arthroscopic lavage in combination with subsequent injection of hyaluronic acid into the joint cavity at shortand long-term follow-ups. Subjects and methods. Eighty-two patients with knee osteoarthrosis (OA were examined in accordance with the American College of Rheumatology criteria. Group 1 consisted of 40 patients only after arthroscopic lavage; Group 2 comprised 42 patients who were administered hyaluronic acid after arthroscopic lavage. Clinical evaluation encompassed pain while walking, resting, and moving (by a visual analogue scale, limited ability in covering 100 m (by a 5-point scale, general clinical evaluation (by a 5-point ordinal scale, the presence or absence of pain after 100-m walking, as well as resting pain (its presence or absence. Results. The treatment effect evaluated using different indicators was comparably positive in both groups within 3 months. Following 3 months of therapy, its effect remained stable and even better in Group 2. The latter showed a particularly noticeable superiority a year later. Thus, there were excellent and good results in 88 and 47.5% in Groups 2 and 1, respectively. The clinical symptoms of the disease were absent in 58% in Group 2 and in only 15% in Group 1. Moreover, Group 1 showed worsening and 20% of the patients had no effect. This trend was also seen while evaluating the therapeutic effectiveness in different periods. Thus, after therapy, no substantial difference was found in both groups, but 3 months later this difference was as many as 0.8 scores and a year later Group 2 had many points in its favor (1.2 scores. Conclusion. Arthroscopic lavage followed by the administration of hyaluronic acid makes it possible to prevent the negative effect of a washing liquid on the metabolism and structure of the articular cartilage and to achieve a long-term effect against the major clinical symptoms (joint pain and function affecting the quality of life. The

  9. Development and Validation of Cognitive Rehearsal as a Training Strategy for Arthroscopic Surgery

    Science.gov (United States)

    Kovacevic, David; Hodgins, Justin Lane; Lowe, Dylan T.; He, Janice; Popkin, Charles Aaron; Lynch, Thomas Sean; Ahmad, Christopher S.

    2016-01-01

    Objectives: Surgical performance is a highly intellectual activity that involves the processing of perceptual information from the five senses. Strategies to process, organize, and retain this perceptual information may benefit learning techniques. Once such strategy, cognitive rehearsal, is the activity where a skill is rehearsed in memory prior to the actual performance. This study aimed to develop and validate a cognitive rehearsal strategy for arthroscopic knee surgery in orthopaedic residents. We hypothesized that this training tool will lead to increased comfort and confidence with arthroscopic surgery performance. Methods: An expert surgeon was filmed performing an arthroscopic ACL reconstruction using patellar bone-tendon-bone autograft. An instructional training video was then created incorporating the extracorporeal and arthroscopic footage with voice over and subtitles. Following the surgery, cognitive recall of the procedure was conducted with the surgeon to identify key visual, cognitive, and kinesthetic cues to develop a mental imagery script to enhance rehearsal of arthroscopic surgery. Orthopaedic residents from two academic training programs were invited to participate. Demographic information including training level, previous musical experience, organized sports participation, and preferred learning style was collected. The training session consisted of a relaxation exercise, instructional video of an expert performing the procedure, learning the mental imagery script, and rehearsing the procedure out loud with a partner. The residents’ ability to rehearse the procedure was assessed before and after the training session with a modified version of a previously validated questionnaire, and a post-training session survey was administered to define which components of the rehearsal seemed most beneficial. Statistical analysis included a reliability analysis for internal consistency, and a nonparametric Wilcoxon test to compare the composite

  10. One strategy for arthroscopic suture fixation of tibial intercondylar eminence fractures using the Meniscal Viper Repair System

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    Ochiai Satoshi

    2011-08-01

    Full Text Available Abstract Background Principles for the treatment of tibial intercondylar eminence fracture are early reduction and stable fixation. Numerous ways to treatment of this fracture have been invented. We designed a simple, low-invasive, and arthroscopic surgical strategy for tibial intercondylar eminence fracture utilizing the Meniscal Viper Repair System used for arthroscopic meniscal suture. Methods We studied 5 patients, who underwent arthroscopic suture fixation that we modified. The present technique utilized the Meniscal Viper Repair System for arthroscopic suture of the meniscus. With one handling, a high-strength ultra-high molecular weight polyethylene(UHMWPE suture can be passed through the anterior cruciate ligament (ACL and the loops for suture retrieval placed at both sides of ACL. Surgical results were evaluated by the presence or absence of bone union on plain radiographs, postoperative range of motion of the knee joint, the side-to-side differences measured by Telos SE, and Lysholm scores. Results The reduced position achieved after surgery was maintained and good function was obtained in all cases. The mean distance of tibia anterior displacement and assessment by Lysholm score showed good surgical results. Conclusion This method simplified the conventional arthroscopic suture fixation and increased its precision, and was applicable to Type II fractures that could be reduced, as well as surgically indicated Types III and IV. The present series suggested that our surgical approach was a useful surgical intervention for tibial intercondylar eminence fracture.

  11. Evaluation of patients submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment

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    Fabio Alexandre Martynetz

    2013-12-01

    Full Text Available Objective: to evaluate the results of the arthroscopic treatment of the lateral epicondylitis. Methods: we evaluated 14 patients (15 elbows submitted to the arthroscopic treatment of the lateral epicondylitis refractory to the conservative treatment, which was realized for a minimum period of 18 months. Beyond the demographic data collection, patients were evaluated according to the arthroscopic classification of Baker et al., the Disabilities of the Arm, Shoulder, and Hand (DASH questionnaire and the Mayo Elbow Performance Score (MEPS. The patients' ages ranged between 23 and 56 years (average 46 years (eight males and six females. Of the 15 elbows, 12 were the dominant and one patient had bilateral lesion. The follow-up after surgery was minimum 24 months and maximum 72 months (average 41 months. Results: we found, according to the arthroscopic classification of Baker et al., two patients with type I lesions, nine with type II lesions and three with type III lesions. We found the following complications: one patient with altered sensitivity in the region of the lateral portal, one with a deficit of ten degrees in length, one with synovial plica and one with synovitis in the lateral compartment. Our score on the DASH questionnaire was minimum of 32 points and maximum of 120 points (average 57 points and the scale of MEPS had a minimum score of 60 points and a maximum of 100 points (average 90 points. Conclusion: the arthroscopic treatment of the lateral epicondylitis, plus insurance, provides satisfactory results.

  12. All-Arthroscopic Autologous Matrix-Induced Chondrogenesis for the Treatment of Osteochondral Lesions of the Talus

    Science.gov (United States)

    Usuelli, Federico Giuseppe; de Girolamo, Laura; Grassi, Miriam; D'Ambrosi, Riccardo; Montrasio, Umberto Alfieri; Boga, Michele

    2015-01-01

    Several surgical techniques have been described for the treatment of talar chondral lesions. Among them, microfracture is well established. Autologous matrix-induced chondrogenesis (AMIC), using microfracture and biomaterials, has shown promising results for the treatment of knee osteochondral lesions and has been proposed for the ankle as an open technique. We describe an all-arthroscopic AMIC technique. The benefits of an all-arthroscopic procedure include smaller incisions with less soft-tissue dissection, better visualization of the joint, and a quicker recovery compared with open surgery. The use of matrix to support cartilage regeneration promotes good-quality cartilage tissue with satisfactory long-term outcomes. Our all-arthroscopic AMIC technique uses a type I–type III porcine collagen matrix (Chondro-Gide; Geistlich Pharma, Wolhusen, Switzerland) and is characterized by 2 different arthroscopic surgical phases. First, adequate exposure is achieved through use of a Hintermann spreader (Integra LifeSciences, Plainsboro, NJ) with sufficient joint distraction and wet lesion preparation. The second surgical step is performed dry, involving matrix placement and fixation. The all-arthroscopic AMIC technique for the treatment of osteochondral lesions of the talus allows a very precise reconstruction in the case of cartilage defects and avoids the need for a more invasive operation associated with higher morbidity and a longer surgical time. PMID:26258040

  13. Early Clinical Results of Arthroscopic Remplissages in Patients with Anterior Shoulder Instability with Engaging Hill-Sachs Lesion in Iran

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    Hamid Reza Aslani

    2014-03-01

    Full Text Available Background:   To assess the outcome of the remplissage arthroscopic surgical method in patients with anterior shoulder dislocation associated with Hill-Sachs lesion.     Methods:   Ten patients with anterior shoulder dislocations and Hill-Sachs lesions were entered into this study and were operated on by the remplissage arthroscopic surgical method. They were followed up 22 months after surgery in   order to evaluate the outcome of the treatment, including recurrence of dislocation and motion limitation.     Results:   During the internal follow up period no case of recurrence was found. Motion limitation during the follow up   period was not significant (internal rotation limitation=5°±1°, and external rotation limitation=4°±1° Conclusions:   Our findings suggest that the remplissage arthroscopic surgical method is an acceptable, safe and   reliable treatment for anterior shoulder dislocation with engaging Hill-Sachs lesion.

  14. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    Science.gov (United States)

    Arun, G R; Kumar, Pradeep; Patnaik, Sarthak; Selvaraj, Karthik; Rajan, David; Singh, Anant; Kumaraswamy, Vinay

    2016-01-01

    Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. Materials and Methods: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. Results: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair. PMID:27293291

  15. T2 relaxometry of the infrapatellar fat pad after arthroscopic surgery

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    Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Taneja, Atul K. [Hospital do Coracao (HCor), Teleimagem, and Hospital Israelita Albert Einstein, Division of Musculoskeletal Imaging, Department of Radiology, Sao Paulo (Brazil); Hosseini, Ali; Li, Guoan [Massachusetts General Hospital and Harvard Medical School, Bioengineering Laboratory, Department of Orthopedics, Boston, MA (United States); Gill, Thomas J. [Massachusetts General Hospital and Harvard Medical School, Sports Medicine Center, Department of Orthopedics, Boston, MA (United States)

    2014-03-15

    To investigate the T2 relaxation values of the infrapatellar fat pad (IFP) after arthroscopic surgery. This study was approved by the institutional review board; all individuals signed informed consent. We performed MRI in 16 knees from 8 subjects. Prior to imaging, each subject had unilateral arthroscopic knee surgery and an asymptomatic non-operated contralateral knee. We used a 10-echo multiple-TE fast-spin echo pulse sequence for creation of T2 relaxation time maps. Two musculoskeletal radiologists independently placed regions of interest in the IFP, suprapatellar subcutaneous and deep intermuscular adipose tissue. Qualitative assessments were performed to assess fibrotic changes affecting patellar retinaculum and IFP. Statistical analyses of T2 values determined differences between groups, correlation with time after surgery, and cut-off values to differentiate groups. The average time between arthroscopy and imaging was 3.5 ± 0.4 years. IFP of knees with prior surgery had significantly shorter mean T2 values (133 ± 14 ms) compared with control knees (147 ± 8 ms, P = 0.03). There was no significant difference between operated and control knees regarding T2 values of suprapatellar subcutaneous (P = 0.3) or deep intermuscular adipose tissue (P = 0.2). There was no correlation between IFP T2 values and time after surgery (P > 0.2). IFP T2 values ≤ 139 ms had 75 % sensitivity and 88 % specificity in identifying prior arthroscopy. Shortening of T2 relaxation values is present in IFP chronically after arthroscopic surgery and may be an indicator of adipose tissue fibrosis. (orig.)

  16. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

  17. Clinical outcomes of arthroscopic single and double row repair in full thickness rotator cuff tears

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    Ji Jong-Hun

    2010-01-01

    Full Text Available Background: There has been a recent interest in the double row repair method for arthroscopic rotator cuff repair following favourable biomechanical results reported by some studies. The purpose of this study was to compare the clinical results of arthroscopic single row and double row repair methods in the full-thickness rotator cuff tears. Materials and Methods: 22 patients of arthroscopic single row repair (group I and 25 patients who underwent double row repair (group II from March 2003 to March 2005 were retrospectively evaluated and compared for the clinical outcomes. The mean age was 58 years and 56 years respectively for group I and II. The average follow-up in the two groups was 24 months. The evaluation was done by using the University of California Los Angeles (UCLA rating scale and the shoulder index of the American Shoulder and Elbow Surgeons (ASES. Results: In Group I, the mean ASES score increased from 30.48 to 87.40 and the mean ASES score increased from 32.00 to 91.45 in the Group II. The mean UCLA score increased from the preoperative 12.23 to 30.82 in Group I and from 12.20 to 32.40 in Group II. Each method has shown no statistical clinical differences between two methods, but based on the sub scores of UCLA score, the double row repair method yields better results for the strength, and it gives more satisfaction to the patients than the single row repair method. Conclusions: Comparing the two methods, double row repair group showed better clinical results in recovering strength and gave more satisfaction to the patients but no statistical clinical difference was found between 2 methods.

  18. A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations

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    Jordan, R.W.; Naeem, R.; Srinivas, K.; Shyamalan, G. [Birmingham Heartlands Hospital, Birmingham (United Kingdom)

    2015-05-01

    The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations. A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries. Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83-0.95) and 0.94 (CI 0.9-0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44-0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14-0.86). The overall positive predictive value was 0.88 (CI 0.76-0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07-0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05-0.7). Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor. (orig.)

  19. EVALUATION OF RESULTS OF ARTHROSCOPIC BANKART REPAIR FOR POST TRAUMATIC ANTERIOR SHOULDER INSTABILITY

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    Mainak

    2015-08-01

    Full Text Available BACKGROUND: The study was to evaluate the surgical outcomes of arthroscopic repair of post - traumatic Bankart lesions with the use of suture anchors. Patients with >20% bony lesions, SLAP ( superior labral tear from anterior to posterior lesions and multi - directional instability were excluded. The patients were followed up for a period of minimum 4 years. MATERIALS AND ME THODS: We evaluated the results of arthroscopic Bankart repair with use of suture anchors in 35 patients with traumatic recurrent anterior instability of the shoulder. The mean age at operation was 25.71 years. The patients were evaluated pre - operatively a nd at follow - up using the UCLA (University of California Los Angeles shoulder scoring system and the modified Rowe scores, which were 6.2 and 29.3 respectively pre - operatively. RESULTS: The UCLA shoulder scoring system and the modified Rowe scores at foll ow - up were 32 and 72.57 respectively and both improvements were significant. The Modified Rowe Shoulder Scoring System showed 14 patients having excellent results, 12 patients good, 6 patients fair and 3 patients with poor results. One patient had subluxat ion and another had positive apprehension test. Five patients had discomfort/pain with arm in abducted and externally rotated position but negative apprehension test. Remaining 28 patients had negative apprehension test; no subluxation. Significant improve ments occurred for each motion tested for each follow up visit. CONCLUSION: We conclude that arthroscopic Bankart lesion repair with suture anchors is an effective surgical technique for the treatment of an isolated Bankart lesion having good results with respect to pain relief, stability and function.

  20. Arthroscopic repair of type II SLAP lesions: Clinical and anatomic follow-up

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    John N Trantalis

    2015-01-01

    Full Text Available Aims: The aim was to evaluate the clinical and anatomic outcome of arthroscopic repair of type II SLAP lesions. Materials and Methods: The senior author performed isolated repairs of 25 type II SLAP lesions in 25 patients with a mean age of 40.0 ± 12 years. All tears were repaired using standard arthroscopic suture anchor repair to bone. All patients were reviewed using a standardized clinical examination by a blinded, independent observer, and using several shoulder outcome measures. Patients were evaluated by magnetic resonance imaging arthrogram at a minimum of 1-year postoperatively. Statistical Analysis Used: Two-tailed paired t-test were used to determine significant differences in preoperative and postoperative clinical outcomes scores. In addition, a Fisher′s exact test was used. Results: At a mean follow-up of 54-month, the mean American Shoulder and Elbow Surgeons Shoulder Index (ASES scores improved from 52.1 preoperatively to 86.1 postoperatively (P < 0.0001 and the Simple Shoulder Test (SST scores from 7.7 to 10.6 (P < 0.0002. Twenty-two out of the 25 patients (88% stated that they would have surgery again. Of the 21 patients who had postoperative magnetic resonance imaging arthrographys (MRAs, 9 patients (43% demonstrated dye tracking between the labrum bone interface suggestive of a recurrent tear and 12 patients (57% had a completely intact repair. There was no significant difference in ASES, SST, and patient satisfaction scores in patients with recurrent or intact repairs. Conclusions: Arthroscopic repair of type II SLAP lesions demonstrated improvements in clinical outcomes. However, MRA imaging demonstrated 43% of patients with recurrent tears. MRA results do not necessarily correlate with clinical outcome.

  1. Arthroscopic resection of multiple ossifying tumors in the infrapatellar fat pad

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    Oshigiri Tsutomu

    2012-11-01

    Full Text Available Abstract A 49 year-old male visited a nearby clinic five years back with a complaint of pain in the right knee during exercise. Plain radiographs revealed absence of any anomalies. He began to feel a lumpy mass in his right knee two years back. The pain worsened, on imaging, an anomaly was identified in the infrapatellar fat pad of his right knee, and he was subsequently referred to our department where he was hospitalized. On examination, a mass extending on either side of the patellar tendon was identified along with rigid tenderness in that area. The knee’s range of motion was 0degrees-130degrees, and knee flexion was accompanied by pain. The results of blood tests were normal. A plain radiograph of the knee revealed multiple ossifying tumors at a site consistent with the infrapatellar fat pad. T1-weighted MRI exhibited low-signal intensity, while T2-weighted MRI exhibited a mosaic-shaped tumor. We performed arthroscopic surgery to excise the tumor. The patient resumed work shortly after surgery and did not experience any pain during the two year postoperative observation period. The joint’s range of motion improved to the extent that it was comparable with that of the left knee. No recurrence was observed on radiographic examination. In past studies, resection of similar tumors has been performed with an arthrotomy; however, we performed arthroscopic resection on our patient, who demonstrated a quick improvement in symptoms and range of motion after surgery. We believe that arthroscopic surgery is a feasible option to consider while treating such cases.

  2. Arthroscopic optical coherence tomography provides detailed information on articular cartilage lesions in horses.

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    te Moller, N C R; Brommer, H; Liukkonen, J; Virén, T; Timonen, M; Puhakka, P H; Jurvelin, J S; van Weeren, P R; Töyräs, J

    2013-09-01

    Arthroscopy enables direct inspection of the articular surface, but provides no information on deeper cartilage layers. Optical coherence tomography (OCT), based on measurement of reflection and backscattering of light, is a diagnostic technique used in cardiovascular surgery and ophthalmology. It provides cross-sectional images at resolutions comparable to that of low-power microscopy. The aim of this study was to determine if OCT is feasible for advanced clinical assessment of lesions in equine articular cartilage during diagnostic arthroscopy. Diagnostic arthroscopy of 36 metacarpophalangeal joints was carried out ex vivo. Of these, 18 joints with varying degrees of cartilage damage were selected, wherein OCT arthroscopy was conducted using an OCT catheter (diameter 0.9 mm) inserted through standard instrument portals. Five sites of interest, occasionally supplemented with other locations where defects were encountered, were arthroscopically graded according to the International Cartilage Repair Society (ICRS) classification system. The same sites were evaluated qualitatively (ICRS classification and morphological description of the lesions) and quantitatively (measurement of cartilage thickness) on OCT images. OCT provided high resolution images of cartilage enabling determination of cartilage thickness. Comparing ICRS grades determined by both arthroscopy and OCT revealed poor agreement. Furthermore, OCT visualised a spectrum of lesions, including cavitation, fibrillation, superficial and deep clefts, erosion, ulceration and fragmentation. In addition, with OCT the arthroscopically inaccessible area between the dorsal MC3 and P1 was reachable in some cases. Arthroscopically-guided OCT provided more detailed and quantitative information on the morphology of articular cartilage lesions than conventional arthroscopy. OCT could therefore improve the diagnostic value of arthroscopy in equine orthopaedic surgery. PMID:23810744

  3. Arthroscopic single-bundle reconstruction of posterior cruciate ligament with quadrupled hamstring tendon

    Institute of Scientific and Technical Information of China (English)

    SUN Lei; NING Zhi-jie; ZHANG Hui; TIAN Min; NING Ting-min

    2007-01-01

    Objective:To evaluate the technique and outcome of arthroscopic single-bundle reconstruction of posterior cruciate ligament (PCL) with quadrupled hamstring tendon. Methods:From April 2001 to October 2004,49 knees with PCL tears in 49 patients were verified with arthroscope in this department. Of them, 13 were combined with anterior cruciate ligament tears,14 with disruptions of the posterolateral corner,6 with ruptures of the posteromedial corner and medial collateral ligament,9 with lateral meniscus tears,5 with medial meniscus tears and 2 with popliteal vascular tears.All the damaged PCLs were reconstructed with single-bundle of autogenous quadrupled hamstring tendons under arthroscope.Biodegradable interference screws or blunt titanium interference screws were used for direct anatomic fixation of the reconstructed ligament. Results:After operation,no severe complications occurred at early stage in the 49 patients.All of them were followed up for 10-52 months with an average of 22.0 months±10.7 months.Lysholm score was remarkably improved from 30-60 ( mean:47.96 ± 8.16) preoperatively to 70-95 ( mean:89.08 ± 6.10) at the last postoperative follow-up (P < 0.01 ).Furthermore,there was a significant improvement in International Knee Documentation Committee (IKDC) score from abnormal ( Grade C) in 10 knees and severely abnormal ( Grade D ) in 39 preoperatively to normal ( Grade A) in 20,nearly normal ( Grade B) in 24 and abnormal in 5 at the last follow-up.Of the 49 patients,40 returned to the same activity level as before and 9 were under the level. Conclusions:Single-bundle reconstruction of PCL with quadrupled hamstring tendons has the advantage of minimal trauma in surgery and satisfactory outcome.

  4. Arthroscopic and computer-assisted high tibial osteotomy using standard total knee arthroplasty navigation software.

    Science.gov (United States)

    Thompson, Stephen R; Zabtia, Nazar; Weening, Bradley; Zalzal, Paul

    2013-05-01

    Opening-wedge high tibial osteotomy is an increasingly performed procedure for treatment of varus gonarthrosis and correction of malalignment during meniscal transplantation or cartilage restoration. Precise preoperative planning and meticulous surgical technique are required to achieve an appropriate mechanical axis correction. We describe our technique of arthroscopic and computer-assisted high tibial osteotomy using commonly available total knee arthroplasty navigation software as an intraoperative goniometer. We believe that our technique, by providing intraoperative real-time guidance of the degree of correction that is accurate and reliable, represents a useful tool for the surgeon who uncommonly performs high tibial osteotomy.

  5. Arthroscopic debridement and biological resurfacing of the glenoid in glenohumeral arthritis.

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    de Beer, Joe F; Bhatia, Deepak N; van Rooyen, Karin S; Du Toit, Donald F

    2010-12-01

    The purpose of this study was to analyse the intermediate-term results of an arthroscopic procedure to debride and resurface the arthritic glenoid, in a middle-aged population, using an acellular human dermal scaffold. Between 2003 and 2005, thirty-two consecutive patients underwent an arthroscopic debridement and biological glenoid resurfacing for glenohumeral arthritis. The diagnoses included primary osteoarthrosis (28 patients), arthritis after arthroscopic reconstruction for anterior instability (1 patient) and inflammatory arthritis (3 patients). All shoulders were assessed clinically using the Constant and Murley score, and results graded according to Neer's criteria. Statistical analysis was performed to determine significant parameters and associations. A significant improvement (P < 0.0001) in each parameter of the subjective evaluation component (severity of pain, limitation in daily living and recreational activities) of the Constant score was observed. The Constant and Murley score increased significantly (P < 0.0001) from a median of 40 points (range 26-63) pre-operatively to 64.5 (range 19-84) at the final assessment. Overall, the procedure was considered as "successful outcome" in 23 patients (72%) and as a "failure" in 9 patients (28%). According to Neer's criteria, the result was categorized as excellent in 9 (28%), satisfactory in 14 (44%) and unsatisfactory in 9 (28%). Within the unsatisfactory group, there were five conversions to prosthetic arthroplasty. A standard magnetic resonance imaging was performed on 22 patients in the successful outcome group; glenoid cartilage was identified in 12 (thick in 5, intermediate in 1, thin in 6) and could not be identified in 10 patients (complete/incomplete loss in 5, technical difficulties in 5). Overall, five complications included transient axillary nerve paresis, foreign-body reaction to biological material, inter-layer dissociation, mild chronic non-specific synovitis and post-traumatic contusion

  6. Torn discoid lateral meniscus treated with arthroscopic meniscectomy: observations in 62 knees

    Institute of Scientific and Technical Information of China (English)

    LU Ying; LI Qiang; HAO Jie

    2007-01-01

    Background Discoid lateral meniscus of the knee is common in Chinese population. There has been considerable debate about the best treatment for discoid lateral meniscus tears. The purpose of this study was to observe the effect of arthroscopic meniscectomy for the treatment of discoid lateral meniscus tears.Methods Between July 1999 and December 2004, arthroscopic meniscectomy was performed on 62 menisci of 57 patients with discoid lateral meniscus tears (52 unilateral, 5 bilateral). 41 menisci were "complete discoid meniscus", 21 "incomplete". According to the extent of the meniscus tears, partial meniscectomy was performed on 52 knees, total meniscectomy on 7 knees, and partial meniscectomy combined with meniscus suture on 3 knees through an arthroscope.After the operations, early rehabilitation training programs, including straight-leg-raising and range-of-motion exercises,were carried out. 51 patients were followed up for 1 year 2 months to 6 years 5 months (mean, 3 years 3 months), 6 patients were lost. Lysholm-Ⅱ scoring system was used to assess the function of the knee joints before the operation and during the follow-up.Results The operations on all the 62 knees were successful without complications. The patients could walk normally after completing the 2-week postoperation rehabilitation program. After 3-4 weeks they could lead a normal life and participate in a moderate amount of sports or other physical activities. The mean Lysholm-Ⅱ score was 89 (60-100)during the follow-up, which was significantly higher than that before the operation (50, range 34-74; P<0.01). 88% of the patients achieved excellent or good clinical results.Conclusions Arthroscopic meniscectomy is an alternative for treatment of discoid lateral meniscus tears with minimal traumatic effects. It can achieve early mobilization and a low complication rate, as well as the preservation of the meniscus structure and functions to the largest extent. In combination with proper

  7. Evaluation Of Range Of Motion After Arthroscopic Arthroloysis In Postoperative Arthrofibrosis Of The Knee

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    Moghtader Azadi G

    2003-07-01

    Full Text Available Arthrofibrosis continue to be a difficult complication of operative procedures of trauma about the knee. We present our experience in 8 cases of arthroscopic Arthrolysis between 1997 and 2001. in 3 Cases the etiology was prior Knee ligament surgery and 5 cases had sustained fractures about the knee. Technique begins with the liberation of the adhesions of suprapatellar Pouch, continues down both gutters , and ends with a cleaning of the notch where necessary. The result obtained are very satisfactory, with an average increase in the arc of mobility of 61 degrees."n 

  8. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje;

    2016-01-01

    clinics in Norway. PARTICIPANTS: 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. INTERVENTIONS: 12 week supervised exercise therapy alone or arthroscopic partial....... Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.Trial registration www.clinicaltrials.gov (NCT01002794)....

  9. Arthroscopic Excision of Juxta-articular Osteoid Osteoma of the Calcaneum

    Science.gov (United States)

    Tauheed, Mohammed; Korula, Ravi Jacob; Shankarnarayanan, Sriram

    2016-01-01

    Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques. PMID:27073769

  10. [Arthroscopic treatment of chondral lesions of the ankle joint. Evidence-based therapy].

    Science.gov (United States)

    Thomas, M; Jordan, M; Hamborg-Petersen, E

    2016-02-01

    Ankle sprains are the most relevant injuries of the lower extremities and can lead to damage to ligaments and osteochondral lesions. Up to 50 % of patients with a sprained ankle later develop a lesion of the cartilage in the ankle joint or an osteochondral lesion of the talus. This can lead to osteoarthritis of the injured ankle joint. Spontaneous healing is possible in all age groups in cases of a bone bruise in the subchondral bone but in isolated chondral injuries is only useful in pediatric patients. In many cases chondral and osteochondral injuries lead to increasing demarcation of the affected area and can result in progressive degeneration of the joint if not recognized in time. There also exist a certain number of osteochondral changes of the articular surface of the talus without any history of relevant trauma, which are collectively grouped under the term osteochondrosis dissecans. Perfusion disorders are discussed as one of many possible causes of these alterations. Nowadays, chondral and osteochondral defects can be treated earlier due to detection using very sensitive magnetic resonance imaging (MRI) and computed tomography (CT) techniques. The use of conservative treatment only has a chance of healing in pediatric patients. Conservative measures for adults should only be considered as adjuvant treatment to surgery.Based on a comprehensive analysis of the current literature, this article gives an overview and critical analysis of the current concepts for treatment of chondral and osteochondral injuries and lesions of the talus. With arthroscopic therapy curettage and microfracture of talar lesions are the predominant approaches or retrograde drilling of the defect is another option when the chondral coating is retained. Implantation of autologous chondral cells or homologous juvenile cartilage tissue is also possible with arthroscopic techniques. Osteochondral fractures (flake fracture) are usually performed as a mini-open procedure supported by

  11. The arthroscopic treatment of displaced tibial spine fractures in children and adolescents using Meniscus Arrows(A (R))

    NARCIS (Netherlands)

    Wouters, Diederick B.; de Graaf, Joost S.; Hemmer, Patrick H.; Burgerhof, Johannes G. M.; Kramer, William L. M.

    2011-01-01

    This article summarises the results of a newly developed technique that utilises Meniscus Arrows(A (R)) for the arthroscopic fixation of displaced tibial spine fractures in children and adolescents. Twelve tibial spine fractures in the knees of eleven children between 6 and 15 years old, with an ave

  12. Arthroscopic Latarjet and Capsular Shift (ALCS) procedure: a new "freehand" technique for anterior shoulder instability associated with significant bone defects.

    Science.gov (United States)

    Bhatia, Deepak N

    2015-03-01

    Anterior shoulder instability associated with significant bone loss has been described as "bony-instability," and this condition is usually treated with an anterior glenoid bone grafting procedure (Latarjet procedure). The Latarjet procedure involves transfer of the horizontal limb of the coracoid process along with the conjoint tendon to the anterior glenoid rim, and is traditionally performed as an open surgical procedure. Recently, an arthroscopic technique for the Latarjet procedure has been described; the technique necessitates the use of specialized instrumentation and involves excision of the entire anterior capsule to facilitate coracoid fixation. We describe a new "freehand" arthroscopic technique for the Latarjet procedure, and, in addition, a simultaneous capsular shift to further optimize mid and end range stability. This technique eliminates the use of additional instrumentation and can be done using routine arthroscopic instruments. Preliminary experience with this technique suggests that the arthroscopic Latarjet and capsular shift is a technically demanding procedure. Glenohumeral capsule can be preserved, and this should be attempted wherever possible to optimize stability. Additional specialized instrumentation would probably reduce surgical time; however, the procedure can be performed with routine instruments.

  13. Early rehabilitation affects functional outcomes and activities of daily living after arthroscopic rotator cuff repair: a case report.

    Science.gov (United States)

    Shimo, Satoshi; Sakamoto, Yuta; Tokiyoshi, Akinari; Yamamoto, Yasuhiro

    2016-01-01

    [Purpose] The effect of early rehabilitation protocols after arthroscopic rotator cuff repair is currently unknown. We examined short-term effects of early rehabilitation on functional outcomes and activities of daily living after arthroscopic rotator cuff repair. [Subject and Methods] An 82-year-old male fell during a walk, resulting in a supraspinatus tear. Arthroscopic rotator cuff repair was performed using a single-row technique. He wore an abduction brace for 6 weeks after surgery. [Results] From day 1 after surgery, passive range of motion exercises, including forward flexion and internal and external rotation were performed twice per day. Starting at 6 weeks after surgery, active range of motion exercises and muscle strengthening exercises were introduced gradually. At 6 weeks after surgery, his active forward flexion was 150°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 36 points. At 20 weeks after surgery, his active forward flexion was 120°, UCLA shoulder rating scale score was 34 points, and Quick Disabilities of the Arm, Shoulder, and Hand questionnaire disability/symptom score was 0 points. [Conclusion] These protocols are recommended to physical therapists during rehabilitation for arthroscopic rotator cuff repair to support rapid reintegration into activities of daily living. PMID:27064886

  14. Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee sur

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    Mohamed Abdulatif

    2015-07-01

    Conclusion: The combined use of femoral nerve block with IA or IV MgSO4 is associated with significant reduction of the intensity and duration of postoperative pain and postoperative analgesic requirements in patients undergoing arthroscopic knee surgery with the IA MgSO4 being superior to IV route of administration.

  15. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term?☆

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Checchia, Sérgio Luiz; Yonamine, Alexandre Maris

    2015-01-01

    Objective To evaluate whether the good and excellent functional results from arthroscopic repair of massive rotator cuff tears are maintained over the long term. Methods From the sample of the study conducted by our group in 2006, in which we evaluated the functional results from arthroscopic repair of massive rotator cuff tears, 35 patients were reassessed, 8 years after the first evaluation. The inclusion criteria were that these patients with massive rotator cuff tears operated by means of an arthroscopic technique, who participated in the previous study and achieved good or excellent outcomes according to the UCLA criteria. Patients whose results were not good or excellent in the first evaluation according to the UCLA criteria were excluded. Results Among the 35 patients reassessed, 91% of them continued to present good and excellent results (40% excellent and 51% good), while 3% presented fair results and 6% poor results. The time interval between the first and second evaluations was 8 years and the minimum length of follow-up since the immediate postoperative period was 9 years (range: 9–17 years), with an average of 11.4 years. Conclusion The good and excellent results from arthroscopic repair of massive rotator cuff tears were mostly maintained (91%), with the same level of function and satisfaction, even though 8 years had passed since the first assessment, with a follow-up period averaging 11.4 years. PMID:26962491

  16. Risk Factors for Recurrent Shoulder Dislocation Arthroscopically Managed with Absorbable Knotless Anchors

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    Raffaele Russo

    2014-01-01

    Full Text Available Purpose. To evaluate the clinical outcome and risk factors for recurrent dislocation after arthroscopic stabilization with absorbable knotless anchor. Methods. We treated 197 patients affected by anterior shoulder instability, either traumatic or atraumatic with the same arthroscopic suture technique. We recorded age at surgery and number and type of dislocations (traumatic/atraumatic. Of the 197 patients, 127 (65.4% were examined with a mean follow-up of 5.6 years (range: 25–108 months. Eighty-one shoulders were evaluated with the Rowe score and 48 with the Simple Shoulder Test (SST. Results. The mean Rowe score was 90.8, while the mean SST score was 10.9. Recurrence occurred in 10 cases (7.7% but only in 4 cases was atraumatic, which reduces the real recurrence rate to 3.1%. Patients with recurrence were significantly younger at surgery than patients who did not relapse (P=0.040. Moreover, neither the number (P=0.798 nor the type of shoulder instability (P=0.751, or the amount of glenoid bone loss (P=0.184 significantly affected the probability of recurrence. Conclusions. In a patient population with involuntary monodirectional anterior shoulder instability, use of absorbable knotless anchor was reliable and resulted in a good outcome. In this series the statistical significant risk factors for recurrent dislocation were age of patient.

  17. RELEVANCE OF ARTHROSCOPIC SYNOVIAL BIOPSY IN JOINT DISORDERS - A PROSPECTIVE STUDY

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    Kali Vara Prasad

    2015-10-01

    Full Text Available BACK GROUND : Synovial biopsy is considered as the gold standard in the diagnosis of various joint disorders and synovial diseases. But sometimes the definitive diagnosis is elusive only by doing biopsy then clinical, hematological and x - ray examinations will help. The advantage with arthroscopic synovial biopsy is that it is easy to perform, minimal discomfort to the patient and can be done at intervals if the diagnosis can n ot be made in the first examination. MATERIAL & METHODS : The present study was conducted in the Department of Orthopedics & Traumatology, Osmania General Hospital/ Medical College, Hyderabad. The duration of the study was from Sept 2012 to Sept 2014. CONCLUSIONS : Arthroscopic synovial biopsy is the mainstay in the management of Joint disorders and Synovial diseases. It is patient friendly and repeated procedures can be undertaken when the definitive diagnosis could not be established in the initial attempt, as is common in some cases of Non - specific synovitis, later being diagnosed either as Osteoarthritis or Rheumatoid Arthritis. This is the greatest advantage in using this procedure.

  18. Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis,

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    Alberto Naoki Miyazaki

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate the functional result from arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis, defined as incapacity to actively raise the arm above 90◦ , while complete passive elevation was possible.METHODS: we reevaluated 38 patients with a mean follow-up of 51 months (minimum of 24. We analyzed the pseudoparalysis reversion rate and the functional result obtained.RESULTS: according to the assessment criteria of the University of California in Los Angeles (UCLA, 31 (82% patients had good and excellent results, two (5% had fair results and five (13% had poor results. The mean active elevation went from 39◦ before the operation to 139◦ after the operation (p < 0.05; the mean active lateral rotation went from 30◦ to 48◦ (p < 0.05 and the mean active medial rotation went from level L3 to T12 (p < 0.05.CONCLUSION: arthroscopic repair of rotator cuff injuries produced good and excellent results in 82% of the cases and a statistically significant improvement of active range of motion, with reversion of the pseudoparalysis in 97.4% of the cases. It is therefore a good treatment option.

  19. Functional evaluation of arthroscopic treatment of SLAP lesions through the O’Brien portal☆

    Science.gov (United States)

    Rebouças, Fabiano; Pereira, Bruno Cesar; Rocha, Ricardo Dantas; Filardi, Cantídio Salvador; da Costa, Miguel Pereira; Filho, Romulo Brasil; Junior, Antonio Carlos Tenor

    2015-01-01

    Objective To evaluate the functional results from arthroscopic repair of SLAP lesions through the portal described by O’Brien. Methods A retrospective evaluation was conducted on 19 shoulders in 18 patients who underwent arthroscopic repair of SLAP lesions through the O’Brien portal between November 2007 and January 2012. Results Nineteen shoulders in 18 patients were evaluated: 16 male patients (84.2%) and three female patients (15.7%). The patients’ ages ranged from 27 to 40 years (mean of 34.3 years). There were 12 patients (63.1%) with injuries on the right shoulder, six (31.5%) with injuries on the left shoulder and one (5.2%) with bilateral injury. In relation to dominance, 13 patients (68.4%) presented the injury on the dominant limb and five (26.3%) were affected on the non-dominant limb. We observed that nine cases (47.3%) had SLAP lesions alone and 10 cases (52.6%) were related to glenohumeral instability. There was one case (5.2%) of recurrence of glenohumeral dislocation, but this patient chose not to undergo a new surgical intervention. According to the UCLA and ASES scales translated and adapted to the Portuguese language, 96% of the results were good or excellent. Conclusion The approach for treating SLAP lesions through the portal described by O’Brien et al. is easy to reproduce, with a high rate of good and excellent results and a low complication rate. PMID:26229936

  20. Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft.

    Science.gov (United States)

    Mei-Dan, Omer; Mann, Gideon; Steinbacher, Gilbert; Ballester, Soleda J; Cugat, Ramon Bertomeu; Alvarez, Pedro Diaz

    2008-01-01

    Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft.

  1. Massive bone loss from fungal infection after anterior cruciate ligament arthroscopic reconstruction.

    Science.gov (United States)

    Muscolo, D Luis; Carbo, Lisandro; Aponte-Tinao, Luis A; Ayerza, Miguel A; Makino, Arturo

    2009-09-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction.

  2. Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

    Directory of Open Access Journals (Sweden)

    Kenji Shirakura

    1995-01-01

    Full Text Available Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral, 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05. Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

  3. Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival.

    Science.gov (United States)

    van der Wal, Robert J P; Thomassen, Bregje J W; Swen, Jan-Willem A; van Arkel, Ewoud R A

    2016-07-01

    Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute ( 2 to  12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury.

  4. The global percutaneous shuttling technique tip for arthroscopic rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Bryan G. Vopat

    2014-05-01

    Full Text Available Most arthroscopic rotator cuff repairs utilize suture passing devices placed through arthro- scopic cannulas. These devices are limited by the size of the passing device where the suture is passed through the tendon. An alternative technique has been used in the senior author’s practice for the past ten years, where sutures are placed through the rotator cuff tendon using percutaneous passing devices. This technique, dubbed the global percutaneous shuttling technique of rotator cuff repair, affords the placement of sutures from nearly any angle and location in the shoulder, and has the potential advantage of larger suture bites through the tendon edge. These advantages may increase the area of tendon available to compress to the rotator cuff footprint and improve tendon healing and outcomes. The aim of this study is to describe the global percutaneous shuttling (GPS technique and report our results using this method. The GPS technique can be used for any full thickness rotator cuff tear and is particularly useful for massive cuff tears with poor tissue quality. We recently followed up 22 patients with an average follow up of 32 months to validate its usefulness. American Shoulder and Elbow Surgeons scores improved significantly from 37 preoperatively to 90 postoperatively (P<0.0001. This data supports the use of the GPS technique for arthroscopic rotator cuff repair. Further biomechanical studies are currently being performed to assess the improvements in tendon footprint area with this technique.

  5. Arthroscopically assisted treatment for Schatzker type I-V tibial plateau fractures

    Institute of Scientific and Technical Information of China (English)

    DUAN Xiao-jun; YANG Liu; GUO Lin; CHEN Guang-xing; DAI Gang

    2008-01-01

    Objective: To report the clinical outcome of arthroscopically assisted treatment for tibial plateau fractures.Methods: A total of 39 patients with tibial plateau fractures were treated by arthroscopic fixation from February 2002 to December 2005,including 11 patients with bony avulsion of the anterior cruciate ligament and 19 with meniscal injury.There were 4 cases of type I fracture,12 type II,9 type III,12 type IV and 2 type V according to Schatzker criteria.Firstly,the combined injuries were treated.Then the plateau fractures with the displacement over 3 mm or more were reduced and fixed.Finally,the internal fixation was observed by X-ray equipment.Postoperative management was early motion and delayed weight bearing.Results: All the fractures healed in 3 or 4 months.All patients were followed up for 1 to 5 years after operation.No case had severe complications,such as poor wound healing,infection,osteofascial compartment syndrome and osteoarthritis.According to the Rasmussen scoring system,36 cases obtained excellent or good results and the other 3 cases had moderate clinical results.The average score was 26 ± 3.Conclusions: As an adjuvant treatment of intraarticular fractures such as tibial plateau fracture,arthroscopy has many advantages.It can treat associated intraarticular soft tissue components,visualize the chondral surface reduction,lavage the hematoma and smaller loose fragments,decrease soft tissue dissection,reduce the risk of scarring and promote rapid recovery.

  6. Analgesic effects of intra-articular fentanyl, pethidine and dexamethasone after knee arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    H Saryazd

    2006-07-01

    Full Text Available BACKGROUND: Many different methods have been used in an effort to provide adequate analgesia after knee arthroscopic surgery. In this study analgesic effect of intra-articular fentanyl, pethidine and dexamethasone was compared. METHODS: In a double blind randomized study 48 male patients undergoing knee arthroscopic meniscectomy were allocated to groups receiving intra-articular fentanyl 50 µg or pethidine 20 mg or dexamethasone 8 mg at the end of arthroscopy during general aesthesia. Postoperative pain scores using visual analogue scale were measured and also analgesic requirements and the time of ability to walk were recorded. RESULTS: Pain scores at one, two, six and 24 h after intra-articular injection were not significantly different for fentanyl and pethidine but were higher significantly for dexamethasone at all four mentioned times. The mean average time of ability to walk was significantly longer for dexamethasone. The analgesic requirements during the first 24 h after intraarticular injection were significantly greater only for dexamethasone too. CONCLUSION: Better postoperative analgesia, less pain score and shorter time to walk were achieved by fentanyl and pethidine in comparison to dexamethasone but the results were not significantly different between fentanyl group and pethidine. KEYWORDS: Arthroscopy, opioid, pain.

  7. Technical guide and tips on the all-arthroscopic Latarjet procedure.

    Science.gov (United States)

    Rosso, Claudio; Bongiorno, Vito; Samitier, Gonzalo; Dumont, Guillaume D; Szöllösy, Gregor; Lafosse, Laurent

    2016-02-01

    Shoulder dislocation and subsequent anterior instability is a common problem in young athletes. The arthroscopic Bankart repair was originally described by Morgan et al. in 1987. The procedure has benefited from many technical advancements over the past 25 years and currently remains the most commonly utilized procedure in the treatment of anterior glenohumeral instability without glenoid bone loss. Capsulolabral repair alone may not be sufficient for treatment of patients with poor capsular tissue quality and significant bony defects. In the presence of chronic anterior glenoid bony defects, a bony reconstruction should be considered. The treatment of anterior shoulder instability with transfer of the coracoid and attached conjoint tendon such as the Latarjet procedure has provided reliable results. The arthroscopic Latarjet procedure was described in 2007 by the senior author, who has now performed the procedure over 450 times. The initial surgical technique has evolved considerably since its introduction, and this article presents a comprehensive update on this demanding but well-defined procedure. This article reviews technical tips to help the surgeon perform the surgery more smoothly, navigate through challenging situations, and avoid potential complications. Level of evidence V.

  8. Functional evaluation of arthroscopic treatment of SLAP lesions through the O'Brien portal

    Directory of Open Access Journals (Sweden)

    Fabiano Rebouças

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the functional results from arthroscopic repair of SLAP lesions through the portal described by O'Brien.METHODS: A retrospective evaluation was conducted on 19 shoulders in 18 patients who underwent arthroscopic repair of SLAP lesions through the O'Brien portal between November 2007 and January 2012.RESULTS: Nineteen shoulders in 18 patients were evaluated: 16 male patients (84.2% and three female patients (15.7%. The patients' ages ranged from 27 to 40 years (mean of 34.3 years. There were 12 patients (63.1% with injuries on the right shoulder, six (31.5% with injuries on the left shoulder and one (5.2% with bilateral injury. In relation to dominance, 13 patients (68.4% presented the injury on the dominant limb and five (26.3% were affected on the non-dominant limb. We observed that nine cases (47.3% had SLAP lesions alone and 10 cases (52.6% were related to glenohumeral instability. There was one case (5.2% of recurrence of glenohumeral dislocation, but this patient chose not to undergo a new surgical intervention. According to the UCLA and ASES scales translated and adapted to the Portuguese language, 96% of the results were good or excellent.CONCLUSION: The approach for treating SLAP lesions through the portal described by O'Brien et al. is easy to reproduce, with a high rate of good and excellent results and a low complication rate.

  9. Retrospective Analysis of Arthroscopic Superior Labrum Anterior to Posterior Repair: Prognostic Factors Associated with Failure

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank

    2013-01-01

    Full Text Available Background. The purpose of this study was to report on any prognostic factors that had a significant effect on clinical outcomes following arthroscopic Type II SLAP repairs. Methods. Consecutive patients who underwent arthroscopic Type II SLAP repair were retrospectively identified and invited to return for follow-up examination and questionnaire. Statistical analysis was performed to determine associations between potential prognostic factors and failure of SLAP repair as defined by ASES of less than 50 and/or revision surgery. Results. Sixty-two patients with an average age of years met the study criteria with a mean followup of 3.3 years. There were statistically significant improvements in mean ASES score, forward elevation, and external rotation among patients. Significant associations were identified between ASES score less than 50 and age greater than 40 years; alcohol/tobacco use; coexisting diabetes; pain in the bicipital groove on examination; positive O’Brien’s, Speed’s, and/or Yergason’s tests; and high levels of lifting required at work. There was a significant improvement in ASES at final followup. Conclusions. Patients younger than 20 and overhead throwers had significant associations with cases requiring revision surgery. The results from this study may be used to assist in patient selection for SLAP surgery.

  10. Technical guide and tips on the all-arthroscopic Latarjet procedure.

    Science.gov (United States)

    Rosso, Claudio; Bongiorno, Vito; Samitier, Gonzalo; Dumont, Guillaume D; Szöllösy, Gregor; Lafosse, Laurent

    2016-02-01

    Shoulder dislocation and subsequent anterior instability is a common problem in young athletes. The arthroscopic Bankart repair was originally described by Morgan et al. in 1987. The procedure has benefited from many technical advancements over the past 25 years and currently remains the most commonly utilized procedure in the treatment of anterior glenohumeral instability without glenoid bone loss. Capsulolabral repair alone may not be sufficient for treatment of patients with poor capsular tissue quality and significant bony defects. In the presence of chronic anterior glenoid bony defects, a bony reconstruction should be considered. The treatment of anterior shoulder instability with transfer of the coracoid and attached conjoint tendon such as the Latarjet procedure has provided reliable results. The arthroscopic Latarjet procedure was described in 2007 by the senior author, who has now performed the procedure over 450 times. The initial surgical technique has evolved considerably since its introduction, and this article presents a comprehensive update on this demanding but well-defined procedure. This article reviews technical tips to help the surgeon perform the surgery more smoothly, navigate through challenging situations, and avoid potential complications. Level of evidence V. PMID:24817106

  11. Massive bone loss from fungal infection after anterior cruciate ligament arthroscopic reconstruction.

    Science.gov (United States)

    Muscolo, D Luis; Carbo, Lisandro; Aponte-Tinao, Luis A; Ayerza, Miguel A; Makino, Arturo

    2009-09-01

    Although there are numerous reports of septic pyogenic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction, there is limited information regarding the outcomes of fungal infection. We determined the outcomes of six patients with mycotic infection after regular ACL reconstruction. There were four males and two females with a mean age of 33 years. We determined the number of procedures performed, bone loss originating to control infection, and final reconstruction in these patients. An average of five arthroscopic lavage procedures had been performed at the referring centers. Fungal infection was diagnosed based on pathologic samples; five infections were the result of mucormycosis and one was Candida. After final débridement, the mean segmental bone loss was 12.8 cm. All patients were treated with intravenous antifungal coverage and cement spacers before final reconstruction. At final followup, all patients were free of clinical infection. Three had reconstruction with an allograft-prosthesis composite, two with hemicylindrical allografts, and one with an intercalary allograft arthrodesis. Despite the extremely unusual presentation of this complication, surgeons should be aware of potential and catastrophic consequences of this severe complication after ACL reconstruction. PMID:19190972

  12. Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft.

    Science.gov (United States)

    Mei-Dan, Omer; Mann, Gideon; Steinbacher, Gilbert; Ballester, Soleda J; Cugat, Ramon Bertomeu; Alvarez, Pedro Diaz

    2008-01-01

    Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft. PMID:17684731

  13. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Yong-Chan; Kim, Jae Yoon [Chung-Ang University College of Medicine, Department of Orthopaedic Surgery, Seoul (Korea, Republic of); Choi, Jung-Ah; Lee, Guen Young; Kang, Heung Sik [Seoul National University Bundang Hospital, Departments of Radiology, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam (Korea, Republic of); Lee, Young-Kyun; Koo, Kyung-Hoi [Seoul National University Bundang Hospital, Orthopaedic Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2013-05-15

    The purpose of this study was first, to determine the sensitivity, specificity, and accuracy of MDCT arthrography (CTA) for the diagnosis of acetabular labral tear and sulcus; second, to correlate tear types using the Lage classification system on CTA compared with the arthroscopic classification; and third, to correlate CTA localization with arthroscopic localization. Direct CTA was performed using 16- or 64-slice MDCT in 126 hips (124 patients) who had chronic groin pain and positive impingement test. Images were reviewed and evaluated by two experienced musculoskeletal radiologists preoperatively. CTA findings were compared with arthroscopic findings in 58 hips (56 patients) under consensus by two orthopedic surgeons. Forty-one of the 58 hips were diagnosed as labral tears on CT arthrography. Forty-three of the 58 hips were shown to have a labral tear on arthroscopy. Sensitivity, specificity, and accuracy for detecting labral tear and sulcus by CTA were 90.7%, 86.7%, and 89.7%, and 93.8%, 97.6% and 96.6% respectively for observer 1, and 90.7% and 80.0%, 87.9% and 87.5%, 95.2%, and 93.1 % respectively for observer 2. Thirty-five out of 41 hips (85%) that were diagnosed with labral tear on CTA correlated substantially with arthroscopic Lage classification (kappa coefficient = 0.65). CTA and arthroscopic findings showed similar distribution patterns of the tears with most lesions located in antero- and postero-superior areas (p = 0.013). Direct CT arthrography using MDCT may be a useful diagnostic technique in the detection of acetabular labral tear. (orig.)

  14. Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results

    OpenAIRE

    Gökkuş, Kemal; Aydın, Ahmet Turan

    2014-01-01

    Objectives: The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients. Methods: 56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidri...

  15. Tratamento artroscópico do impacto femoroacetabular Arthroscopic treatment of femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Giancarlo C. Polesello

    2009-06-01

    Full Text Available OBJETIVOS: O propósito deste estudo é avaliar os resultados em curto prazo do tratamento artroscópico do impacto femoroacetabular. A hipótese é a de que os resultados do tratamento artroscópico são favoráveis. MÉTODOS: Entre agosto de 2003 e agosto de 2007, 28 quadris foram submetidos ao tratamento do impacto femoroacetabular pela via artroscópica. A idade média dos pacientes foi de 34 anos, com média de seguimento de 27 meses. Quanto à melhora clínica, os pacientes foram avaliados pré e pósoperatoriamente pelo Harris Hip Score (HHS modificado por Byrd. Os pacientes foram avaliados pré e pós-operatoriamente em relação à rotação interna do quadril acometido. Os valores obtidos nos índices acima foram analisados estatisticamente através do método de Wilcoxon para a avaliação de variáveis não paramétricas. RESULTADOS: O Harris Hip Score médio pré-operatório foi de 54,2 e o pós-operatório, de 94,8 (p OBJECTIVE: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable. METHODS: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy. The mean age was 34 years, with mean follow-up period of 27 months. Clinical results were graded with the modified Harris hip score, which was measured pre-and postoperatively. Patients had also their internal rotation analyzed. These parameters were calculated by using Wilcoxon's t test for analysis of nonparametric paired samples performed. RESULTS: The mean preoperative Harris Hip Score was 54.2, improving to 94.8 postoperatively (p<0,001. The mean increase was 37.5 points. We had 4 good results (15% and 24 excellent results (85%. Preoperatively, the patients had a mean internal rotation of 17º, and, postoperatively, 36º. The average internal rotation increase was 19º (p<0,001. CONCLUSIONS

  16. Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach

    International Nuclear Information System (INIS)

    The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopy-guided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of ≥2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after

  17. A case of unusual septic knee arthritis with Brucella abortus after arthroscopic meniscus surgery.

    Science.gov (United States)

    Lee, Keun Hwa; Kang, Hyunseong; Kim, Taejung; Choi, Sungwook

    2016-01-01

    We present a 51-year-old male patient with Brucella abortus septic arthritis in the right knee following arthroscopic meniscus surgery. He had eaten a traditional dish of raw minced cattle conceptus (bovine fetus) that was prepared after the cow was slaughtered. Despite treatment with empirical antibiotics and debridement of the postoperative surgical wound, the infection persisted without improvement. Polymerase chain reaction sequencing identified Brucella abortus from tissue samples obtained from the patient. After confirmation of the diagnosis of brucellar infection, antibiotics were replaced with doxycycline and rifampin, which were used for 4 months. In patients with a non-specific arthralgia who eat raw meat or live close to animals, it is important to consider the possibility of septic arthritis due to infection with Brucella spp.

  18. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Monu, J.U.V. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pruett, S. [Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Vanarthos, W.J. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pope, T.L. Jr. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States)

    1994-10-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  19. Anatomical reference point for harvesting a flexor graft during arthroscopic reconstruction of the anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Clécio de Lima Lopes

    2015-04-01

    Full Text Available OBJECTIVES: To evaluate the prevalence of a vascular network adjacent to the insertion of the pes anserinus, so that it could be used as an anatomical reference point to facilitate harvesting flexor grafts for arthroscopic reconstruction of the anterior cruciate ligament (ACL.METHODS: Thirty patients with ACL tears who were going to undergo ACL reconstruction using the tendons of the semitendinosus and gracilis muscles as grafts were selected randomly. During the harvesting of these tendons, the presence or absence of this anatomical reference point was noted.RESULTS: All the patients presented a vascular network of greater or lesser diameter.CONCLUSION: The vascular network seems to be a good reference point during harvesting of the tendons of the semitendinosus and gracilis muscles, for facilitating graft harvesting.

  20. Anaesthetic management of shoulder arthroscopic repair in Parkinson′s disease with deep brain stimulator

    Directory of Open Access Journals (Sweden)

    Ranju Gandhi

    2014-01-01

    Full Text Available We describe the anaesthetic management of arthroscopic repair for complete rotator cuff tear of shoulder in a 59-year-old female with Parkinson′s disease (PD with deep brain stimulator (DBS using a combination of general anaesthesia with interscalene approach to brachial plexus block. The DBS consists of implanted electrodes in the brain connected to the implantable pulse generator (IPG normally placed in the anterior chest wall subcutaneously. It can be programmed externally from a hand-held device placed directly over the battery stimulator unit. In our patient, IPG with its leads was located in close vicinity of the operative site with potential for DBS malfunction. Implications of DBS in a patient with PD for shoulder arthroscopy for anaesthesiologist are discussed along with a brief review of DBS.

  1. Graft infection following arthroscopic anterior cruciate ligament reconstruction: a report of four cases.

    Science.gov (United States)

    Wee, James; Lee, Keng Thiam

    2014-04-01

    Septic arthritis following arthroscopic anterior cruciate ligament reconstruction (ACL) is a rare complication and associated with severe morbidity. Its risk factors include (1) concomitant procedures during the reconstruction, (2) previous knee surgery, (3) allograft usage, (4) peri-operative wound contamination, and (5) presence of intra-articular foreign bodies. We present a series of 3 men and one woman aged 22 to 35 years who developed septic arthritis following ACL reconstruction. The risk factors identified were local infection (n=2), previous ipsilateral knee surgery (n=2), and the use of an allograft (n=1). All patients underwent emergency knee washout and debridement with graft retention within 24 hours, together with a course of intravenous antibiotic therapy. All the patients achieved eradication of their infections (with intact ACL grafts) and satisfactory functional outcome at a mean follow-up of 32 (range, 25-45) months.

  2. Arthroscopic tibiotalocalcaneal arthrodesis in neurological pathologies: outcomes after at least one year of follow up.

    Science.gov (United States)

    Mencière, Maxime-Louis; Ferraz, Linda; Mertl, Patrice; Vernois, Joël; Gabrion, Antoine

    2016-03-01

    The main complications of open tibiotalocalcaneal arthrodesis are wound healing disorders and nonunion. Our hypothesis was that arthroscopy and interlocking intramedullary nailing decrease these complications. We retrospectively reviewed six patients (mean age: 58 years; mean preoperative Kitaoka score: 51/100) having undergone arthroscopic tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing between January and November 2011 for equinus deformity of the hindfoot and subtalar instability of neurological origin. Postoperative pain disappeared completely in four cases, one patient presented some pain associated with projection of the proximal locking screw head under the skin and the remaining patient presented fibular tendinitis that resolved after infiltration of anti-inflammatory drugs. The mean postoperative Kitaoka score was 64/100. None of the patients presented any wound healing complications or nonunion. The observed incidence of wound complications and bone consolidation disorders after tibiotalocalcaneal arthrodesis was lower than the ones reported for open tibiotalocalcaneal arthrodesis. Level of clinical evidence IV: retrospective case series. PMID:26984662

  3. Arthroscopic Ankle Arthrodesis for Treating Osteoarthritis in a Patient with Kashin-Beck Disease

    Directory of Open Access Journals (Sweden)

    Kenjiro Iwasa

    2014-01-01

    Full Text Available Kashin-Beck disease (KBD is an endemic degenerative osteoarthritis. Death of cartilage and growth plate is the pathologic feature; therefore, KBD involves skeletal deformity and often results in osteoarthritis. Deficiency of selenium, high humic acid levels in water, and fungi on storage gains are considered the cause of KBD. The most frequently involved joints are ankles, knees, wrists, and elbows and symptoms are pain and limited motions of those joints. The main treatments for KBD are rehabilitation and osteotomy to correct the deformities because preventive treatment has not been established. In this report, we present a case of ankle osteoarthritis due to KBD and first describe arthroscopic ankle arthrodesis for treating osteoarthritis of KBD.

  4. The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy

    DEFF Research Database (Denmark)

    Dempsey, Alasdair R.; Wang, Yuanyuan; Thorlund, Jonas Bloch;

    2013-01-01

    osteoarthritis at arthroscopic partial medial meniscectomy, underwent gait analysis and MRI on the operated knee once for each sub-cohort of 3 months, 2 years, or 4 years post-surgery. Cartilage volume, cartilage defects, and bone size were assessed from the MRI using validated methods. The 1st peak in the knee...... adduction moment, knee adduction moment impulse, 1st peak in the knee flexion moment, knee extension range of motion, and the heel strike transient from the vertical ground reaction force trace were identified from the gait data. Results Increased knee stance phase range of motion was associated......Purpose To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy. Methods For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee...

  5. Arthroscopic Removal of Symptomatic Proximal Humerus Locking Plates With Bone-Void Filler Augmentation.

    Science.gov (United States)

    Voleti, Pramod B; Camp, Christopher L; Sinatro, Alec L; Dines, Joshua S

    2016-04-01

    Open reduction internal fixation of proximal humerus fractures is often accomplished with proximal humerus locking plates. While these plates have a good track record, they can become symptomatic and require removal once the fracture has healed. Open hardware removal is associated with a number of additional risks to the patient, including infection, scarring, nerve damage, and blood loss. In addition, the recovery time after open hardware removal may be prolonged, thereby predisposing the patient to postoperative stiffness. The purpose of this article is to describe a technique for removing proximal humerus locking plates arthroscopically. Although technically demanding, the benefits of this technique include smaller incisions, quicker recovery time, decreased risk of infection, and reduced blood loss. Arthroscopy also provides the surgeon with the ability to address concomitant intra-articular pathology at the time of surgery. Additionally, we use a bone-void filler to reduce the risk of fracture through stress caused by previous screw holes. PMID:27462532

  6. Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

    DEFF Research Database (Denmark)

    Rasmussen, S; Hjorth Jensen, C

    2002-01-01

    A consecutive series of 105 patients with a median age of 35 (16-62) years who were operated on with arthroscopic resection for impingement of the ankle using standardized technique without distraction is presented. All patients complained of painful dorsiflexion and had failed to respond...... to conservative treatment. A total of 177 diagnoses were found, soft tissue impingement or synovitis in 89, anterior bony impingement in 44, chondral lesion in 20, loose bodies in 16 and osteoarthritis in eight. At follow-up after 2 years, 65 patients were pain free while 28 patients had experienced reduction...... synovectomy and intravenous antibiotics. In one patient persistent symptoms were recorded. Ankle arthroscopy yielded good results in the treatment of anterior impingement of the ankle as it effectively reduced pain and enhanced function....

  7. Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

    DEFF Research Database (Denmark)

    Werner, Mads U; Duun, Preben; Kraemer, Otto;

    2003-01-01

    thresholds were higher during the second burn injury in patients (P 0.8), secondary hyperalgesia areas (P > 0.1), mechanical and thermal pain perception (P > 0.1), or mechanical and thermal pain......BACKGROUND: Experimental studies suggest that surgical injury may up- or down-regulate nociceptive function. Therefore, the aim of this clinical study was to evaluate the effect of elective arthroscopically assisted knee surgery on nociceptive responses to a heat injury. METHODS: Seventeen patients...... scheduled to undergo repair of the anterior cruciate ligament and 16 healthy controls were studied. The first burn injury was induced 6 days before surgery, and the second burn was induced 1 day after surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min) placed on the medial aspect of the calf...

  8. Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

    DEFF Research Database (Denmark)

    Werner, Mads U; Duun, Preben; Kraemer, Otto;

    2003-01-01

    thresholds were higher during the second burn injury in patients (P injury (P > 0.8), secondary hyperalgesia areas (P > 0.1), mechanical and thermal pain perception (P > 0.1), or mechanical and thermal pain......BACKGROUND: Experimental studies suggest that surgical injury may up- or down-regulate nociceptive function. Therefore, the aim of this clinical study was to evaluate the effect of elective arthroscopically assisted knee surgery on nociceptive responses to a heat injury. METHODS: Seventeen patients...... scheduled to undergo repair of the anterior cruciate ligament and 16 healthy controls were studied. The first burn injury was induced 6 days before surgery, and the second burn was induced 1 day after surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min) placed on the medial aspect of the calf...

  9. Graft infection following arthroscopic anterior cruciate ligament reconstruction: a report of four cases.

    Science.gov (United States)

    Wee, James; Lee, Keng Thiam

    2014-04-01

    Septic arthritis following arthroscopic anterior cruciate ligament reconstruction (ACL) is a rare complication and associated with severe morbidity. Its risk factors include (1) concomitant procedures during the reconstruction, (2) previous knee surgery, (3) allograft usage, (4) peri-operative wound contamination, and (5) presence of intra-articular foreign bodies. We present a series of 3 men and one woman aged 22 to 35 years who developed septic arthritis following ACL reconstruction. The risk factors identified were local infection (n=2), previous ipsilateral knee surgery (n=2), and the use of an allograft (n=1). All patients underwent emergency knee washout and debridement with graft retention within 24 hours, together with a course of intravenous antibiotic therapy. All the patients achieved eradication of their infections (with intact ACL grafts) and satisfactory functional outcome at a mean follow-up of 32 (range, 25-45) months. PMID:24781628

  10. When should the external approach be resorted to in the arthroscopic treatment of perimeniscal cyst?

    Directory of Open Access Journals (Sweden)

    Bombaci Hasan

    2016-01-01

    Full Text Available Introduction: Meniscal cysts very often cause meniscal tears and especially when it is peripheral, some of the healthy parts of meniscus might be needlessly sacrificed. In particular conditions, extraarticular approaches might save some menisci. In the present study, we evaluated the conditions which required using the extraarticular approach in addition to the arthroscopic procedure, to maximally preserve the meniscus. Methods: Eight patients with perimeniscal cysts were evaluated retrospectively. One cyst was localized within the medial meniscus and seven in the lateral meniscus. The mean age was 36.13 (range; 19–63 years, mean follow-up time, 27.3 (range; 12–47 months. Patients were evaluated by using a Visual Analogue Score (VAS to measure pain relief and “Lysholm score” to measure functional improvement. In all patients except one, in which the cystic cavity was connected with the joint at the periphery of the meniscus, the cyst was drained from the intraarticular opening. When the cyst was too large (three cases and in one case where a large amount of meniscus was preserved for reasons mentioned above, additional extraarticular drainage was carried out. Results: The mean preoperative and postoperative VAS were 6 (range; 2–8 and 1.55 (range; 0–3 (p = 0.00058 and Lysholm scores were 64.75 (range; 48–86 and 93.11 (range; 80–100 (p = 0.0014, respectively. Discussion: In cysts, which have very limited or no connection with the joint on the most peripheral region of the meniscus and/or are larger than the meniscus height, extraarticular drainage of the cyst might produce unnecessary meniscal loss and function. In the extraarticular drainage, scrapping the walls of the cyst, while inspecting with an arthroscope, reduces recurrence of the cyst.

  11. Arthroscopic Patelloplasty and Circumpatellar Denervation for the Treatment of Patellofemoral Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Gang Zhao; Yujie Liu; Bangtuo Yuan; Xuezhen Shen; Feng Qu; Jiangtao Wang; Wei Qi

    2015-01-01

    Background:Patellofemoral osteoarthritis commonly occurs in older people,often resulting in anterior knee pain and severely reduced quality of life.The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA).Methods:A total of 156 PFOA patients (62 males,94 females; ages 45-81 years,mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study.Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs,squatting down,or standing up.PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation.The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores.The therapeutic effects were graded by classification of the degree of cartilage defect.Results:A total of 149 cases were successfully followed up for 14.8 months,on average.The incisions healed well,and no complications occurred.After surgery,the average Lysholm score improved from 73.29 to 80.93,and the average Kujala score improved from 68.34 to 76.48.This procedure was highly effective for patients with cartilage defects Ⅰ-Ⅲ but not for patients with cartilage defect Ⅳ.Conclusions:For PFOA patients,this procedure is effective for significantly relieving anterior knee pain,improving knee joint function and quality of life,and deferring arthritic progression.

  12. Development of an Arthroscopic Joint Capsule Injury Model in the Canine Shoulder.

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    David Kovacevic

    Full Text Available The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle strength and shoulder function. To facilitate study of possible biologic mechanisms involved in early degenerative changes to rotator cuff muscle and tendon tissues, the objective of this study was to develop a joint capsule injury model in the canine shoulder using arthroscopy.Arthroscopic surgical methods for performing a posterior joint capsulectomy in the canine shoulder were first defined in cadavers. Subsequently, one canine subject underwent bilateral shoulder joint capsulectomy using arthroscopy, arthroscopic surveillance at 2, 4 and 8 weeks, and gross and histologic examination of the joint at 10 weeks.The canine subject was weight-bearing within eight hours after index and follow-up surgeries and had no significant soft tissue swelling of the shoulder girdle or gross lameness. Chronic synovitis and macroscopic and microscopic evidence of pathologic changes to the rotator cuff bony insertions, tendons, myotendinous junctions and muscles were observed.This study demonstrates feasibility and proof-of-concept for a joint capsule injury model in the canine shoulder. Future work is needed to define the observed pathologic changes and their role in the progression of rotator cuff disease. Ultimately, better understanding of the biologic mechanisms of early progression of rotator cuff disease may lead to clinical interventions to halt or slow this process and avoid the more advanced and often irreversible conditions of large tendon tears with muscle fatty atrophy.

  13. Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

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    Fritz Thorey

    2013-09-01

    Full Text Available An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i the feasibility of placing the AMIC in the different zones of the hip joint and ii check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm and 2/24 showed major displacement (>3 mm. None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone.

  14. Comparison of Bristow procedure and Bankart arthroscopic method as the treatment of recurrent shoulder instability

    Directory of Open Access Journals (Sweden)

    Abolghasem Zarezade

    2014-01-01

    Full Text Available Background: Anterior shoulder dislocation is the most common major joint dislocation. In patients with recurrent shoulder dislocation, surgical intervention is necessary. In this study, two methods of treatment, Bankart arthroscopic method and open Bristow procedure, were compared. Materials and Methods: This clinical trial survey had been done in the orthopedic department of Alzahra and Kashani hospitals of Isfahan during 2008-2011. Patients with recurrent anterior shoulder dislocation who were candidates for surgical treatment were randomly divided into two groups, one treated by Bankart arthroscopic technique and the other treated by Bristow method. All the patients were assessed after the surgery using the criteria of ROWE, CONSTANT, UCLA, and ASES. Data were analyzed by SPSS software. Results: Six patients (16.22% had inappropriate condition with ROWE score (score less than 75; of them, one had been treated with Bristow and five with Bankart (5.26 vs. 27.78. Nine patients (24.32% had appropriate condition, which included six from Bristow group and three treated by Bankart technique (31.58 vs. 16.67. Finally, 22 patients (59.46% showed great improvement with this score, which included 12 from Bristow and 10 from Bankart groups (63.16 vs. 55.56. According to Fisher′s exact test, there were no significant differences between the two groups (P = 0.15. Conclusion: The two mentioned techniques did not differ significantly, although some parameters such as level of performance, pain intensity, use of analgesics, and range of internal rotation showed more improvement in Bristow procedure. Therefore, if there is no contraindication for Bristow procedure, it is preferred to use this method.

  15. [Arthroscopic sub-acromial decompression. Comments on indications and surgical technique].

    Science.gov (United States)

    Hartig, A; Rojczyk, M

    1993-02-01

    Between January 1989 and December 1991 614 arthroscopic subacromial decompressions were performed for impingement syndromes. The first 100 cases represented our learning curve. The first 74 of the remaining 514 cases were available for evaluation and form the basis of the results presented here. Twenty (27.02%) patients were rated stage II in Neer's classification and 54 (72.98%) were rated stage III, 33 (44.59%) of them with a small full-thickness tear (less than 1 cm) and 21 (28.37%) with larger defects. Patients were evaluated pre- and postoperatively utilizing the ULCA shoulder score. The average follow-up was 7.9 months. The overall results were satisfactory in 67 cases (90.5%) and unsatisfactory in 7 cases (9.5%). Within the satisfactory group, 28 results (37.8%) were rated excellent and 39 (52.7%) were rated good. In the unsatisfactory group four results (5.4%) were rated fair and three (4.1%) poor. The results in advanced stage III (n = 21), with an average follow-up of 8.4 months, were satisfactory in 20 cases (excellent in 8 and good in 12) and unsatisfactory in one case. It is concluded that arthroscopic subacromial decompression is an effective treatment for both stage II and III impingement syndromes, producing acceptable results that are comparable to those of open procedures. Technically, it seems necessary to perform synovectomy of the ventral synovia in the glenohumeral joint, to resect the coracoacromial ligament completely and also to remove calcifications completely. Depending on the findings of a preoperative sonographic examination of the shoulder joint, the extent of the acromioplasty may be minimized. PMID:8451648

  16. Isometric exercises with elements postisometric relaxation to eliminate the knee joint contracture after arthroscopic plastics of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Pylypenko O.V.

    2014-02-01

    Full Text Available Purpose : to determine the efficiency of isometric exercises and post isometric relaxation of character for removal and prevention of contractures and recovery of motor function after arthroscopic reconstruction of the anterior cruciate ligament in the late postoperative period. Material: The study involved 22 patients aged less than 40 years. Results: The results showed that the level of pain decreased equally in patients of main and control group from 3 to 0 points, the performance difference in the amplitude of the bending of the knee joint during the goniometry in the treatment group was 70 in the control group – 30 and the extension 10 – fixed, reaching 5 hyperextension and not changed in the control group. Conclusions: The use of isometric exercises and post isometric relaxation prevent postoperative contracture of the knee joint. Methods of their application are recommended for use in the comprehensive rehabilitation of patients after arthroscopic plastics anterior cruciate ligament.

  17. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    Directory of Open Access Journals (Sweden)

    Riccardo D′Ambrosi

    2015-01-01

    Full Text Available This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  18. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    Science.gov (United States)

    D’Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process. PMID:26288539

  19. Arthroscopic burring of exposed cement following curettage and cavity filling cementation for chondroblastoma of the proximal tibia.

    Science.gov (United States)

    Park, Jong-Hoon; Chae, In-Jung; Han, Seung-Beom; Lee, Dae-Hee

    2015-03-01

    Chondroblastoma of the proximal tibia is difficult to treat because of its epiphyseal predilection. This condition can be treated by curettage, which results in immediate restoration of stability and a reduced recurrence rate, followed by cement filling of the bone defect. Nevertheless, contact with cement can damage articular cartilage, potentially leading to severe knee osteoarthritis. Most previous reports regarding this complication described patients with giant cell tumors of the proximal tibia. We present here a patient who underwent arthroscopic treatment for cement exposure caused by articular cartilage loss of the tibial plateau, which occurred after initial curettage and cementation for chondroblastoma of the proximal tibia. To our knowledge, this is the first report on arthroscopic treatment of this condition.

  20. Arthroscopic burring of exposed cement following curettage and cavity filling cementation for chondroblastoma of the proximal tibia.

    Science.gov (United States)

    Park, Jong-Hoon; Chae, In-Jung; Han, Seung-Beom; Lee, Dae-Hee

    2015-03-01

    Chondroblastoma of the proximal tibia is difficult to treat because of its epiphyseal predilection. This condition can be treated by curettage, which results in immediate restoration of stability and a reduced recurrence rate, followed by cement filling of the bone defect. Nevertheless, contact with cement can damage articular cartilage, potentially leading to severe knee osteoarthritis. Most previous reports regarding this complication described patients with giant cell tumors of the proximal tibia. We present here a patient who underwent arthroscopic treatment for cement exposure caused by articular cartilage loss of the tibial plateau, which occurred after initial curettage and cementation for chondroblastoma of the proximal tibia. To our knowledge, this is the first report on arthroscopic treatment of this condition. PMID:25750896

  1. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation.

    Science.gov (United States)

    D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  2. Arthroscopic meniscectomy of the middle and posterior parts of the medial and lateral meniscus and our operative technique

    OpenAIRE

    Alturfan, Aziz; Gogus, Abdullah; Taser, Omer; Daldal, Fehmi

    2004-01-01

    Between December 1983 and March 1991 , 2200 knee artnroscopies were performed at the Department of Orthopaedics and Traumatology of İstanbul University, İstanbul Faculty of Medicine. Ouring the last four years, over 500 surgical arthroscopies were performed and 63 in 62 patients were arthroscopic meniscectomies of the middle and posterior parts of the medial and lateral menisci for isolated meniscallesions without any instability. The mean age was 38, 8 (15-58) years. The right knee was invol...

  3. The effects of intraarticular bupivacaine, morphine and bupivacaine+morphine in arthroscopic knee surgery on postoperative analgesia

    OpenAIRE

    Kucukay, Suleyman; Celiker, Tulay Soner; Koyluoglu, Isil Okan; Taser, Omer; Alturfan, Aziz; Sozen, Yunus V.

    2004-01-01

    In this study, we investigated the effect of intraarticular injection of bupivacaine, morphine, bupivacaine+morphine and placebo on postoperative pain during arthroscopic knee surgery. The pain was evaluatedaccording to visualanalogousscale (VAS) at. 0.5, 1, 1. 5, 2, 6 and 24 hourafterthe operation. The need for additional analgesic administration was compared between different groups. In placebo group the values of VAS were higher than the three groups. In bupivacaine group the effective an...

  4. Arthroscopic Treatment for Shoulder Instability with Glenoid Bone Loss Using Distal Tibia Allograft Augmentation - Short Term Results

    Science.gov (United States)

    Wong, Ivan; Amar, Eyal; Coady, Catherine M.; Dilman, Daryl B.; Smith, Ben

    2016-01-01

    Objectives: Background: The results of arthroscopic anterior labral (Bankart) repair have been shown to have high failure rate in patients with significant glenoid bone loss. Several reconstruction procedures using bone graft have been described to overcome the bone loss, including autogenous coracoid transfer to the anterior glenoid (Latarjet procedure) as well as iliac crest autograft and tibial allografts. In recent years, trends toward minimally invasive shoulder surgery along with improvements in technology and technique have led surgeons to expand the application of arthroscopic treatment. Purpose: This study aims to perform a retrospective analysis of prospectively collected data to evaluate the clinical and radiological follow up of patient who underwent anatomic glenoid reconstruction using distal tibia allograft for the treatment of shoulder instability with glenoid bone loss at 1-year post operation time point. Methods: Between December 2011 and January 2015, 55 patients underwent arthroscopic stabilization of the shoulder by means of capsule-labral reattachment to glenoid ream and bony augmentation of glenoid bone loss with distal tibial allograft for recurrent instability of the shoulder. Preoperative and postoperative evaluation included general assessment by the western Ontario shoulder instability index (WOSI) questionnaire, preoperative and postoperative radiographs and CT scans. Results: Fifty-five patients have been evaluated with mean age of 29.73 years at time of the index operation. There were 40 males (mean age of 29.66) and 15 female (mean age of 29.93). Minimum follow up time was 12 months. The following adverse effects were recorded: none suffered from recurrent dislocation, 2 patients suffered from bone resorption but without overt instability, 1 patient had malunion due to screw fracture, none of the patients had nonunion. The mean pre-operative WOSI score was 36.54 and the mean postoperative WOSI score was 61.0. Conclusion: Arthroscopic

  5. Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection

    OpenAIRE

    Ehud Atoun; Artan-Athanasios Bano; Alexander Van Tongel; Ali Narvani; Giuseppe Sforza; Ofer Levy

    2014-01-01

    Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an a...

  6. Short-term evaluation of arthroscopic management of tennis elbow; including resection of radio-capitellar capsular complex

    Science.gov (United States)

    Babaqi, AbdulRahman A.; Kotb, Mohammed M.; Said, Hatem G.; AbdelHamid, Mohamed M.; ElKady, Hesham A.; ElAssal, Maher A.

    2014-01-01

    Background There has been controversy regarding the pathogenesis and treatment of lateral epicondylitis. Different surgical techniques for the treatment of lateral epicondylitis prescribed. The purpose of this study was to evaluate the short-term outcomes of arthroscopic management including resection of the radio-capitellar capsular complex, using different validated scores. Methods In this study, arthroscopic resection of a capsular fringe complex was done beside debridement of the undersurface of Extensor Carpi Radialis Brevis (ECRB). Thirty-one patients with recalcitrant lateral epicondylitis for a minimum of 6 months had surgery. In all patients, a collar-like band of radio-capitellar capsular complex was found to impinge on the radial head and subluxate into the radio-capitellar joint with manipulation under direct vision. Outcomes were assessed using Mayo Elbow Performance Index (MEPI), the Patient-Rated Tennis Elbow Evaluation (PRTEE), and the Disability of the Arm, Shoulder, and Hand (DASH), beside visual analog scale (VAS) for pain and satisfaction criteria. Results After arthroscopic surgery, overall satisfaction was extremely positive, over the 31 patients, 93.5% of the patients are satisfied. The mean score for pain improved from 8.64 to 1.48 points. The total PRTEE improved from 55.53 to 10.39 points. The mean MEPI score was improved from 61.82 to 94.10 points. DASH score also improved from 24.46 to 4.81 points. All improvements are statistically significant (P < 0.05). Conclusion Arthroscopic release of ECRB in patients with chronic lateral epicondylitis is a reproducible method with a marked improvement in function within a short period, with special consideration for resection of radio-capitellar capsular complex. PMID:25104891

  7. Comparative analysis on arthroscopic sutures of large and extensive rotator cuff injuries in relation to the degree of osteopenia

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2015-02-01

    Full Text Available OBJECTIVE: To analyze the results from arthroscopic suturing of large and extensive rotator cuff injuries, according to the patient's degree of osteopenia.METHOD: 138 patients who underwent arthroscopic suturing of large and extensive rotator cuff injuries between 2003 and 2011 were analyzed. Those operated from October 2008 onwards formed a prospective cohort, while the remainder formed a retrospective cohort. Also from October 2008 onwards, bone densitometry evaluation was requested at the time of the surgical treatment. For the patients operated before this date, densitometry examinations performed up to two years before or after the surgical treatment were investigated. The patients were divided into three groups. Those with osteoporosis formed group 1 (n = 16; those with osteopenia, group 2 (n = 33; and normal individuals, group 3 (n = 55.RESULTS: In analyzing the University of California at Los Angeles (UCLA scores of group 3 and comparing them with group 2, no statistically significant difference was seen (p = 0.070. Analysis on group 3 in comparison with group 1 showed a statistically significant difference (p = 0.027.CONCLUSION: The results from arthroscopic suturing of large and extensive rotator cuff injuries seem to be influenced by the patient's bone mineral density, as assessed using bone densitometry.

  8. A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.

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    Yue Xu

    Full Text Available Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements.

  9. Is Gabapentin Effective on Pain Management after Arthroscopic Anterior Cruciate Ligament Reconstruc tion? A Triple Blinded Randomized Controlled Trial

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    Mohsen Mrdani Kivi

    2013-09-01

    Full Text Available Background: Acute pain is common after arthroscopic surgeries and it is one of the most important causes of patient dissatisfaction, admission time and increased morbidity . Gabapentin with anti-hyperalgesic effects can play a critical role in pre-emptive analgesia methods. The aim of this study was to assess the efficacy of gabapentin in pain management after surgery and the rate of drug consumption in patients who are candidate for anterior cruciate ligament (ACL reconstruction arthroscopic surgery. Methods: In this randomized, triple blind clinical trial, 114 patients who were candidate for arthroscopic ACL reconstruction were divided into two groups of gabapentin (G and placebo (p, with 57 patients in each group. The intervention group received gabapentin 600 mg and a placebo was administered in control group. Patients received on-demand pethedine for pain management. The primary outcome was pain intensity according to the visual analogue scale (VAS and the secondary outcome was the amount of opioid consumption and incidence of side effects (including: dizziness, sedation, nausea and vomiting at 6 and 24 h visits. Results: The mean pain intensity in G group at both the 6 and 24 hour visits was significantly lower than the control group (Both p

  10. EFFICACY OF SOFT TISSUE APPLICATION, MANUALLY-THERAPEUTICAL TECHNIQUES FOR KNEE ARTHROKINEMATICS RECOVERY COMPLEX IN PATIENTS AFTER ARTHROSCOPIC MENISCECTOMY

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    Kostov Rostislav V

    2015-07-01

    Full Text Available Introduction: In this article we present the final effect of the application of complex soft tissue manually-treatment system for recovery of joint kinematics in patients with moderate and minimal protective period of rehabilitation after arthroscopic meniscectomy. Material and Methods: The study was conducted in 2005-2012 into three medical centers in Bulgaria: Blagoevgrad, Sofia and Pleven. The study included a total of 110 patients divided into three groups (Control and Experimental I and Experimental Group II who studied the effect of topical application of the manual therapeutic techniques compared to traditional rehabilitation methods applied. For testing the efficacy of a treatment approach in the three groups of patients, the results have processed by the method of variational analysis. Results: After analysis of results we find significantly more fully and without residual short violations recovery for all controlled parameters in patients who have implemented comprehensive manually-therapeutic treatment compared with control group patients. Conclusion: Application of adequate physiological and pedagogically grounded complex rehabilitation is required in patients after arthroscopic meniscectomy model with motor deficits in tractable routine rehabilitation. Observations allow us to offer a methodology for implementation in general practice rehabilitation in patients after meniscal ruptures treated by arthroscopic meniscectomy and motor deficits, intractable routine rehabilitation.

  11. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    Science.gov (United States)

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  12. Two-Year Outcomes following Arthroscopic Treatment for Snapping Scapula Syndrome

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    Menge, Travis; Horan, Marilee P.; Mitchell, Justin; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: Snapping scapula syndrome is a rare cause of shoulder pain that can result in significant dysfunction. The purpose of this study was to report clinical outcomes following arthroscopic treatment for snapping scapula syndrome, as well as identify associated risk factors that affect outcomes. Methods: One-hundred patients underwent arthroscopic treatment for snapping scapula syndrome from October 2005 to October 2013. This was an IRB-approved retrospective outcomes study with prospectively collected data. Patients were excluded if they had prior scapula or rib surgeries, or concomitant sternoclavicular or glenohumeral reconstructive procedures. Patients included in this study failed non-operative modalities for mechanical symptoms of snapping scapula and reported symptomatic relief from a local anesthetic injection prior to surgery. Preoperative and postoperative pain and functioning levels were assessed with the American Shoulder and Elbow Surgeons (ASES), QuickDASH (Disabilities of the Arm, Shoulder and Hand), and general health SF-12 including both physical (PCS) and mental (MCS) components. Patient satisfaction was recorded on a 10-point visual analog scale (VAS). Results: There were 86 scapulae in 79 patients that met inclusion criteria. Mean age at time of surgery was 33 years old (range 12-65). A partial scapulectomy and bursectomy was performed in 79 scapulae, with 7 having bursectomy alone. Mean duration from onset of symptoms to surgery was 3.8 years (range 90 days-16.6 years). One patient died in the follow-up period from unrelated causes, and 6 patients refused to participate. Of the remaining 72 scapula, 8/72 (11%) failed and underwent a revision procedure at a mean of 309 days (SD+283 days). Of those that met inclusion criteria and did not require revision surgery, 86% (55/64) returned surveys with a mean follow-up of 3.4 years (range 2-7 years). There was a significant improvement following surgery in SF-12 PCS (p<0.001), SF-12 MCS (p=0

  13. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

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    Matsuzaki, S. [Dept. of Radiology, Osaka Kosei-nenkin Hospital (Japan); Yoneda, M. [Shoulder and Sports Medicine Service, Osaka Kosei-nenkin Hospital, Osaka City, Osaka (Japan); Kobayashi, Y. [Dept. of Pathology, Osaka Kosei-nenkin Hospital (Japan); Fukushima, S. [Dept. of Orthopaedic Surgery, Sapporo Tokeidai Hospital, Osaka (Japan); Wakitani, S. [Dept. of Orthopaedic Surgery, Shinsyu Univ., Matsumato (Japan)

    2003-09-01

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  14. [Arthroscopic management of recent or chronic lesions of triangular fibrocartilage complex of the wrist].

    Science.gov (United States)

    Fontès, D

    2006-11-01

    Lesions of the triangular fibrocartilage complex of the wrist (TFCC) have perfectly been dismembered by Andrew Palmer and have largely benefited from progress of arthroscopy of the wrist. One distinguishes thus traumatic lesions (class 1) individualized according to their localization, central (1-A), ulnar (1-B), radial (1-D) or distal (1-C). Central lesions are classically associated to a positive ulnar variance. The clinical symptomatology evokes a meniscal like syndrome of the wrist. In case of failure of the medical treatment, it will be necessary to propose a surgical procedure guided by histopathology of the triangular complex. Thus, ulnar peripheral richly vascularized lesions (1-B) could therefore potentially heal and will have to benefit by an attempt of surgical reattachment (arthroscopic technique of Whipple, Poehling or other techniques) or by an osteosynthesis in case of fracture on the basis on the ulnar styloid process. Central fibrocartilage lesions (1-A) or radial avulsions (1-D) are less vascularized and have therefore little probability to heal; they will benefit then ideally from the endoscopic debridement of unstable flaps of the central portion of TFCC. No immobilization is required and rehabilitation is immediately undertaken. Less frequent class 1-C lesions justify in our practice a simple arthroscopic regularization, alone complete ruptures could have necessitate a direct suture. Class 2 degenerative lesions are graduated (A to E) according to evolution of the chondromalacia of the ulnar head and carpal bone, perforation of the central disc and lunotriquetral ligament degeneration. They are usually associated with a constitutional or an acquired ulnar plus variance syndrome, for example after a distal radius fracture malunion. The clinical symptomatology needs to differentiate them from the simple frequent physiological perforations after the age of 50 years. Arthroscopy will allow to regularize unstable non-vascularized lesions and to

  15. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

    International Nuclear Information System (INIS)

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  16. Tako-Tsubo syndrome in an anaesthetised patient undergoing arthroscopic knee surgery

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    Artukoglu Feyzi

    2008-01-01

    Full Text Available We present a case of stress-induced myocardial stunning, also known as tako-Tsubo syndrome, in an anaesthetised patient undergoing arthroscopic replacement of the cruciate ligament. The patient′s (44 y male, ASA class II had a history of hypertension with no other known disease. He underwent a femoral nerve block with 20 ml of 0.5% ropivacaine before receiving a balanced general anaesthesia (propofol induction, sevoflurane maintenance, 10 µg/kg sufentanil. Ten min after the beginning of surgery during endoscopic intra-articular manipulation, the patient suffered from bradycardia and hypotension; following the administration of ephedrine and atropine, he developed tachycardia, hypertension and ST segment depression. Subsequently, his systemic blood pressure dropped necessitating inotropic drug support and - later - intraaortic balloon counterpulsation; a TEE revealed no evidence of hypovolemia, anterior and antero-septal hypokinesia with an ejection fraction of 25%. Surgery was finished whilst stabilising the patient haemodynamically. Postoperative cardiac enzymes showed little elevation, an emergency coronary angiogram apical akinesia with typical ballooning and basal hyperkinesias, compatible with Tako-tsubo syndrome. The patient′s postoperative course was uneventful. We theorize that stress caused by sudden surgical pain stimulus (introduction of the endoscope into the articulation, superficial anaesthesia and insufficient analgesia created a stressful event which probably might have caused a catecholamine surge as basis of Tako-tsubo syndrome.

  17. Arthroscopic Marginal Resection of a Lipoma of the Supraspinatus Muscle in the Subacromial Space.

    Science.gov (United States)

    Pagán Conesa, Alejandro; Aznar, Carlos Verdú; Herrera, Manuel Ruiz; Lopez-Prats, Fernando Anacleto

    2015-08-01

    Subacromial impingement syndrome is a common cause of shoulder pain in young adults and seniors at present. The etiology of this syndrome is associated with several shoulder disorders, most related to aging, overhead activities, and overuse. The subacromial space is well circumscribed and limited in size, and soft-tissue growing lesions, such as tumors, can endanger the normal function of the shoulder girdle. We present a case of shoulder impingement syndrome caused by an intramuscular lipoma of the supraspinatus muscle in the subacromial space in a 50-year-old male bank manager. Radiographs, magnetic resonance imaging, and a computed tomography scan showed a well-circumscribed soft-tissue tumor at the supraspinatus-musculotendinous junction. It was arthroscopically inspected and dissected and complete marginal excision was performed through a conventional augmented anterolateral portal, avoiding the need to open the trapezius fascia or perform an acromial osteotomy. Microscopic study showed a benign lipoma, and the shoulder function of the patient was fully recovered after a rehabilitation period of 4 months. This less invasive technique shows similar results to conventional open surgery. PMID:26759779

  18. Arthroscopic retrograde osteochondral autologous transplantation to chondral lesion in femoral head.

    Science.gov (United States)

    Cetinkaya, Sarper; Toker, Berkin; Taser, Omer

    2014-06-01

    This report describes the treatment of 2 cases of full-thickness cartilage defect of the femoral head. The authors performed osteochondral autologous transplantation with a different technique that has not been reported to date. One patient was 37 years old, and the other was 42 years old. Both presented with hip pain. In both patients, radiograph and magnetic resonance imaging scan showed a focal chondral defect on the weight-bearing area of the femoral head and acetabular impingement. A retrograde osteochondral autologous transplantation technique combined with hip arthroscopy and arthroscopic impingement treatment was performed. After a 2-month recovery period, the symptoms were resolved. In the first year of follow-up, Harris Hip scores improved significantly (case 1, 56.6 to 87.6; case 2, 58.6 to 90). The technique described yielded good short- and midterm clinical and radiologic outcomes. To the authors' knowledge, this report is the first to describe a retrograde osteochondral transplantation technique performed with hip arthroscopy in the femoral head. PMID:24972445

  19. MRI of the knee before and after arthroscopic synovectomy in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    The effectiveness of arthroscopic synovectomy (A-S) for the knee of rheumatoid arthritis (RA) patients was assessed by comparing the severity of synovial proliferation on MRI before and after the surgery. Twenty-five patients (30 knees) were studied. The mean duration of RA was 6 years and 7 months and the mean age at the time of A-S was 49.0 years. The mean follow-up period was 19 months (range: 6-39 months). The preoperative Larsen's classification from grade I to IV was 8, 13, 6, and 3 knees, respectively. Synovial proliferation was evaluated by the modified Takeuchi's classification (MRI score). The MRI score was investigated in relationships with the radiographic grade, wet weight of excised tissue, treatment score for RA knees of the Japanese Orthopaedic Association (JOA score), and the CRP value. The MRI score, JOA score, and CRP all significantly improved during follow-up. The radiographic grade showed less progression, the JOA score improved more, and CRP was lower during follow-up in patients with a postoperative MRI score less than 5. The wet weight of excised tissue showed no related with the MRI score. These results suggest that the effectiveness of A-S can be determined by evaluation of improvement of the MRI score. (author)

  20. Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation

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    Chang, Connie Y.; Gill, Corey M.; Huang, Ambrose J.; Simeone, Frank J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); McCarthy, Joseph C. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2014-12-20

    To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation. Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded. The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95 %, respectively. MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres. (orig.)

  1. The results of arthroscopic anterior stabilisation of the shoulder using the bioknotless anchor system

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    Cooke Stephen J

    2009-01-01

    Full Text Available Abstract Background Shoulder instability is a common condition, particularly affecting a young, active population. Open capsulolabral repair is effective in the majority of cases, however arthroscopic techniques, particularly using suture anchors, are being used with increasing success. Methods 15 patients with shoulder instability were operated on by a single surgeon (VK using BioKnotless anchors (DePuy Mitek, Raynham, MA. The average length of follow-up was 21 months (17 to 31 with none lost to follow-up. Constant scores in both arms, patient satisfaction, activity levels and recurrence of instability was recorded. Results 80% of patients were satisfied with their surgery. 1 patient suffered a further dislocation and another had recurrent symptomatic instability. The average constant score returned to 84% of that measured in the opposite (unaffected shoulder. There were no specific post-operative complications encountered. Conclusion In terms of recurrence of symptoms, our results show success rates comparable to other methods of shoulder stabilisation. This technique is safe and surgeons familiar with shoulder arthroscopy will not encounter a steep learning curve. Shoulder function at approximately 2 years post repair was good or excellent in the majority of patients and it was observed that patient satisfaction was correlated more with return to usual activities than recurrence of symptoms.

  2. Effect of irrigation fluid temperature on body temperature during arthroscopic elbow surgery in dogs

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    K.R. Thompson

    2013-10-01

    Full Text Available This prospective randomised clinical trial evaluated the effect of warmed irrigation fluid on body temperature in anaesthetised dogs undergoing arthroscopic elbow surgery. Nineteen dogs undergoing elbow arthroscopy were included in the study and were randomly allocated to one of two groups. Group RT received irrigation fluid at room temperature (RT while dogs in group W received warmed (W irrigation fluid (36oC. A standardised patient management and anaesthetic protocol was used and body temperature was measured at four time points; (T1 pre-anaesthetic examination, (T2 arrival into theatre, (T3 end of surgery and (T4 arrival into recovery. There was no significant difference in body temperature at any time point between the groups. The mean overall decrease in body temperature between pre-anaesthetic examination (T1 and return to the recovery suite (T4 was significant in both groups, with a fall of 1.06±0.58oC (p<0.001 in group RT and 1.53±0.76oC (p<0.001 group W. There was no significant difference between the groups. At the end of surgery (T3 4/19 (21.1% of dogs were hypothermic (<37oC. The addition of warmed irrigation fluids to a temperature management protocol in dogs undergoing elbow arthroscopy during general anaesthesia did not lead to decreased temperature losses.

  3. The POLPSA lesion: MR imaging findings with arthroscopic correlation in patients with posterior instability

    International Nuclear Information System (INIS)

    Objective. To evaluate the features of the posterior labrocapsular periosteal sleeve avulsion (POLPSA) lesion on MR imaging in athletes with posterior shoulder instability.Design and patients. Six male athletes (age range 19-43 years) with avulsion of the posterior glenoid periosteum were identified on MR imaging. There were four football players, one wrestler, and one competitive weightlifter. The weightlifter had a bilateral condition so that seven shoulders were evaluated. MR imaging was performed with a 1.5 T magnet utilizing conventional and fat-saturated fast spin-echo coronal oblique and sagittal oblique sequences and a 3D-GRE transaxial sequence. Surgical correlation was available in all shoulders.Results. All patients presented with pain and a joint effusion. The size of the periosteal sleeve and redundant joint recess was variable. Fibrous proliferation was noted arthroscopically in four shoulders beneath the sleeve. Although the posterior labrum was detached in all studies, only one labrum had a tear while two showed marked degeneration.Conclusion. The POLPSA lesion is an abnormality that can be associated with posterior instability. It differs from a reverse Bankart lesion because the periosteum, although detached, remains intact with the posterior capsule and detached posterior labrum. This lesion may represent an acute form of a Bennett lesion. (orig.)

  4. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

  5. Arthroscopic ultrasound technique for simultaneous quantitative assessment of articular cartilage and subchondral bone: an in vitro and in vivo feasibility study.

    Science.gov (United States)

    Liukkonen, J; Hirvasniemi, J; Joukainen, A; Penttilä, P; Virén, T; Saarakkala, S; Kröger, H; Jurvelin, J S; Töyräs, J

    2013-08-01

    Traditional arthroscopic examination is subjective and poorly reproducible. Recently, we introduced an arthroscopic ultrasound method for quantitative diagnostics of cartilage lesions. Here we describe our investigation of the feasibility of ultrasound arthroscopy for simultaneous measurements of articular cartilage and subchondral bone. Human osteochondral samples (n = 13) were imaged using a clinical 9-MHz ultrasound system. Ultrasound reflection coefficients (R, IRC), the ultrasound roughness index (URI) and the apparent integrated backscattering coefficient (AIB) were determined for both tissues. Mechanical testing, histologic analyses and micro-scale computed tomography imaging were the reference methods. Ultrasound arthroscopies were conducted on two patients. The ultrasound reflection coefficient correlated with the Mankin score and Young's modulus of cartilage (|r| > 0.56, p 0.70, p 0.59, p 0.65, p < 0.05). Arthroscopic ultrasound examination provided diagnostically valuable information on cartilage and subchondral bone in vivo. PMID:23743098

  6. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2016-04-01

    Full Text Available OBJECTIVE: To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. METHODS: Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A or greater than or equal to 3.0 cm (group B. All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles score and strength measurements. RESULTS: The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743. Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416. CONCLUSION: The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation.

  7. Evaluation of functional results from shoulders after arthroscopic repair of complete rotator cuff tears associated with traumatic anterior dislocation

    Science.gov (United States)

    Godinho, Glaydson Gomes; Freitas, José Márcio Alves; de Oliveira França, Flávio; Santos, Flávio Márcio Lago; de Simoni, Leandro Furtado; Godinho, Pedro Couto

    2016-01-01

    Objective To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. Methods Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A) or greater than or equal to 3.0 cm (group B). All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles) score and strength measurements. Results The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743). Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416). Conclusion The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation. PMID:27069884

  8. Outcomes following arthroscopic transosseous equivalent suture bridge double row rotator cuff repair: a prospective study and short-term results

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    Imam Mohamed Abdelnabi

    2016-01-01

    Full Text Available Background: The transosseous-equivalent cross bridge double row (TESBDR rotator cuff (RC repair technique has been developed to optimize healing biology at a repaired RC tendon insertion. It has been shown in the laboratory to improve pressurized contact area and mean foot print pressure when compared with a double row anchor technique. Pressure has been shown to influence healing between tendon and bone, and the tendon compression vector provided by the transosseous-equivalent suture bridges may enhance healing. The purpose was to prospectively evaluate the outcomes of arthroscopic TESBDR RC repair. Methods: Single center prospective case series study. Sixty-nine patients were selected to undergo arthroscopic TESBDR RC repair and were included in the current study. Primary outcome measures included the Oxford Shoulder Score (OSS, the University of California, Los Angeles (UCLA score, the Constant-Murley (CM Score and Range of motion (ROM. Secondary outcome measures included a Visual Analogue Scale (VAS for pain, another VAS for patient satisfaction from the operative procedure, EuroQoL 5-Dimensions Questionnaire (EQ-5D for quality of life assessment. Results: At 24 months post-operative, average OSS score was 44, average UCLA score was 31, average CM score was 88, average forward flexion was 145°, average internal rotation was 35°, average external rotation was 79°, average abduction was 150°, average EQ-5D score was 0.73, average VAS for pain was 2.3, and average VAS for patient satisfaction was 9.2. Conclusion: Arthroscopic TESBDR RC repair is a procedure with good post-operative functional outcome and low re-tear rate based on a short term follow-up.

  9. MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification

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    Aydingoez, Uestuen; Firat, Ahmet K. [Department of Radiology, Hacettepe University Medical Center, 06100 Ankara (Turkey); Atay, Ahmet Oe.; Doral, Nedim M. [Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, 06100 Ankara (Turkey)

    2003-03-01

    Our objective was to review the MR imaging signs of meniscal bucket-handle tears and assess the relevance of these signs to the arthroscopic classification of displaced meniscal tears. Forty-five menisci in 42 patients who had a diagnosis of bucket-handle tear either on MR imaging or on subsequent arthroscopy (in which Dandy's classification of meniscal tears was used) were retrospectively analyzed for MR imaging findings of double posterior cruciate ligament (PCL), fragment within the intercondylar notch, absent bow tie, flipped meniscus, double-anterior horn, and disproportional posterior horn signs. Arthroscopy, which was considered as the gold standard, revealed 41 bucket-handle tears (either diagnosed or not diagnosed by MR imaging) in 38 patients (33 males, 5 females). There was a stastistically significant male preponderance for the occurrence of meniscal bucket-handle tears. Overall, sensitivity and positive predictive value of MR imaging for the detection of meniscal bucket-handle tears were calculated as 90%. Common MR imaging signs of meniscal bucket-handle tears in arthroscopically proven cases of such tears were the fragment in the notch and absent bow tie signs (98% frequency for each). Double-PCL, flipped meniscus, double-anterior horn, and disproportional posterior horn signs, however, were less common (32, 29, 29, and 27%, respectively). An arthroscopically proven bucket-handle tear was found in all patients who displayed at least three of the six MR imaging signs of meniscal bucket-handle tears. The presence of three or more MR imaging signs of meniscal bucket-handle tears is highly suggestive of this condition. (orig.)

  10. Pelleted bone marrow derived mesenchymal stem cells are better protected from the deleterious effects of arthroscopic heat shock

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    Gauthaman eKalamegam

    2016-05-01

    Full Text Available Introduction: The impact of arthroscopic temperature on joint tissues is poorly understood and it is not known how mesenchymal stem cells (MSCs respond to the effects of heat generated by the device during the process of arthroscopy assisted experimental cell-based therapy. In the present study, we isolated and phenotypically characterized human bone marrow mesenchymal stem cells (hBMMSCs from osteoarthritis (OA patients, and evaluated the effect of arthroscopic heat on cell viability in suspension and pellet cultures.Methods: Primary cultures of hBMMSCs were isolated from bone marrow aspirates of OA patients and cultured using DMEM supplemented with 10% FBS and characterized for their stemness. hBMMSCs (1 x 106 cells cultured as single cell suspensions or cell pellets were exposed to an illuminated arthroscope for 10, 20 or 30 min. This was followed by analysis of cellular proliferation and heat shock related gene expression. Results: hBMMSCs were viable and exhibited population doubling, short spindle morphology, MSC related CD surface markers expression and tri-lineage differentiation into adipocytes, chondrocytes and osteoblasts. Chondrogenic and osteogenic differentiation increased collagen production and alkaline phosphatase activity. Exposure of hBMMSCs to an illuminated arthroscope for 10, 20 or 30 min for 72 h decreased cell proliferation in cell suspensions (63.27% at 30 min and increased cell proliferation in cell pellets (62.86% at 10 min and 68.57% at 20 min. hBMMSCs exposed to 37C, 45C and 55C for 120 seconds demonstrated significant upregulation of BAX, P53, Cyclin A2, Cyclin E1, TNF-α, and HSP70 in cell suspensions compared to cell pellets. Conclusions: hBMMSC cell pellets are better protected from temperature alterations compared to cell suspensions. Transplantation of hBMMSCs as pellets rather than as cell suspensions to the cartilage defect site would therefore support their viability and may aid enhanced cartilage

  11. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

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    Schaffler, Gottfried J. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Tirman, Phillip F.J.; Stoller, David W. [San Francisco Magnetic Resonance Center, 3333 California Street, Suite 105, San Francisco, CA 94118 (United States); Genant, Harry K. [Department of Radiology, University of California San Francisco, 350 Parnassus Avenue, Suite 150, San Francisco, CA 94117 (United States); Ceballos, Cecar; Dillingham, Michael F. [Sports Orthopedics and Rehabilitation, 2884 Sand Hill Rd., Suite 110, Menlo Park, CA 94025 (United States)

    2003-06-01

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  12. Impingement syndrome of the ankle following supination external rotation trauma: MR imaging findings with arthroscopic correlation

    International Nuclear Information System (INIS)

    Our objective was to identify MR imaging findings in patients with syndesmotic soft tissue impingement of the ankle and to investigate the reliability of these imaging characteristics to predict syndesmotic soft tissue impingement syndromes of the ankle. Twenty-one ankles with chronic pain ultimately proven to have anterior soft tissue impingement syndrome were examined by MR imaging during January 1996 to June 2001. The MR imaging protocol included sagittal and coronal short tau inversion recovery (STIR), sagittal T1-weighted spin echo, axial and coronal proton-density, and T2-weighted spin-echo sequences. Nineteen ankles that underwent MR imaging during the same period of time and that had arthroscopically proven diagnosis different than impingement syndrome served as a control group. Fibrovascular scar formations distinct from the syndesmotic ligaments possibly related to syndesmotic soft tissue impingement were recorded. Arthroscopy was performed subsequently in all patients and was considered the gold standard. The statistical analysis revealed an overall frequency of scarred syndesmotic ligaments of 70% in the group with ankle impingement. Fibrovascular scar formations distinct from the syndesmotic ligaments presented with low signal intensity on T1-weighted images and remained low to intermediate in signal intensity on T2-weighted MR imaging. Compared with arthroscopy, MR imaging revealed a sensitivity of 89%, a specificity of 100%, and a diagnostic accuracy of 93% for scarred syndesmotic ligaments. The frequency of scar formation distinct from the syndesmotic ligaments in patients with impingement syndrome of the ankle was not statistically significantly higher than in the control group. In contrast to that, anterior tibial osteophytes and talar osteophytes were statistically significantly higher in the group with anterior impingement than in the control group. Conventional MR imaging was found to be insensitive for the diagnosis of syndesmotic soft tissue

  13. [Examination of the knee joint. The value of clinical findings in arthroscopic control].

    Science.gov (United States)

    Steinbrück, K; Wiehmann, J C

    1988-01-01

    Purely clinical examination of the knee joint can, at best, only be regarded as a "screening procedure". Diagnosis with the aid of apparatus (sonography, arthrography, CT, NMR) produces better results. However, arthroscopy performed by an experienced examiner confirms the diagnosis in cases of suspected meniscus injury or isolated lesions of the cruciate ligaments and leads to early and therefore optimal therapy. In a retrospective study 300 arthroscopies performed in 1985 were selected and evaluated. In 1986/87, a further 300 patients were clinically examined prospectively, according to the same criteria, and findings were compared with the arthroscopy performed the following day. Clinically, in 287 patients with multiple diagnoses, internal meniscus lesions were diagnosed in 162 cases (54%), external meniscus lesions in 38 (13%), chondropathia patellae in 54 (18%), and old ruptures of the cruciate ligaments in 46 (15%). In 13 patients no diagnosis could be established. Arthroscopically, pathology of the internal meniscus was found in 98 (33%) of the 300 patients, of the external meniscus in 40 (13%), cartilage damage in 103 (34%), old cruciate ligament ruptures in 51 (17%), and recent anterior cruciate ligament ruptures in 156 (52%); in 40 cases findings were normal. At 78%, the highest positive predictive value (proportion of tentative clinical diagnoses confirmed by arthroscopy) was found in cases of old ruptures of the anterior cruciate ligament, followed by external meniscus lesions (61%) and internal meniscus lesions (55%); i.e., only 55 out of 100 clinically suspected internal meniscus lesions are diagnosed by arthroscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Arthroscopic-Assisted Fixation of Tibial Plateau Fractures: Patient-Reported Postoperative Activity Levels.

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    Kampa, John; Dunlay, Ryan; Sikka, Robby; Swiontkowski, Marc

    2016-05-01

    Tibial plateau fractures may result in significant limitations postoperatively. Studies have described outcomes of arthroscopic-assisted percutaneous fixation (AAPF) of these injuries but have rarely reported postoperative activity levels. Between 2009 and 2013, patients who sustained a lateral split, split depression, or pure depression type tibial plateau fracture (Schatzker types I-III fractures) and underwent outpatient AAPF were eligible for the study. Outcomes were assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm score, and Marx activity score. Twenty-five consecutive patients were eligible for the study, and 22 (88%) were included in the final analysis, with average follow-up of 2.5 years (range, 1-5.2 years). Thirteen women and 9 men with an average age of 48.3 years (range, 23-65 years) comprised the study population. Average number of screws used for fixation was 2 (range, 1-4). The average depression was 8 mm preoperatively and 0.9 mm (range, 0-3 mm) postoperatively. Four patients (18%) had complications: 2 with hardware removal and 2 with postoperative deep venous thrombosis. Average postoperative Marx activity score was 5.7. Average postoperative KOOS Symptoms, Sports, and Quality of Life scores were 88 (range, 68-100), 85 (range, 45-100), and 77 (range, 50-100), respectively. Average IKDC and Lysholm scores were 81 (range, 55-97) and 87 (range, 54-100), respectively. The AAPF surgical technique, which was performed in an outpatient setting, facilitated excellent postoperative range of motion, outcomes, and activity scores with minimal complications. [Orthopedics. 2016; 39(3):e486-e491.].

  15. MR Imaging of Stable Posterior Cruciate Ligament Grafts in 21 Arthroscopically Proven Cases

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    Yoon, Young Cheol; Chung, Hye Won; Ahn, Jin Hwan [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-10-15

    To describe the magnetic resonance (MR) appearance of intact posterior cruciate ligament (PCL) grafts. Thirty-one postoperative MR examinations were performed in 21 grafts of 20 patients after PCL reconstruction. All 21 grafts were proven to be intact on second-look arthroscopic examination. Two musculoskeletal radiologists retrospectively analyzed the MR findings and reached decisions by consensus. The signal intensity (SI) of the graft on proton density-weighted and T2-weighted images, as well as the shapes, locations, and segments of increased SI were recorded. The graft thickness was also recorded and correlated to elapsed time since reconstructive surgery. The SI of the graft was high (15/31, 48%), intermediate (10/31, 32%), or low (6/31, 19%) on proton density-weighted images, and high (9/31, 29%), intermediate (6/31, 19%), or low (16/31, 52%) on T2-weighted images. The graft SI decreased significantly as postoperative time elapsed. The shape of the increased SI within the grafts was band-like (14/25, 56%) or focal (11/25, 44%). The increased SI was located in the proximal (18/25, 72%), middle (21/25, 82%), and distal (12/25, 48%) segments. In the axial plane, the location of increased SI was intrasubstance (19/25, 76%) or peripheral (10/25, 40%). A 'focal' shape of increased SI was found significantly more in Achilles tendon allografts, while a band-like shape was more frequent in autogenous double-loop hamstring tendon grafts. Graft thickness ranged from 5 15 mm. The difference in graft thickness relative to postoperative time was not statistically significant (p = 0.79). Stable PCL grafts commonly showed an increased SI at any segment or location, even though they were stable. The shape of increased SI differed according to allograft donor sites. However, SI tended to decrease as time elapsed.

  16. MR Imaging of Stable Posterior Cruciate Ligament Grafts in 21 Arthroscopically Proven Cases

    International Nuclear Information System (INIS)

    To describe the magnetic resonance (MR) appearance of intact posterior cruciate ligament (PCL) grafts. Thirty-one postoperative MR examinations were performed in 21 grafts of 20 patients after PCL reconstruction. All 21 grafts were proven to be intact on second-look arthroscopic examination. Two musculoskeletal radiologists retrospectively analyzed the MR findings and reached decisions by consensus. The signal intensity (SI) of the graft on proton density-weighted and T2-weighted images, as well as the shapes, locations, and segments of increased SI were recorded. The graft thickness was also recorded and correlated to elapsed time since reconstructive surgery. The SI of the graft was high (15/31, 48%), intermediate (10/31, 32%), or low (6/31, 19%) on proton density-weighted images, and high (9/31, 29%), intermediate (6/31, 19%), or low (16/31, 52%) on T2-weighted images. The graft SI decreased significantly as postoperative time elapsed. The shape of the increased SI within the grafts was band-like (14/25, 56%) or focal (11/25, 44%). The increased SI was located in the proximal (18/25, 72%), middle (21/25, 82%), and distal (12/25, 48%) segments. In the axial plane, the location of increased SI was intrasubstance (19/25, 76%) or peripheral (10/25, 40%). A 'focal' shape of increased SI was found significantly more in Achilles tendon allografts, while a band-like shape was more frequent in autogenous double-loop hamstring tendon grafts. Graft thickness ranged from 5 15 mm. The difference in graft thickness relative to postoperative time was not statistically significant (p = 0.79). Stable PCL grafts commonly showed an increased SI at any segment or location, even though they were stable. The shape of increased SI differed according to allograft donor sites. However, SI tended to decrease as time elapsed

  17. Evaluation of the intensive rehabilitation protocol after arthroscopically assisted anterior cruciate ligament reconstruction

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    Dubljanin-Raspopović Emilija

    2006-01-01

    Full Text Available Introduction: Optimal treatment of ACL (anterior cruciate injury injuries is one of the most dynamic topics of contemporary orthopedics. Despite huge amount of publications on this subject, golden rehabilitation standard has not been established yet. Objective: The aim of our study was to compare two different rehabilitation groups in respect to dynamics and safety of recovery, and accordingly to recommend contemporary rehabilitation approach. Method: A prospective study included 45 patients with unilateral ACL rupture who were randomized into conservative (THC and intensive rehabilitation (TH-I group. The arthroscopic reconstruction of ACL was performed using the BTBP or STG graft. After the operation, in the TH-C group, ROM was limited to 0-0-90˚ and weight bearing was not allowed in the first 4 postoperative weeks. In the TH-I group, progression depended only on the knee edema and pain. The groups were compared in relation to demographic, anamnestic, and clinical characteristics (knee circumference, thigh circumference, stability tests, Lysholm, Tegner and one-leg hop test, and single stance test. Data were recorded preoperatively and postoperatively after 6 weeks, 4, 6, 9 and 12 months, and compared with parametric and non-parametric statistical tests. Results: The investigated groups clearly differed already after 6 weeks by range of motion (p<0.05, thigh circumference (p<0.01 and Lysholm test score (p<0.01, after 4 months in relation to one leg hop test (p<0.05, and after 6 months according to Tegner test (p<0.01. In the TH-I group, graft integrity was not compromised in any of these patients, nor did postoperative arthrofibrosis develop. Conclusion: Our investigation has undoubtedly revealed that early intensive rehabilitation approach leads to faster functional recovery without complications compared to conventional rehabilitation treatment.

  18. Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

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    Srinath Kamineni

    2015-01-01

    Full Text Available Introduction. The purpose of this study is to describe the inner synovial membrane (SM of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%, an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

  19. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

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    Santosh Kumar

    2015-06-01

    Full Text Available BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effe ct of arthroscopic repair of Bankart’s lesion using suture anchors and compared our results with other studies published in literature . MATERIALS & METHODS : Since June 2012, arthroscopic Bankart’s repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with . INCLUSION CRITERIA: All patients > 15 years but =2 . EXCLUSION CRITERIA: Age group 60 years. Clinical evidence of multidirectional instability. Surgery of injured shou lder before 1 st episode of traumatic shoulder dislocation. Number o f dislocations <2 . Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions . Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57% were involved in significant occupation requiring overhead activity such as students with sporting activities, agricul turists. 21(60% patients had their Right shoulder involved

  20. A Randomized, Controlled Trial to Assess the Efficacy of Arthroscopic Debridement in Combination with Oral Medication Versus Oral Medication in Patients with Gouty Knee Arthritis.

    Science.gov (United States)

    Wang, Xin; Wanyan, Pingping; Wang, Jian Min; Tian, Jin Hui; Hu, Long; Shen, Xi Ping; Yang, Ke Hu

    2015-12-01

    Gouty knee arthritis refers to a form of inflammatory diseases caused by deposits of needle-like crystals of uric acid in knee joint. The aim of this study was to assess the efficacy and safety of arthroscopic debridement in combination with oral medication versus oral medication alone for the treatment of gouty knee arthritis. A total of 60 patients with gouty knee arthritis were randomized to receive either arthroscopic surgery in combination with oral medication or oral medication alone. Efficacy was assessed with the angle of motion, functions, and visual analog scale (VAS). These indices were measured prior to treatment and at 2, 4, 12, 24, and 48 weeks posttreatment. Surgery- and medication-related complications were observed. Significant differences in flexion and extension of the knee joint, lymphoma scores, and VAS were detected between the two groups at 2, 4, and 12 weeks posttreatment (P  0.05) . Significant differences in these indices were detected at different time points in each group (P  0.05). Arthroscopic surgery in combination with oral medication is superior to single oral medication in the flexion and extension of the knee joint, lymphoma scores, and pain relief (VAS) before 24 weeks, although no statistical differences were detected in the efficacy after 24 weeks, and in medication-related safety between the two groups. Although arthroscopic debridement cannot replace systemic uric acid-lowering treatments such as medication and dietary control, it is still an effective approach.

  1. Arthroscopically assisted autologous osteochondral transplantation for osteochondral lesions of the talar dome: an MRI and clinical follow-up study.

    Science.gov (United States)

    Assenmacher, J A; Kelikian, A S; Gottlob, C; Kodros, S

    2001-07-01

    Osteochondral Lesions of the Talar Dome (OLT) are common problems encountered in orthopedics. Although the etiology remains uncertain, a myriad of treatment options exists. The authors describe arthroscopically assisted autologous osteochondral graft (OCG) transplantation procedures in the treatment of unstable OLTs in nine patients. The patients underwent standard preoperative MRI examination to assess fragment stability (using De Smet criteria for stability). Intraoperative arthroscopy was used to correlate the preoperative MRI assessment (using Cheng/Ferkel grading). After transplantation procedures, MRI (using De Smet criteria for stability) assessed graft incorporation for stability at an average of 9.3 months after the procedure. Preoperative MRI correlated highly with arthroscopic findings of OLT instability (sensitivity = 1.0). This has been demonstrated in the current orthopedic literature. The post transplantation MRI demonstrated stable graft osteointegration by De Smet criteria in all patients. Postoperative visual analogue pain scales showed significant improvement from preoperative assessment. Postoperative AOFAS Ankle-Hindfoot scores averaged 80.2 (S.D. +/- 18.9). Our favorable early results and those of other authors using similar techniques may validate OCG transplantation as a viable alternative for treating unstable osteochondral defects in the talus that are refractive to more commonly used surgical techniques. PMID:11503978

  2. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    International Nuclear Information System (INIS)

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths

  3. Clinical and Magnetic Resonance Imaging Results of Arthroscopic Repair of Intratendinous Partial-thickness Rotator Cuff Tears

    Institute of Scientific and Technical Information of China (English)

    Jian Xiao; Guo-Qing Cui

    2015-01-01

    Background:Partial-thickness rotator cufftears (PTRCTs) are being diagnosed more often because of high-resolution magnetic resonance imaging (MRI).Compared with articular and bursal side tears,there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair.Methods:From 2008 to 2012,33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair.All of them were retrospectively evaluated.The University of California at Los Angeles (UCLA) and constant scores were evaluated before operation and at the final follow-up.Postoperative cuff integrity was determined using MRI according to Sugaya's classification.Results:At the 2-year follow-up,the average UCLA score increased from 16.7 ± 1.9 to 32.5 ± 3.5,and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 (P < 0.001).Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery.Of these 27 patients,22 (81.5%) had a healed tendon,and five patients had partial tears.There was no association between functional and anatomic results.Conclusions:For intratendinous PTRCT,clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.

  4. Mid-Long Term Results in the Arthroscopic Selective Capsular Release and Manipulation Treatment of Frozen Shoulder

    Science.gov (United States)

    Celik, Haluk; Seckin, Mustafa Faik; Kara, Adnan; Camur, Savas; Kilinc, Eray; Akman, Senol

    2014-01-01

    Objectives: Our aim was to present mid-long term functional outcomes of patients who underwent arthroscopic selective capsular release and manipulation for frozen shoulder refractory to conservative treatment. Methods: Between 2006 and 2012, 32 patients presented to our clinic with the diagnosis of frozen shoulder. 24 shoulders of 22 patients treated with arthroscopic selective capsular release and manipulation were included in the study. Functional results were analyzed with Constant shoulder score. The mean follow-up was 4.3 years (range 1-7 years). Results: We detected an average increase in passive range of motion in flexion 72°, abduction 90°, abduction-internal rotation 33°, and abduction-external rotation 38°, adduction-external rotation at 37° compared to the preoperative status. Constant shoulder score increased by an average of 44 points after surgery. Eighteen (82%) patients were satisfied with the operation. Three of four patients whose symptoms persisted had resistant diabetes mellitus. Conclusion: Frozen shoulder is one of the most well-known causes of shoulder pain and disability. Although surgery has a good rate of success it does not help in all cases. Unsatisfactory results may be experienced in patients who have diabetes mellitus as a confounding factor.

  5. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Sampson, M.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland)], E-mail: allymattsampson@hotmail.com; Jackson, M.P.; Moran, C.J.; Moran, R. [Department of Orthopaedics, Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Eustace, S.J. [Department of Radiology Sports Surgery Clinic, Santry Demesne, Dublin (Ireland); Shine, S. [Department of Radiology, Cappagh Hospital, Finglas, Dublin (Ireland)

    2008-10-15

    Aim: To assess the accuracy of 3 T magnetic resonance imaging (MRI) in the evaluation of meniscal and anterior cruciate ligament (ACL) injury. Materials and methods: Sixty-one consecutive patients were identified who were referred for evaluation of suspected intra-articular pathology with a 3 T MRI and who, subsequently, underwent an arthroscopic procedure of the knee were included for the study. Two musculoskeletal radiologists interpreted the images. The sensitivity, specificity, positive predictive value, and negative predictive value were then calculated for the MRI versus the arthroscopic findings as a reference standard. Results: The sensitivity and specificity for the overall detection of meniscal tears in this study was 84 and 93%, respectively. The results for the medial meniscus separately were 91 and 93% and for the lateral 77 and 93%. The evaluation of ACL integrity was 100% sensitive and specific. The meniscal tear type was correctly identified in 75% of cases and its location in 94%. Conclusion: This study demonstrates good results of 3 T MRI in the evaluation of the injured knee. Caution should still be given to the interpretation on MRI of a lateral meniscus tear, and it is suggested that the standard diagnostic criteria of high signal reaching the articular surface on two consecutive image sections be adhered to even at these higher field strengths.

  6. Protocol for a multicentre, parallel-arm, 12-month, randomised, controlled trial of arthroscopic surgery versus conservative care for femoroacetabular impingement syndrome (FASHIoN)

    Science.gov (United States)

    Griffin, D R; Dickenson, E J; Wall, P D H; Donovan, J L; Foster, N E; Hutchinson, C E; Parsons, N; Petrou, S; Realpe, A; Achten, J; Achana, F; Adams, A; Costa, M L; Griffin, J; Hobson, R; Smith, J

    2016-01-01

    Introduction Femoroacetabular impingement (FAI) syndrome is a recognised cause of young adult hip pain. There has been a large increase in the number of patients undergoing arthroscopic surgery for FAI; however, a recent Cochrane review highlighted that there are no randomised controlled trials (RCTs) evaluating treatment effectiveness. We aim to compare the clinical and cost-effectiveness of arthroscopic surgery versus best conservative care for patients with FAI syndrome. Methods We will conduct a multicentre, pragmatic, assessor-blinded, two parallel arm, RCT comparing arthroscopic surgery to physiotherapy-led best conservative care. 24 hospitals treating NHS patients will recruit 344 patients over a 26-month recruitment period. Symptomatic adults with radiographic signs of FAI morphology who are considered suitable for arthroscopic surgery by their surgeon will be eligible. Patients will be excluded if they have radiographic evidence of osteoarthritis, previous significant hip pathology or previous shape changing surgery. Participants will be allocated in a ratio of 1:1 to receive arthroscopic surgery or conservative care. Recruitment will be monitored and supported by qualitative intervention to optimise informed consent and recruitment. The primary outcome will be pain and function assessed by the international hip outcome tool 33 (iHOT-33) measured 1-year following randomisation. Secondary outcomes include general health (short form 12), quality of life (EQ5D-5L) and patient satisfaction. The primary analysis will compare change in pain and function (iHOT-33) at 12 months between the treatment groups, on an intention-to-treat basis, presented as the mean difference between the trial groups with 95% CIs. The study is funded by the Health Technology Assessment Programme (13/103/02). Ethics and dissemination Ethical approval is granted by the Edgbaston Research Ethics committee (14/WM/0124). The results will be disseminated through open access peer

  7. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  8. 髌骨骨折关节镜下闭合复位内固定术后的康复训练%Rehabilitation exercises after closed reduction internal fixation of fracture of patella under arthroscope

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 李培; 阿良; 王敏

    2003-01-01

    @@ INTRODUCTION Closed reduction internal fixation under arthroscope is performed from August, 2000 to April, 2001 and advanced domestic and foreign rehabilitation programs are combined to treat fracture of patella comprehensively, satisfying effects are achieved.

  9. Applied anatomy of arthroscopic surgery for proximal interphalangeal joints%近指间关节关节镜手术的应用解剖学研究

    Institute of Scientific and Technical Information of China (English)

    姜浩力; 庄永青; 赖彩红; 常丽鹏; 方锡池; 汤银魁

    2010-01-01

    Objective To provide the anatomical basis for arthroscopic surgery of the proximal interphalangeal (PIP) joints by studying the anatomical features of human PIP joints, exploring suitable approaches and portals into the PIP joint and identifying the proper traction force. Methods Forty PIP joints of the 2 to 4 fingers and 10 interphalangeal joints of the thumb from five fresh cadavers were dissected. The portals for arthroscope insertion and the traction forces for proper exposure were identified. Arthroscopic surgery of the PIP joint was simulated using two severed fingers that were unsalvageable. Results The dorsoradial side and dorsoulnar side are the suitable arthroscopic portals into the PIP joints. The optimal traction force was 3.0 kg. In the surgical simulation arthroscope with 1.9 mm diameter was successfully inserted into the joint cavity and the structures of the joint were clearly visualized. Conclusion Arthroscopic surgery of the PIP joints is feasible for diagnosis and treatment of joint diseases.%目的 研究人体近指间关节的解剖结构特点,探索关节镜的手术入路和术中牵引力,为近指间关节关节镜手术的开展提供解剖学基础.方法 对5具国人新鲜尸体示、中、环、小指共40个近指间关节及10个拇指指间关节标本进行解剖学研究,找出合适的关节镜人路和术中牵引力.利用2个废弃指进行临床手术模拟实验研究.结果 选择近指间关节的桡背侧或尺背侧作为关节镜的入路,以3.0 kg的牵引力最为合适.在手术模拟实验中,成功置入1.9 mm的关节镜并清晰地观察到关节内各个结构.结论 近指间关节关节镜手术用于明确关节内病变的诊断和辅助治疗是可行的.

  10. A Fluoroscopy-Free Technique for Percutaneous Screw Positioning During Arthroscopic Treatment of Depression Tibial Plateau Fractures.

    Science.gov (United States)

    Thaunat, Mathieu; Camelo Barbosa, Nuno; Tuteja, Sanesh; Jan, Nicolas; Fayard, Jean Marie; Sonnery-Cottet, Bertrand

    2016-06-01

    This article aims to describe a simple and reliable technique that helps in positioning the cannulated percutaneous screws during fixation of depression-type tibial plateau fractures. After fracture reduction under arthroscopic control, an outside-in anterior cruciate ligament femoral guide is introduced through the tibial cortical metaphyseal window and positioned under endoscopic control just underneath the elevated fragment. When proper height is achieved, a guide pin is drilled from lateral to medial through the sleeve, 1 to 2 cm distal to the articular surface of the depressed fragment. The cannulated screw can then be introduced under endoscopic control, without fluoroscopic assistance, just under the previously elevated joint surface. This technique ensures optimal placement of the cannulated screw in the middle of the bony tunnel to obtain optimal subchondral bone support during fixation of the depressed tibial plateau fracture. PMID:27656370

  11. Arthroscopic reconstruction of the posterior cruciate ligament. MR studies for bone tunnel positioning and comparison with physical findings

    International Nuclear Information System (INIS)

    The success of arthroscopic cruciate ligament construction depends on several factors., such as patient selection, current surgical execution and postoperative rehabilitation. Technical considerations include graft choice, positioning, fixations, intercondylar notch enlargement, and new ligament tensioning. Graft acceptance is effected by all these factors. Tunnel position is of great importance both for bio mechanical reasons and optimal function of the new ligament, and to avoid stress, friction, abnormal strain, and/or damage to the reconstructed ligament. Many orthopedic and radiographic literature studies discuss the exact site of anterior cruciate ligament insertion for the best possible anatomical reconstruction, In contrast, the debate over the insertional area and anatomical landmarks is open for the posterior cruciate ligament (PCL), because of the difficult execution of this type of reconstruction and the smaller number of candidate

  12. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

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    Alberto Naoki Miyazaki

    2015-06-01

    Full Text Available OBJECTIVES: To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over.METHODS: Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65-69 years (49.1%, 70-74 (26.4% and 75 years and over (24.5%. Their mean age was 71 years (range: 65-83. There were 63 male patients (38.7%. The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months. Sixty-two patients (38% reported histories of trauma and 26 (16% reported that their pain worsened through exertion.RESULTS: From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001 between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027 with the postoperative results: the longer this time was, the worse the results were.CONCLUSION: Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were.

  13. Arthroscopic Management of Full-Thickness Rotator Cuff Tears in Major League Baseball Pitchers: The Lateralized Footprint Repair Technique.

    Science.gov (United States)

    Dines, Joshua S; Jones, Kristofer; Maher, Patrick; Altchek, David

    2016-01-01

    Clinical outcomes of surgical management of full-thickness rotator cuff tears in professional baseball players have been uniformly poor. We conducted a study to investigate return-to-play data and functional performance using a novel arthroscopic repair technique. We hypothesized that arthroscopic rotator cuff repair would result in a high rate of return to professional pitching and favorable functional outcomes. We identified 6 consecutive Major League Baseball (MLB) pitchers who underwent surgical repair of full-thickness rotator cuff injuries using the lateralized footprint repair technique. At most recent follow-up, patients were evaluated to determine their ability to return to athletic activity. Functional outcomes were also assessed using player performance statistics. By mean follow-up of 66.7 months (range, 23.2-94.6 months), 5 (83%) of the 6 pitchers had returned to their preinjury level of competition for at least 1 full season. Despite the high rate of return to MLB play, few pitchers resumed pitching productivity at their preoperative level; mean number of innings pitched decreased from 1806.5 to 183.7. A slight performance reduction was also found in a comparison of preoperative and postoperative pitching statistics. Of note, the return rate was higher for players over age 30 years than for those under 30 years. Overhead athletes require a delicate balance of shoulder mobility and stability to meet functional demands. Anatomical adaptations at the glenohumeral joint should be considered when performing rotator cuff repair in these patients in order to preserve peak functional performance. This novel repair technique affords a high rate of return to MLB play, though elite overhead throwers should be counseled that pitching productivity might decrease after surgery. PMID:26991564

  14. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures.

    Science.gov (United States)

    Nakamura, Toshiyasu; Iwamoto, Takuji; Matsumura, Noboru; Sato, Kazuki; Toyama, Yoshiaki

    2014-02-01

    Background As the triangular fibrocartilage complex (TFCC) anchors the distal radius to the ulna via the radioulnar ligament (RUL), a severely displaced distal fragment of the radius may be associated with a foveal avulsion of the TFCC. The purpose of this retrospective study was to assess, radiographically and arthroscopically, the relationship between displacement of the radius, the ulnar styloid, and avulsion of the RUL resulting in distal radioulnar joint (DRUJ) instability. Materials and Methods Twenty-nine wrists of 29 patients with intra- and extra-articular distal radius fractures/malunion who underwent reduction or a corrective osteotomy of the displaced/malunited fracture, and/or wrist arthroscopy, were assessed radiographically and arthroscopically. Radial translation, radial inclination, radial shortening, volar or dorsal tilt, and the presence of an ulnar styloid fracture with more than 4 mm of displacement were measured from the initial films. Radiocarpal arthroscopy was used to assess peripheral lesions of the TFCC, while DRUJ arthroscopy was used to assess the foveal attachment. The relationship between displacement of the distal radius or the ulnar styloid fracture and the TFCC injury, including avulsion of the RUL, was recorded. Results Univariate analysis revealed that increased radial translation, decreased radial inclination, increased radial shortening, and an ulnar styloid fragment radially displaced by more than 4 mm were significant predictors of RUL avulsion at the fovea. Volar or dorsal tilt of the radius and ulnar variance did not correlate with RUL avulsion or TFCC injuries. Multiple logistic regression analysis revealed that radial translation was an independent risk factor of foveal avulsion of the RUL. Conclusions Increased radial translation and radial shortening and decreased radial inclination of the distal fragment can be associated with a foveal avulsion of the RUL. Radial translation can be an independent risk

  15. Arthroscopic Excision of a Huge Ununited Ossicle Due to Osgood-Schlatter Disease in an Adult Patient

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    LI Zhi-yao

    2013-04-01

    Full Text Available Introduction: Surgical excision of the ununited ossicles has been suggested for unresolved sequelae of Osgood-Schlatter disease in adults resistant to conservative measures. We report a case where arthroscopy was used to excise the ossicles. A bird eye view from the superolateral portal was helpful in the arthroscopic procedure for excision of the deep low lesion. Case Report: A 32-year-old, male driver had anterior knee pain during walking and sports activity that had been treated conservatively for 3 months. On physical examination, there was a prominent tibial tubercle, but without palpable pain. There was obvious pain when the knee was approaching full extension. On image, a huge ununited ossicle was seen behind the patellar tendon, intruding into the joint space, and there was another two small ununited ossicles beneath the bow-shaped patellar tendon. Arthroscopy was performed through a three portals technique, and a bird eye view was achieved from the superolateral portal. The ossicles were separated from the surrounding soft tissue with a motorized shaver. The small ununited ossicles were removed by use of a grasper. The huge ossicle was removed by use of a motorized bur, and the contouring of the irregular surface of the tibial tubercle was performed. After 3 months, the patient returned to sports activities without any restrictions. Conclusion: This report shows that a huge ossicle can cause impingement in anterior knee compartment, and it can be easily removed arthroscopically under assistance of an additional portal. Keywords: Osgood-Schlatter disease; Knee; Arthroscopy; Superolateral portal.

  16. Treatment of Type 3 Arthrofibrosis Following Arthroscopic Reconstruction of ACL and Posterolateral Corner Injury with Tibia Plateau Fracture in a Professional Dancer

    OpenAIRE

    Aksu, Neslihan; Abay, Burak; Soydan, Ramazan; Atansay, Vefa

    2014-01-01

    Objectives: Arthrofibrosis is a serious complication following the reconstruction of anterior cruciate ligament (ACL) and posterolateral corner (PLC) injury. Loss of motion caused by arthrofibrosis can be disabling in young and active patients. We report the clinical results of the treatment of arthrofibrosis following arthroscopic reconstruction of ACL with ipsilateral hamstring tendon graft and surgically repairing PLC with 2 suture anchors in a 30 year-old professional dancer, treated with...

  17. Arthroscopic debridement of the osteoarthritic knee combined with hyaluronic acid (Orthovisc® treatment: A case series and review of the literature

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    Li Xinning

    2008-09-01

    Full Text Available Abstract Objective An evaluation of safety and efficacy of high molecular weight hyaluronan (HA delivered at the time of arthroscopic debridement of the osteoarthritic knee. Methods Thirty consecutive patients who met inclusion and exclusion criteria underwent arthroscopic debridement by a single surgeon and concomitant delivery of 6 ml/90 mg HA (Orthovisc®. These patients were evaluated preoperatively, at 6 weeks, 3 and 6 months post-operatively. Evaluations consisted of WOMAC pain score, SF-36 Physical Component Summary (PCS score and complications. Results No complications occurred during this study. Pre-op average WOMAC pain score was 6.8 +/- 3.5 (n = 30 with a reduction to 3.4 +/- 3.1 at 6 weeks (n = 27. Final average WOMAC pain score improved to 3.2 +/- 3.8 at six months (n = 23. No patients had deterioration of the WOMAC pain score. Mean pre-operative SF-36 PCS score was 39.0 +/- 10.4 with SF-36 PCS score of the bottom 25th percentile at 29.9 (n = 30. Post procedure and HA delivery, mean PCS score at 6 weeks improved to 43.7 +/- 8.0 with the bottom 25th percentile at 37.5 (n = 27. At 6 months, mean PCS score was 48.0 +/- 9.8 with the bottom 25th percentile improved to 45.8 (n = 23. Conclusion The results show that concomitant delivery of high molecular weight hyaluronan (Orthovisc® – 6 ml/90 mg is safe when given at the time of arthroscopic debridement of the osteoarthritic knee. By delivering HA (Orthovisc® at the time of the arthroscopic debridement, there may be a decreased risk of joint infection and/or injection site pain. Furthermore, the combination of both procedures show efficacy in reducing WOMAC pain scores and improving SF-36 PCS scores over a six month period.

  18. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance

    OpenAIRE

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-01-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals...

  19. Arthroscopic suture fixation in patients with a tibial intercondylar eminence fracture using a simple device to penetrate the anterior cruciate ligament

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    Masato Aratake

    2014-04-01

    Full Text Available Displaced tibial intercondylar eminence fractures require early reduction and stable fixation to prevent nonunion, knee instability, and a lack of extension. Many types of surgical procedure are recommended including arthrotomy or an arthroscopic technique to stabilize the fracture segment using Kirschner wire, screws, staples, and suture fixation. However, contemporary arthroscopic techniques and devices can facilitate intra-articular surgery and have been applied to the treatment of this fracture. In our current report, we describe a simple suture fixation method under arthroscopy for the treatment of tibial intercondylar eminence fractures. We treated eight knees of eight patients. One patient had a Type II fracture and seven patients had a Type III fracture according to Meyer's classification. Following the arthroscopic inspection of concomitant injuries, debridement of hematoma, and reduction of the fragment, two nonabsorbable sutures (Ethibond No. 2, Johnson & Johnson, Somerville, NJ, USA were advanced through the suture passer device, which is used to penetrate the anterior cruciate ligament (ACL near to the insertion site of the displaced fragment. Two surgical sutures were pulled out by the suture retriever from the anterior proximal tibia hole and were fixed to the tibia cortex bone with a double-spike plate. At follow-up, radiographic examinations showed that bone union was achieved in all cases. All but one patient could resume normal activities with no restrictions and no ligamentous instability. All knees had a negative Lachman's test and showed a gain of stable ligament function by KT2000 arthrometer evaluation. One patient had an insignificant extension limitation and experienced slight pain after walking but these symptoms were minimal. In conclusion current arthroscopic surgery techniques for tibial intercondylar fractures can be easily performed and reproducibly achieve secure fixation and early mobilization of the knee.

  20. Arthroscopic treatment of ulnar impaction syndrome%尺骨撞击综合征的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    朱波; 赵力; 赵金岩

    2016-01-01

    ).The preoperative values of wrist range of motion (ROM) were 44.17°±6.22° at volar flexion,42.72°±3.37° at dorsal extension,17.45°±4.11° at radial deviation,19.12°±3.70° at ulnar deviation,66.81°±4.28° at pronation,and 70.27°±5.30° at supination.Arthroscopic exploration was conducted in all patients,aiming to observe the ulnar variance,wrist osteonecrosis,articular cartilage damage and triangular fibrocartilage complex tear.Arthroscopic synovectomy were performed in all cases;33 cases of articular cartilage injury were treated with arthroscopic chondroplasty;16 cases of osteonecrosis were treated with arthroscopic drilling decompression;30 cases with tear of TFC were treated with arthroscopic repair;26 cases with ulna positive mutation were treated with arthroscopic distal ulna resection.Patients were followed at 3,6,and 12 months after operation.At 12 months follow-up,the values of wrist range of motion was evaluated for volar flexion,dorsal extension,radial deviation,ulnar deviation,pronation,and supination.GreenO'Brien method was used to evaluate the function of wrist joint.Results Primary healing was presented in all patients without neurovascular injury and joint infection.All patients were followed up 12-36 months (mean,17.5 months).At 12 months followup,the values of ROM compared with that preoperative increased with significant difference,49.13° ±3.47° at volar flexion,47.13°±2.39° at dorsal extension,19.33°±3.29° at radial deviation,25.17°±4.89° at ulnar deviation,75.73°±7.66° at pronation,and 77.22°±4.89° at supination.According to Green-O'Brien standard,the results were excellent in 21 case,good in 17 cases and fair in 3 case,with 93% excellent and good rate.Conclusion Wrist arthroscopy dose not only contribute to the diagnosis in ulnar impingement syndrome but also can be used in treating inflammatory synovium and cartilage lesions,bone drilling decompression,TFC repair and arthroscopic distal ulna resection with improvement in the

  1. Outcome and Structural Integrity of Rotator Cuff after Arthroscopic Treatment of Large and Massive Tears with Double Row Technique: A 2-Year Followup

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    Ignacio Carbonel

    2013-01-01

    Full Text Available Purpose. The purpose of this study was to evaluate the functional outcome and the tendon healing after arthroscopic double row rotator cuff repair of large and massive rotator cuff tears. Methods. 82 patients with a full-thickness large and massive rotator cuff tear underwent arthroscopic repair with double row technique. Results were evaluated by use of the UCLA, ASES, and Constant questionnaires, the Shoulder Strength Index (SSI, and range of motion. Follow-up time was 2 years. Magnetic resonance imaging (MRI studies were performed on each shoulder preoperatively and 2 years after repair. Results. 100% of the patients were followed up. UCLA, ASES, and Constant questionnaires showed significant improvement compared with preoperatively (P<0.001. Range of motion and SSI in flexion, abduction, and internal and external rotation also showed significant improvement (P<0.001. MRI studies showed 24 cases of tear after repair (29%. Only 8 cases were a full-thickness tear. Conclusions. At two years of followup, in large and massive rotator cuff tears, an arthroscopic double row rotator cuff repair technique produces an excellent functional outcome and structural integrity.

  2. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance.

    Science.gov (United States)

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-12-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used. Soft tissues around the talus are cleared with a motorized shaver and a radiofrequency device. The posterior aspects of the talus, os trigonum, and FHL tendon surrounded by the tendon sheath are visualized. The dynamic pathology of the FHL tendon is well observed on passive motion of the great toe. The prominent bone fragment of the talus is removed and the tendon sheath is cut with a retrograde knife and a motorized shaver from the superior border down to the entrance of the fibro-osseous tunnel. Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in female ballet dancers. PMID:27284509

  3. Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results

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    Tudisco Cosimo

    2013-01-01

    Full Text Available Abstract Background Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA, showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. Methods The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS, the Simple Shoulder Test (SST scores, surgical time and implant expense. Results The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. Conclusions To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant

  4. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue.

  5. Infrapatellar plica of the knee: Revisited with MR arthrographies undertaken in the knee flexion position mimicking operative arthroscopic posture

    International Nuclear Information System (INIS)

    Purpose: To describe the appearance of the infrapatellar plica (IPP) on magnetic resonance arthrography (MRA) taken in 70° knee flexion, corresponding to the arthroscopic posture. Materials and methods: Twenty-two patients (23 knee joints) who underwent MRA with 70° knee flexion were enrolled. All patients underwent MRA with 70° knee flexion to simulate operative arthroscopy. The images included fat-suppressed T1-weighted spin echo axial, sagittal, and coronal images. The visualization and morphology of the IPP were retrospectively assessed by two musculoskeletal radiologists. Results: The IPP was demonstrated in 78.3% (n = 18/23) and was best visualized on the sagittal section through the intercondylar notch. The IPP manifested as a linear hypointense structure with variable thicknesses. The intercondylar component was delineated clearly, arising from the anterior intercondylar notch in parallel with the ACL and curving gently downward to attach to the infrapatellar fat pad. On the other hand, the Hoffa's fat pad component was not depicted clearly. The morphology of the IPP was either a separate type (60.9%) or a split type (17.4%). Conclusion: The IPPs can be visualized with a high rate of detection and various morphologic appearances must be appreciated under the review of a flexed knee MRA

  6. Arthroscopic Labral Reconstruction of the Hip Using Iliotibial Band Allograft and Front-to-Back Fixation Technique.

    Science.gov (United States)

    White, Brian J; Herzog, Mackenzie M

    2016-02-01

    Labral repair has been shown to be an effective treatment option with excellent early outcomes; however, in cases of severe labral damage or when the labral tissue is too large or diminutive, labral repair may be less effective. The purpose of this article is to present a modified technique for hip labral reconstruction using iliotibial band allograft tissue and a front-to-back fixation technique. The described technique is modified from the original report of a technique for arthroscopic labral reconstruction. The front-to-back technique allows the surgeon to make a graft that is longer than necessary and cut excess graft after front-to-back fixation, resulting in the correct graft size and a reproducible procedure. Allograft tissue offers several advantages, including the ability to control graft thickness and length, as well as the ability to eliminate donor-site morbidity. This procedure adds to the available techniques for treatment of labral pathology by providing a labral reconstruction technique using allograft tissue. PMID:27073784

  7. Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison

    Energy Technology Data Exchange (ETDEWEB)

    Schmaranzer, Florian; Klauser, Andrea; Henninger, Benjamin [Medical University Innsbruck, Department of Radiology, Innsbruck (Austria); Kogler, Michael; Schmaranzer, Ehrenfried [District Hospital St. Johann in Tyrol, Department of Radiology, St. Johann in Tyrol (Austria); Forstner, Thomas [Johannes Keppler University, Department for Applied Systems Research and Statistics, Linz (Austria); Reichkendler, Markus [District Hospital St. Johann in Tyrol, Department of Orthopedic Surgery, St. Johann in Tyrol (Austria)

    2015-06-01

    To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison. Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus. No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively. Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions. (orig.)

  8. The "paraglider-wing" sign: an arthroscopic indicator of partial-thickness bursal-surface tears of the supraspinatus tendon.

    Science.gov (United States)

    Bhatia, Deepak N; van Rooyen, Karin S; de Beer, Joe F

    2007-06-01

    Partial-thickness bursal-surface tears of supraspinatus tendon may be missed on preoperative investigations and can be overlooked at surgery if not specifically sought. The authors describe an arthroscopic sign to detect these tears, when they involve more than half the tendon fibres, from the articular-side of the joint. The "paraglider-wing" sign, visualized during diagnostic glenohumeral arthroscopy, is demonstrated as an upward bulge of the capsulo-tendinous layer through the bursal-surface tear, under pressure of the inflow fluid. A positive sign indicates (1) presence of a partial-thickness bursal-side tear of the supraspinatus tendon, (2) significant depth (stage II or III) of the tear, and (3) the medial extent of the tear along the length of the tendon. A meticulous subacromial bursoscopy and excision of the bursa is then performed to visualize the tear from the subacromial space. Repair of the tear is performed with a double-row suture anchor fixation technique; the medial row of sutures is passed through the intact region of the tendon using the "paraglider-wing" sign as a guide. PMID:17119924

  9. Biomechanical Evaluation of Two Arthroscopic Biceps Tenodesis Techniques: Proximal Interference Screw and Modified Percutaneous Intra-Articular Transtendon.

    Science.gov (United States)

    Hartigan, David E; Beran, Matthew C; Fleischli, James E; D'Alessandro, Donald F; Zheng, Naiquan Nigel

    2016-01-01

    The percutaneous intra-articular transtendon (PITT) technique has recently been shown to have results comparable to those of more accepted techniques. Its mode of failure was secondary to the suture pulling through the tendon substance. A modification was made whereby the tendon is locked within the suture configuration in an attempt to avoid pullout. We compared this new technique with a well-accepted technique of all-arthroscopic interference screw. In each of 8 pairs of cadaveric shoulders (mean age, 55 years; range, 51-59 years), one shoulder was randomized to be treated with either modified PITT or interference screw (Biceptor; Smith & Nephew) biceps tenodesis, and the other shoulder was treated with the other technique. The tendons were preloaded at 10 N and then cycled at 0 to 50 N for 100 cycles at 1 Hz. Load to failure was calculated at a rate of 1.0 mm per second until peak load was observed. Mean (SD) ultimate load to failure was 157 (41) N for the modified PITT technique and 107 (29) N for the interference screw technique (P = .003). In 7 of 8 specimens, the interference screw technique failed at the junction of the tendon, the screw, and the bone interface. In 7 of 8 specimens, the PITT technique failed by the tendon slipping through the suture or pulling through transverse ligament/rotator interval tissue. Study results showed the modified PITT technique was a biomechanically superior construct. PMID:27552463

  10. Obstetric paralysis: anterior arthroscopic release of the shoulder and transfer of the latissimus dorsi using a homologous graft

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: Description of a new surgical technique for treating the shoulders of patients with sequelae of obstetric paralysis. Preliminary analysis on the results obtained from this technique. METHODS: Five consecutive patients underwent the proposed surgical procedure, consisting of arthroscopic anterior joint release followed by transfer of the latissimus dorsi tendon (elongated and reinforced with a homologous tendon graft to the posterosuperior portion of the greater tubercle, using a single deltopectoral approach. All the patients were reevaluated after a minimum postoperative period of twelve months. The functional assessment was based on the range of motion and the modified Mallet classification system. Statistical analyses were not possible because of the small sample. RESULTS: Overall, passive and active lateral rotations increased, while medial rotation decreased. The other movements (elevation, capacity to place a hand in the mouth and capacity to place a hand behind the neck had less consistent evolution. The mean modified Mallet score improved by 4.2 points (from 11.4 to 15.6. CONCLUSION: The latissimus dorsi tendon can be transferred to the posterosuperior portion of the greater tubercle through a single deltopectoral approach when elongated and reinforced with a homologous tendinous graft.

  11. FUNCTIONAL OUTCOME OF ARTHROSCOPICALLY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING PATELLAR BTB GRAFT: A PROSPECTIVE STUDY OF 45 CASES

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    Suresh

    2014-09-01

    Full Text Available : In today’s world high velocity road traffic accidents, sports activities and increased fitness awareness, ACL injuries is a common clinical problem. Once upon a time ACL rupture led to a relatively safe existence and was thought to be of less significance. Now with improved knee kinematics and clinical skills, it has been established that post ACL injury, the prevalence of clinically significant meniscal damage increases with time and is associated with increasing disability and arthrosis. Ligament reconstruction has not been shown to prevent arthrosis, but studies show that it appears to reduce the risk of subsequent meniscal injury and improve anteroposterior knee motion and facilitates return to high level sporting activities. As surgical techniques like Arthroscopy improve the ability to tackle complex problems, complex decisions regarding Meniscal repair and transplantation, Cartilage repair and regeneration are now commonplace, as are decisions regarding the need for Osteotomies in Arthritically unstable knees. Arthroscopic reconstruction of the Anterior Cruciate Ligament with patellar bone - tendon - bone graft is minimally invasive and is relatively quick and simple to perform, although attention to detail as required for good results. Thus arthroscopy helps in diagnosis and treatment of internal derangement and on extra articular reconstruction.

  12. MR arthrogram findings of luxatio erecta in a pediatric patient - arthroscopic confirmation and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Stensby, J.D.; Fox, Michael G. [University of Virginia, Department of Radiology and Medical Imaging, 1218 Lee Street, Box 800170, Charlottesville, VA (United States)

    2014-08-15

    Luxatio erecta or inferior glenohumeral dislocation is a rare type of shoulder dislocation, accounting for less than 1 % of all reported shoulder dislocations. We describe a 15-year-old male who presented with luxatio erecta following an injury to his shoulder that resulted from a mountain biking accident. Clinically, the patient had shoulder pain and fixed abduction of the arm. Radiographs confirmed the diagnosis of luxatio erecta. A magnetic resonance arthrogram (MRA) performed 9 days after presentation demonstrated both a greater tuberosity fracture and avulsion of the anterior and posterior inferior glenohumeral ligaments from their humeral attachment. The MR findings were confirmed on arthroscopy. The bone and soft tissue injury pattern seen in our patient clearly supports the described mechanism of injury for luxatio erecta and lends credence to the theory that a fracture of the greater tuberosity spares injury to the rotator cuff, especially in children. A review of the literature failed to reveal any prior description of the MRI or MRA findings of luxatio erecta in a pediatric patient or any publication with arthroscopic confirmation of the MR findings. (orig.)

  13. MR arthrogram findings of luxatio erecta in a pediatric patient - arthroscopic confirmation and review of the literature

    International Nuclear Information System (INIS)

    Luxatio erecta or inferior glenohumeral dislocation is a rare type of shoulder dislocation, accounting for less than 1 % of all reported shoulder dislocations. We describe a 15-year-old male who presented with luxatio erecta following an injury to his shoulder that resulted from a mountain biking accident. Clinically, the patient had shoulder pain and fixed abduction of the arm. Radiographs confirmed the diagnosis of luxatio erecta. A magnetic resonance arthrogram (MRA) performed 9 days after presentation demonstrated both a greater tuberosity fracture and avulsion of the anterior and posterior inferior glenohumeral ligaments from their humeral attachment. The MR findings were confirmed on arthroscopy. The bone and soft tissue injury pattern seen in our patient clearly supports the described mechanism of injury for luxatio erecta and lends credence to the theory that a fracture of the greater tuberosity spares injury to the rotator cuff, especially in children. A review of the literature failed to reveal any prior description of the MRI or MRA findings of luxatio erecta in a pediatric patient or any publication with arthroscopic confirmation of the MR findings. (orig.)

  14. Arthroscopic biceps tenodesis compared with repair of isolated type II SLAP lesions in patients older than 35 years.

    Science.gov (United States)

    Denard, Patrick J; Lädermann, Alexandre; Parsley, B K; Burkhart, Stephen S

    2014-03-01

    This study compared arthroscopic biceps tenodesis with biceps repair for isolated type II superior labrum anterior and posterior (SLAP) lesions in patients older than 35 years. The authors identified isolated type II SLAP lesions that were surgically managed over a 5-year period. Minimum 2-year follow-up data were available for 22 patients who underwent biceps repair (repair group) and for 15 patients who underwent a primary biceps tenodesis (tenodesis group). Mean age at surgery was 45.2±5.5 years in the repair group and 52.0±8.0 years in the tenodesis group. In the repair group, functional outcome improved from baseline to final follow-up using the American Shoulder and Elbow Surgeons (ASES) (47.5 to 87.4, respectively; PSLAP lesion had a shorter postoperative recovery, a more predictable functional outcome, and a higher rate of satisfaction and return to activity with a biceps tenodesis compared with a biceps repair. Based on these observations, biceps tenodesis is preferable to biceps repair for isolated type II SLAP lesions in nonoverhead athletes older than 35 years.

  15. Pain relief after Arthroscopic Knee Surgery: A comparison of intra-articular ropivacaine, fentanyl, and dexmedetomidine: A prospective, double-blinded, randomized controlled study

    Directory of Open Access Journals (Sweden)

    Mohammed Babrak Manuar

    2014-01-01

    Full Text Available Background: Postoperative pain is very common distressing symptom after any surgical procedure. Different drugs in different routes have been used for controlling post-arthroscopic pain. No one proved to be ideal. We have compared the analgesic effect of ropivacaine, fentanyl, and dexmedetomidine when administered through the intra-articular route in arthroscopic knee surgery. Materials and Methods: From March 2008 to July 2010, 99 patients undergoing arthroscopic knee surgery were randomly assigned into three groups (A,B,C in a prospective double-blinded fashion. Group A received 10 ml of 0.75% ropivacaine, where Group B received 50 μg fentanyl, and Group C received 100 μg of dexmedetomidine through the intra-articular route at the end of procedure. Pain assessed using visual analog scale and diclofenac sodium given as rescue analgesia when VAS >4. Time of first analgesia request and total rescue analgesic used in 24 hours were calculated. Results: Demographic profiles are quite comparable among the groups. Time for requirement of first postoperative rescue analgesia in Group A was 380.61 ± 22.973 min, in Group B was 326.82 ± 17.131 min and in Group C was 244.09 ± 20.096 minutes. Total rescue analgesia requirement was less in Group A (1.394 ± 0.496 compared to Group B (1.758 ± 0.435 and Group C (2.546 ± 0.546. Group A had higher mean VAS score at 6 th and 24 th postoperative hours. No side effects found among the groups. Conclusion: Therefore, it suggests that intra-articular ropivacaine gives better postoperative pain relief, with increased time of first analgesic request and decreased need of total postoperative analgesia compared to fentanyl and dexmedetomidine.

  16. Pain relief in day care arthroscopic knee surgery: A comparison between intra-articular ropivacaine and levobupivacaine: A prospective, double-blinded, randomized controlled study

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    Anjan Das

    2014-01-01

    Full Text Available Background: Post-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anesthetic drugs and routes of administration. Aims: The aim of the present study was carried out to compare the efficacy of ropivacaine and levobupivacaine when administered through intra-articular route in controlling pain after day care arthroscopic knee surgery. Setting and Design: It was a prospective, double-blinded and randomized controlled study. Materials and Methods: April 2008-December 2008, 60 patients of both sex, of American Society of Anesthesiologists physical status I and II, undergoing day care arthroscopic knee surgery were randomly assigned into two groups (R, L. Group R received 10 ml of 0.75% ropivacaine, whereas group L received 10 ml of 0.50% levobupivacaine through intra-articular route at the end of the procedure. Pain assessed using visual analog scale (VAS and diclofenac sodium given as rescue analgesia when VAS >3. Time of first analgesic request and total rescue analgesic were calculated. Statistical Analysis and Results: based on comparable demographic profiles; time for the requirement of first post-operative rescue analgesia (242.16 ± 23.86 vs. 366.62 ± 24.42 min and total mean rescue analgesic requirement was (104.35 ± 18.96 vs. 76.82 ± 14.28 mg in group R and L respectively. Group R had higher mean VAS score throughout the study period. No side effects found among the groups. These two results were clinically and statistically significant (P < 0.05. Conclusion: Hence, it was evident that intra-articular levobupivacaine give better post-operative pain relief, with an increase in time of first analgesic request and decreased need of total post-operative analgesia compared with ropivacaine.

  17. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

    DEFF Research Database (Denmark)

    Haahr, J. P.; Ostergaard, S.; Dalsgaard, J.;

    2005-01-01

    18 to 55 years were enrolled. Symptom duration was between six months and three years. All fulfilled a set of diagnostic criteria for rotator cuff disease, including a positive impingement sign. Patients were randomised either to arthroscopic subacromial decompression, or to physiotherapy...... with exercises aiming at strengthening the stabilisers and decompressors of the shoulder. Outcome was shoulder function as measured by the Constant score and a pain and dysfunction score. "Intention to treat" analysis was used, with comparison of means and control of confounding variables by general equation...

  18. Arthroscopic fixation with a minimally invasive axillary approach for latissimus dorsi transfer using an endobutton in massive and irreparable postero-superior cuff tears

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    Yariv Goldstein

    2013-01-01

    Full Text Available Arthroscopically assisted latissimus dorsi transfer is a viable option for treatment of patients in their 50s to 70s, without arthritis of the glenohumeral joint, who suffer from massive rotator cuff tears that are not amendable to primary repair due to fatty changes in the muscle tissue, or that have failed previous repair attempts. This procedure offers immediate and dramatic pain relief and is not as technically demanding as one might think. Understanding and respecting the principles of tendon transfer is a key to the success of this procedure.

  19. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Mayer, Michael; Tauber, Mark [Department of Traumatology and Sports Injuries, Salzburg (Austria); Forstner, Rosemarie [University Hospital of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria)

    2011-02-15

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 {+-} 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 {+-} 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 {+-} 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  20. Resultados do tratamento artroscópico das rupturas do manguito rotador Outcomes of arthroscopic treatment for rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Ramos

    2010-01-01

    Full Text Available OBJETIVO: Analisar os resultados do reparo artroscópico das rupturas do manguito rotador. MÉTODOS: Realizado estudo retrospectivo com avaliação dos resultados da técnica em 42 pacientes operados entre 2002 e 2006. O seguimento médio foi de 31 meses e a média de idade foi de 57 anos, sendo o lado dominante operado em 73,8% dos casos. Para avaliação foram usadas escalas de UCLA e Escala Visual Analógica da dor no pós-operatório. RESULTADOS: Os resultados foram satisfatórios em 85,7% (59,5% excelentes e 26,2% bons respectivamente e insatisfatórios em 14,3% dos pacientes. Nos casos com lesões associadas, a mais frequente foi no tendão da porção longa do bíceps (57,1%. Associação com outras lesões não comprometeu o resultado. O mesmo aconteceu com relação a idade e tempo de acompanhamento pós-cirurgia. Quanto ao tamanho da lesão, diferença significativa ocorreu nos casos de lesões grandes e maciças demonstrando resultados inferiores em relação às pequenas e médias. A função foi inferior principalmente nos casos de lesão maciça. CONCLUSÃO: A reparação artroscópica das lesões do manguito rotador (MR proporciona baixa morbidade cirúrgica e possibilita diagnóstico de lesões articulares associadas. O benefício do procedimento foi confirmado principalmente pela melhora significativa da dor, mesmo nos casos de lesões maiores.OBJECTIVE: To evaluate the results of arthroscopic treatment for rotator cuff tears. METHODS: A retrospective study was carried out demonstrating the results of this technique in 42 patients operated between 2002 and 2006. The mean follow-up was 31 months and average age was 57 years. The dominant limb was operated in 73.8% of cases. Function and pain were evaluated using criteria of UCLA Score System and Visual Analogic Scale respectively. RESULTS: The results were satisfactory in 85.7% (59.5% excellent and 26.2% good, with 14.3% unsatisfactory. The most frequent associated lesion was the

  1. A follow-up study of arthroscopic combined reconstruction of anterior and posterior cruciate ligaments with allograft patellar tendon

    Institute of Scientific and Technical Information of China (English)

    XIE Feng; YANG Liu; GUO Lin; DAI Can; HAN Xue-song

    2007-01-01

    Objective: To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament( ACL ) and posterior cruciate ligament ( PCL )simultaneously by using allograft patellar tendon under arthroscopy.Methods: From May 2003 to November 2005, 10 cases of ruptured ACL and PCL were fixated with compressed screws and reconstructed under arthroscopy with allograft patellar tendon simultaneously. The clinical results were evaluated according to IKDC, Lysholm, and Tegner clinical rating scales.Results: All patients were followed up for 12-30 months (mean: 18 months). At the last follow-up, there was no knee extension limitation and knee flexion was between 120° and 135°, with an average of 128.38°. The Lysholm score of the 10 cases was 66. 5 ± 5. 6 before operation and 89.8 ± 3.4 at last follow up. The difference was statistically significant (P < 0.01 ). The average Tegner activity score decreased from 6.9 ± 1.7 ( range: 4-9 ) before injury to 5.5 ± 1. 6 (rang: 2-9 ) at the follow-up(P =0.53 ). At the end of follow-up, IKDC score was graded as A in 4 cases (40.0%), B in 5 (50.0 % ), and C in 1 (10.0%). Of the 10 patients, 8 returned to the same sports level as before injury and 2 were under the level.Conclusion: Arthroscopic combined reconstruction of ACL and PCL with allograft patellar tendon has the advantages of minimal trauma in surgery and reliable satisfactory outcome.

  2. The Effects of Spinal, Inhalation, and Total Intravenous Anesthetic Techniques on Ischemia-Reperfusion Injury in Arthroscopic Knee Surgery

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    Müge Koşucu

    2014-01-01

    Full Text Available Purpose. To compare the effects of different anesthesia techniques on tourniquet-related ischemia-reperfusion by measuring the levels of malondialdehyde (MDA, ischemia-modified albumin (IMA and neuromuscular side effects. Methods. Sixty ASAI-II patients undergoing arthroscopic knee surgery were randomised to three groups. In Group S, intrathecal anesthesia was administered using levobupivacaine. Anesthesia was induced and maintained with sevoflurane in Group I and TIVA with propofol in Group T. Blood samples were obtained before the induction of anesthesia (t1, 30 min after tourniquet inflation (t2, immediately before (t3, and 5 min (t4, 15 min (t5, 30 min (t6, 1 h (t7, 2 h (t8, and 6 h (t9 after tourniquet release. Results. MDA and IMA levels increased significantly compared with baseline values in Group S at t2–t9 and t2–t7. MDA levels in Group T and Group I were significantly lower than those in Group S at t2–t8 and t2–t9. IMA levels in Group T were significantly lower than those in Group S at t2–t7. Postoperatively, a temporary 1/5 loss of strength in dorsiflexion of the ankle was observed in 3 patients in Group S and 1 in Group I. Conclusions. TIVA with propofol can make a positive contribution in tourniquet-related ischemia-reperfusion.

  3. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction with autologous hamstring grafts-isokinetic assessment with control group.

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    Tomasz Piontek

    Full Text Available OBJECTIVE: The aim of the study was to: 1 evaluate the differences in pre-post operative knee functioning, mechanical stability, isokinetic knee muscle strength in simultaneous arthroscopic patients after having undergone an anterior cruciate ligament (ACL and the posterior cruciate ligament (PCL with hamstring tendons reconstruction, 2 compare the results of ACL/PCL patients with the control group. DESIGN: Controlled Laboratory Study. MATERIALS AND METHODS: Results of 11 ACL/PCL patients had been matched with 22 uninjured control participants (CP. Prior to surgery, and minimum 2 years after it, functional assessment (Lysholm and IKDC 2000, mechanical knee joint stability evaluation (Lachman and "drawer" test and isokinetic tests (bilateral knee muscle examination had been performed. Different rehabilitation exercises had been used: isometric, passive exercises, exercises increasing the range of motion and proprioception, strength exercises and specific functional exercises. RESULTS: After arthroscopy no significant differences had been found between the injured and uninjured leg in all isokinetic parameters in ACL/PCL patients. However, ACL/PCL patients had still shown significantly lower values of strength in relative isokinetic knee flexors (p = 0.0065 and extensors (p = 0.0171 compared to the CP. There were no differences between groups regarding absolute isokinetic strength and flexors/extensors ratio. There was statistically significant progress in IKDC 2000 (p = 0.0044 and Lysholm (p = 0.0044 scales prior to (44 and 60 points respectively and after the reconstruction (61 for IKDC 2000 and 94 points for Lysholm. CONCLUSIONS: Although harvesting tendons of semitendinosus and/or gracilis from the healthy extremity diminishes muscle strength of knee flexors in comparison to the CP, flexor strength had improved. Statistically significant improvement of the knee extensor function may indicate that the recreation of joint mechanical stability is

  4. Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction

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    Swierstra Bart A

    2011-09-01

    Full Text Available Abstract Background The arthroscopic findings in patients with chronic anterior syndesmotic instability that need reconstructive surgery have never been described extensively. Methods In 12 patients the clinical suspicion of chronic instability of the syndesmosis was confirmed during arthroscopy of the ankle. All findings during the arthroscopy were scored. Anatomical reconstruction of the anterior tibiofibular syndesmosis was performed in all patients. The AOFAS score was assessed to evaluate the result of the reconstruction. At an average of 43 months after the reconstruction all patients were seen for follow-up. Results The syndesmosis being easily accessible for the 3 mm transverse end of probe which could be rotated around its longitudinal axis in all cases during arthroscopy of the ankle joint, confirmed the diagnosis. Cartilage damage was seen in 8 ankles, of which in 7 patients the damage was situated at the medial side of the ankle joint. The intraarticular part of anterior tibiofibular ligament was visibly damaged in 5 patients. Synovitis was seen in all but one ankle joint. After surgical reconstruction the AOFAS score improved from an average of 72 pre-operatively to 92 post-operatively. Conclusions To confirm the clinical suspicion, the final diagnosis of chronic instability of the anterior syndesmosis can be made during arthroscopy of the ankle. Cartilage damage to the medial side of the tibiotalar joint is often seen and might be the result of syndesmotic instability. Good results are achieved by anatomic reconstruction of the anterior syndesmosis, and all patients in this study would undergo the surgery again if necessary.

  5. Arthroscopic guided biopsy and radiofrequency thermoablation of a benign neoplasm of the tibial spines area: a treatment option

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    Zoccali Carmine

    2012-04-01

    Full Text Available Abstract Background Lesions located in the area of the tibial spines are rare. In most cases, treatment follows histological diagnosis, but when imaging and clinical data are considered to be "very" characteristic for benign lesions, such as chondroblastoma or osteoid osteoma, treatment may be performed without biopsy. Traditional curettage requires opening the joint, which presents a high risk of contamination of the joint itself and surrounding structures, such as the popliteal area, with possible contamination of the neurovascular bundle when performing curettage with the posterior approach. In this case, the re-excision of a local recurrence would be extremely difficult. Results We describe a technique using arthroscopic guidance for radiofrequency thermoablation of a benign lesion in the tibial spines area. We report on an illustrative case. The patient so treated, reported immediate relief from the pain, and after two weeks, was free of pain. The biopsy performed before the treatment confirmed the radiological diagnosis of chondroblastoma. At one year of follow-up, the patient is without pain, with a 0-130°range of motion, has no activity limitations and is apparently free of disease. Conclusion This technique allows a radiofrequency thermoablation of a lesion in the tibial spines area and in the posterior tibial surface to be performed without opening the joint, monitoring the tibial plateau surface, probably decreasing the risk of cartilage damage. Unfortunately, in the case presented, the high pressure from the arthroscopy's pump broke the tibial plateau surface creating a communication to the tibial tunnel used for thermoablation.

  6. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  7. 全关节镜下治疗肩锁关节脱位%Arthroscopic treatment of acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    汪国友; 沈骅睿; 曾胜强; 徐平; 邓凯; 扶世杰

    2014-01-01

    Background The dislocation of acromioclavicular joint is a common injury clinically. This study is to investigate the treatment of acute acromioclavicular joint dislocation (Rockwood typeⅢ)and compare the clinical effect of two different ways of coracoclavicular ligament reconstruction. Methods We select the patients with fresh Rockwood type Ⅲ to V dislocation of acromioclavicular joint from January 2008 to June 2013.After randomization,1 6 cases received the reconstruction of coracoclavicular and acromioclavicular ligament arthroscopically with semitendinosus tendon (autogenous group).Among them,12 were males and 4 were females,aged 1 6-62 years old,the average age is 39.8 years old.They were followed up for 9-39 months,the average follow-up was 25.6 months;13 cases underwent the reconstruction of coracoclavicular ligament with the double Endobutton plate and Ethibond suture (Ethibond suture group),including 9 cases of male,4 cases of female,aging from 1 9 to 57 years old,the average age is 36.5 years old,were followed up for 12-35 months with a mean follow-up of 1 9.6 months.The reason of injury:12 cases of traffic injuries,9 cases of sports injury,4 cases of fall,bruise in 2 cases and 2 cases of other injuries.The time between injury to operation was 3-1 1 d,averagely 6 d.8 patients were accompanied by SLAP injury of shoulder joint (5 cases of autologous ligament group,3 cases of Ethibond suture group),3 patients were accompanied by rotator cuff injury (1 cases of autologous ligament group,2 cases of Ethibond suture group).2 patients were combined with glenohumeral joint cartilage injury (1 case of autologous ligament group 1 case,1 case of love help group),2 patients were combined with Bankart injury (both in autologous ligament group ), 1 patient was combined with glenoid fracture (Ethibond suture group).The age,sex,cause of injury,injury side and time from getting injured to operation of the two groups are without significant differences (P >0

  8. 距骨骨软骨损伤的诊断及关节镜治疗%Diagnosis and arthroscopic treatment of osteochondral lesions of the talus

    Institute of Scientific and Technical Information of China (English)

    郭秦炜; 胡跃林; 焦晨; 敖英芳; 于长隆

    2008-01-01

    目的 总结、分析距骨骨软骨损伤的症状、体征、影像学特点、关节镜下治疗方法及手术效果.方法 2000年至2005年共收治34例距骨骨软骨损伤患者,对其临床资料包括症状、体征、X线片、MRI表现、关节镜手术方法等进行回顾性分析,术后随访根据主观和客观评分判断疗效.术前美国足踝外科后足评分平均(71±8)分,术前主观疼痛程度评分(7.5±1.3)分.结果 34例患者MRI均有骨软骨损伤征象,其中21例通过X线片检查发现距骨骨软骨损伤.距骨骨软骨损伤的主要症状为负重疼痛以及运动后加重,MRI诊断准确率较X线片高(χ2=16.07,P<0.001).31例患者获得随访,平均随访时间为28个月.术后美国足踝外科后足评分(91±9)分,显著高于术前(t=9.147,P<0.001);术后主观疼痛程度评分(2.4±2.3)分,显著低于术前(t=10.853,P<0.001);临床疗效优良率为87.1%.结论 MRI检查能够提高诊断的正确率,关节镜微创手术治疗距骨骨软骨损伤效果良好.%Objective To summarize and analyze the diagnosis and arthroscopic treatment of osteochondral lesion of talus(OLT).Methods From 2000 to 2005 the data of 34 patients of OLT of the talus were retrospectively studied,including the symptom,physical examination,image,arthroscopic treatment.All patients took X-ray and MRI examination before the arthroscopic surgery.Arthroscopic debridement was performed for all patients,in addition to drilling in 5 cases,and microfracture in 18 cases.Before operation,ankle-hindfoot score of American Orthopaedic Foot and Ankle Society(AOFAS)was 71±8,and the score of pain(visual analogue scale,VAS)Was 7.5±1.3.Results Weight-bearing pain of the ankle joint aggravated after exercise was the predominant complaint of OLT.X-ray examination was negative in 13 cases,and all lesions were detected by MRI,which was signifcantly better than X-ray(χ2=16.07,P<0.001).Thirty-one patients were followed up for an average of 28

  9. Clinical Experience of Arthroscopic Treatment of Knee Injury%关节镜下治疗膝关节损伤的临床体会

    Institute of Scientific and Technical Information of China (English)

    孙忠林

    2015-01-01

    Objective Clinical experience of arthroscopic treatment of knee injury is to be explored. Methods We chose 41 patients with knee injury who were received and treated in hospital from November 2013 to November 2014 and separated them into two groups at random with 21 patients in study group and 20 patients in control group,patients in study group were given arthroscopic treatment,while patients in control group were given conventional treatment,and then compared treatment effects between two groups. Results Treatment efficacy,treatment effect and patients’lysholm assessment score in study group were much more favorable than counterparts in control group,there was a treatment differential between two groups,and such a differential had statistic value(P<0.05). Conclusion Arthroscopic treatment is of efficacy in treatment of patients with knee injury,it is conducive to increasing treatment efficacy,shortening treatment time,promoting patients’recovery and improving postoperative action function of knee.%目的:探讨关节镜下治疗膝关节损伤的临床体会。方法选取2013年11月~2014年11月我院接诊的41例膝关节损伤患者,随机分为两组,21例实验组和20例对照组,实验组采用关节镜下手术治疗,对照组采用常规治疗,观察两组患者的治疗效果。结果实验组患者的治疗总有效率、治疗效果及Lysholm膝关节评定优于对照组,差异有统计学意义(P<0.05)。结论关节镜下治疗膝关节损伤的临床效果显著,能够有效提高患者治疗的总有效率,缩短治疗时间,加快恢复,提高膝关节术后的活动度。

  10. 关节镜下ACL重建术后关节感染诊疗进展%Diagnosis and treatment progress of joint infection after arthroscopic ACL reconstruction

    Institute of Scientific and Technical Information of China (English)

    区永亮(综述); 黄华扬(审校)

    2015-01-01

    Nowadays arthroscopic anterior cruciate ligament (ACL) reconstruction has been used widely due to its good therapeutic efficacy, but the following joint infection after ACL reconstruction often causes destructive outcomes such as articular cartilage destruction, joint stiff and chronic osteomyelitis, which should be paid much attention for clinician. There existed varied of factors resulted in joint infection after arthroscopic ACL reconstruction with non-unified diagnosis standards. Early diagnosis and reasonable choice of therapeutic protocol are of important significance for enhancing ligament reservation rate and joint stability. Once given incorrect or delayed treatment, the rehabilitation of joint function would not be very ideal. Current situation and research hot spots of epidemiology, etiology, diagnosis, treatment and prognosis of joint infection after arthroscopic ACL reconstruction were reviewed in this paper.%关节镜下前交叉韧带(ACL)重建术临床应用广泛,疗效良好,但术后关节感染往往导致关节软骨破坏、关节强直、慢性骨髓炎等破坏性结局,临床医师需高度重视。导致关节镜下ACL重建术后关节感染的因素多种多样,诊断标准仍未统一,早期诊断及治疗方案的合理选择对于提高韧带保留率和关节稳定性具有重要意义,如处理不当或延误治疗,往往导致关节功能恢复不佳。该文围绕关节镜下ACL重建术后关节感染的流行病学、病因、诊断、治疗及预后等方面的现状和研究热点进行综述。

  11. Treatment of tibia intercondylar eminence fracture under arthroscope%关节镜辅助治疗胫骨髁间嵴骨折

    Institute of Scientific and Technical Information of China (English)

    唐葆青; 林舟丹; 黄育强

    2011-01-01

    目的 探讨关节镜在辅助治疗胫骨髁间嵴骨折的应用价值及手术技巧.方法 2007年5月至2010年3月,关节镜下对14例新鲜胫骨髁间嵴骨折行断端清理和器械复位,用单枚空心螺丝钉固定,其中2例粉碎性骨折辅以克氏针短期固定,2例陈旧性骨折并畸形愈合者镜下行髁间窝成形及前交叉韧带皱缩术,强调术后早期关节功能锻炼.结果 随访4-12个月,X线片复查提示平均4个月骨折骨性愈合.16例患者全部术后膝关节屈伸功能恢复好,参照Lysholm 膝关节评分标准,优良率87.5%.结论 关节镜辅助治疗胫骨髁间嵴骨折创伤小,操作精确,功能恢复快.%Objective To study the application value of arthroscope in the treatment of tibia intercondylar eminence fracture and the surgical technique.Methods From May 2007 to March 2010, 14 cases with newly occurred tibia intercondylar eminence fracture were treated under arthroscopy.All cases were performed cleaning in the fracture site and mechanical reduction.Fixation with single cannulated tensile screw was applied.Among14 cases, 2 cases with comminuted fracture were conducted short-term Kirschner wire cross fixation.2 cases with oldfracture and malunion were applied intercondylar plasty and anterior cruciate ligament (ACL) shrinkage under arthroscope.Early stage joint functional exercise after the surgery was emphasized.Results The follow-up (range, 4-12 months) showed that all fractures healed in an average of 4 months after the surgery under X-ray inspection.Bending and stretching function of stifle in all 16 patients recovered well.According to the Lysholm knee scoring scale, the excellent rate was 87.5%.Conclusions Arthroscopic treatment of tibia intercondylar eminence fracture has advantages of small lesion, accurate operation and quick recovery.

  12. 膝关节骨关节炎关节镜清理术的疗效%Outcomes of arthroscopic debridement on knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    沙磊; 耿庆贺; 范卫民

    2009-01-01

    Objective To investigate the curative effect of arthroscopic debridement on knee osteoarthritis. Methods Retrospective analysis was performed in 92 knee joints(76 patients) with knee ostearthritis, which underwent selective and limited invasive debridement under arthroscope. The Lysholm knee scores were recorded before and after operation. Results The Lysholm knee scores for 6-month, 1- and 2-year after surgery were (77. 08 ± 8. 34)scores, (. 76. 38±8. 74)scores and(69. 60± 10. 44)scores, respectively, which were all higher than (44. 78±8. 79) scores before (P<0. 05). The Lysholm knee score of 2-year was lower than that of 6-month or that of 1-year (P<0. 05). Conclusion Arthroscopic debridement can effectively reduce pain and improve knee function, especially in 2 years in the patients with knee osteoarthritis.%目的 探讨关节镜清理术治疗膝关节骨关节炎(OA)的疗效.方法 在关节镜下行选择性、有限关节清理术76例,按Lysholm膝关节评分标准对92膝术前、术后6个月、1、2年进行评分.结果 92膝膝关节术前Lysholm评分(44.78±8.79)分,术后6个月、1、2年综合评分分别为(77.08±8.34)分、(76.38±8.74)分和(69.60±10.44)分,均较术前明显提高(P<0.05).术后2年的评分明显低于术后6个月和1年(P<0.05).结论 关节镜清理术治疗膝关节骨关节炎能够减轻疼痛、改善功能,2年内疗效好.

  13. Effect of Exercise Therapy Compared with Arthroscopic Surgery on Knee Muscle Strength and Functional Performance in Middle-Aged Patients with Degenerative Meniscus Tears

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2015-01-01

    group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18-33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements (P ≤ 0.002) in all other measured variables, with moderate to large effect sizes (0......OBJECTIVE: The aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears. DESIGN: A total of 82 patients (mean age, 49 yrs; 35% women...... isokinetic knee muscle strength, lower extremity performance, and self-reported global rating of change. RESULTS: Mean difference in isokinetic knee extension peak torque between the two groups was 16% (95% confidence interval, 7.1-24.0) (P group. Patients in the exercise...

  14. Reparo artroscópico das lesões completas isoladas do subescapular Arthroscopic repair of complete, isolated lesions of the subscapularis tendon

    Directory of Open Access Journals (Sweden)

    Niso Eduardo Balsini

    2008-12-01

    Full Text Available OBJETIVO: Avaliar o resultado retrospectivo de 12 pacientes submetidos ao reparo artroscópico de lesões completas isoladas do tendão do subescapular com seguimento mínimo de um ano. MÉTODOS: De 11 de abril de 2002 a 24 de setembro de 2004, realizou-se o reparo artroscópico de lesões completas do manguito rotador em 95 pacientes no Instituto Balsini. Pacientes com subescapular lesado somavam 31; 12 lesões isoladas compunham o grupo de estudo. Foram reavaliados com seguimento mínimo de um ano da cirurgia, considerando grau de elevação anterior ativa, escala da UCLA e satisfação do paciente. RESULTADOS: A elevação anterior ativa pré-operatória atingiu a média de 102º, o grau de elevação anterior ativa pós-operatória obteve a média de 175º. O ganho médio na elevação anterior ativa foi de 73º (p OBJECTIVE: To evaluate the retrospective result of 12 patients submitted to arthroscopic repair of complete, isolated lesions of the subscapularis tendon with minimum follow-up of one year. METHODS: From April 11, 2002 to September 24, 2004, the authors performed the arthroscopic repair of complete rotator cuff lesions in 95 patients at the Balsini Institute. Patients with lesioned subscapularis amounted to 31, and 12 isolated lesions were included in the study group. They were re-analyzed with a minimum follow-up of one year after surgery to evaluate the degree of active anterior elevation, according to the UCLA scale and to patient satisfaction. RESULTS: Pre-operative active anterior elevation had a mean of 102º, and the degree of active anterior elevation after surgery presented a mean of 175º. The mean gain in active anterior elevation was 73º (p < 0.0001. Preoperative UCLA had a mean of 15.25 score points, and after surgery, a mean of 31.66 score points. The mean UCLA index was 16 score points (p < 0.0001; 10 excellent results, one good, and one poor. Satisfactory results: 10, unsatisfactory: 1. CONCLUSION: 1 The

  15. Tratamento artroscópico da rigidez pós-traumática do cotovelo Arthroscopic treatment of post-traumatic elbow stiffness

    Directory of Open Access Journals (Sweden)

    Jose Carlos Garcia Júnior

    2012-01-01

    Full Text Available OBJETIVO: Avaliar pacientes submetidos à artroscopia para liberação do cotovelo rígido, discutindo a técnica, possíveis dificuldades e riscos. MÉTODOS: Foram realizadas 24 artroscopias de cotovelos. Todos os pacientes foram avaliados usando goniometria pré e seis meses pós-cirurgia e pontuados com o escore de cotovelo Mayo. RESULTADOS: Operados 15 homens e nove mulheres, 14 cotovelos direitos e 10 esquerdos, média de idade de 34,58 anos e de tempo de seguimento de 38,41 meses. A média do ganho do arco de movimento foi de 43,3º e MES de 85,4. CONCLUSÃO: A liberação artroscópica pode viabilizar melhor visualização e aumento das opções de mudança de estratégia durante a cirurgia, diminuição do trauma cirúrgico e possibilidade de reabilitação precoce, podendo atingir resultados similares ou melhores que os da cirurgia aberta. Contra a artroscopia há a grande curva de aprendizado e o maior custo do procedimento. Ambas as técnicas relatam complicações neurovasculares. Para evitar tais problemas, o protocolo para realização dos portais deve ser rigorosamente seguido. A liberação artroscópica mostrou ser opção segura e eficaz no ganho da ADM no cotovelo rígido pós-traumático.To evaluate patients undergoing arthroscopic release of a stiff elbow, with discussion of the technique, possible difficulties and risks. METHODS: Twenty-four elbow arthroscopy procedures were performed. All the patients were evaluated using goniometry before the operation and six months after wards and were rated using the Mayo elbow performance score (MEPS. RESULTS: Fifteen men and nine women underwent surgery (14 right elbows and ten left elbows. Their mean age was 34.58 years and length of follow-up, 38.41 months. Their mean gain of range of motion was 43.3º and of MEPS, 85.4. CONCLUSION: Arthroscopic liberation might enable better intrarticular visualization and enhance options to change strategy during surgery, reduction of surgical

  16. The arthroscopic treatment of intraosseous ganglion cysts of the wrist%腕关节镜辅助治疗腕骨内腱鞘囊肿

    Institute of Scientific and Technical Information of China (English)

    朱瑾; 刘波; 陈山林; 田光磊

    2014-01-01

    Objective To investigate the arthroscopic treatment methods of intraosseous ganglion cysts of the wrist. Methods From May 2013 to May 2014, 5 patients with intraosseous ganglion cysts in the wrist were treated with arthroscopic technique. There were 3 cases in the lunate, 1 in the scaphoid and 1 in the triangular bone. The main symptom was chronic wrist pain, decreased grip strength and limitation of wrist movement. The X-ray and CT showed circular and quasi-circular areas of reduced bone mineral density within the carpal bone with a clear boundary and slightly sclerotic margin. The MRI revealed the liquid content. All the patients were treated by arthroscopic technique: curettage of the ganglion cysts and autologous cancellous bone or injectable artificial bone grafting. The wrists were immobilized at the functional position for 3 weeks after the operation. Results All the patients were followed up for a mean period of 6.8 months ( range 4~12 months ). All cases had no recurrence and obtained bone healing. The symptoms were relieved. All the patients recovered to their normal life and work. Conclusion Intraossous ganglion cysts in the wrist remain a cause of chronic wrist pain. The arthroscopic technique in the treatment of intraosseous ganglion cysts of the wrist is safe, less complication, rapid recovery of function, the effect is satisfactory.%目的:探讨腕关节镜治疗腕骨内腱鞘囊肿的方法及疗效。方法2013年5月—2014年5月,应用腕关节镜治疗腕骨内腱鞘囊肿5例,其中月骨3例,舟骨1例,三角骨1例。主要症状为腕部不适、疼痛,伴握力下降和活动度降低。 X线平片及CT显示腕骨内圆形或类圆形骨密度减低区,边界清楚,有硬化缘。 MRI显示病灶内为液体。采用腕关节镜下病灶刮除+自体松质骨或注射型人工骨移植术治疗,术后腕关节功能位固定3周。结果5例均获得随访,平均6.8个月。所有病例无复发,

  17. Comparing etoricoxib and celecoxib for preemptive analgesia for acute postoperative pain in patients undergoing arthroscopic anterior cruciate ligament reconstruction: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Glabglay Prapakorn

    2010-10-01

    Full Text Available Abstract Background The efficacy of selective cox-2 inhibitors in postoperative pain reduction were usually compared with conventional non-selective conventional NSAIDs or other types of medicine. Previous studies also used selective cox-2 inhibitors as single postoperative dose, in continued mode, or in combination with other modalities. The purpose of this study was to compare analgesic efficacy of single preoperative administration of etoricoxib versus celecoxib for post-operative pain relief after arthroscopic anterior cruciate ligament reconstruction. Methods One hundred and two patients diagnosed as anterior cruciate ligament injury were randomized into 3 groups using opaque envelope. Both patients and surgeon were blinded to the allocation. All of the patients were operated by one orthopaedic surgeon under regional anesthesia. Each group was given either etoricoxib 120 mg., celecoxib 400 mg., or placebo 1 hour prior to operative incision. Post-operative pain intensity, time to first dose of analgesic requirement and numbers of analgesic used for pain control and adverse events were recorded periodically to 48 hours after surgery. We analyzed the data according to intention to treat principle. Results Among 102 patients, 35 were in etoricoxib, 35 in celecoxib and 32 in placebo group. The mean age of the patients was 30 years and most of the injury came from sports injury. There were no significant differences in all demographic characteristics among groups. The etoricoxib group had significantly less pain intensity than the other two groups at recovery room and up to 8 hours period but no significance difference in all other evaluation point, while celecoxib showed no significantly difference from placebo at any time points. The time to first dose of analgesic medication, amount of analgesic used, patient's satisfaction with pain control and incidence of adverse events were also no significantly difference among three groups. Conclusions

  18. Reply to "Analgesic Effect of Gabapentin on Post-Operative Pain After Arthroscopic Anterior Cruciate Ligament Reconstruction"

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2014-03-01

    amount of requested pethidine for every patient were different and patient-dependent and were registered in the medical file for further evaluations. 4. Since randomization was performed prior to surgery, all eligible cases were first randomized in the intervention or control groups. So to our knowledge, primary demographic characteristics were better to contain all eligible case rather than those who remained in the trial. If we would demonstrated the data, as you had commented, one may object that the data is not complete and how can someone be sure about the randomization, so we prefer to put all the data. 5. The criticism about table 2 is correct. The table we have sent to the journal has been probably mis-typed during the publishing process. The original table is attached to the end of this manuscript. Your comment about the table 3 is correct again; it is the mean pethidine consumption during the first 6 and 24 hour (in milligrams. 6. The main purpose of this study is to apply another agent to decrease the opioid consumption after arthroscopic surgeries such as recent works (3, 4. It was the main reason of utilizing Gabapentin as an adjuvant to the pethidine to evaluate whether it could facilitate the decrease of opioid consumption and its complication. Finally authors wanted to show their appreciations to Dr. Ortiz and Dr. Romero-Quezada for their precise and meticulous comments.

  19. 小剂量曲马多用于膝关节镜术后镇痛效果比较%Analgesic effects of low-dose tramadol after arthroscopic knee surgery

    Institute of Scientific and Technical Information of China (English)

    袁红斌; 李科; 王新华; 刘虎

    2001-01-01

    Objective To investigate analgesic effect of intra-articular low-dose tramadol after arthroscopic knee surgery.Methods 60 patients undergoing arthroscopic knee surgery under lumbar anesthesia were randomly divided into intra-articular injection of tramadol(TJ group),mulscle injection of tramadol(TM)and saline control group.Vision analog scoring was conducted under extension of knee joint 8h and 24h after drugs administration.Follow-up was done to observe unwanted effects 48h after surgery.Results Score of TJ group was significantly lower than those of other groups(P<0.05).No unwanted effects were found.Conclusion Intra-articular tramadol in low-dose could relieve operative pain.

  20. COMPARATIVE STUDY OF ARTHROSCOPIC SINGLE BUNDLE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION AND NON-ANATOMICAL DOUBLE BUNDLE WITH SINGLE TIBIAL TUNNEL ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH SEMITENDINOSUS ± GRACILIS AUTOGRAFTS USING LAXOMETRY

    Directory of Open Access Journals (Sweden)

    Sivananda

    2016-01-01

    Full Text Available BACKGROUND The knee joint is the most commonly injured of all joints and the ACL is the most commonly injured ligament. Arthroscopic reconstruction of ACL has become gold standard in treating these injuries. AIM 1. To compare the short-term results of ACL reconstruction using single bundle (one Tibial + one Femoral tunnel and non-anatomical double-bundle (one Tibial + two Femoral tunnels techniques using Hamstrings (Semitendinosus ± Gracilis graft. 2. To evaluate ACL graft reconstruction stability measured by laxometry and to find out an association with clinical findings. MATERIAL & METHODS We performed a prospective study between 2014-2015 of 20 case of ACL injuries & compared single bundle reconstruction with Non – anatomical double Bundle reconstruction with semitendinosus ± Gracilis, Autograft using laxometry. CONCLUSION Arthroscopic Non-anatomical double ACL Reconstruction is Bio-mechanically stable reconstruction resembling anatomy of the ACL.

  1. Arthroscopic treatment of the athletic recurrent shoulder anterior dislocations%运动员复发性肩关节前脱位的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 闫辉; 杨渝平; 刘玉雷; 敖英芳; 于长隆

    2009-01-01

    目的 评价关节镜下肩关节前向稳定手术对运动员复发性肩关节前脱位的治疗效果.方法 2001年1月至2006年12月,应用关节镜下肩关节前向稳定手术治疗运动员复发性肩关节前脱位29例,男15例,女14例;年龄15~35岁,平均(20.7±1.4)岁.手术均采用关节镜下盂唇缝合固定术(带线锚钉技术),必要时辅以关节囊折叠缝合术、旋转间隙闭合术或热皱缩术.以脱位复发率、肩关节活动度、恢复运动水平级别及UCLA、Dawson、SST评分系统对术后疗效进行评价.结果 全部病例随访17~66个月,平均30.2个月.4例(13.8%)失败,其中3例(10.3%)脱位复发,1例发生半脱位.24例(82.8%)基本恢复到伤前运动水平(恢复≥90%).UCLA、Dawson及SST评分与术前比较差异均有统计学意义.优良率82.8%~89.7%.术后患侧前屈、0°外展位及90°外展位外旋活动度较术前增加,与健侧差值的差异均有统计学意义.结论 运动员复发性肩关节前脱佗的关节镜下肩关节前向稳定手术的治疗效果良好,术后肩关节功能评分及关节活动度有明显改善,脱位复发率及运动水平的恢复程度与大多数文献报道的切开手术效果相近.%Objective To assess the results of arthroscopic anterior shoulder stabilization of athletes with recurrent anterior shoulder dislocations. Methods From Jan. 2001 to Dec. 2006, 29 athletes (15 males and 14 females) suffered recurrent anterior shoulder dislocations underwent arthroscopic anterior shoulder stabilizations. The age of the patients at the time of surgery was from 15 to 35 years (average, 20.7±1.4 years). The surgical procedure was performed in a consistent manner:, arthroscopic suture anchor repair of the displaced labrum, rotator interval closure supplemented with thermal treatment of the capsule when indicat-ed. The clinical results, including the postoperative recurrence rate, range of motion, and the levels of post-operative recovered to

  2. Indications and techniques of arthroscopic treatment for knee osteoarthritis%膝骨关节炎关节镜治疗指征及手术方法探讨

    Institute of Scientific and Technical Information of China (English)

    黄迅悟; 常青; 孙继桐; 冯会成; 隰建成

    2011-01-01

    Objective To evaluate the indications and techniques of arthroscopic treatment for knee osteoarthritis. Methods A retrospective analysis was conducted on 305 patients (412 knees, aged over 45 years) with osteoarthritis treated in our hospital through arthroscopy from January 2004 to December 2006. We collected the data of gender, age, pathological changes under the arthroscope, and arthroscopic procedures. Hospital for Special Surgery (HSS) scoring system was applied to detect the function of the knee Preoperatively and two years postoperatively. Results 201 patients (289 knees) were followed up more than 2 years. Among them, 113 patients were of unilateral knee osteoarthritis, and 88 cases (176 knees) of bilateral knee osteoarthritis. The follow-up rate was 70%. Among the 289 knees followed up, 78 were excellent, 108 good, 64 fair, and 39 bad. The overall excellent and good rate was 64%. Conclusions Arthroscopic treatment for knee osteoarthritis should be individualized for each patient according to their different pathological changes. Satisfactory clinical outcome can be achieved through proper selection of indications, and accurate appropriate intraoperative arthroscopic procedures.%目的 探讨膝骨关节炎关节镜治疗指征及手术方法.方法 回顾性分析2004年1月至2006年12月应用关节镜治疗、年龄>45岁膝骨关节炎患者305例412膝,统计其性别、年龄、镜下病理变化、镜下手术方法,术前及术后2年膝关节功能HSS评分.结果 获得2年以上随访有289膝,其中单膝113膝,双膝88例176膝,随访率70%.在随访的289膝中,优:78膝,良:108膝,中:64膝,差:39膝,优良率64%.结论 关节镜治疗膝骨关节炎需要根据不同病理改变采取针对性治疗.选择合适的指征,手术中精确、合理的关节镜治疗,有希望获得理想的疗效.

  3. Tratamento artroscópico da tendinite calcária do manguito rotador Arthroscopic treatment of calcifying tendinitis of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Arnaldo Amado Ferreira Neto

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos e radiográficos do tratamento cirúrgico por via artroscópica em pacientes com tendinite calcária do manguito rotador. MÉTODO: Foi realizado um estudo retrospectivo com análise de 20 pacientes que foram submetidos ao tratamento artroscópico da tendinite calcária do ombro, de março de 1999 a novembro de 2005. Seis pacientes foram excluídos devido à perda do seguimento. Com seguimento médio de 41,4 meses, oito pacientes (57% eram do sexo feminino e seis (43% do masculino; sendo o lado direito acometido em 10 (71% e o esquerdo em quatro (29%. Nove casos (64% apresentavam calcificação no tendão supraespinal, dois (14% no infraespinal e três (21% envolvendo os dois tendões. RESULTADOS: Em todos os casos, realizou-se a ressecção dos depósitos de cálcio através da perfuração com agulha (Jelco® nº 14 e curetagem (minicureta. Dois ombros (14% foram submetidos à descompressão subacromial; um, (7% à exérese distal da clavícula; e, em três, (21% houve a necessidade de se fazer sutura tendão-tendão. Nenhum paciente foi submetido à reinserção tendão-osso. Pela escala da UCLA, a média da pontuação foi de 33 pontos (26-35, indicando que a maioria teve resultados bons. Na avaliação final radiográfica, nenhum paciente apresentava sinais de calcificações. CONCLUSÃO: O tratamento artroscópico da tendinite calcária do ombro permite a exérese da calcificação com segurança, obtendo-se resultados bons com relação à dor e à função do ombro.OBJECTIVE: To evaluate the clinical and radiographic results of arthroscopic treatment of the rotator cuff in patients with Calcifying Tendinitis. METHOD: A retrospective study of twenty patients submitted to arthroscopic treatment for rotator cuff Calcifying Tendinitis from March 1999 to November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57% were female and

  4. Arthroscopic treatment of osteoid osteoma in hind-foot%关节镜手术治疗后足骨样骨瘤疗效分析

    Institute of Scientific and Technical Information of China (English)

    何能斌; 胡涂; 宋国勋; 许同龙; 施忠民

    2015-01-01

    Objective To evaluate clinical outcome of arthroscopic treatment of osteoid osteoma in hind‐foot . Methods From February 2013 to July 2014 ,8 cases of osteoid osteoma in hind‐foot were treated by arthroscopic manner .There were 5 males and 3 females with a mean age of 21 .25 years .The calcaneus was implicated in 5 cases and the talus was implicated in 3 cases .Overall functional evaluation was carried out according to Visual Analogue Scale (VAS) ,American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind‐foot score .Results Eight cases were followed up for 4‐22 months (mean ,16 months) .There was no wound infection and neoplasm recurrence . The average VAS score reduced significantly from 8 .375 preoperatively to 0 .375 postoperatively ,and the average AOFAS ankle and hind‐foot score improved significantly from 40 .375 preoperatively to 92 .500 postoperatively . Conclusion The arthroscopic treatment of osteoid osteoma in hind‐foot is a safe and reliable treatment ,because it can resect the tumor completely ,and also limited the soft tissue complications .%目的探讨关节镜手术治疗后足骨样骨瘤临床疗效。方法2013年2月至2014年7月,采用关节镜手术治疗后足骨样骨瘤患者8例,其中男性5例,女性3例,平均年龄21.25岁。受累部位为跟骨5例,距骨3例。采用疼痛视觉模拟评分(VAS)、美国足踝骨科学会(AOFAS)踝‐后足评分综合评估临床疗效。结果术后随访4~22个月,平均16个月。所有患者术后均无伤口感染、肿瘤复发等并发症发生。末次随访时 VAS评分由术前平均8.375分改善至术后平均0.375分,差异有统计学意义;AOFAS踝‐后足评分由术前平均40.375分改善至术后平均92.500分,差异有统计学意义。结论关节镜手术治疗后足骨样骨瘤在完整切除肿瘤的同时,可减少软组织并发症,是一种安全、可靠的治疗技术。

  5. 关节镜下前交叉韧带重建术的临床研究%Clinical research of anterior cruciate ligament revascularization under arthroscopic

    Institute of Scientific and Technical Information of China (English)

    张强

    2016-01-01

    目的:观察关节镜下前交叉韧带重建术治疗前交叉韧带断裂的临床效果。方法选取我院收治的36例前交叉韧带断裂患者作为研究对象,均采用关节镜下前交叉韧带重建术治疗。观察治疗前后膝关节功能的改善情况及膝关节稳定性的改善情况。结果治疗后患者的Lysholm评分(89.75±8.24)分、IKDC评分(89.57±3.69)分,显著高于治疗前,差异具有统计学意义(P<0.05);治疗后Lachmann试验阳性为5.8%、轴移试验阳性比例为3.5%,均显著低于治疗前,差异具有统计学意义(P<0.05)。结论对前交叉韧带断裂患者采用关节镜下前交叉韧带重建术治疗,可获得良好效果,患者膝关节功能恢复良好,稳定性显著改善,值得临床推广应用。%Objective To observe the clinical effect of anterior cruciate liga ment under arthroscopy revascularization in the treatment of anterior cruciate ligament rupture. Methods Thirty six patients in our hospital with anterior cruciate ligament rupture were selected and adopt arthroscopic anterior cruciate ligament revascularization therapy. Then observed the improvement of the function, and stability of the knee joint before and after the treatment. Results The Lysholm score is (89.75±8.24), IKDC is (89.57± 3.69) after treatment, which is significantly higher than that before treatment (P<0.05). After treatment, the Lachmann test positive is 5.8%, the axial shift test positive percentage is 3.5%, which is significantly lower than that before treatment (P<0.05). Conclusion Patients with anterior cruciate ligament rupture treated by arthroscopic anterior cruciate ligament under revascularization therapy and thetreatment, the results are good. The recovery of the knee joint function is good, and the stability is improved significantly, which imply the clinical popularization and application of anterior cruciate ligament revascularization under arthroscopic.

  6. Efficacy comparison of arthroscopic and incision in treatment of rheuma-toid arthritis%关节镜与切开术治疗类风湿性关节炎的效果比较

    Institute of Scientific and Technical Information of China (English)

    余海龙

    2014-01-01

    Objective To investigate the clinical effect of arthroscopic and incision in the treatment of rheumatoid arthritis. Methods 86 cases of patients with rheumatoid arthritis of the knee in our hospital from October 2009 to Oc-tober 2011 were divided into incision group (43 cases) treated by open surgical synovectomy and the arthroscopic group (43 cases) treated by arthroscopic synovectomy.The hospitalization time,blood loss,postoperative functional exercise time were analysed.All patients were followed up for 6-24 months and the recovery of knee function were compared by using the HSS score. Results The exercise recovery time,the average length of stay in arthroscopic group was shorter than that of the incision group,and the mean blood loss was less than that of the incision group,the difference was significant (P0.05). Conclusion Arthroscopic and incision surgery can effectively recover joint function,is an effective method for the treatment of rheumatoid arthritis.Compared with incision surgery,the arthroscopic surgery has advantage of less trauma,less bleeding, shorter hospitalization time and patients should be preferred arthroscopy if they adapt to arthroscopic surgery.%目的:比较关节镜与切开术治疗类风湿性关节炎的效果。方法选择2009年10月~2011年10月于本院就诊的膝关节类风湿性关节炎患者86例,根据患者意愿分为切开术组和关节镜组,切开术组43例患者采用切开直视滑膜切除术,关节镜组43例患者采用关节镜下滑膜切除术,比较两组的住院时间、术中出血量、术后功能锻炼时间。所有患者均随访6~24个月,采用膝关节HSS评分,对膝关节功能恢复情况进行比较。结果关节镜组恢复功能锻炼时间、平均住院时间均短于切开术组,术中平均出血量少于切开术组,两组差异有统计学意义(P0.05)。结论关节镜与切开术均可有效恢复患者的关节功能,是治疗类风湿性关节炎的有效方

  7. Arthroscopic Surgery in the Treatment of Limb Joint Bursitis%关节镜下手术治疗四肢关节滑囊炎

    Institute of Scientific and Technical Information of China (English)

    段圆慧; 田孟强; 刘军; 曹建刚; 田峥巍

    2013-01-01

    Objective To explore the therapeutic effects of arthroscopic surgery for limb joints bursitis.Methods From April 2008 to March 2011,arthroscopic bursa resection was performed on 17 cases of limb joint bursitis,including 13 cases of knee prepatellar subcutaneous bursitis,2 cases of elbow olecranon subcutaneous cyst and 2 cases of greater trochanteric bursitis.Results The operation time ranged from 23 to 60 min,with an average of 32 min.The postoperative hospital stay was 3-7 d (mean,4 d).17 patients were followed up for 2 to 19 months,with an average of 9.6 months.1 case of traumatic prepatellar bursitis relapsed and others healed well,without obvious scar on the skin,significant pain and dysfunction.Conclusion Arthroscopy surgery for larger limb joints bursitis has satisfactory therapeutic effects with small incision and quick recovery.%目的 探讨关节镜下手术治疗四肢关节滑囊炎的效果.方法 2008年4月~ 2011年3月,关节镜下滑囊切除术治疗四肢关节滑囊炎17例,其中膝关节髌前皮下滑囊炎13例,肘关节鹰嘴皮下囊肿2例,股骨大转子滑囊炎2例.结果 手术时间23 ~60 min,平均32 min.术后3~7d出院,平均4d.17例随访2~19个月,平均9.6月,1例外伤性髌前滑囊炎术后3周复发,余患者均愈合良好,皮肤无明显瘢痕,无明显疼痛和功能障碍.结论 关节镜下手术治疗四肢较大的关节周围滑囊炎效果良好,体表切口小,恢复快.

  8. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    Science.gov (United States)

    Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial’s inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider

  9. Second-look arthroscopic evaluation of the articular cartilage after primary single-bundle and double-bundle anterior cruciate ligament reconstructions

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-jun; AO Ying-fang; CHEN Lian-xu; GONG Xi; WANG Yong-jian; MAYong; LEUNG Kevin; Kar Ming; YU Jia-kuo

    2011-01-01

    Background Several reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction.No report has been published about the cartilage comparing changes after single-bundle (SB) and double-bundle (DB) ACL reconstructions.The purpose of this study was to evaluate the articular cartilage changes after SB and DB ACL reconstructions by second-look arthroscopy.Methods Ninety-nine patients who received arthroscopic ACL reconstruction were retrospectively reviewed at an average of 14 months after reconstruction,58 patients underwent SB ACL reconstruction and 41 patients underwent DB ACL reconstruction.Hamstring tendon autografts were used in all patients.Second-look arthroscopy was done in conjunction with the tibial staple fixation removal at least one year after the initial ACL reconstruction.Arthroscopic evaluation and grading of the articular cartilage degeneration for all patients were performed at the initial ACL reconstruction,and at the second-look arthroscopy.Results The average cartilage degeneration at the patellofemoral joint (PFJ) was found significantly worsened after both SB and DB ACL reconstructions.This worsening were not seen at medial tibiofemoral joint (TFJ) and lateral TFJ.Grade Ⅱ cartilage damage was the most common.At second-look arthroscopy,the average patellar cartilage degeneration was 1.14±0.14 (at first look 0.52±0.11) for the SB group,and 1.22±0.15 (at first look 0.56±0.12) for the DB group.The average trochlear cartilage degeneration was 1.05±0.16 (at fist look 0.10±0.06) and 0.66±0.17 (at fist look 0.17±0.09),respectively.The average patellar cartilage degeneration showed no significant difference in both groups.However,the average trochlea cartilage degeneration in DB group was significantly less than in SB group.Conclusions Patellofemoral cartilage degeneration continued to aggravate after ACL reconstruction.DB ACL reconstruction could significantly decrease the trochlea

  10. Osteoid Osteoma of the Distal Humerus Mimicking Sequela of Pediatric Supracondylar Fracture: Arthroscopic Resection—Case Report and A Literature Review

    Directory of Open Access Journals (Sweden)

    Jordi Font Segura

    2013-01-01

    Full Text Available Osteoid osteoma (OO is a small and painful benign osteoblastic tumour located preferentially in the shaft of long bones near the metaphyseal junctions, with a predilection for the lower limbs. Juxta- and intra-articular OOs are rare and even though hip, elbow, and talus are the most commonly reported locations, they may be found in any joint accounting for approximately 13% of all osteoid osteomas. There is usually a significant time delay between symptom initiation and diagnosis when the lesion is present in an uncommon location due to the diagnostic challenge it presents due to the lack of classical clinical signs and/or radiographic features found in the extra-articular lesions. A case of a distal humerus OO of a 15-year-old girl is presented to point out that a confounding factor, such as a previous paediatric supracondylar fracture, may further delay the already difficult diagnosis of a juxta- or intra-articular osteoid osteoma and also to emphasize the possibility of arthroscopic treatment of such lesions.

  11. Osteoid osteoma of the distal humerus mimicking sequela of pediatric supracondylar fracture: arthroscopic resection-case report and a literature review.

    Science.gov (United States)

    Font Segura, Jordi; Barrera-Ochoa, Sergi; Gargallo-Margarit, Albert; Correa-Vázquez, Eva; Isart-Torruella, Anna; Mir Bullo, Xavier

    2013-01-01

    Osteoid osteoma (OO) is a small and painful benign osteoblastic tumour located preferentially in the shaft of long bones near the metaphyseal junctions, with a predilection for the lower limbs. Juxta- and intra-articular OOs are rare and even though hip, elbow, and talus are the most commonly reported locations, they may be found in any joint accounting for approximately 13% of all osteoid osteomas. There is usually a significant time delay between symptom initiation and diagnosis when the lesion is present in an uncommon location due to the diagnostic challenge it presents due to the lack of classical clinical signs and/or radiographic features found in the extra-articular lesions. A case of a distal humerus OO of a 15-year-old girl is presented to point out that a confounding factor, such as a previous paediatric supracondylar fracture, may further delay the already difficult diagnosis of a juxta- or intra-articular osteoid osteoma and also to emphasize the possibility of arthroscopic treatment of such lesions.

  12. Hallazgos artroscópicos en un caso de disco articular adherido de la ATM Arthroscopic findings in a fixed disc case of the TMJ

    Directory of Open Access Journals (Sweden)

    R. Martín-Granizo López

    2005-12-01

    Full Text Available El síndrome de disco adherido (SDA o stuck syndrome de la articulación temporomandibular (ATM es un fenómeno que ha sido descrito recientemente y cuya fisiopatogenia es una alteración bioquímica que se produce en algunas ATMs con disfunción temporomandibular. En el presente artículo describimos un caso clínico y especialmente los interesantes hallazgos artroscópicos encontrados, que ayudarían a corroborar el mecanismo fisiopatogénico propuesto. Son de especial relevancia la correcta posición discal dentro de la articulación y una zona eritematosa encontrada en la sinovial que recubre la fosa-eminencia glenoidea de la articulación.The anchored disc phenomenon (ADP or ‘stuck syndrome’ of the TMJ is a phenomenon that has only recently been described, with a physiopathogeny of biochemical disturbances that are produced in some TMJs with temporomandibular dysfunction. In this article we describe a clinical case and, in particular, the interesting arthroscopic findings that help to corroborate the physiopathogenic mechanisms proposed. Of special relevance is the correct position of the disc within the joint and an erythematous area found in the synovial membrane covering the glenoid fossa-eminence of the joint.

  13. Arthroscopic removal of palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarso-phalangeal joints of standardbred trotters--outcome and possible genetic background to POF.

    Science.gov (United States)

    Roneus, B; Arnason, T; Collinder, E; Rasmussen, M

    1998-01-01

    A clinical material of 133 Standardbred horses with palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarsophalangeal joints were studied. All horses had their fragments removed with arthroscopic surgery. 102 of the horses were 3 years old or younger when surgery was performed. Anatomical localisations of the fragments were in agreement with earlier reports. There was no statistical significant difference in month of birth in the POF--group compared to the total population. Eighty % of the horses that had raced before surgery came back to racing. The racing performance relative to their contemporaries remained the same after the POF operation. 65% of the horses that had not raced before surgery raced after the operation. The breeding index BLUP (Best Linear Unbiased Prediction) was used to evaluate if the POF-horses differed genetically in racing ability from the total population. The average BLUP value of the POF group was 103.4 (+/- 0.65), while the mean BLUP value of the total population was 98.9. This difference was highly significant and indicated that these POF horses belonged to a selected group. A homogeneity test of allele frequencies in blood type systems was performed to evaluate if any genetic difference was persistent between POF horses compared to the total population. The statistical analysis of gene frequencies for alleles in blood type systems indicated a genetic discrimination in blood type systems D and Tf.

  14. Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Holzapfel, Konstantin; Waldt, Simone; Bruegel, Melanie; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Paul, Jochen; Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Klinikum rechts der Isar, Munich (Germany); Heinrich, Petra [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany)

    2010-03-15

    The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers for the presence and type of SLAP lesions. MR arthrograms were reviewed twice by each reader with a time interval of 4 months between the two readings. Inter- and intraobserver agreement for detection and classification of SLAP lesions were calculated using {kappa} coefficients. Arthroscopy confirmed 48 SLAP lesions: type I (n = 4), type II (n = 37), type III (n = 3), type IV (n = 4). Sensitivity and specificity for detecting SLAP lesions with MR arthrography for each reader were 88.6%/93.3%, 90.9%/80.0% and 86.4%/76.7%. MR arthrographic and arthroscopic grading were concurrent for 72.7%, 68.2% and 70.5% of SLAP lesions for readers 1-3, respectively. Interobserver agreement was excellent ({kappa} = 0.82) for detection and substantial ({kappa} = 0.63) for classification of SLAP lesions. For each reader intraobserver agreement was excellent for detection ({kappa} = 0.93, {kappa} = 0.97, {kappa} = 0.97) and classification ({kappa} = 0.94, {kappa} = 0.84, {kappa} = 0.93) of SLAP lesions. MR arthrography allows reliable and accurate detection of SLAP lesions. In addition, SLAP lesions can be diagnosed and classified with substantial to excellent inter- and intraobserver agreement. (orig.)

  15. Ultrasonographic-arthroscopic correlation in knee injuries in patients operated on at the Hospital Mexico, during the period from January 1, 2010 until December 31, 2010

    International Nuclear Information System (INIS)

    Ultrasound is evaluated as a method of diagnosis for intra-articular pathologies of knee, widely used as a means to rule out injuries to the institutional level. The advantages of ultrasound are mentioned: low cost, availability and is a noninvasive method. In order to implement this study has been to create a question about the real utility of ultrasound in the Hospital Mexico, as further support for the correct diagnosis of knee pathology. A search of clinical records of patients was conducted in the orthopedics and traumatology service with diagnosis of gonalgia, to which was conducted a preoperative ultrasound and, subsequently, have been operated at the Hospital by arthroscopy, during the period 1 January 2010 to December 31, 2010. Subsequently, a comprehensive review of the operative notes was performed, ultrasound reports and records, for the purpose of making an analysis and compare the results of both procedures. This paper has clearly demonstrated poor training in musculoskeletal system of the ultrasound operators. A poor correlation was determined between the arthroscopic results against ultrasound. The need to create care protocols to patients with intra-articular pathology of knee was evidenced. (author)

  16. A CLINICAL STUDY ON FUNCTIONAL OUTCOME AFTER COMBINED ARTHROSCOPIC AND FLUOROSCOPIC ASSISTED REDUCTION AND INTERNAL FIXATION OF CLOSED TIBIAL PLATEAU FRACTURES IN ADULTS

    Directory of Open Access Journals (Sweden)

    Bhavani Prasad

    2015-06-01

    Full Text Available BACKGROUND AND INTRODUCTION: Management of tibial plateau fractures had witnessed tremendous improvement in surgical techniques over the past decades. Conservative treatment of these fractures results in consistently poor results. The present literature supports that absolute anatomi cal reduction and stable fixation of peri articular fractures followed by early post - operative rehabilitation is crucial for good results. And if this is achieved by minimal damage to soft tissue the results are much better. In this study it is achieved by arthroscopy and fluoroscopy. MATERIALS AND METHODS: We have conducted a prospective study between September 2009 to august 2013 including 9 patients with tibial plateau fractures treated with combined arthroscopic and fluoroscopic reduction and internal f ixation with or without bone grafting. And then the radiographic and functional evaluation done. RESULTS: According to Hohl’s clinical and radiographic scoring systems 4 patients were assessed excellent, 3 good, 2 fair. According to Rasmussen’s clinical sc oring system 4 patients excellent, 3 good and 2 fair results. CONCLUSION: The use of arthroscopy and fluoroscopy in the management of tibial plateau fractures results in good outcome. It also helped to simultaneously treat the meniscal injuries. But its use is mainly limited to Shatzkar type1, 2, 3, 4

  17. 关节镜下治疗骨性膝关节炎56例临床分析%Clinical analysis of arthroscopic treatment of 56 cases with osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    梁现会; 尚志平

    2015-01-01

    Objective:To investigate the clinical effect of arthroscopic treatment on osteoarthritis.Methods:56 cases with osteoarthritis were treated with arthroscopically assisted meniscus repair,synovial hyperplasia,cartilage resection of loose bodies and broken extraction,the removal of osteophytes and lateral retinacular release,postoperative joint Chinese herbal fumigation.Results: According to the evaluation standard of curative effect,among the 62 knees in the group,21 knees were cured excellent,24 knees satisfactory,11 knees acceptable,6 knees poor recovered and the total effective rate was 90.3%.Conclusion:Arthroscopic treatment of knee osteoarthritis has significant curative effect with small trauma and low cost which is an effective method for the treatment of knee osteoarthritis.%目的:探讨关节镜下治疗膝骨性关节炎的临床疗效。方法:对56例骨性膝关节炎采用关节镜下半月板修复、增生滑膜切除、游离体及破碎软骨摘除、切除部分骨赘及外侧支持带松解、术后关节中药熏洗等方法。结果:根据疗效评价标准评价疗效,本组共62个膝,优21个,良24个,可11个,差6个,总有效率90.3%。结论:关节镜下治疗骨性膝关节炎疗效肯定,创伤小,费用低,是治疗膝骨性关节炎的有效方法。

  18. 关节镜下病灶清除治疗膝关节结核性滑膜炎%Analysis on arthroscopic synovectomy in treatment of tuberculous synovitis of knee joint

    Institute of Scientific and Technical Information of China (English)

    高天君; 杨达宇

    2012-01-01

    Objective To evaluate the therapeutic effect of arthroscopic synovectomy in the treatment of tuberculous synovitis of the knee joint. Methods A total of 89 cases of tuberculous synovitis of the knee joint were treated by arthroscopic synovectomy. All patients were followed up for 12 ~36 months and the therapeutic effects were evaluated. Results In the 89 cases,the scores were ( 48. 2 ±3. 2 ) before the surgery and ( 92. 0 ± 3. 7 ) after the surgery according to the Lysholm criteria;the scores were ( 43. 4 ± 3. 6 ) before the surgery and ( 89. 3 ± 1.6) after the surgery according to the JOA criteria. Conclusion Arthroscopical synovectomy is an effective treatment for tuberculous synovitis of the knee.%目的 探讨关节镜下病灶清除治疗膝关节结核性滑膜炎的疗效.方法 89例膝关节结核性滑膜炎患者,采用关节镜活检和病变清除,通过12~36个月的随访,观察治疗效果.结果 89例随访患者,术前Lysholm膝关节功能评分为(48.2±3.2)分,术后随访Lysholm膝关节功能评分为(92.0±3.7)分,术前JOA膝关节功能评分为(43.4±3.6)分,术后随访JOA膝关节功能评分为(89.3±1.6)分.结论 关节镜下病灶清除术治疗膝关节结核性滑膜炎是一种有效的治疗方法.

  19. Arthroscopic Treatment of Media Plica Syndrome of the Knee%关节镜下治疗膝关节内侧滑膜皱襞综合征

    Institute of Scientific and Technical Information of China (English)

    丁欢; 胡小鹏; 朱燕辉; 马捷; 顾剑华; 陆雄伟

    2012-01-01

    目的 探讨膝关节内侧滑膜皱襞综合征的临床诊断、治疗方法及结果.方法 自2006年10月至2010年11月期间,我院共诊治膝关节内侧滑膜皱襞综合征患者87例,其中46例采取保守治疗后症状无缓解而接受关节镜下手术切除滑膜皱襞.男24例,女22例;年龄23~72岁,平均年龄为41岁.按Sakakibara法对滑膜皱襞进行分类,在关节镜下行皱襞切除术,并随访记录其疗效.结果 46例经关节镜下皱襞切除的患者,其中A型27例,B型15例,C型3例,D型1例;同时合并9例半月板损伤,5例髌股关节内侧面骨关节炎形成.增生的滑膜皱襞均采用篮钳知刨削器将其切除.43例获得随访,平均随访时间为25个月,无复发病例.膝关节功能根据Lysholm评分进行评定,术后功能较术前明显改善,治疗结果优良率为90.7%.结论 膝关节内侧滑膜皱襞综合征根据临床症状和MRI表现即可诊断,关节镜下可以确诊,同时镜下行滑膜皱襞切除可获得满意的效果.%Objective To evaluate the clinical diagnosis and the arthroscopic treatment results of and medial plica syndrome. Methods From October 2006 to November 2010,there were 87 patients diagnosed media plica syndrome of the knee,46 of them were treated by arthroscopic resection. Results According to the Sakakibara classification, there were 27 cases of Type A, 15 cases of Type B,3 cases of Type C,l case of Type D. There were 9 cases with meniscus lesion and 5 cases of femoral-patellar osteoarthritis. 43 cases were followed up. The mean follow-up period was 25months.The knee function was evaluated with Lysholm score,the results of 39 cases were graded as excellent or good. Conclusions The diagnosis of media plica syndrome can be made by clinical symptom and MRI,and arthroscopy can confirm the diagnosis. The results treated by arthroscopy were satisfactory.

  20. 肩关节镜治疗复发性肩关节前脱位%Arthroscopic treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    马佳; 崔国庆; 王健全; 肖健; 敖英芳; 于长隆

    2008-01-01

    目的 对关节镜治疗复发性肩关节前脱位的疗效进行评价.方法 2001年1月至2006年3月关节镜治疗复发性肩关节前脱位患者52例,其中44例获得随访,随访时间12~54个月,平均26个月.对获得随访的44例患者的临床资料进行回顾性研究.采用美国加州洛杉矶大学肩关节评分系统(UCLA)、肩关节简明测试(SST)、Dawson评分对术后效果进行评价.采用Dawson评分对患者年龄、是否存在松弛、术前脱位频率、复位情况和病程长短等因素对术后疗效的影响进行评价.结果 获得随访的44位患者的脱位复发率为4.5%.术后UCLA、SST、Dawson评分与术前比较差异具有统计学意义,肩关节镜治疗术后优良率在91%以上.患者年龄、病程长短、术前脱位频率、是否伴有关节松弛、复位方法对治疗效果无明显影响.结论 关节镜治疗复发性肩关节前脱位手术效果较好,术后肩关节功能改善明显.%Objective To investigate the effect of the arthroscopic procedure on the patients with recurrent anterior shoulder dislocation. Methods From January 2001 to March 2006, 52 patients with recurrent anterior shoulder dislocation were treated by arthroscopy. Among them 44 patients were followed up for 12 to 54 months(on average of 26 months). The data of the 44 patients was reviewed. Three evaluation systems,University of California at Los Angeles Shoulder Scores(UCLA),Simple Shoulder Test(SST) and Dawson,were used. The study evaluated the effect based on the Dawson system by the factors as:age,course of the disease, frequency of dislocation and relocation methods and the range of shoulder movement.Results The ratio of recurrent dislocation after operation was 4.5%. Assessing through 3 evaluation systems,UCLA,SST and Dawson,results were similar:the follow-up evaluation were extraordinarily different from preoperative assessment,and the rating of good or excellent at the time of the final follow-up reached 91

  1. Classification and arthroscopic surgery of chronic achilles tendinitis%慢性跟腱炎的分型与关节镜微创治疗

    Institute of Scientific and Technical Information of China (English)

    刘玉杰; 朱娟利; 王晓; 王志刚; 陈旭; 李众利; 蔡谞; 齐玮; 李春宝; 魏民

    2010-01-01

    目的 观察慢性跟腱炎的分型与局部麻醉下关节镜微创治疗的效果.方法 2003年3月至2009年3月,采用局部麻醉下关节镜微创治疗慢性跟腱炎22例,男16例,女6例,年龄17~53岁,平均33.5岁.运动损伤16例,病因不明6例.术前根据X线片、MRI检查、CT扫描和临床特点,将其分为:增生肥大型(10例)、钙化结节型(5例)和纤维撕裂型(7例).分别采用局麻关节镜下等离子刀消融、刨削清理术治疗.结果 术后随访22例,平均随访14个月(9~54个月),采用制定的评定标准和VAS评分进行疗效评价,优:12例,良8例,可2例.无血管神经损伤、感染和跟腱断裂等并发症.结论 跟腱炎分型有助于临床诊断和治疗方案制定;局麻关节镜下微创治疗慢性跟腱炎方法可行,操作简便,疗效显著.%Objective To investigate the clinical classification of chronic achilles tendinitis and analyze the surgical technique and efficacy of arthroscopic surgery. Methods Twenty-two patients ( 16 males, 6 females) with chronic achilles tendinitis were recruited. The average age was 33.5 years old ( range: 17-53). Sixteen cases were caused by sport injury while 6 cases had no definite etiological factor.The Achilles tendinopathy was divided into three types according to clinical characteristics and the results of X ray, CT scan and MRI examination of ankle: Type 1, hypertrophy (n = 10); Type 2, calcified tubercle (n = 5 ); Type 3, fiber tear (n = 7 ). All cases were treated with endoscopic debridement of ventral neovascularized area, poritendineum and Achilles tendon by shaver and radiofrequency (RF) probe.Resuits The patients were followed-up for a mean of 14 months (range: 9-15). Evaluated by our criteria and visual analogue scale, the post-operative efficacy was excellent in 12 cases, good in 8 and fair in 2. No postoperative complications, such as neurovascular injury, infection and rupture of Achilles tendon, was recorded. Conclusion This scheme of

  2. 大型及巨大肩袖撕裂的肩关节镜下治疗%Arthroscopic repair of large to massive rotator cuff tears

    Institute of Scientific and Technical Information of China (English)

    周可; 陆伟; 王大平; 朱伟民; 柳海峰; 冯文哲; 彭亮权

    2010-01-01

    Objective To evaluate arthroscopic repair of large to massive rotator cuff tears (LMRCT) . Methods From March 2004 to September 2008, 13 LMRCT patients, 3 nales and 10 females, were treated under arthroscopy. Their mean age was 58.3 years old, with a range of 45 to 72 years.Arthroscopic operations included 11 cases of acromioplasty, 8 cases of rotator cuff repair with metal suture anchor and 5 cases of simple debridement. The clinical outcome was assessed by the visual analog scale (VAS) and University of California Los Angeles (UCLA) scoring system. Results The follow-up periods averaged 18.2 months, with a range of 16 to 32 months. The mean preoperative and end follow-up VAS scores were 6. 6 ± 1.3 vs. 1.5 ± 1.1. The mean preoperative and end follow-up UCLA scores were 11.2 ± 2. 2 vs.29. 5 ± 2.2. There were significant differences between preoperative and postoperative scores ( P < 0.05 ).Conclusion Arthroscopy may be the least invasive, most effective and safest treatment for LMRCT.%目的 探讨全关节镜下手术对大型及巨大肩袖撕裂进行治疗的手术技巧与临床疗效.方法 2004年3月至2008年9月对13例大型或巨大肩袖撕裂患者行肩关节镜下手术治疗,男3例,女10例;年龄45~72岁,平均58.3岁.4例有肩关节摔伤病史,3例有搬抬重物致伤史,其余患者无明显外伤史.肩关节疼痛、无力病史4个月~7年,平均10.6个月.关节镜下11例患者行肩峰成形术,8例行肩袖组织缝合锚修复,5例行单纯肩袖组织清理等.采用视觉模拟法(VAS)疼痛评分和加州大学洛杉矶分校(UCLA)肩关节功能评分进行疗效评估.结果 所有患者术后随访16~32个月,平均18.2个月.术前VAS评分为(6.6±1.3)分,末次随访时为(1.5±1.1)分.术前UCLA肩关节评分为(11.2±2.2)分,末次随访时为(29.5±2.2)分.术前与末次随访时各项评分差异均有统计学意义(P<0.05).结论 肩关节镜下手术治疗大型及巨大肩袖撕裂是一种微创、有效、安全的治疗方式.

  3. 关节镜下横杆悬挂法重建前交叉韧带%Arthroscopic anterior cruciate ligament reconstruction using the Transfix technique

    Institute of Scientific and Technical Information of China (English)

    吴磊; 徐斌; 徐洪港

    2011-01-01

    背景:固定移植腱的方法多种多样,每种系统各有其优势,对于用何种方法固定移植的肌腱,目前国际上仍没有一个统一的标准.目的:观察关节镜下横杆悬挂固定法固定自体腘绳肌腱重建膝关节前交叉韧带的临床疗效.方法:选择2008-09/2010-01于安徽医科大学第一附属医院骨二科行膝关节前交叉韧带重建的患者20例.所有患者均应用股骨端横杆悬挂固定和胫骨端界面螺钉组成前交叉韧带固定系统行自体腘绳肌腱前交叉韧带单束重建.重建后随访6~16个月(平均10个月),评估患者的关节活动度、稳定性等指标.结果与结论:随访期间,无严重并发症发生,重建后膝关节活动度均正常.所有患者术前Lysholm膝关节评分为(60.20±11.54)分,重建后6个月为(92.95±3.55)分,较术前明显提高(P < 0.05).截至重建后6个月,IKDC评分18例正常,其余2例接近正常.说明关节镜下应用自体腘绳肌腱横杆悬挂固定法重建前交叉韧带是一种疗效确切的固定方法.%BACKGROUND: The fixed tendon graft have many ways, each system has its own advantages as well as shortcomings. For fixed by what method the tendon graft, the current is still not a unified international standard .OBJECTIVE: To retrospectively evaluate clinical results of arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring autograft and the Transfix technique.METHODS: A total of 20 patients that had been treated with arthroscopic single bundle ACL reconstruction by use of hamstring tendon autografts with ACL fixation system composed of femoral fixation via Transfix and tibia fixation via interference screw in Second Department of Orthopedics, First Affiliated Hospital of Anhui Medical University from September 2008 to January 2010.Twenty cases were followed up for 6-16 months (average 10 months) to assess the patient's range of motion, stability, and other indicators.RESULTS AND CONCLUSIONS: During

  4. Cold bupivacaine versus magnesium sulfate added to room temperature bupivacaine in sonar-guided femoral and sciatic nerve block in arthroscopic anterior cruciate ligament reconstruction surgery

    Science.gov (United States)

    Alzeftawy, Ashraf Elsayed; El-Daba, Ahmad Ali

    2016-01-01

    Background: Cooling of local anesthetic potentiates its action and increases its duration. Magnesium sulfate (MgSo4) added to local anesthetic prolongs the duration of anesthesia and postoperative analgesia with minimal side effects. Aim: The aim of this prospective, randomized, double-blind study was to compare the effect of cold to 4°C bupivacaine 0.5% and Mg added to normal temperature (20–25°C) bupivacaine 0.5% during sonar-guided combined femoral and sciatic nerve blocks on the onset of sensory and motor block, intraoperative anesthesia, duration of sensory and motor block, and postoperative analgesia in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. Patients and Methods: A total of 90 American Society of Anesthesiologists classes I and II patients who were scheduled to undergo elective ACL reconstruction were enrolled in the study. The patients were randomly allocated to 3 equal groups to receive sonar-guided femoral and sciatic nerve blocks. In Group I, 17 ml of room temperature (20–25°C) 0.5% bupivacaine and 3 ml of room temperature saline were injected for each nerve block whereas in Group II, 17 ml of cold (4°C) 0.5% bupivacaine and 3 ml of cold saline were injected for each nerve block. In Group III, 17 ml of room temperature 0.5% bupivacaine and 3 ml of MgSo4 5% were injected for each nerve block. The onset of sensory and motor block was evaluated every 3 min for 30 min. Surgery was started after complete sensory and motor block were achieved. Intraoperatively, the patients were evaluated for heart rate and mean arterial pressure, rescue analgesic and sedative requirements plus patient and surgeon satisfaction. Postoperatively, hemodynamics, duration of analgesia, resolution of motor block, time to first analgesic, total analgesic consumption, and the incidence of side effects were recorded. Results: There was no statistically significant difference in demographic data, mean arterial pressure, heart rate, and duration of

  5. Evaluation of the results from arthroscopic tenodesis of the long head of the biceps brachii on the tendon of the subscapularis muscle

    Directory of Open Access Journals (Sweden)

    Marcelo Baggio

    2016-04-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the results from arthroscopic tenodesis of the long head of the biceps brachii (LHBB on the tendon of the subscapularis muscle, with regard to the presence of pain, subscapularis lesion, presence of Popeye's sign and patient satisfaction. METHODS: A prospective cohort study was conducted on 32 patients with LHBB lesions, through preoperative interviews and physical examinations, which were repeated six months after the operation. The main variables studied were the belly press, bear hug and lift-off tests, Popeye's sign, anterior pain and satisfaction. The data were entered into Epi Info 3.5.4 and SPSS 18.0. In order to investigate the variables of interest, the chi-square, Student t and Kruskal-Wallis tests were used. The confidence interval was 95% and p values less than 0.05 were taken to be statistically significant. RESULTS: 32 patients of median age 57.5 years were evaluated. Anterior pain was reported by one interviewee after the operation. The tests for evaluating subscapularis lesions did not show any damage to this musculature after the surgery. Popeye's sign was negative in all the patients. The patient satisfaction rate reached 90.6% of the interviewees. CONCLUSION: This study showed that the new surgical technique described here presented excellent performance, without any subscapularis lesion and without identifying Popeye's sign. Only 3.1% of the patients had complaints of residual pain. The high level of satisfaction among the patients after the surgery confirms the results presented.

  6. Arthroscopic Fixation of Cell Free Polymer-Based Cartilage Implants with a Bioinspired Polymer Surface on the Hip Joint: A Cadaveric Pilot Study

    Directory of Open Access Journals (Sweden)

    Matthias Lahner

    2014-01-01

    Full Text Available This study investigates the adhesion capacity of a polyglycolic acid- (PGA- hyaluronan scaffold with a structural modification based on a planar polymer (PM surface in a cadaver cartilage defect model. Two cadaver specimens were used to serially test multiple chondral matrices. In a cadaver hip model, cell free polymer-based cartilage implants with a planar bioinspired PM surface (PGA-PM-scaffolds were implanted arthroscopically on 10 mm × 15 mm full-thickness femoral hip cartilage lesions. Unprocessed cartilage implants without a bioinspired PM surface were used as control group. The cartilage implants were fixed without and with the use of fibrin glue on femoral hip cartilage defects. After 50 movement cycles and removal of the distraction, a rearthroscopy was performed to assess the outline attachment and integrity of the scaffold. The fixation techniques without and with fibrin fixation showed marginal differences for outline attachment, area coverage, scaffold integrity, and endpoint fixation after 50 cycles. The PGA-PM-scaffolds with fibrin fixation achieved a higher score in terms of the attachment, integrity, and endpoint fixation than the PGA-scaffold on the cartilage defect. Relating to the outline attachment, area coverage, scaffold integrity, and endpoint fixation, the fixation with PGA-PM-scaffolds accomplished significantly better results compared to the PGA-scaffolds (P=0.03752, P=0.03078, P=0.00512, P=0.00512. PGA-PM-scaffolds demonstrate increased observed initial fixation strength in cadaver femoral head defects relative to PGA-scaffold, particularly when fibrin glue is used for fixation.

  7. Evaluation of the results from arthroscopic tenodesis of the long head of the biceps brachii on the tendon of the subscapularis muscle☆

    Science.gov (United States)

    Baggio, Marcelo; Martinelli, Fabrício; Netto, Martins Back; Martins, Rafael Olívio; da Cunha, Romilton Crozetta; Stipp, Willian Nandi

    2016-01-01

    Objectives The aim of this study was to evaluate the results from arthroscopic tenodesis of the long head of the biceps brachii (LHBB) on the tendon of the subscapularis muscle, with regard to the presence of pain, subscapularis lesion, presence of Popeye's sign and patient satisfaction. Methods A prospective cohort study was conducted on 32 patients with LHBB lesions, through preoperative interviews and physical examinations, which were repeated six months after the operation. The main variables studied were the belly press, bear hug and lift-off tests, Popeye's sign, anterior pain and satisfaction. The data were entered into Epi Info 3.5.4 and SPSS 18.0. In order to investigate the variables of interest, the chi-square, Student t and Kruskal–Wallis tests were used. The confidence interval was 95% and p values less than 0.05 were taken to be statistically significant. Results 32 patients of median age 57.5 years were evaluated. Anterior pain was reported by one interviewee after the operation. The tests for evaluating subscapularis lesions did not show any damage to this musculature after the surgery. Popeye's sign was negative in all the patients. The patient satisfaction rate reached 90.6% of the interviewees. Conclusion This study showed that the new surgical technique described here presented excellent performance, without any subscapularis lesion and without identifying Popeye's sign. Only 3.1% of the patients had complaints of residual pain. The high level of satisfaction among the patients after the surgery confirms the results presented. PMID:27069883

  8. Arthroscopic reconstruction of multiple ligaments injury of knees%膝关节多发韧带损伤的修复与重建

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 王锋; 朱越; 刘闻欣

    2011-01-01

    目的 探讨关节镜下重建膝关节前十字韧带(anterior cruciate ligament,ACL)、后十字韧带(posterior cruciate ligament,PCL)、后内侧韧带结构(posteromedial complex,PMC)或后外侧韧带结构(posterolateral complex,PLC)损伤的疗效.方法 2005年3月至2007年5月,43例膝关节多发韧带损伤患者采用异体肌腱于关节镜下重建ACL和PCL,同期重建增强PMC或PLC损伤.其中24例行ACL和PCL重建+PMC重建,19例行ACL和PCL重建+PLC重建.根据国际膝关节文献委员会(International Knee Documentation Committee,IKDC)评分和Lysholm膝关节功能评分表对患膝功能进行评估.结果 全部患者随访24~48个月,平均(33.10±9.65)个月.患者在0°和20°应力测试时稳定性均完全恢复.IKDC评分入院时均为显著异常(D级),术后随访时正常(A级)29例(67%,29/43)、接近正常(B级)11例(26%,11/43)、异常(C级)3例(7%,3/43).患者术前Lysholm膝关节功能评分为(46.7±4.2)分,末次随访时为(89.6±2.8)分,差异有统计学意义(t=8.563,P<0.01).结论 膝关节多发韧带损伤可于关节镜下行ACL和PCL联合重建,同期行关节外韧带结构修复增强,能有效恢复关节功能,治疗效果满意.%Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were

  9. 关节镜辅助治疗急性髌骨脱位%ARTHROSCOPICALLY ASSISTED TREATMENT FOR ACUTE PATELLAR DISLOCATION

    Institute of Scientific and Technical Information of China (English)

    唐恒涛; 苏训同; 王义隽; 金大地; 赵亮

    2011-01-01

    目的 探讨关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱何的疗效.方法 2006年4月-2009年3月,应用关节镜辅助下改良髌外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位22例25膝.男5例,女17例;年龄14~34岁,平均23.6岁.均突发于屈膝活动过程中.左侧11膝,右侧14膝.出现症状至入院时间为1~10 d,平均5.9 d.患者均为外侧脱位,其中14例脱位后自行复位,8例入院时仍呈脱位状态,给予手法闭合复位.检查示膝关节脱位恐惧试验均为阳性,被动活动受限,其中15例浮髌试验阳性.结果 术后切口均Ⅰ期愈合.22例均获随访,随访时间12~36个月,平均17个月.术后3个月内,12膝出现髌骨内侧皮肤穿刺处凹陷,10膝出现髌骨外侧疼痛,15膝出现髌骨内侧紧绷牵拉感,经理疗康复后均逐渐自行消失或好转.随访期间无复发性髌骨脱位.术后1年膝关节Lysholm评分为(96.6±4.5)分,高于术前的(67.3±5.7)分,差异有统计学意义(t=3.241,P=0.003);疼痛视觉模拟评分(VAS)为(1.8±0.4)分,低于术前的(6.5±0.5)分,差异有统计学意义(t=2.154,P=0.040).术后1年患膝功能采用Insall评分标准,获优18膝,良5膝,可2膝,优良率92%.结论 关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位,创伤小,恢复快,早期临床疗效满意.%Objective To evaluate an improving operative procedure and the clinical results of arthroscopically assisted treatment for acute patellar dislocation. Methods Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, rdease of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The

  10. Pseudoaneurisma de artéria genicular após cirurgia artroscópica de joelho: Relato de dois casos Geniculate artery pseudoaneurysm after arthroscopic knee surgery: Two case reports

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    Edgard dos Santos Pereira Junior

    2010-01-01

    Full Text Available A artroscopia do joelho é considerado um procedimento cirúrgico muito seguro, com um número relativamente pequeno de complicações. Relatamos o caso de dois pacientes do sexo masculino que foram submetidos à artroscopia de joelho (para meniscectomia parcial e reconstrução do ligamento cruzado anterior com parafuso transverso femoral e interferência tibial que desenvolveram um pseudoaneurisma de artéria genicular superior lateral após o procedimento. A ultrassonografia com Doppler realizou o diagnóstico e os pacientes foram tratados cirurgicamente com ligadura arterial. Um paciente apresentou extenso hematoma na coxa e foi necessária reposição volêmica. Estes casos exemplificam uma complicação vascular rara, nem sempre benigna, em uma cirurgia minimamente invasiva do joelho.Arthroscopy of the knee is a very safe surgical procedure, with relatively few complications. Here we present the cases of two patients submitted to arthroscopic surgery for partial meniscectomy and reconstruction of the anterior cruciate ligament with femoral transverse screw and tibial interference screw that developed a superior lateral genicular artery pseudoaneurysm. Doppler ultrasonography was performed for diagnostic purposes and the patients were treated by direct arterial suture. One patient developed a large haematoma requiring volemic replacement. These cases illustrate a rare, and not always benign vascular complication, in a minimally invasive arthroscopic surgery.

  11. Perioperative Nursing of 45 Patients with Knee Joint Surgery Via Arthroscope%45例膝关节镜手术的围手术期护理探讨

    Institute of Scientific and Technical Information of China (English)

    刘惠花

    2013-01-01

    Objective:To investigate perioperative nursing method for patients with knee joint surgery via arthroscope.Methods:A retrospective analysis of 45 cases underwent knee joint surgery via arthroscope.Results:45 patients were all successfully discharged.There was no serious complication occurred. Conclusion:Strengthen perioperative nursing can help to improve clinical outcomes,reduce patient pain,reduce complications,and promote the speedy recovery of patients.%  目的:探讨膝关节镜术患者的围手术期护理方法。方法:回顾性分析45例行膝关节镜术患者的临床资料及护理措施。结果:本组45例患者均顺利康复出院,无严重并发症发生。结论:加强围手术期护理有助于提高临床疗效,减轻患者痛苦,减少并发症,促进患者早日康复。

  12. Arthroscopic treatment for septic arthritis of the knee%膝关节感染性关节炎的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    杨波; 林进

    2014-01-01

    背景:膝关节感染性关节炎的治疗由于所需时间长、易复发和术后功能恢复差等特点,一直是关节外科临床上的棘手问题,相关的病例报道很多,但对手术技术细节的全面探讨并不多见。  目的:探讨关节镜下清理、冲洗、置管,术后持续大流量灌洗治疗膝关节感染性关节炎的疗效及技术细节。  方法:回顾性分析2004年1月至2014年8月,采用关节镜下清理及术后持续灌洗的方法治疗的膝关节感染性关节炎患者14例。男9例,女5例;年龄28~81岁,平均(48.07±14.56)岁。比较患者术前、术后1周及末次随访时膝关节的伸屈活动度、VAS评分及Lysholm评分。  结果:14例患者平均随访(24.18±12.60)个月(3~45个月)。膝关节术前、术后1周和末次随访时的平均伸直度分别为5.71°±5.29°、3.57°±3.49°和1.14°±1.50°;平均屈曲度分别为85.77°±33.32°、95.01°±25.12°和116.79°±11.43°;VAS评分分别为(8.64±0.97)分、(5.43±1.80)分和(1.14±1.19)分。术前和末次随访时的Lysholm评分分别为(51.93±10.86)分和(89.07±4.99)分。至末次随访时,无1例复发。t检验结果:术后1周和末次随访时的VAS评分均较术前有明显下降(P0.05),但末次随访时的伸屈度数与术前比较,均有显著统计学差异(P  结论:关节镜下清理、冲洗、置管,术后持续灌洗治疗膝关节感染性关节炎可以显著改善患膝的症状及功能,是一种创伤小、恢复快的有效方法。%Background:Treatment of septic arthritis of the knee has been a troublesome problem in joint surgery due to its prolonged time needed for treatment, recurrent characteristics and poor functional recovery. Though there are many reports about it, few comprehensive discussion on the technical details of the operation is seen. Objective:To investigate the role of arthroscopic debridement

  13. Avaliação dos resultados do tratamento artroscópico da epicondilite lateral Evaluation of the results of arthroscopic treatment of the lateral epicondylitis

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    Alberto Naoki Miyazaki

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes com epicondilite lateral tratados cirurgicamente pela técnica artroscópica. MÉTODOS: Vinte pacientes foram operados pela técnica artroscópica. A idade variou de 19 a 54 anos (média de 41 anos e oito meses, sendo 12 (60% pacientes do sexo feminino e oito (40%, do masculino. O seguimento mínimo foi de 12 meses e o máximo, de 48 meses, sendo a média de 20 meses. Todos os casos eram refratários ao tratamento conservador (repouso e fisioterapia, com tempo de tratamento clínico prévio variando entre seis e 136 meses. Para a avaliação dos resultados utilizamos os critérios da Associação Médica Americana (AMA, modificados por Bruce. RESULTADOS: Obtivemos 13 (65% resultados excelentes e sete (13% regulares, com apenas uma complicação (distrofia simpático-reflexa. Este foi o único caso que referiu não estar satisfeito. CONCLUSÃO: O tratamento cirúrgico pela técnica artroscópica da epicondilite lateral do cotovelo representa uma boa opção para 65% dos casos.OBJECTIVE: To evaluate the results in patients with lateral epicondylitis surgically treated by the arthroscopy technique. METHODS: Twenty patients were submitted to surgery by the arthroscopic technique. Age ranged from 19 to 54 years (average 41 years and eight months. Twelve (60% of the patients were female and eight (40% male. The minimum follow-up period was 12 months and the maximum period, 48 months, with an average of 20 months. All the cases were refractory to conservative treatment (rest and physiotherapy, with previous clinical treatment times varying ranging from six to 136 months. For the evaluation of the results, we used the criteria of the American Medical Association (AMA, modified by Bruce. RESULTS: We obtained 13 (65% excellent results and seven (13% regular results, with just one complication (reflex sympathetic dystrophy. This was the only patient who reported dissatisfaction. CONCLUSION: Surgical treatment

  14. 关节镜下重建前交叉韧带的康复护理%Rehabilitation nursing of arthroscopic reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    范柳萍; 黄房珍; 李晓芳

    2012-01-01

    目的:探讨膝关节镜下行前交叉韧带重建的康复护理.方法:对26例膝关节前交叉韧带损伤患者在膝关节镜下行前交叉韧带重建术后进行系统的护理和康复训练,如术前重视心理护理,术后进行患肢膝关节持续冰敷48 h,并指导患者在佩戴膝关节角度锁定支具下早期进行有计划、有规律性的康复训练.结果:患者均顺利康复出院.随访3个月~2年,所有病例术前症状消失,完全恢复正常行走,步态、关节的稳定性及活动度均正常,抽屉试验阴性,无1例发生关节僵硬、皮肤坏死、股四头肌功能下降.结论:膝关节镜下行前交叉韧带重建手术,术前进行有效的心理护理是手术成功的基本前提,术后进行系统的护理和早期进行有计划、有目的、循序渐进的功能锻炼是保证其成功康复的关键.%Objective;To explore rehabilitation nursing of arthroscopic reconstmcition of the anterior cruciate ligament. Methods: Postoperative rehabilitation training for 26 case3 of anterior cruciate ligament reconstructed in the arthroscopy, preoperative psychological nursing, limb knee sustained ice 48 h affter surgeny,guided patients to train designedly and regularly under angle locking brace protected in the early. Results;All patients were followed up for3 months to 2 years, got normal walking gait, good joint stability and activity, drawer test was negative. And no case of stiff joints,skin necrosis,and quadriceps function decreased. Conclusion: Psychological nursing before operation was the basic of the surgery. Postoperative systematic nursing and early, planned, purposeful and progressive functional exercise was the key of success.

  15. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

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    Hall Michelle

    2012-11-01

    Full Text Available Abstract Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home

  16. Analysis of clinical effect of arthroscopic surgery in osteoarthrosis of knee%膝关节骨关节病应用关节镜手术疗效临床分析

    Institute of Scientific and Technical Information of China (English)

    吴健; 姚力; 王兵; 马克勇

    2015-01-01

    Objective To analyze the clinical effect of arthroscopic surgery in osteoarthrosis of knee. Methods 60 patients with osteoarthrosis of knee were selected in our hospital as the research object and were divided into two groups based on the different treatment nethods,with 30 cases in each group.To observe and to compare the clinical effect of patients in control group who were treated with conservative treatment,such as physical therapy,drug,and Chinese medicine and so on,and patients in observation group who were treated with arthroscopic surgery. Results Clinical results showed that,the total effective rate in observation group was better than which in control group, the change of postoperative score in observation group was better than which in control group,the differences were statically significant(P<0.05). Conclusion Arthroscopic surgery in the treatment of osteoarthrosis of knee has less trauma,faster rehabilitation,less complication,has significant clinical effect,is worthy of popularization and application.%目的:分析并研究膝关节骨关节病应用关节镜手术临床疗效。方法将我院膝关节骨关节病患者60例作为研究对象,按其治疗方法分成两组,每组30例。对照组患者实施保守治疗,比如:理疗、药物、中医中药等,观察组患者借助关节镜手术进行治疗,观察、比较两组患者临床治疗结果。结果临床结果显示,观察组患者治疗总有效率优于对照组,差异有统计学意义(P<0.05);且观察组术后评分变化情况优于对照组,差异有统计学意义(P<0.05)。结论对膝关节骨关节病患者借助关节镜手术进行治疗,创伤小、康复快、并发症少,临床效果显著,值得推广应用。

  17. 肩关节镜带线锚钉内固定术治疗复发性肩关节脱位%Clinical Research of Arthroscopic Suture Anchor Fixation Treatment with Recurrent Shoulder Joint Dis-location

    Institute of Scientific and Technical Information of China (English)

    沈烈军

    2014-01-01

    目的:探讨肩关节镜下带线锚钉内固定术治疗复发性肩关节脱位的效果。方法:选取复发性肩关节脱位患者76例,随机分为观察组与对照组各38例,观察组采用肩关节镜下带线锚钉内固定术治疗,对照组给予改良Bristow手术治疗。结果:观察组UCLA评分(33.13±1.49)分,VAS评分(0.54±0.49)分,外展90°位外旋角度(73.62±13.98)°,肩关节前屈上举角度为(157.24±17.38)°,优良率97.37%,均优于对照组的78.9%(P<0.05)。结论:肩关节镜下带线锚钉内固定术治疗复发性肩关节脱位,具有良好的应用价值,改善肩关节功能。%Objective To investigate the clinical effects of arthroscopic suture anchor fixation in the treat⁃ment with recurrent shoulder joint dislocation. Methods A total of 76 patients were included in study, were divided into observation group and control group randomly. Observation group were treated with arthroscopic su⁃ture anchor fixation, control group were treated with improved surgical bristow. Results In observation group after surgery, the UCLA score was (33.13±1.49), the VAS score was (0.54±0.49), the abduction and external rota⁃tion angle of 90° position was (73.62±13.98)°, the shoulder flexion angle was (157.24±17.38)°, the excellent rate was 97.37%. All indicators had significant differences compared with control group (P<0.05). Conclusion These results suggest that recurrent shoulder joint dislocation in the treatment of arthroscopic suture anchor fixa⁃tion has the exact value, can improve joint function.

  18. Arthroscopic Treatment for Tibial Avulsion Fractures of Anterior Crucial Ligament with Orthocord Suture Fixation%关节镜下Orthocord缝线固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    王洪; 孙川; 孟春庆; 杨述华; 杜靖远; 邵增务

    2011-01-01

    Objective To investigate the methods and effects of the arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament. Methods Twenty seven patients with tibial avulsion fractures were treated with operation. The avulsion fragment was reduced under arthroscopy. Two bone tunnels were drilled from internal tibial tuberosity to the both sides of the avulsed fragment.2# Orthocord suture was used for arthroscopic fixation of the fractures. Results All patients were followed up for 12.3 months on average (7-24 months). X-ray confirmed satisfactory healing. At the latest follow-up, the average Lysholm knee score was 93.1 points (84-100 points), the Lach-man test and anterior drawer test were both negative and the range of motion was normal in 22 cases while limited in 5 cases. Conclusion Arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament with Orthocord suture fixation is easy and minimally invasive. It can lead to reliable fixation and less complications, and facilitate early rehabilitation.%目的 探讨前交叉韧带(ACL)胫骨止点撕脱骨折关节镜下治疗的方法及疗效.方法 对27例ACL胫骨止点撕脱骨折进行手术,关节镜下将骨折复位后,从胫骨结节内侧向骨折块的两侧钻取两个骨隧道,使用2号Orthocord缝线固定骨折.结果 本组均得到随访,平均12.3个月(7~24个月),X线片示骨折愈合良好.术后末次随访Lysholm评分平均93.1分(84~100分),Lachman试验及前抽屉试验均为阴性,22例关节活动度达到正常,5例存在关节活动受限.结论 关节镜下使用Orthocord缝线固定治疗ACL胫骨止点撕脱骨折具有固定可靠、操作简单、手术创伤小、术后恢复快、并发症少等优点.

  19. 采用关节镜技术治疗化脓性关节炎的个性化护理%Individual nursing of arthroscopic technology to treat the septic arthritis

    Institute of Scientific and Technical Information of China (English)

    王粉粉; 吴九妹

    2016-01-01

    目的:观察关节镜下治疗早中期化脓性关节炎的疗效。方法从2013~2014年在本院采取关节镜下清理病灶和术后无菌生理盐水+庆大霉素持续行关节腔冲洗的方法进行治疗26例化脓性关节炎,并根据治疗方法进行评估,采用个性化的护理。结果经临床治疗观察,治疗前后膝关节活动度和膝关节功能明显恢复。结论采用关节镜技术治疗早中期化脓性膝关节炎并结合个性化护理,能够做到创伤小,痛苦少,恢复快,大大缩短卧床时间,减轻了患者的经济负担。%Objective To observe the efficacy of treatment of the early and mid-septic arthritis under the ar-throscopic technology. Methods A total of 26 cases of patients with septic arthritis in our hospital from 2013 to 2014 , who were treated with arthroscopic technology to clean the lesion and post-operation sterile saline, combined with genta-micin for continuous articular cavity flushing, were evaluated according to the treatment method and were given the per-sonalized care. Results After clinical observation, the activity and function of the knee recovered obviously after treat-ment. Conclusions Arthroscopic treatment combined with personalized care for early and mid-septic knee beared the characteristics of less trauma, less pain, quicker recovery, and meanwhile, it shortened the time in bed and reduced the financial burden on patients.

  20. 关节镜下射频气化联合碳酸氢钠灌洗治疗膝痛风性关节炎%The Treatment of Knee Gouty Arthritis with Radio Frequency and Sodium Bicarbonate by Arthroscope

    Institute of Scientific and Technical Information of China (English)

    臧学慧; 高立华; 孙辉; 苗贵强

    2014-01-01

    目的:探讨关节镜下射频气化联合酸氢钠灌洗治疗膝痛风性关节炎的疗效。方法对56例痛风性关节炎患者,术前碳酸氢钠灌洗,利用关节镜下射频气化清理膝关节痛风结石。结果56例患者膝关节疼痛均消失,随访时间16~38(24±4)个月,无复发。根据Lysholm膝关节评分方法,术前评分平均43.6分;术后终末复查评分平均89.8分,两者相比,差异有显著性(<0.05)。结论关节镜下利用射频气化联合碳酸氢钠灌洗清除关节内痛风结晶,具有效率高、清除完全,是一种见效快、创伤小、效果确切的治疗方法。%Objective To explore the effect of radio frequency and sodium bicarbonate by arthroscope in treatment of knee gouty arthritis .Methods 56 patients with knee gouty arthritis were treated by sodium bicarbonate preoperatively and then gouty stone was cleared out with radio frequency and sodium bicarbonate by arthroscope.Results Pain in 56 patients was significantly alleviated postoperatively and no case recurred after fol owing up 16~38 (24±4)months . Lysholm score improved from 43.6 preoperatively to 89.8 postoperatively and the dif erence was statistical y significant ( <0.05).Conclusion That the treatment of knee gouty arthritis with radio frequency and sodium bicarbonate by arthroscope is rapid,micro-traumatic and effective for high ef iciency and completely clearing up.

  1. Efficacy analysis of arthroscopic reconstruction of anterior cruciate ligament with autogenous semitendinosus%关节镜下4股半腱肌肌腱重建前交叉韧带疗效观察

    Institute of Scientific and Technical Information of China (English)

    寿志强; 孙俊英; 管国华; 谢文龙

    2011-01-01

    Objective To analyze the influential factors on effect of arthroscopic anterior cruciate ligament ( ACL )reconstruction with semitendinosus.Methods A retrospective analysis was performed in 25 patients of arthroscopic ACL reconstruction with semitendinosus autograft.Through anterior knee small incision.semitendinosus was folded into four strands.After respectively established the tibia tunnel and femur tunnel, the anatomical structure and ACL physiological function reconstruction was performed, and followed by early postoperative function exercise.Results All of the 25 patients were followed up for 12 ~ 36 months.Preoperative Lachman test was ( + ) , and postoperative Lachman test was( - ).Preoperative Lysholm score was 27 ~ 71(53 ± 13.22 )points, which raised to postoperative 78 ~ 94( 87 ±3.42 )points.Conclusions Semitendinosus autograft has good tensile strength and rigidity.Under the arthroscope,using four strands of semitendinosus for reconstruction of knee anterior cruciate ligament is a reliable treatment.%目的 关节镜下以半腱肌肌腱重建膝前交叉韧带(ACL),分析影响治疗效果的因素.方法 关节镜下4股半腱肌肌腱修复膝ACL损伤25例.膝前小切口取半腱肌肌腱对折后成4股,分别建立胫骨隧道及股骨隧道,重建膝ACL的解剖结构和生理功能,术后早期行功能锻练.结果 25例均获随访,时间12~36个月.术前Lachman征(+),术后Lachman征(-).Lysholm评分从术前27~71(53±13.22)分提高到术后78~94(87±3.42)分.结论 半腱肌肌腱具有良好的抗拉强度和刚度,在关节镜下用4股半腱肌肌腱重建膝ACL是一种疗效可靠的治疗方式.

  2. Operative cooperation of arthroscopic reconstruction of anterior cruciate ligament and posterior ligament with autologous tendons%关节镜下自体肌腱重建膝关节前后交叉韧带的手术配合

    Institute of Scientific and Technical Information of China (English)

    冯立文; 韩华; 安亚珍; 关冬叶

    2015-01-01

    目的 探讨关节镜下自体肌腱重建膝关节前后交叉韧带手术的效果及总结护理经验. 方法 对11例前后交叉韧带同时断裂患者行关节镜下自体肌腱重建膝关节前后交叉韧带手术,做好手术前物品准备,熟练掌握仪器性能、使用步骤、连接方式和注意事项;术中熟练、准确、敏捷的配合.结果 患者手术顺利完成,手术时间(2.7 ± 0.2)h,术中出血(32.0 ± 9.8)mL,术后无1例感染.术后Lyshlom评分(92.6 ± 3.2)分高于术前(65.5 ± 3.1)分,差异有统计学意义(P<0.01).结论 关节镜下应用自体肌腱进行膝关节前后交叉韧带的重建具有良好的临床治疗效果. 充足的术前准备、熟练的手术配合是手术成功的关键.%Objective To summarize the operative effect and nursing experience of arthroscopic reconstruction of anterior cruciate ligament (ACL) and posterior ligament (PCL) with autologous tendons. Methods Eleven patients with both ACL and PCL were treated with surgical operation by arthroscopic reconstruction of anterior cruciate ligament and posterior ligament with autologous tendons. Before operation, supplies of surgical articles, mastery of the instrument's properties, procedures, connection mode and precautions were well performed. During the operation, the nursing measure covered also accurate, skilled and agile cooperation. Results The operation was successfully completed, with the average time of (2.7 ± 0.2)h, bleed volume of (32.0 ± 9.8)mL. No infections occurred after surgery. The Lysholm score after operation was higher than that before operation (92.6 ± 3.2 vs. 65.5 ± 3.1;P<0.01). Conclusion Arthroscopic reconstruction of anterior cruciate ligament and posterior ligament with autologous tendons has good clinical therapeutic effect. Preoperative well preparation and expertly operative cooperation are critical for the success of surgery.

  3. Clincal report on arthroscopic reconstruction of anterior cruciate ligament using ligament advanced reinforcement system%关节镜下人工韧带重建前交叉韧带临床研究

    Institute of Scientific and Technical Information of China (English)

    董伟强; 尹知训; 白波; 郭志勇

    2011-01-01

    目的 总结关节镜下先进韧带加强系统(LARS,ligament advanced reinforcement system)人工韧带在膝关节前交叉韧带(ACL,anterior cruciate ligament)重建中的早期疗效及注意事项.方法 2006年1月-2010年8月,对15例膝关节ACL损伤患者行关节镜下LARS人工韧带重建术.结果 术后患者均随访9~24个月,平均15个月,术后膝关节不稳症状消失,屈伸活动度为O°~135°;术后14例前抽屉试验、Lanchman试验和轴移试验均为阴性,1例出现可疑Lanchman试验和前抽屉试验阳性;Lysholm膝关节均分为(86.40±2.14)分,与术前比较差异有显著性(P<0.05).结论 LARS人工韧带重建ACL早期效果满意;术中应尽量保留较多的韧带残端和使用准确的等长重建方法.%Objective To explore the operative techniques and preliminary clinical effect of arthroscopic reconstruction of anterior cruciate ligament (ACL) using ligament advanced reinforcement system (LARS).Methods From Jan.2006 to Aug.2010,15 patients with ACL rupture were treated with LARS under arthroscopic observation.All were males,aged 23.0-53.0 years old.All patients had unstable feeling in their knees.The anterior drawer test,Lanchan test and pivot shift test were positive.The average Lyshlom scores was (43.30 ± 1.32).Results All the patients were regular followed up for 9 to 36 months (15 months at average).All the patients feel their knees with no more unstability.The pivot shift test showed 15 case(-); the anterior drawer test and Lanchan test showed 14 case(-),(I) case( ± ).Lysholm scores was (86.40:±:2.14)(P < 0.05) with significant difl`erences with that before operation.Conclusion ACL arthroscopic reconstruction with the use of LARS artificial ligaments leads to rapid recovery and satisfactory clinical efficacy.

  4. Arthroscopic treatment of calcifying tendinitis of the supraspinatus%肩关节镜手术治疗钙化性冈上肌肌腱炎

    Institute of Scientific and Technical Information of China (English)

    戴雪松; 蔡友治

    2011-01-01

    目的 探讨钙化性冈上肌肌腱炎的病理特点和肩关节镜手术的疗效.方法 2009年3月至2010年10月采用关节镜下手术治疗钙化性冈上肌肌腱炎34例.根据法国关节镜协会分类方法将钙化灶分成三组:小(<10mm)、中(10~20mm)和大(>20mm).所有病例均行关节镜下钙化灶清除术和肩峰下滑囊切除术,同时行肩峰成形术(8例),肩袖修补术(10例).所有研究病例均在术前及术后随访时采用Constant评分、疼痛视觉模拟评分(visual analog scale,VAS)评估其疗效,手术前后均摄肩关节X线片和MR检查,其中9例行组织学和透射电镜检查.结果 34例患者获得平均11.5个月的随访.术前1个月、术前2天和末次随访时Constant评分分别为(36.1±6.9)分、(55.6±12.4)分和(89.7±2.7)分,VAS评分分别为(8.2±0.8)分、(7.03±0.7)分和(1.7±0.3)分,治疗前后评分的差异均有统计学意义,而三组间(小、中和大钙化灶)疗效的差异无统计学意义.患者在术后随访期间均未复发.病理检查发现钙化灶周围组织未见胶原纤维退变,周围可见新生胶原,细胞未见坏死溶解.结论 正确认识钙化性肌腱炎的临床特点并准确把握手术时机是取得良好疗效的关键.肩关节镜手术是治疗钙化性肌腱炎安全、有效且微创的方法.对不同大小的钙化灶,术后均可取得满意的效果.%Objective To investigate the pathological features and clinical outcomes of the arthroscopic treatment for calcifying tendinitis of the supraspinatus. Methods From March 2009 to October 2010,34 patients with calcifying tendinitis of the supraspinatus were treated with shoulder arthroscopy. Based on size of calcifying deposits, they were divided into three groups: small (<10 mm), middle (≥ 10 mm, ≤20mm), and large (>20 mm). All patients underwent arthroscopic calcium excision and subacromial decompression, and acromioplasty of shoulder was performed in 8 cases, rotator cuff

  5. 复发性肩关节前脱位的关节镜治疗%Arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    朱以明; 鲁谊; 冯华; 洪雷; 姜春岩

    2008-01-01

    目的 探讨肩关节镜下Bankart重建手术治疗复发性肩关节前脱位的疗效、适应证和手术要点.方法 随访40例应用肩关节镜下Bankart重建进行治疗的复发性肩关节前脱位患者,随访时间为24~58个月,平均35.9个月;年龄15~54岁,平均27.8岁.40例均为单方向性不稳定.术前平均脱位次数为14.1次(2~90次),其中28例发生于主力侧.术中采用金属缝合锚(Mini-Revo)进行Bankart重建.随访内容包括ASKS评分、Constant-Murley评分、VAS不稳定评分及ROWE评分进行功能评估.结果 40例患者术前和终末随访时肩关节前屈上举平均为[(157.5±20.6)°,x ±s.下同]和(170.0±6.7)°,体侧外旋平均为(58.5±18.9)°和(55.9±15.0)°,ASES评分平均为(82.7±16.7)和(97.2±6.9),VAS不稳定评分平均为(6.2±1.6)和(1.3±1.4),Constant-Murley评分平均为(80.5 ±11.1)和(98.1±3.1),Rowe评分平均为(30.4±8.7)和(92.8±15.2).除体侧外旋术前和术后差异无统计学意义外,其余各项结果差异均有统计学意义.终末随访时有1例患者曾出现肩关节半脱位.随访时发现残存恐惧试验阳性3例(占7.5%).所有患者均恢复术前工作,29例(占70.7%)恢复到第一次脱位前的运动水平.结论 肩关节镜下Bankart重建手术是治疗复发性肩关节前脱位的有效方法之一.适当的病例选择、术者的关节镜下操作技术水平及术后长期而严格的功能康复锻炼是手术成功的关键.%Objective To discuss the indications, surgical techniques and results of arthroscopic Bankart repair for the treatment of recurrent anterior shoulder dislocation. Methods Fourty patients with recurrent anterior shoulder dislocation treated by athroscopic Bankart repair were reviewed with a mean follow- up period of 35.9 (24 -58) months. The mean age was 27.8 (15 -54) years. All patients were diagnosed as unidirectional anterior instability. They were treated with arthroscopic Bankart repair. Metal suture anchors

  6. Arthroscopic repair of meniscal injury with Fast-fix system%Fast-fix系统修复半月板损伤临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    唐恒涛; 赵亮; 燕华; 金大地; 苏训同

    2012-01-01

    [ Objective ] To evaluate the effect of the arthroscopic repair of the meniscal injury with the Fast-fix system. [ Method ] From July 2007 to June 2009, totally 2S4 cases of meniscus injury were treated with Fast-fix system under arthroscope and 96 cases were followed up successfully. There were 58 males and 38 females,aged from 12 to 46(mean 24.3) years. The course was 3 days - 1 year (mean 43.5 days)from injury to treatment. Forty-six right and fifty left knees were involved. They were located in ante-homer (n = 12), body (n = 46) and post-horner (n = 38). The lesion were in the red ( n = 32 ) , red white ( n = 42) and while (n = 22) region, respectively. All inside were used in 56 cases, outside in were used in 8 cases and inside out was used in 32 cases. Generally ,1-3 sutures were used for each patient. The hospital stay was 3-14 days( mean 8 days). The clinical cure criteria of menical injury included no lock.no pain.no swell and negative McMurray test. [Result] All the patients were followed-up.Lysholm rating system was used to determine the function of the knee and the level of activity of the patients. After operation, all the patients were clinically cured. The effects of surgery were satisfactory. The preoperative Lysholm score was 45.10 ±12.55 and the postoperative Lysholm score was 82.34± 10.50,and there was significant difference (t =3. 25,P <0.01). [Conclusion]The Fast-fix system is an efficient,safe and effective suture instrument for meniscal repair.%[目的]评价Fast-fix系统修复半月板损伤的临床疗效.[方法]自2007年7月~2009年6月,关节镜辅助下用Fast-fix系统治疗半月板损伤患者254例,96例患者得到随访.男58例,女38例,年龄12~46岁,平均24.3岁.病程3d~1年,平均43.5 d.右膝46例,左膝50例;前角损伤12例,体部撕裂46例,后角撕裂38例;红区损伤32例,红白区损伤42例,白区损伤(延长红白区)22例.All-inside缝合56例,Outside-in缝合8例,Inside-Out缝合32

  7. Tratamento artroscópico da luxação acromio-clavicular pelo método "tight rope" (arthrex® Arthroscopic treatment of acromioclavicular joint dislocation by tight rope technique (arthrex®

    Directory of Open Access Journals (Sweden)

    Luis Alfredo Gómez Vieira

    2009-02-01

    Full Text Available OBJETIVO: Apresentar a técnica cirúrgica artroscópica pelo método "Tight Rope" e a avaliação dos resultados com esta técnica no tratamento da luxação acrômio-clavicular aguda. MÉTODOS: entre agosto de 2006 e maio de 2007, 10 ombros de 10 pacientes com luxação acrômio-clavicular aguda foram submetidos a tratamento artroscópcio pela técnica Tight Rope-Arthrex®. O seguimento mínimo foi de 12 meses, com média de 15 meses. A idade variou de 26 e 42 anos com média de 34 anos. Todos os pacientes eram do sexo masculino. Todos os pacientes foram atendidos na fase aguda da lesão sendo avaliados por radiologia simples (série trauma. Os pacientes foram acompanhados semanalmente no primeiro mês e a cada três meses após o procedimento artroscópico. A avaliação clínica foi feita por meio dos critérios da University of Califórnia at Los Angeles (UCLA. RESULTADOS: Todos os pacientes operados agudamente encontravam-se satisfeitos com os resultados do tratamento cirúrgico artroscópico com uma média de 32,5 pontos na escala de avaliação da UCLA. CONCLUSÃO: O tratamento artroscópico da luxação acrômio-clavicular aguda pelo método "Tight Rope" é uma técnica cirúrgica minimamente invasiva que mostrou-se eficiente para o tratamento destas lesões.OBJECTIVE: Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. METHODS: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University

  8. 膝关节疾病合并下肢静脉血栓的关节镜治疗%The treatment of arthroscopic surgery on knee joint disease accompanied by thrombosis of lower limb

    Institute of Scientific and Technical Information of China (English)

    冯伟; 许建中; 辛若冰; 吴增浦

    2011-01-01

    [ Objective ] To explore the methods and therapeutic effect of arthroscope on knee joint disease accompanied by thrombosis of lower limb. [ Methods ] 30 patients with knee joint disease accompanied by thrombosis of lower limb, been cured from December 2007 to January 2010, all come from Department of Orthopaedics, First Affiliated Hospital, Zhengzhou University. Of which 11 patients are osteoarthritis, 19 cases are cruciate ligament injury. 20 cases are left keen, while 10 cases are right keen. Arthroscopic treatment was carried out on the clean-up, cruciate ligament reconstruction. Give early postoperative inflammatory, anticoagulant, expansion, while strengthening the limb muscle strength and functional exercise. [ Results ] All 30 patients successfully, no long-term complications of surgery, were followed up for 10-24 months, the efficacy rates were evaluated by Lysholm and Hss. The Lysholm scores ascended from (50±6.0) to (85.5±3.5) (t =30.267, P =0.000). The Hss scores ascended from (49.5± 5.5) to (87.0±2.5) (t=33.6O9, P =0.000). Using SPSS 16.0 software using matching t test analysis, P <0.05, with a statistical significance. [Conclusion] With lower limb thrombosis is not hamper combined surgery arthroscope, Arthroscopic surgery has a small, trauma and rapid recovery features.%目的 探讨膝关节疾病同时伴有下肢血栓的关节镜治疗方法及临床疗效.方法 对2007年12月~2010年1月郑州大学一附院骨科收治的30例膝关节疾病同时伴有下肢血栓患者临床资料进行分析,其中骨性关节炎患者11例,交叉韧带损伤者19例,左膝20例,右膝10例,在关节镜下分别对之进行关节清理、交叉韧带重建,术后早期给以抗炎、抗凝、扩容,同时加强患肢肌力和功能锻炼.结果 30例患者全部成功,随访6~25个月,术后均无出现下肢血栓,无手术远期并发症,疗效按Lysholm及Hss膝关节评分标准进行评定,Lysholm评分由术前(50.0±6.0)分提高到术后(85

  9. Características radiográficas, artroscópicas y biomecánicas de perros con ruptura del ligamento cruzado anterior Radiographic, arthroscopic and biomechanical findings in dogs with ruptured anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    RF Silva

    2013-01-01

    Full Text Available Los objetivos de este estudio fueron describir los signos clínicos asociados con alteraciones de la marcha, y correlacionar los resultados del examen radiológico, artroscópico y análisis de la marcha en la plataforma de fuerza en perros con ruptura natural del ligamento cruzado anterior (LCA. 10 perros con ruptura clínica del LCA se utilizaron en este estudio. Durante el ingreso cada perro fue evaluado para conocer el grado del daño articular artroscópico y radiológico, además del tipo de trastorno de la marcha por análisis de la marcha en plataforma de fuerza. El examen radiográfico no se correlacionó con los hallazgos artroscópicos. Los cambios radiológicos fueron menos severos que la evaluación directa de la articulación durante la artroscopia. Las alteraciones de la marcha fueron variadas. La distribución de la masa corporal fue de 66,38% para los miembros anteriores y 33,62% para los miembros afectados. Se encontró una fuerte correlación negativa (ρ = -0,80 entre el grado de sinovitis y la velocidad de desplazamiento. Los resultados obtenidos de esta investigación permiten concluir que: 1 la artroscopia es necesaria para establecer el compromiso real de la articulación, 2 los signos radiográficos no se correlacionan con los hallazgos artroscópicos, y 3 la sinovitis fue la principal causa de alteración de la marcha en los perros de este estudio.The aims of this study were to describe the clinical signs associated with gait disturbances, and correlate the results of radiographic and arthroscopic examination and gait analysis in force platform, in dogs with naturally occurring rupture of the anterior cruciate ligament (ACL. 10 dogs with clinical rupture LCA were used in this study. On admission each dog was evaluated to find out the degree of arthroscopic and radiologic joint damage and the type of gait disturbance by force plate gait analysis. Radiographic examination was not correlated with arthroscopic findings

  10. Modified arthroscopic Latarjet procedure for the treatment of anterior shoulder insta-bility%改良关节镜下喙突移位 Latarjet 手术治疗肩关节前方不稳定

    Institute of Scientific and Technical Information of China (English)

    吴关; 姜春岩; 鲁谊; 朱以明; 李奉龙; 李旭

    2015-01-01

    目的:探讨改良关节镜下喙突移位Latarjet手术的技术特点及手术效果。方法:关节镜下Latarjet手术是治疗复杂肩关节前方不稳定的有效方法,而经典的关节镜下Latarjet手术没有进行前方关节囊的重建,且术中对肩胛下肌破坏较明显。从2013年2月开始,北京积水潭医院运动损伤科对经典关节镜下Latarjet手术进行改良,术中加入前方关节囊重建术,并采取经腱腹结合部位分离肩胛下肌的技术充分保护肩胛下肌,术后第2天行CT检查评价骨移植物位置。结果:2013年2月至2014年8月,共有51例肩关节前向不稳定患者行改良后的关节镜下Latar-jet手术,所有患者手术均顺利完成,术后CT显示,骨块与肩盂平齐的病例为48例(94.1%),偏内侧病例3例(5.9%)。骨块位于2点至5点位置的病例49例占96.0%,高于2点位置1例占2.0%,低于5点位置1例占2.0%。术后随访未发现复发脱位及半脱位。结论:改良关节镜下Latarjet手术不仅可按照经典切开术式进行操作,同时又能兼具关节镜下手术的微创、精细等优势,喙突骨块可达到良好的位置,手术结果满意。%Objective:To present the surgical technique and to evaluate the results of the modified ar-throscopic Latarjet procedure.Methods: Arthroscopic Latarjet procedure has proven to be a reliable method of treatment for difficult anteroinferior instability of the shoulder joint.However, there is no ante-rior capsule reattachment and too much subscapularis damage for the classic procedure.From February 2013 , we modified the classic procedure with reattachment of anterior joint capsule and muscle-tendon junction splitting of subscapularis.Coracoid graft position was evaluated using CT scanning.Results:From March 2012 to August 2014, 51 modified Latarjet procedures were successfully performed arthro-scopically for patients with anterior shoulder

  11. One-stage arthroscopic reconstruction of both cruciate ligaments using Achilles tendon-bone allografts%关节镜下同种异体跟腱骨一期重建膝关节前后交叉韧带

    Institute of Scientific and Technical Information of China (English)

    史德海; 李东会; 刘斌; 金文涛; 蔡道章

    2009-01-01

    Objective To evaluate one-stage arthroscopic reconstruction of anterior crueiate ligament (ACL)and posterior cruciate ligament(PCL)using Achilles tendon-bone allografts. Methods From July 2000 to February 2005.we treated 15 patients(11 males and 4 females)whose ACL and PCL were ruptured at one knee but the eontralateral knee was intact.Their associated meniscus injuries were treated arthroscopically according to established procedures prior to ligament reconstruction.Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees at one stage.Reconstruction of both ligaments was performed at subacute or chronic phase(>3 to 8 weeks)in 12 casses,and at acute phase in 3 cases(3周)重建12例,急性期(<3周)重建3例.手术前后采用IKDC和Lysholm评分系统对患膝关节功能进行评估,随访结果与对侧健康膝火节进行比较.结果 所有患者均获得36~40个月(平均38个月)随访.根据IKDC评分,术前所有患膝关节功能都严重异常,术后9例患膝功能改善为止常,5例接近正常,1例异常.Lysholm评分由术前平均(56±5)分改善为术后(90±4)分,差异有统汁学意义(t=15.660,P<0.05.结论同种异体跟腱骨可用于关节镜下重建膝关节前后交叉韧带,疗效满意.

  12. Arthroscopic coracoclavicular ligament reconstruction for Rockwood type Ⅲ acromioclavicular joint dislocations%肩关节镜下喙锁韧带重建术治疗 RockwoodⅢ型肩锁关节脱位的疗效研究

    Institute of Scientific and Technical Information of China (English)

    李奉龙; 姜春岩

    2015-01-01

    目的:分析采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效。方法回顾性研究2013年2月至2014年1月连续收治并获得随访的21例 Rockwood Ⅲ型肩锁关节脱位患者的资料。其中男性17例,女性4例。平均年龄42.8岁,平均受伤到手术时间11.1 d。所有患者均于肩关节镜下应用同种异体肌腱重建喙锁韧带并高强度缝线捆扎固定喙锁间隙治疗肩锁关节脱位。术后定期随访,记录患侧肩关节活动范围,并采用疼痛视觉模拟评分(visual analogue score,VAS)、ASES(American shoulder and elbow surgeons)评分及 UCLA(university of California Los Angeles)评分评价患者肩关节功能状况;同时拍摄肩关节正位、侧位及腋位 X 线片,评估是否有肩锁关节复位丢失。结果21例患者术后平均随访(14.6±3.9)个月。末次随访时肩关节平均前屈上举为173.9°±10.3°,体侧外旋为59.5°±14.3°,内旋为第12胸椎体水平,平均 UCLA 评分为(34.1±2.5)分,平均 ASES 评分为(95.5±4.7)分,平均 VAS 评分(0.3±0.6)分。末次随访拍摄肩关节 X 线片未发现肩锁关节复位丢失。结论采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效满意,患者术后可获得良好的肩关节功能。%Background Dislocation of the acromioclavicular joint is a common injury of shoulder girdle.For the dislocation of acromioclavicular joint of Rockwood type Ⅰ and type Ⅱ,patient can obtain satisfactory result from conservative treatment; For the severe dislocation such as Rockwood type Ⅳ and type Ⅴ,operative treatment should be a good choice.However,for the patients of Rockwood type Ⅲ dislocation,the treatment is still controversial.With the development of minimally invasive technique,arthroscopic ligament reconstruction is gradually widely used in the treatment of acromioclavicular joint dislocation.Shoulder arthroscopic operation has the

  13. 膝关节镜下自体腘绳肌腱移植重建前十字韧带部分束损伤%Arthroscopic treatment for anterior cruciate ligament with harmstring autograft transplant

    Institute of Scientific and Technical Information of China (English)

    郑民庆; 侯之启; 陈铭

    2011-01-01

    目的 探讨关节镜下自体腘绳肌腱单束移植重建前十字韧带(anterior cruciate ligament,ACL)部分束损伤的临床效果.方法 2007年1月至2010年5月关节镜下行自体腘绳肌单束重建ACL部分束损伤16例.术前Lysholm评分平均为55.4±6.7分.结果 全部获得随访,随访时间为12~23个月,平均18±4.3个月.术后Lysholm 评分增至平均89.3 +3.3分,有统计学差异(P<0.05).所有患者主观症状均消失,全部恢复正常工作与体育锻炼.结论 应用自体腘绳肌腱重建ACL部分束损伤明显改善膝关节功能.%Objective To observe the clinical outcome of arthroscopic anterior cruciate ligament (ACL) partial bundle reconstruction with harmstring autograft tendon. Methods Sixteen patients underwent reconstruction arthroscopic ACL partial bundle reconstruction with harmstring autograft tendon from January 2007 to May 2010. Results All the patients were followed up, and the duration ranged from 12 to 23 months (average 18 ±4. 3 months). The preoperative subjective symptoms disappeared in all patients. Lysholm scores increased from preoperatively 55. 4 ±6. 7 to 89. 3 ±3. 3 post-operatively (P<0. 05). All patients returned to normal work and physical exercise. Conclusion ACL partial bundle reconstruction with harmstring autograft tendon can significantly improve the function of postoperative knees.

  14. Clinical effectiveness analysis of arthroscopic debridement combined with ozone irrigation for treating gouty arthritis of the knee%关节镜下清理术联合臭氧灌注治疗痛风性膝关节炎

    Institute of Scientific and Technical Information of China (English)

    吴乘风; 徐新毅; 胡英彦; 曾海龙

    2015-01-01

    目的:探讨关节镜下关节清理术联合医用臭氧灌注治疗痛风性膝关节炎的方法和疗效。方法2014年1月至2015年3月,收治的20例24膝痛风性膝关节炎患者,行关节镜下关节清理术联合臭氧灌注;术后密切随访,与我院之前2013年1月至2013年12月,随机选取的20例痛风性膝关节炎单纯行关节镜下关节清理术进行疗效对比。两组术后均接受正规内科抗痛风治疗及饮食控制。结果关节清理术联合臭氧灌注组患者术后3个月膝关节功能Lysholm评分较术前有明显改善(t=-12.534,P<0.05)。膝关节伸直、屈曲、膝关节活动度均较术前明显改善(P<0.05)。随访期间1例1膝术后随访第12个月有复发,总复发率为5%(1/20);但发作频率、持续时间以及发病时关节肿胀、疼痛症状均较术前改善。单纯行关节镜下关节清理术患者术后3个月各项评分虽较术前有改善,但相对联合治疗组Lysholm评分、膝关节屈曲度、复发率及关节活动度有明显统计学差异(均P<0.05)。结论膝关节镜下关节清理术联合医用臭氧灌注治疗痛风性膝关节炎,不但可彻底清理尿酸盐结晶体,复发率低,关节活动功能症状改善明显,近期临床疗效良好。%Objective:To investigate the method and the clinical effectiveness of a combination of the arthroscopic de-bridement postoperatively and ozone irrigation for treating gouty arthritis of the Knee. Methods:Between January 2014 and March 2015,20 cases of 24 Knees with arthritis of the Knee were treated by arthroscopic debridement combined with ozone irrigation. As the control,only arthroscopic debridement was performed in 20 other cases of gouty arthritis of the Knee,who were selected randomly between January 2013 and December 2013. The paitients of two groups were treated with the anti-gout agents and diet control after operation. Results:The Lysholm score was 89. 4 ± 6. 5 at 3

  15. Estudio comparativo de la eficacia del bloqueo supraclavicular en la artroscopia de hombro Comparative study of the efficacy of the supraclavicular block for arthroscopic shoulder surgery

    Directory of Open Access Journals (Sweden)

    C. Morales Muñoz

    2010-12-01

    Full Text Available Introducción: Nuestro objetivo es valorar la eficacia de dos técnicas anestésicas en el tratamiento del dolor postoperatorio, así como su influencia en la estancia hospitalaria, tras la cirugía artroscópica de hombro. Material y métodos: Estudio retrospectivo basado en la recogida de datos de las historias de anestesiología y de nuestra unidad de dolor agudo (UDA, durante un período de 6 meses, seleccionando los casos de artroscopias de hombro realizadas y distribuyendo los pacientes en 2 grupos en función de la técnica anestésica empleada. En el grupo I se incluyó a pacientes con anestesia locorregional (bloque interescalénico e interesternocleidomastoideo combinado con anestesia general. En el grupo II se incluyeron los casos de anestesia general con analgesia por vía intravenosa con bolos de fentanilo. Las variables registradas fueron: dolor posoperatorio, tanto en reposo como en movimiento, en las primeras 24h, utilizando una escala verbal simple (EVS, la presencia de efectos secundarios, la necesidad de rescate analgésico y el tiempo quirúrgico empleado. En los casos en que los pacientes fueron dados de alta en las primeras 24h, se realizó una consulta telefónica para valoración de dichas variables. El análisis estadístico se realizó mediante prueba de la t de Student (para variables numéricas y prueba de la χ² (para analizar las relaciones entre variables cualitativas, considerando el estudio estadísticamente significativo si se obtuvo una p0,05. En el grupo de la anestesia combinada el tiempo medio de estancia fue de 36h, frente a las 60h de media en el grupo de anestesia general (pObjectives: Our aim is to evaluate the efficacy of two anesthetic techniques for the treatment of the postoperative pain, as well as their influence on hospital stay, after surgery arthroscopic of shoulder. Materials and methods: Retrospective study based on the collection of data from anesthesia histories and from of our

  16. Tratamento artroscópico da luxação acromioclavicular aguda com âncoras Arthroscopic treatment of acute acromioclavicular joint dislocation using suture anchors

    Directory of Open Access Journals (Sweden)

    Leonardo Muntada Cavinatto

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados clínicos e radiográficos de uma série de casos com diagnóstico de Luxação Acromioclavicular (LAC Aguda, tratados através da fixação coracoclavicular com âncoras por via artroscópica. MÉTODO: Vinte pacientes apresentando LAC com menos de 30 dias de evolução foram operados pela técnica da estabilização coracoclavicular com âncoras por via artroscópica. Duas âncoras metálicas com dois fios cada, foram inseridas no coracóide. Os fios foram amarrados sobre a clavícula passando por túneis transósseos claviculares. Para a avaliação radiográfica, foi utilizada a medida comparativa da distância coracoclavicular com o lado contralateral e a avaliação funcional através dos escores de Constant e UCLA o seguimento foi de seis meses. RESULTADO: Dos vinte casos inicialmente selecionados, seis necessitaram de novo procedimento cirúrgico e foram excluídos do estudo. Dos quatorze pacientes restantes, apenas dois mantiveram redução da articulação acromioclavicular, enquanto os demais apresentaram algum grau de desvio no decorrer da evolução. Desconsiderando os pacientes excluídos, os escores de Constant e UCLA tiveram média 94,79 (82-100 e, 32,64 (26-35, respectivamente. CONCLUSÃO: A técnica apresentou um alto índice de perda da redução ao longo da evolução de seis meses. A avaliação funcional apresentou resultado satisfatório com escore médio elevado de Evidência: Nível de Evidência: Nível III, estudo retrospectivo.OBJECTIVE: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (AAD treated by arthroscopic coracoclavicular fixation with suture anchors. METHOD: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2

  17. The Arthroscopic Superior Capsular Reconstruction.

    Science.gov (United States)

    Adams, Christopher R; Denard, Patrick J; Brady, Paul C; Hartzler, Robert U; Burkhart, Stephen S

    2016-01-01

    In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative. In this article, we describe our technique for the SCR. PMID:27552457

  18. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; Juhl, C B; Roos, E M;

    2015-01-01

    . DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

  19. 关节镜下保留残端重建前交叉韧带的临床前瞻性对照研究%Arthroscopic anterior cruciate ligament reconstruction with remnant preservation:a prospective comparison study

    Institute of Scientific and Technical Information of China (English)

    洪雷; 李旭; 王雪松; 张辉; 冯华

    2011-01-01

    目的 前瞻性评估保留残端对于前交叉韧带重建临床疗效的意义.方法 2008年8月至2009年9月共70例有韧带残端存留的前交叉韧带损伤患者入选本研究组,随机分为保留残端组(n=35)和对照组(n=35).分别采取关节镜下保留残端重建前交叉韧带和切除残端的前交叉韧带重建手术技术,移植物均使用同种异体肌腱.术后随访分别进行膝关节功能评分(IKDC分级和Lysholm评分)、客观稳定性评估(Lachman试验、轴移试验和KT-1000测量)、本体感觉功能测量和二次关节镜手术探查.结果 70例患者中共61例(87%)获得随访,平均随访时间13.1个月.两组的功能评分无显著差异:Lysholm评分:保留残端组96.4分,对照组94.9分(P=0.71);IKDC分级中A和B级:保留残端组30例,对照组29例(P=0.586).两组的客观稳定性评估无显著差异:KT-1000测量的侧-侧差值:保留残端组1.69 mm,对照组1.65 mm(P=0.83);Lachman试验阴性例数:保留残端组29例,对照组28例(P=1.00);轴移试验阴性例数:保留残端组31例,对照组27例(P=0.225).本体感觉的角度重复试验结果无显著差异:保留残端组4.56°,对照组4.28°(P=0.522).二次手术探查时发现的移植物滑膜覆盖率无显著差异:保留残端组85%,对照组84.2%.结论 保留残端同时使用异体肌腱移植重建前交叉韧带,对术后膝关节主观功能评分、稳定性和本体感觉和移植物滑膜覆盖程度并无促进作用.%Objective To evaluate the clinical significance of arthroscopic anterior cruciate ligament (ACL)reconstruction using the remnant-preserved technique.Methods From August 2008 to September 2009,70 cases with the remnant of injured ACL were included in the trials,which were randomized into the remnant preservation(RP)group and the control group,35 cases in each group.All patients in the two groups underwent arthroscopic ACL reconstruction surgeries,with ACL-remnant preserving technique in RP group and ACL

  20. Arthroscopic tenodesis in the treatment of long head of biceps tendon lesions%关节镜下肌腱固定术治疗肱二头肌腱近端病损

    Institute of Scientific and Technical Information of China (English)

    高庆峰; 鄂刚; 何耀华; 张尧; 赵金忠; 皇甫小桥; 沈继; 刘闻欣

    2015-01-01

    目的:探讨关节镜下通过肌腱固定术治疗肱二头肌腱近端病损的手术方法及临床效果。方法2010年1月至2012年6月关节镜下通过肌腱固定术治疗肱二头肌腱近端病损49例,患者诊断明确,肱二头肌长头肌腱近端病损为其症状产生的主要原因,其中男性21例,女性28例。年龄37~60岁。分别记录术前及最终随访时疼痛、活动范围、前屈上举肌力以及功能评分,并进行统计学分析。结果所有患者术程顺利,术后顺利愈合并获随访平均18(12~34)个月。术前 Constant 评分为平均39.4分,UCLA 评分为平均15.4分;术后 Constant 评分为平均89.1分,UCLA 评分为平均31.2分。术后与术前相比,在疼痛、活动范围、屈肘、肌力及功能恢复方面差异均有统计学意义(P <0.05)。结论关节镜下通过肌腱固定技术治疗肱二头肌腱近端病损的临床效果满意。%Background The purpose of this study is to evaluate operative technique and clinical results of Arthroscopic Biceps Tenodesis for proximal lesion of the long head of biceps tendon. Methods Inclusion criteria:patient was younger than 60 years old;confirmed diagnosis of proximal lesion of biceps brachii tendon;conservative treatment was failed;biceps tendon lesion was supposed to be the main cause of shoulder symptoms.Exclusion criteria:other shoulder diseases such as neuropathy.From January 2010 to June 2012,49 patients underwent arthroscopic biceps Tenodesis for proximal lesion of long head of biceps tendon using suture anchor technique.There were 21 males and 28 females.Thirty-nine cases were diagnosed as bicipital tendinitis;5 cases as tendon tear;2 cases as biceps tendon instability and tendinitis with tears in 3 cases.Operatiive technique:patients were positioned in lateral decubitus position with 40 degrees of abduction,1 5 degrees of flexion and 4KG longitudinal traction.The viewing portal was routine posterior portal.Arthroscopic gleno-humeral joint

  1. 关节镜下止点重建治疗膝关节外侧半月板后根部撕裂%Arthroscopic ending reconstruction of posterior root tears of the lateral meniscus in the knee

    Institute of Scientific and Technical Information of China (English)

    刘玉强; 刘宁; 梁振雷; 王续鹏; 胡滨

    2015-01-01

    Objective To evaluate clinical outcomes of arthroscopic ending reconstruction of posterior root tear of the lateral meniscus in the knee.Methods From March 2010 to March 2014, 18 cases of posterior root tear of the lateral meniscus in the knee underwent arthroscopic ending reconstruction. Seven cases were of simple tear of the root, 11 were of combined radial tear of the posterior lateral complex. Fifteen cases combined with anterior cruciate ligament ( ACL ) injury and 3 cases with multiple ligaments injury underwent one-stage reconstruction. Lysholm score, IKDC score and visual analog scale ( VAS ) were applied to evaluate knee functions preoperatively and postoperatively. MRI and arthroscopic exploration of patients with follow-up were used to evaluate the healing of the lateral meniscus tear.Results The mean follow-up period was 20.2 months ( range: 6-41 months ). Postoperatively, the Lysholm knee score was 90.0±4.5, IKDC knee score was 84.6±3.2, VAS knee score was 0.7±0.9. Differences were statistically significant (P<0.001 ). Eighteen cases received MRI examination 1 year postoperatively: 17 cases ( healing rate: 94.4% ) showed completely healing of the meniscus and 18 cases ( healing rate: 100% ) with cruciate ligaments injury were conifrmed completely healing of the lateral meniscus by arthroscopic exploration.Conclusions Arthroscopic ending reconstruction is a good option in the treatment of posterior root tears of the lateral meniscus in the knee with the advantage of complete internal suture and reconstruction. It can receive satisfactory knee functions.%目的:探讨关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的临床效果。方法2010年3月至2014年3月,18例膝关节外侧半月板后根部损伤患者接受关节镜手术治疗。其中单纯后根部损伤7例,后根联合体部放射状撕裂11例,18例中15例合并前交叉韧带( anterior cruciate ligament,ACL )损伤、3例合并多发韧带损伤者

  2. The isokinetic study of different surgical procedures for the treatment of patients with arthroscopic knee meniscus%膝半月板损伤后关节镜手术不同术式的等速肌力测试分析

    Institute of Scientific and Technical Information of China (English)

    邵正海; 张玉发; 吕宏; 毕霞; 高亮亮; 刘小垒; 黄鑫凝

    2014-01-01

    目的:回顾性分析关节镜下行半月板缝合修整成型术和射频消融术的疗效差异,以向临床推广合适的术式。方法:对60例膝半月板损伤患者关节镜术后采取半月板缝合修整成型术和射频消融术,采用等速肌力测试比较两组治疗的差异。结果:观察组屈膝60°、120°时膝关节单次最大做功、力矩加速能、屈膝伸肌峰力矩测试和平均做功率均优于对照组,差异有统计学意义(P<0.05)。结论:半月板缝合修整成型术对膝半月板损伤关节镜手术后患者具有较好的改善,能够明显改善患者的预后状况。%Objective:Retrospective analysis of the isokinetic study of different surgical procedures for the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation for patients with arthroscop-ic knee meniscus ,in order to promote the appropriate surgery methods for clinical treatment .Methods :60 cases of patients with knee meniscus injury were treated by the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation and the isokinetic treatment were used to compared the difference between the two groups .Results :The knee maximum single acting ,torque acceleration energy ,knee extensor peak torque testing and average power of the observation group were better than those in the control group and all P <0 .05 .Conclu-sion:The treatment of arthroscopic meniscal suture repair angioplasty for the patients can significantly improve the patient's prognosis ,and worthy of clinical application .

  3. Plasma rico em plaquetas no reparo artroscópico das roturas completas do manguito rotador Platelet-rich plasma in arthroscopic repairs of complete tears of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Eduardo Angeli Malavolta

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os resultados funcionais e o índice de rerrotura do reparo do manguito rotador por via artroscópica associado ao uso do PRP. MÉTODOS: Série de casos prospectiva, avaliando os resultados do reparo artroscópico do manguito rotador em fileira simples associada ao uso do PRP. Foram incluídas apenas roturas isoladas do supraespinal, com retração inferior a 3cm. O PRP utilizado foi obtido pelo método de aférese, e aplicado em sua forma ativada, com a adição de trombina autóloga, na consistência líquida. A avaliação pós-operatória foi realizada de maneira padronizada, aos 12 meses de seguimento. Foram utilizadas as escalas de Constant-Murley, UCLA e EVA, além da análise da incidência de rerroturas através da ressonância magnética. RESULTADOS: Foram avaliados 14 pacientes (14 ombros. A escala de Constant-Murley evoluiu em média de 45,64 ± 12,29 no pré-operatório para 80,78 ± 13,22 no pós-operatório (p OBJECTIVE: To evaluate shoulder functional results and the re tear rate of arthroscopic repair of the rotator cuff augmented with platelet-rich plasma (PRP. METHODS: Prospective case series with single-row arthroscopic repair of the rotator cuff augmented with PRP. Only cases of isolated supraspinatus tears with retraction of less than 3 cm were included in this series. The PRP used was obtained by apheresis. It was applied on liquid consistency in its activated form, with the addition of autologous thrombin. Patients were evaluated after 12 months of the surgical procedure. The Constant-Murley, UCLA and VAS scales were used, and the retear rate was assessed using magnetic resonance imaging (MRI. RESULTS: Fourteen patients were evaluated (14 shoulders. The mean Constant-Murley score was 45.64 ± 12.29 before the operation and evolved to 80.78 ± 13.22 after the operation (p < 0.001. The UCLA score increased from 13.78 ± 5.66 to 31.43 ± 3.9 (p < 0.001. The patients' pain level decreased from a median of 7

  4. Avaliação dos resultados e complicações da sutura artroscópica da lesão SLAP Evaluation of results and complications from arthroscopic suture of SLAP lesions

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2011-01-01

    Full Text Available OBJETIVO: Avaliar os resultados e complicações da sutura artroscópica da lesão SLAP. MÉTODOS: Foram avaliados 71 pacientes submetidos à sutura artroscópica da lesão SLAP, entre julho de 1995 a maio de 2008, pelo Grupo de Ombro e Cotovelo do Departamento de Ortopedia e Traumatologia da Santa Casa de São Paulo - "Pavilhão Fernandinho Simonsen". Dos 71 pacientes avaliados, 68 (96% tinham lesões associadas e em três (4% a lesão SLAP era isolada. RESULTADOS: As lesões associadas mais frequentes nos pacientes com idade inferior a 40 anos foram as lesões labiais (69% e naqueles com idade igual ou superior a 40 anos foi a síndrome do impacto, com ou sem lesão do manguito rotador (71,4%. De acordo com o método da UCLA, 79% (56 casos tiveram resultados bons e excelentes e 21% (15 casos tiveram complicações pós-operatórias, entre as quais as mais frequentes foram dor residual (46,6% e capsulite adesiva (33,3%. CONCLUSÕES: Verificamos grande associação da lesão SLAP com outras lesões no ombro, estas variando de acordo com a faixa etária do paciente. A sutura artroscópica da lesão SLAP proporcionou excelentes resultados na maioria dos casos; porém, tiveram 21% de complicações.OBJECTIVE: To evaluate the results and complications from arthroscopic suturing of SLAP lesions. METHODS: Seventy-one patients who underwent arthroscopic suturing of SLAP lesions between July 1995 and May 2008 were evaluated. The procedures were performed by the Shoulder and Elbow Surgery Group of the Department of Orthopedics and Traumatology, Fernandinho Simonsen Wing, Santa Casa de São Paulo, Brazil. Associated lesions were seen in 68 of the 71 patients evaluated (96%, and the other three (4% had SLAP lesions alone. RESULTS: The associated lesions most frequently found in the patients under 40 years of age were labral lesions (69%, while in patients aged 40 years or over, impact syndrome with or without rotator cuff injury was the most commonly

  5. Avaliação funcional do reparo artroscópico das lesões completas do manguito rotador associado a acromioplastia Functional evaluation of arthroscopic repairs of complete rotator cuff tears associated to acromioplasty

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Castro Veado

    2008-12-01

    Full Text Available OBJETIVO: Realizar avaliação funcional dos pacientes portadores de lesão completa do MR que foram submetidos ao reparo artroscópico associados à acromioplastia. MÉTODOS: Trata-se de um estudo retrospectivo realizado com pacientes submetidos a tratamento cirúrgico artroscópico para reparo da lesão do MR. Foram incluídos os pacientes operados entre junho/2000 e outubro/2004 nos Hospitais Mater Dei e Felício Rocho, em Belo Horizonte. Dos 102 pacientes submetidos à reconstrução, 11 foram retirados por não cumprirem os critérios de inclusão, sendo o número final igual a 91 ombros em 91 pacientes. A avaliação funcional foi realizada pela escala UCLA (Universidade da Califórnia em Los Angeles e pelo teste Simples. RESULTADOS: Na avaliação pós-operatória em 35 pacientes, os resultados foram considerados excelentes (38,4%; em 47, bons (51,6%; seis, regulares (6,6%; e três, ruins (3,3%. Desse modo, 82 (90,1% pacientes foram avaliados como tendo obtido resultado bom ou excelente e nove como regulares ou ruins, sendo estes insatisfatórios. CONCLUSÃO: O reparo artroscópico do manguito rotador, associado a acromioplastia, apresentou resultado funcional excelente ou bom, na maioria dos pacientes, quando avaliados pelo método funcional da UCLA.OBJECTIVE: To perform a function evaluation of patients with complete rotator cuff tears that were submitted to arthroscopic repair associated to acromioplasty. METHODS: This is a retrospective study made with patients submitted to arthroscopic surgical treatment to repair rotator cuff tears. Patients included were operated on from June 2000 to October 2004 at the Mater Dei and Felício Rocho Hospitals, in Belo Horizonte. Of the 102 patients submitted to reconstruction, 11 were removed from the study because they did not meet the inclusion criteria, and so the final number of the series was 91 shoulders of 91 patients. The functional evaluation scale was the UCLA scale and the simple test was

  6. Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation%肩关节镜下带线锚钉内固定治疗复发性肩关节前脱位

    Institute of Scientific and Technical Information of China (English)

    姜侃; 孙荣鑫; 钟广军

    2012-01-01

    Objective:To investigate the curative effect of arthroscopic glenoid labrum repair by biodegradable anchor fixation for recurrent anterior shoulder dislocation. Methods: Twenty-one patients of recurrent anterior shoulder dislocation with the average UCLA function score of 22. 3 ±4. 1 were treated with arthroscopic glenoid labrum repair by biodegradable anchor fixation. The shoulder was fixed by shoulder-elbow elastic band for 4 - 6 weeks and canonical exercise of shoulder joint was taken postoperatively. Results; The patients were followed up for 3-18 (mean 8) months; and the average UCLA score was 32. 3 ± 2. 6 postoperatively. The excellent results (34 -35) were obtained in 11 patients, good (28-33) in 7 patients and fair (21-27) in 3-'patients. The activity of shoulder joint was normal in all patients with an excellent subjective degree of satisfaction. Conclusion; Arthroscopic glenoid labrum repair by anchor fixation for recurrent anterior shoulder dislocation has the advantages of less invasiveness, simpler procedure , reliable fixation, less complications and rapid functional recovery.%目的:探讨肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位的疗效与方法.方法:本组21例复发性肩关节前脱位患者,肩关节功能评估采用美国加州洛杉矶大学UCLA功能评分标准,术前评分平均(22.3±4.1)分.全部采用肩关节镜下可吸收带线锚钉内固定修复盂唇损伤.术后肩肘固定带固定患肩4~6周,按规定程序进行康复锻炼.结果:经3~18个月(平均8个月)的随访,术后UCLA评分平均(32.3±2.6)分.优(34~35分)11例,良(28 ~ 33分)7例,中(21 ~27分)3例,无差病例.术后肩关节活动范围正常.患者主观满意度:均较满意.结论:肩关节镜下应用可吸收带线锚钉内固定修复盂唇损伤治疗复发性肩关节前脱位,具有创伤小、操作简便、内固定可靠、术后并发症少、功能恢复快等优点,是

  7. Arthroscopic treatment of chronic painful Achilles tendinopathy%关节镜治疗慢性疼痛性跟腱炎初步临床效果报告

    Institute of Scientific and Technical Information of China (English)

    杨渝平; Hajo Thermann; 敖英芳

    2011-01-01

    Objective To decrease the postoperative complication rate of traditional open surgical treatment of chronic painful Achilles tendinopathy, we created and applied a kind of special arthroscopic technique in curing a series of patients diagnosed with it. Methods 8 consecutive patients (7 men and 1 woman, mean age 52 years) were included in this study and treated by arthroscopic debridement of the ventral neovascularized area, the peritendineum and the Achilles tendon. The visual analogue scale was used to assess the severity of Achilles tendon pain during tendon loading activity pre and postoperatively. Results All the patients were followed-up at 6 months after the surgeries. Every one of them felt immediate postoperative pain relief. And there were no postoperative complications. The median visual analogue score ( VAS) increased from 40 (10-60) (preoperatively) to 97. 5 (85-100) (follow-up at the sixth month ). In terms of Achilles tendon function, the median VAS are 22.5 (0-30) and 90 (80-95) respectively. Conclusion Treatment with arthroscopic technique of chronic painful Achilles tendinopathy can obviously reduce the incidence rate of postoperative complication. The short-term clinical results were satisfactory.%目的 探讨关节镜微创治疗慢性疼痛性跟腱炎的临床效果以及其在降低手术并发症发生率方面的作用.方法 8例(男7例,女1例,平均年龄52岁)经过常规保守治疗无效的慢性疼痛性跟腱炎患者,在德国海德堡ATOS医院接受关节镜下的清理手术.主要清理内容包括跟腱腹侧的神经血管区、腱围以及跟腱本身三个病变部分.术后6个月时进行随访,应用VAS主观疼痛评分表分别对术前和术后随访时患者的跟腱区疼痛程度进行评分.结果 所有患者在手术结束、麻醉作用消退后即感觉疼痛较术前有明显的缓解,而且未发生任何手术并发症.跟腱疼痛的VAS评分的均值从术前的40(10~60)分升至97.5(85~100)分.跟

  8. Arthroscopic reduction and internal fixation of tibial intercondylar eminence fractures in children%关节镜下复位固定治疗儿童胫骨髁间隆突骨折

    Institute of Scientific and Technical Information of China (English)

    曾春; 宋炎成; 蔡道章; 王昆

    2009-01-01

    目的 探讨关节镜下钢丝固定治疗Ⅱ、Ⅲ型儿童胫骨髁间隆突撕脱性骨折的疗效及其影响因素.方法 手法复位失败的Ⅱ、Ⅲ型胫骨髁间隆突撕脱性骨折患儿12例,行关节镜下复位、钢丝内固定治疗.平均随访时间24.4个月(12~32个月),Lachnmn试验、轴移试验评价膝关节稳定性,Lysholm评分及Tegner分级评价膝关节功能,术后X线评价骨折愈合情况.结果 12例骨折均获得满意的复位,术后3个月内骨性愈合,X线检查未见骺板早闭现象.未见关节纤维化内固定松动感染等严重并发症发生.Lysholm膝关节功能评分96.7±2.2分,Tegner评分术前术后分别为2.8±1.1和7.5±0.9.结论 关节镜下钢丝固定是治疗Ⅱ、Ⅲ型儿童胫骨髁间隆突撕脱性骨折的有效方法,可有效重建膝关节的稳定,改善膝关节功能.%Objective To investigate the therapeutic effect of arthroscopic reduetion and internal fixation for children with type Ⅱ and Ⅲ tibial intercondylar eminence fractures. Methods Twelve cases with type Ⅱ and Ⅲ tibial intercondylar eminence fractures were treated with arthroscopic reduction and internal fixation. The average follow-up period was 24. 4 months ranging from 12 to 32 months. Fol-low-up assessment included Lachman test, pivot shift test, Lysholm knee score, Tegner score and ra-diological evaluation. Results All 12 cases successfully achieved reduction and bone union within 3 months without premature closure of epiphysis. No severe complications, such as arthrofibrosis, loss of initial fixation or wound infection, were noted. The pivot shift test and Lachman test showed that the stability of knees was recovered in all cases. At follow-up, the average Lysholm knee score was 96. 7 ± 2. 2. The preoperative and postoperative Tegner scores were 2. 8 ± 1. 1 ranging from 1 to 5 and 7. 5 ± 0. 9 ranging from 6 to 9 respectively. Conclusions Arthroscopic reduction and internal fixation is an effective

  9. Micro-invasive Surgical Treatment for Tibial Plateau Fractures under Knee Arthroscope%膝关节镜引导下胫骨平台骨折的微创治疗

    Institute of Scientific and Technical Information of China (English)

    孙伟; 叶斌; 马辉; 洪方业; 张海林

    2014-01-01

    Objective:To investigate the effect of minimally invasive treatment of tibial plateau fractures under the knee arthroscopic.Method:50 cases of tibial plateau fracture in our hospital was treated by minimally invasive under the knee arthroscopic,followed-up 6 months,prognosis of patients and complications were analysed.Result:50 patients with X examination showed that in 3.5 months the bone healed,articular surface was smooth,anatomic reduction was normal, no incision infection and joint,and there was no delayed wound healing,skin necrosis and breakage of internal fixation or loosening and other complications.The treatment effect was satisfactory,excellent in 42 cases(84.0%),good in 4 cases(4.0%),2 cases(4.0%) acceptable,poor in 2 cases(4.0%),the overall excellent and good rate was 91.9%.Ⅱ to Ⅴ of the excellent and good rate was 100%(16 cases),94.4%(17 cases),60.0%(3 cases) and 50.0%(1 case).Conclusion:Patients with tibial plateau fractures under arthroscope is timely minimally invasive internal fixation operation,not only reduces the probability of serious complications, but also accelerates the healing of fracture,knee joint function recovery was improved,with large-scale popularization and application value in clinic.%目的:探讨膝关节镜引导下胫骨平台骨折的微创治疗效果。方法:笔者所在医院收治的50例胫骨平台骨折病者行膝关节镜引导下微创治疗,随访6个月,统计分析患者预后和并发症发生情况。结果:50例患者经X片检查显示在3.5个月左右骨性愈合,关节面平整,解剖复位正常,切口和关节内无感染,且也不存在创口延迟愈合、皮肤坏死及内固定物断裂或松动等并发症治。优42例(84.0%),良4例(8.0%),可接受2例(4.0%),差2例(4.0%),总体优良率为92.0%。其中Ⅱ~Ⅴ型优良率分别为100%(16例)、94.4%(17例)、60.0%(3例)和50.0%(1例)。结论:患者出现胫骨平台骨折时,及时在

  10. Minimally invasive treatment through arthroscope for anterior cruciate ligament tibial avulsion fracture%关节镜微创治疗前交叉韧带胫骨部撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    崔宗杰; 茹朝阳

    2015-01-01

    目的:探讨关节镜微创治疗前交叉韧带(ACL)胫骨部撕脱骨折的治疗效果。方法关节镜微创治疗ACL胫骨附着部撕脱骨折38例,其中Ⅰ型3例,Ⅱ型12例,Ⅲ型23例。所有患者均采取常规膝关节前外侧入路进镜检查,行骨折复位,然后自胫骨结节两侧钻孔,直达骨折块,用2枚导针穿入,将直径0.7 mm钢丝穿入固定骨块,在骨外拧紧钢丝,观察治疗效果。结果本组38例经4~32个月随访,6周愈合24例,8周愈合8例,12周愈合6例,膝关节功能良好。结论关节镜微创治疗ACL胫骨部撕脱骨折,对膝关节损伤小,用较粗钢丝内固定,固定可靠、恢复快,可早期行膝关节功能锻炼,利于关节功能恢复。%Objective To explore the curative effect of minimally invasive treatment through arthroscope for anterior cruciate ligament (ACL) tibial avulsion fracture.Methods Among 38 patients of ACL tibial avulsion fracture undergoing minimally invasive treatment through arthroscope, there were 3 cases of type Ⅰ, 12 cases of type Ⅱ, and 23 cases of type Ⅲ. Arthroscopy was performed into the front knee with the conventional approach and the reduction of fracture was carried out in all the patients. Then drilling was done from both sides of the tibia to the fracture fragments. After the penetration of two needles, the wire of 0.7 mm diameter was introduced to fix the bone fragments and tightened out of the bone. Curative effects were observed.Results The follow-up of 38 cases lasted 4~32 months. There were 24 healed cases in 6 weeks, 8 healed cases in 8 weeks, and 6 cases in 12 weeks. They all had good knee joint function.Conclusion Minimally invasive treatment through arthroscope for ACL tibial avulsion fracture has few damage to knee joint. Thick wire can provide reliable internal fixation, which can recover quickly. Early exercise of knee joint function can be conducted to benefit joint function recovery.

  11. Arthroscopic Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in 16 Cases%关节镜下治疗前交叉韧带下止点撕脱骨折16例

    Institute of Scientific and Technical Information of China (English)

    俞胜宝; 胡四生; 汪炜; 凌健

    2011-01-01

    Objective To observe the surgical skill and the clinical outcomes of arthroscopic treatment of anterior cruciate ligament(ACL) tibial avulsion fracture. Methods From January 2007 to December 2010,16 cases of avulsion fracture of intercondylar eminence( according to Meyers and Mckeever classification, type Ⅰ 1 case, type Ⅱ 13 cases, type Ⅲ 3 cases) received the arthroscopic treatment. The surgical approach was both sides of the patellar ligament, the fracture reduction was performed under arthroscopy,and then the Kirschner wire was inserted from a point medial to the tibial tubercle to hold the intraarticular fracture fragments. The epidural tube was first penetrated through the Kirschner wire hole,and then the guiding tension suture( No. 2 polyethylene line, diameter was 0.5 - 0.7 mm) was penetrated through the epidural tube to fix the bone block. Results Sixteen patients were followed up for 2 to 36 months,14 cases were healed in 12 weeks,other 2 cases in 18 weeks. 14 cases(87.5% ) recovered completely with a good joint stability and negative drawer test; other 2 cases gained a good functional recovery with a good joint stability but positive drawer test. Conclusion Arthroscopic surgery,with a small incision,simple operation,less postoperafive injury,secure internal fixation, is an effective method for the ACL tibial avulsion fracture. The early functional exercise of knee joint should improve the recovery of knee.%目的 观察关节镜下微创治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术方法及疗效.方法 2007年1月-2010年12月,关节镜下治疗ACL下止点撕脱骨折16例,其中按meyem-meckeever分型1型1例,2型13例,3型2例.常规膝关节髌韧带两侧入路进入关节腔,镜下骨折复位,然后自胫骨结节内侧钻入克氏针,达骨折块,自克氏针孔穿入硬膜外麻醉套管,直径0.5~0.7 mm钢丝导引张力缝线(2号聚乙烯线)经硬膜外麻醉套管穿入固定骨折块.结果 术后16例经2~36

  12. Clinical Observation of Arthroscopic Reconstruction of Anterior Cruciate Ligament with Hamstring Tendon Autograft%关节镜下自体半腱肌腱移植重建前交叉韧带的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    柳学武; 马春蕾

    2015-01-01

    目的:观察关节镜下自体半腱肌腱移植重建前交叉韧带的临床疗效。方法选择我院骨关节外科收治的37例前交叉韧带损伤患者,所有患者均在关节镜下行自体半腱肌腱移植重建术治疗,术后对患者进行随访,观察患者的预后,同时采用Lysholm评分标准及国际膝关节评分委员会(IKDC)评分标准对临床疗效进行评价。结果本组37例患者术后切口均一期愈合,9~10周关节屈伸功能恢复正常。随访期内2例患者发生关节腔肿胀、积液,2例患者剧烈运动后术膝仍感疼痛。末次随访时患者的Lysholm评分及IKDC评分较手术前有明显的改善,差异有统计学意义(P<0.05)。结论关节镜下自体半腱肌腱移植重建前交叉韧带的临床疗效确切,应在临床进一步推广使用。%Objective The clinical effect of arthroscopic reconstruction of anterior cruciate ligament with hamstring tendon autograft.Methods 37 cases of anterior cruciate ligament injury in our hospital were selected. All patients were treated by arthroscopic reconstruction of the anterior cruciate ligament reconstruction. The patients were followed up and the prognosis was observed. The clinical efficacy was evaluated by Lysholm score and International Knee Score Committee (IKDC).Results In the 37 patients, the healing of the incisions healed in the first weeks, and the function of flexion and extension of the joint was normal in 9 ~ 10 weeks. During the follow-up period, 2 patients had a swelling and effusion of the joint, and 2 patients had pain after severe exercise. At the end of the follow-up, the patients' Lysholm score and IKDC score were significantly improved compared with the operation, the difference was statistically significant (P<0.05).Conclusion The clinical efficacy of arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft is accurate, and should be used in clinical practice.

  13. 早期护理介入对膝关节镜手术患者膝关节功能的影响%lnfluence of early nursing intervention on the knee joint function of patients undergoing knee arthroscope operation

    Institute of Scientific and Technical Information of China (English)

    李春荣

    2014-01-01

    Objective:To probe into the influence of early nursing intervention on the knee joint function of patients undergoing knee ar-throscope operation. Methods:The clinical data of 80 patients with knee arthroscope operation( admitted and treated from January 2010 to December 2012)were retrospectively analyzed. 40 patients who were given early nursing intervention were taken as the observation group and other 40 patients given routine nursing care were taken as the control group. The knee joint function of the patients and the excellent and good rate were compared between the two groups. Results:There were statistically significant differences in the comparison of the hospi-talization time,fracture healing and full weight-bearing time between the two groups(P﹤0. 05);the comparison of tibial plateau angle (TPA)and posterior slope angle(PA)was significantly different between the two groups in 3 and 12 months after operation(P﹤0. 05);the excellent and good rate of the knee joint function of the patients was higher in the observation group than the control group in 12 months af-ter operation(P﹤0. 05). Conclusion:The early nursing intervention can significantly improve the knee function of the patients and promote their rehabilitation after knee arthroscope operation.%目的:探讨早期护理介入对膝关节镜手术患者术后膝关节功能的影响。方法:回顾性分析2010年1月~2012年12月我院骨科收治的80例膝关节镜手术患者的临床资料,其中采用早期护理介入的40例患者作为观察组,采用常规护理的40例患者作为对照组。比较两组患者膝关节功能和优良率等指标。结果:观察组患者在住院时间、骨折愈合和完全负重时间方面比较差异均有统计学意义( P﹤0.05);两组术后3个月和12个月胫骨平台内翻角( TPA)和后倾角( PA)比较差异有统计学意义( P﹤0.05);观察组术后12个月膝关节功能优良率高于对照组( P﹤0

  14. Arthroscopic reconstruction of anterior and posterior cruciate ligaments with LARS artificial ligaments%关节镜下使用LARS人工韧带重建膝前、后交叉韧带

    Institute of Scientific and Technical Information of China (English)

    叶俊星; 沈光思; 周海斌; 谢宗刚; 徐炜; 董启榕; 徐又佳

    2013-01-01

    Objective To investigate the initial effect of LARS artificial ligaments arthroscopically in reconstruction of ipsilateral anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).Methods A total of 21 patients (13 males and 8 females,at average age of 31.5 years) received ACL and PCL restoration using LARS artificial ligaments since June 2006.Preoperative MRI exactly confirmed them as ACL and PCL ruptures.Lysholm score on knee joint was (47.6 ±6.7) points.Surgery had reconstruction of PCL prior to ACL under arthroscope.Results All patients were followed up for average 42 months (range,36-49 months),which showed no infection,ligament rupture,ligament loosening,or other postoperative complications.At postoperative 3 years,Lysholm score was (90.8 ± 3.7) points and International Knee Documentation Committee (IKDC) score was normal in 14 patients,near normal in six,and abnormal in one,with excellent-good rate of 95%.Conclusions LARS artificial ligaments can attain anatomical reconstruction and stability of the knee joint in treatment of ACL and PCL ruptures.Meanwhile,arthroscopic surgery shows superiorities of micro-wound,rapid recovery and satisfactory curative effect.%目的 探讨膝关节镜下使用LARS人工韧带重建同侧膝关节前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)的初步临床效果. 方法 从2006年6月开始,在关节镜下运用LARS人工韧带对21例ACL、PCL断裂患者进行重建,其中男13例,女8例,平均年龄31.5岁.所有患者术前MRI明确诊断为ACL、PCL断裂,Lysholm评分(47.6±6.7)分,手术在关节镜下进行,先重建PCL,再重建ACL. 结果 对21例患者均进行36~49个月(平均42个月)的随访,未发生感染、韧带断裂、松动等术后并发症.术后3年,Lysholm评分(90.8±3.7)分;国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分,正常14例,接近正常6例,不正常1例,优良率达95%.

  15. 中期膝关节骨性关节炎关节镜清理术的疗效分析%The efficacy of arthroscopic surgery for the treatment of moderate osteoarthritis of the knee

    Institute of Scientific and Technical Information of China (English)

    钟伟斌; 黄文铎; 黄彦

    2009-01-01

    目的探讨关节镜清理术对中老年中期膝关节骨性关节炎的临床应用价值.方法根据美国风湿病学学会(ARA)标准,选取89例中期膝关节骨性关节炎患者,年龄40-72岁,A组:43例,采用关节镜清理术联合术后关节腔内注射透明质酸钠和膝关节物理治疗.B组:46例,单纯关节腔内注射透明质酸钠和物理治疗.两组治疗前和治疗后2年行Lysholm膝关节综合评分.结果治疗后两年,2组Lysholm膝关节综合评分与治疗前比较均有明显提高(P0.05).结论中老年中期膝关节骨性关节炎患者选择透明质酸钠关节腔内注射结合物理治疗,能明显缓解临床症状,提高关节功能,联合采用关节镜清理术治疗没有未提高患者的远期疗效.%Objective To identify the effectiveness of arthroscopic debridement(AD) in moderate knee OA on pain and function. Methods 87 patients with moderate degenerative osteoarthritis of knees diagonocised according to ARA,were randomly assigned to two groups:43 patients in therapy group were subjected to AD in combine with sodium hyaluronate injection and physiotherapy,44 patients in the control group only received so-dium hyaluronate injection and physiotherapy. The relief of joint pain, swell, fluidity, and the improvement of joint range of motion before and after the treatment were evaluated by score of Lysholm. Results There is no si-ganificant different between in the therapy group and the control group in the score of Lysholm(P<0.05). Con-clusion The sodium hyaluronate injection combined with physiotherapy can relieve clinical symptoms and im-prove joint function in the patients with moderate degenerative osteoarthritis of knees, arthroscopic surgery for moderate osteoarthritis of the knee provides no additional benefit to optimized physical and HA therapy.

  16. 膝骨关节炎关节镜术后康复治疗的临床效果评价%Evaluation of the clinical effect of rehabilitation treatment after knee osteoarthritis arthroscopic surgery

    Institute of Scientific and Technical Information of China (English)

    谢卫娜; 谢川

    2016-01-01

    Objective:To evaluate the clinical effect of rehabilitation treatment after knee osteoarthritis arthroscopic surgery. Methods:98 patients with knee osteoarthritis were selected.They were divided into the control group and the observation group with 49 cases in each.The control group was given simple drug treatment.The observation group was given rehabilitation training and physiotherapy on the basis of the control group.Before treatment,2 months,4 months and 6 months after treatment,the knee joint functions and treatment effects of two groups were compared.Results:The knee joint function recovery of the observation group was significantly better than that of the control group.The total treatment rate of the observation group was significantly higher than that of the control group.Conclusion:The rehabilitation treatment after knee osteoarthritis arthroscopic surgery has a good clinical effect.%目的:评价膝骨关节炎关节镜术后康复治疗的临床效果。方法:收治膝骨关节炎患者98例,分成对照组和观察组各49例,对照组给予单纯药物治疗,观察组在对照组的基础上给予康复训练和物理治疗,对比两组患者在治疗前、治疗后的2个月、4个月、6个月膝关节的功能以及治疗效果。结果:观察组膝关节功能恢复情况明显优于对照组,观察组总治疗率明显高于对照组。结论:膝骨关节炎关节镜术后康复治疗具有较好的临床效果。

  17. 关节镜下异体肌腱修复重建前后交叉韧带断裂的临床观察%Clinical Observation of Arthroscopic Reconstruction of Anterior Cruciate Ligament Rupture with Tendon Allograft

    Institute of Scientific and Technical Information of China (English)

    孙强; 才林; 艾光禹

    2016-01-01

    目的:探讨关节镜下异体肌腱修复重建前后交叉韧带断裂的临床效果。方法选取我院2013年9月-2014年9月经影像学、临床诊断为前后交叉韧带断裂患者18例,均采用深低温冷冻同种异体腱于关节镜下同期重建前后交叉韧带。记录Lachman试验、Lysholm评分结果进行治疗效果的评定。结果术后切口均I期愈合,术前存在的症状、阳性体征基本消失,患膝稳定性正常。其中Lachman试验测试均为阴性或I度阳性。关节活动度:17例达0°-130°,仅有1例0°-120°,手术前后的Lysholm、IKDC评分对比具有统计学意义(P<0.05)。结论关节镜下采用异体肌腱修复重建前后交叉韧带断裂能够恢复膝关节的稳定性及功能,疗效显著,值得临床推广应用。%Objective To investigate the clinical effect of arthroscopic reconstruction of anterior cruciate ligament.Methods 9 cases of -2014 in our hospital from September 2013 to 18 were diagnosed as anterior and anterior cruciate ligament rupture. The anterior and anterior cruciate ligaments were reconstructed with the same time of deep hypothermia and frozen allograft. Evaluation of therapeutic effect of Lachman test and Lysholm score.Results All the incisions healed by I, the symptoms and positive signs of the patients were disappeared, and the stability of the knee was normal. The Lachman test was negative or I positive. Joint mobility: 17 cases reached 0 degrees-130 degrees, only 0 cases of 1 degrees -120 degrees, Lysholm, IKDC before and after surgery, score compared with statistical significance (P<0.05).Conclusion Arthroscopic reconstruction of anterior cruciate ligament with allograft tendon repair can restore the stability and function of the knee joint, and the effect is remarkable. It is worth to be popularized.

  18. Clinical report of autoglaft osteochondral transplantation of cartilage defect under arthroscope%关节镜下自体骨软骨柱移植治疗软骨缺损的临床报告

    Institute of Scientific and Technical Information of China (English)

    郑剑平; 孙春汉; 马晋; 钟浩博; 赖伟强

    2013-01-01

    目的 重点研究和探讨关节镜下采用自体骨软骨柱移植方法治疗软骨缺损(osteochondral autologous transplantation,OAT)修复膝关节软骨缺损的方法及临床效果.方法 2009年6月-2012年6月,采用关节镜下OAT治疗20例股骨髁关节软骨缺损.将股骨髁非负重区骨软骨柱移植至负重区软骨缺损处,术后膝关节支具固定、康复治疗.结果 20例均获得随访,膝软骨缺损患者功能恢复,疼痛明显减轻,术前采用Brittberg-Peterson评分为(82±3.8)分,随访终末时评分为(12±5.1)分,差异具有显著性P<0.05,为有统计学意义.结论 关节镜下OAT创伤小、能恢复关节面的曲度,是治疗小面积软骨缺损有效方法.%Objective To explore the methods and effect of autoglaft osteochondral transplantation (OAT) of cartilage defect under arthroscope.Methods From June.2009 to June.2012 totally 20 cases with cartilage defect underwent autoglaft osteochondral transplantation.The osteochondritis in no-load area of thigh-bone ankle was transplanted into the load area.Postoperative fixed knee-joint and to go into rehab.Results Totally 20 cases were followed up,function of knee-joint cartilage defect patients was restored well and less pains.Preoperative Brittberg-Peterson Score was (82 ± 3.8),Postoperative Brittberg-Peterson Score was (12 ± 5.1),there difference was significant.Conclusion Used OAT under arthroscope have small wound,can recover the curvature of articular surface,it is an efficient method of small area cartilage defect.

  19. 关节镜下修复肩关节V型从前到后上盂唇损伤的临床效果%Clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions

    Institute of Scientific and Technical Information of China (English)

    魏民; 刘玉杰; 李众利; 王志刚; 蔡谞; 朱娟丽; 刘洋

    2013-01-01

    Objective To observe the clinical effect of arthroscopic repair on V type superior labral anterior posterior lesions. Methods Sixteen patients with V type superior labral anterior posterior lesions admitted to our hospital from March 2008 to December 2010 served as an experimental group and 16 patients with Bankart lesions served as a control group in this study. Their labral lesions were repaired by arthroscopy with absorbable lines. Their pain was scored according to the visual analogue scale (VAS) and their shoulder joint function was assessed according to the American Shoulder and Elbow Surgeons (ASES) Scoring System and the Rowe Shoulder Scoring System, respectively. Results The VAS, ASES and Rowe scores were higher in the two groups after operation than before operation (P0.05). Conclusion Arthroscopic repair with absorbable line can achieve satisfactory clinical outcomes in patients with should joint dislocation due to V type superior labral anterior posterior lesions.%目的:观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。在关节镜下采用可吸收带线锚钉修复盂唇。采用视觉模拟评分(visual analogue scale,VAS)评价疼痛,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分系统和Rowe肩关节评分系统评价关节功能。结果两组患者术后VAS评分、ASES评分和Rowe评分均优于术前(P<0.05),没有脱位复发。两组患者术后结果的差异无统计学意义(P>0.05)。结论对V型SLAP损伤的复发性肩关节前脱位,采用可吸收带线锚钉进行修复可获得良好的临床效果。

  20. Efficacy and safety of a subacromial continuous ropivacaine infusion for post-operative pain management following arthroscopic rotator cuff surgery: A protocol for a randomised double-blind placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Bell Simon N

    2008-04-01

    Full Text Available Abstract Background Major shoulder surgery often results in severe post-operative pain and a variety of interventions have been developed in an attempt to address this. The continuous slow infusion of a local anaesthetic directly into the operative site has recently gained popularity but it is expensive and as yet there is little conclusive evidence that it provides additional benefits over other methods of post-operative pain management. Methods/Design This will be a randomised, placebo-controlled trial involving 158 participants. Following diagnostic arthroscopy, all participants will undergo arthroscopic subacromial decompression with or without rotator cuff repair, all operations performed by a single surgeon. Participants, the surgeon, nurses caring for the patients and outcome assessors will be blinded to treatment allocation. All participants will receive a pre-incision bolus injection of 20 mls of ropivacaine 1% into the shoulder and an intra-operative intravenous bolus of parecoxib 40 mg. Using concealed allocation participants will be randomly assigned to active treatment (local anaesthetic ropivacaine 0.75% or placebo (normal saline administered continuously into the subacromial space by an elastomeric pump at 5 mls per hour post-operatively. Patient controlled opioid analgesia and oral analgesics will be available for breakthrough pain. Outcome assessment will be at 15, 30 and 60 minutes, 2, 4, 8, 12, 18 and 24 hours, and 2 or 4 months for decompression or decompression plus repair respectively. The primary end point will be average pain at rest over the first 12-hour post-operative period on a verbal analogue pain score. Secondary end points will be average pain at rest over the second 12-hour post-operative period, maximal pain at rest over the first and second 12-hour periods, amount of rescue medication used, length of inpatient stay and incidence of post-operative adhesive capsulitis. Discussion The results of this trial will

  1. 三角纤维软骨复合体的大体解剖和腕关节镜对比观察研究%Morphological and arthroscopical observation of the triangular fibrocartilage complex of wrist

    Institute of Scientific and Technical Information of China (English)

    谢仁国; 汤锦波; 唐天驷; 刘国峰; 王古衡; 张昌军; 刑树国

    2011-01-01

    Objective Ulnar side wrist pain is one of the commonest symptoms, mostly arised from the triangular fibrocartilage complex ( TFCC) injuries. Arthroscopy is considered as the golden standard for diagnosis of the wrist disorders, superior to the CT and MRI. The aim of this study is to observe the anatomic components of TFCC of the wrist morphologically and arthroscopically, and to obtain the accurate arthroscopic view by comparison. Methods Five fresh cadaver upper limbs were applied to observe distal aspect of TFCC by the routine radiocarpal approach and proximal aspect of TFCC hy a direct approach over the distal radioulnar joint. After arthroscopy and capsulotomy, The TFCC was exposed to examine its components visually, and to examine the corresponding sites under the arthroscope. TFCC was then detached from the distal ends of the radius and the ulna to measure its length and thickness. Results TFC was like a triangular disc , of which peripheral parts became thickened into the palmar radioulnar ligament ( PRU) and the dorsal radioulnar ligament ( DRU) . TFCC originated from the ulnar edge of distal radius. Its distal part inserted and surrounded the base of ulnar styloid process, and its proximal part inserted into the fovea of distal ulna. Compared with the morphological observations, the distal aspect of the TFCC originations was very smooth under the wrist arthroscope. There was no obvious distinction among TFC, PRU and DRU. The proximal aspect of TFCC seemed like an arc over the distal radius and the fovea. The round articular surface of the ulnar head and the sigmoid notch at ulnar side of the distal radius could be seen clearly. Conclusions Wrist arthrosopy is reliable to clarify the TFCC accurately, based on the anatomical and morphological guidance. The direct portal route over the distal radio-ulnar joint is availahle to observe the profound parts of PRU and DRU ligaments.%目的 观察腕尺侧三角纤维软骨复合体的大体结构和腕关节镜

  2. 关节镜下横杆式固定重建膝前十字韧带的中期疗效观察%The mid-term results of arthroscopic anterior cruciate ligament reconstruction using Transfix technique

    Institute of Scientific and Technical Information of China (English)

    李卫平; 陈仲; 宋斌; 杨睿; 谭伟权

    2013-01-01

    目的 评价关节镜下自体腘绳肌腱移植、横杆式固定(transfix)重建膝关节前十字韧带(anterior cruciate ligament,ACL)的中期临床疗效.方法 自2002年8月至2003年12月对38例膝关节ACL断裂患者应用自体腘绳肌腱重建ACL、股骨端采用横杆式固定、胫骨端采用界面螺钉固定.男21例,女17例;年龄19~48岁,平均28.4岁;左膝24例,右膝14例.运动伤27例,交通伤2例,跌倒扭伤2例,余7例无明显外伤.急性损伤6例,陈旧性损伤32例.术前体检:前抽屉试验阳性35例,弱阳性1例,阴性2例;Lachman征阳性37例,弱阳性1例.以Lysholm评分评价中期临床疗效,以MRI及X线观察移植物以及骨隧道变化情况.结果 38例患者中36例获得随访(随访率94.7%),随访时间6.3~7.6年,平均6.8年.所有患者关节活动度正常,Lysholm评分由术前(64.4±4.52)分提高到(85.6±4.60)分,差异有统计学意义.X线及MRI发现3例股骨及胫骨隧道均扩大,5例股骨隧道扩大,3例胫骨隧道近端扩大.未见关节间隙变窄.1例患者在术后4年因外伤再次致ACL断裂,行关节镜下ACL翻修术,采用同种异体肌腱移植物,股骨端及胫骨端采用可吸收挤压钉固定.结论 应用腘绳肌腱、股骨侧横杆式、胫骨侧界面挤压螺钉固定重建膝关节ACL可以获得较为满意的关节活动度及关节稳定性,中期疗效佳.%Objective To evaluate the mid-term results of arthroscopic anterior cruciate ligament (ACL) reconstruction using Transfix technique.Methods From August 2002 to December 2003,38 patients (24 left knees and 14 right knees) with ACL ruptures underwent arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation.There were 21 males and 17 females,aged from 19 to 48 years (average,28.4 years).The causes of injury included sports injury in 27 cases,traffic injury in 2 cases and fall injury in 2 cases,and 7 patients had no

  3. Arthroscopic minimally invasive treatment of tibial intercondylar eminence fractures in children%关节镜下儿童胫骨髁间棘骨折的微创治疗

    Institute of Scientific and Technical Information of China (English)

    华国军; 刘云鹏; 许沛荣; 骆宇春

    2011-01-01

    目的:分析儿童胫骨髁间棘骨折的特点,介绍关节镜辅助下微创治疗的方法.方法:对2004年1月至2008年12月12例儿童胫骨髁间棘骨折进行回顾性分析.按照Meyers-McKeever骨折分型:Ⅰ型1例,Ⅱ型4例,Ⅲ型7例.新鲜骨折10例,陈旧骨折2例;男10例,女2例;年龄8~13岁,平均10岁.所有病例进行了关节镜探查、复位,克氏针固定.随访时间10~36个月,了解骨折愈合、关节活动度、膝关节稳定性等情况.合并半月板损伤1例,滑车区软骨损伤1例,半月板嵌入骨块下5例.结果:骨折愈合时间平均5周,无畸形愈合、骨不连,无髁间窝撞击表现.术后3个月Lysholm膝关节功能评分平均(92.7±2.5)分,术后6个月平均(96.4±1.7)分,所有患膝恢复健侧活动度.结论:儿童胫骨髁间棘骨折以Ⅱ、Ⅲ型多见,软骨及丰月板等关节内合并伤少见.关节镜辅助下交叉克氏针固定法操作简便、手术创伤小、恢复快,符合儿童骨生长快的特点.%Objective:To analyze the characteristics of children tibial intercondylar eminence fractures,and introduce arthroscopic minimally invasive techniques for the treatment of tibial intercondylar eminence fractures in children. Methods: From January 2004 to December 2008,12 children with tibial intercondylar eminence fractures were treated with cross Kirschner wire fixation after arthroscopic reduction. According to Meyers-McKeever classification systems, there were 1 case of type I ,4 cases of type H , and 7 cases of type M. There were 10 fresh and 2 old fractures in all. Among the patients, 10 patients were boy and 2 patients were girl,ranging in age from 8 to 13 years,with an average of 10 years. All the patients underwent arthroscopic exploration,reduction and fixation. During follow-up ranging from 10 to 36 months,the union of fracture,range of motion and stabilization of the knee were assessed. One patient was combined with lesions of the menisci, 1 patient with femoral

  4. 关节镜下治疗创伤复发性Bankart损伤疗效分析%Clinical curative effect of the arthroscopic reconstruction for recurrent anterior dislocation of the shoulder

    Institute of Scientific and Technical Information of China (English)

    李彦林; 王国梁; 何川; 李建; 郑家礼; 陈广超; 李松; 余洋

    2014-01-01

    dislocation of the shoulder joint. With the development and popularization of the arthroscopic technique,shoulder arthroscopic surgery in the treatment of recurrent anterior dislocation of the shoulder joint has been adopted by increasing surgeons.From June 2010 to April 2014,60 patients of recurrent anterior shoulder dislocation were treated arthroscopically with metallic suture anchor Bankart repair to explore its clinical efficacy. Methods Clinical data:From June of 2010 to April of 2014,sixty patients in our hospital were treated with arthroscopic reconstruction for Bankart inj ury of recurrent anterior dislocation of the shoulder. The patients were followed up for 10~38 months and the mean time was 26.6 months.Their ages ranged from 15 to 45 years with an average of 29 years.Each of 60 cases had a unidirectional instability of anterior shoulder,and the average number of dislocation before surgery was 6 .5 times (2-17 times).Suture anchor was applied for reconstruction of Bankart injury.ASES score and Constant-Murley score were adopted for the functional assessment during follow-ups. The postoperative recovery time of shoulder function was 6 weeks without redislocation in each case. Complete rotator cuff tear,subacromial impingement syndrome,etc.were excluded from this group of patients.Imaging examination:X-ray films of anteroposterior view,lateral view and supraspinatus outlet view,CT scanning,MRI and CT three-dimensional reconstruction with humeral head removed were done preoperatively.No obvious bone defect was shown on preoperative X-ray films,no definite bony Bankart inj ury was revealed on CT three-dimensional reconstruction, and all MRI showed hyperintense between anterior labrum and glenoid rim with 3 cases of glenoid labrum disappeared. Operative methods:After successful general anesthesia,the patient was placed in lateral position. Every 3000 ml saline for flushing purpose was added with 1 ml of 0.1% epinephrine,and the pressure of adjustable water pump was

  5. 改良全关节镜下胫骨Inlay技术重建后十字韧带的实验研究%Experimental study of improved arthroscopic reconstruction of posterior cruciate ligament using tibial Inlay technique

    Institute of Scientific and Technical Information of China (English)

    姜雪峰; 杨惠光; 张云庆; 徐军; 黄国伟; 任亚军; 孙惠清

    2011-01-01

    目的 探讨采用改良全关节镜下胫骨Inlay技术重建膝关节后十字韧带(posterior cruciate ligament,PCL)手术方法的特点及优势.方法 设计专门的胫骨隧道形态及配套的胫骨钻头,设计移植物的形态和固定方法.在5具成人膝关节标本上模拟操作,年龄25~65岁;左膝2例,右膝3例.设计出全关节镜下胫骨Inlay技术重建PCL的手术操作流程(包括建立胫骨隧道的方法,移植物的引入等).操作完成后切开实验标本,进行二次观察,观察胫骨隧道内口的形态和位置是否达到设计的要求.通过对30张正常MRI片进行测量,确定胫骨隧道的角度,明确术中PCL定位器的角度.结果 胫骨隧道内口设计成14 mm×7 mm×15 mm的圆锥状,外口为直径7 mm的圆柱状,配套的胫骨钻头设计成分体式,钻头在体外装配.胫骨平台后缘斜坡与水平成36°~47°,定位器角度设定为50°.移植物使用异体跟腱,移植物骨块设计成圆锥状,与胫骨隧道内口相匹配,移植物胫骨隧道外口使用纽扣钢板固定.5例标本手术均获得成功,切开行二次检查结果显示,其中4例移植物和胫骨隧道匹配,另1例隧道外口直径偏小,移植物无法完全嵌入.结论 改良全关节镜下胫骨Inlay技术重建膝关节PCL手术具有操作简单、准确、快速、固定牢靠的特点.%Objective To improve the arthroscopic posterior cruciate ligament (PCL) reconstruction using tibial Inlay technique. Methods The special arthroscopic device and related fixation technique were designed. Five cadaveric knees were used to simulate the process of arthroscopic posterior cruciate ligament reconstruction using tibial Inlay technique. The knees were cut open to observe whether the outlet of the tibial tunnel shape and location met the design requirements. Thirty normal MRI films were measured to identify tunnel angle and localizer angle. Results The inner outlet of tunnel was conical shape(14 mm×7 mm×15 mm

  6. 关节镜诊治关节内桡骨远端粉碎性骨折的软组织损伤%Arthroscopic assessment of soft tissue injuries in comminuted intra-articular fractures of the distal radius

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To diagnose and evaluate soft tissue injuries in intra-articular fractures of the distal radius using arthroscopy. Methods Twenty young patients with displaced intra-articular fractures of distal radius were recruited in this prospective study. Three AO C2 and 17 C3 fractures were included. After arthroscopic examination fractures of distal radius were treated by external fixation with limited internal fixation or open plate fixation.Results Triangular fibrocartilage complex (TFCC) injury was found in 18 patients (90%) . Most were isolated Palmer type 1D injuries (67 %). Scapho-lunate ligament injury was found in two patients: one partial tear (grade Ⅱ) and one complete tear (grade Ⅲ). Follow-ups ranged from 6 to 18 months. At the last follow-up, wrist function was excellent in one patient (6%), good in eight(44%) and fair in 11 (50%). Conclusion TFCC injuries are common in intra-articular fractures of the distal radius while injuries to scapho-luuate ligament are uncommon.

  7. Arthroscopic button plate fixation therapy for instable distal clavicular fracture%关节镜下纽扣钢板固定术治疗不稳定锁骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    陈建海; 党育; 付中国; 姜保国

    2015-01-01

    Background The cases of distal clavicular fracture account for 12%-1 5% of all clavicular fracture cases.Distal clavicular fracture combined with coracoclavicular ligament rupture frequently behave as unstable fracture,with the opportunity for fracture non-union in conservative therapy being as high as 21%.Although partial patients with fracture nonunion show mild clinical symptoms,the symptomatic nonunion may affect the functions of shoulder joint.Therefore,most of physicians suggest operative treatment for unstable distal clavicular fracture.The operative treatment can achieve fracture union rate up to 98%.The distal clavicular fracture is characterized by fracture combined with ligament injury, and there are also diversified clinical therapies. The frequently reported internal fixation methods include kirschner wire,tension band,coraco-clavicular screw, anchor,clavicular hook plate,anatomical locking plate as well as suture fixation,etc.After fracture union,the metallic internal implants are frequently required to be taken out through operation. Different therapies have both their advantages and disadvantages.At present,there has been no unified therapy for unstable distal clavicular fracture.Arthroscopic button plate fixation therapy for unstable distal clavicular fracture is a relatively new minimally invasive treatment method,and its technology is originated from arthroscopic button plate fixation for the treatment of dislocation of acromioclavicular joint.We made retrospective analysis on the clinical effects of arthroscopic button plate fixation on distal clavicular fracture and discussed the potential advantages and disadvantages of this therapy.Method Ⅰ.General materials:Twenty-one patients with unstable distal clavicular fracture who received operative treatment in our department during the period from September 2010 to December 2012 are collected,seventeen cases of these meet inclusion criteria,namely 10 male cases and 7 female cases,with an average

  8. 肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位%Arthroscopic Application with Anchor Fixation Method in the Treatment of Recurrent Dislocation of the Shoulder Joint

    Institute of Scientific and Technical Information of China (English)

    周吉湘

    2013-01-01

    Objective To explore the effect of arthroscopic application with anchor fixation method in the treatment of recurrent dislocation of the shoulder joint. Methods 80recurrent dislocation of the shoulder joint patients were randomly divided into 2 groups,control group were treated conservatively, the observation group routine arthroscopic operation treatment.Observation of effect of operation and clinical indexes. Results The total efficiency of the observation group 95%,better than the control group,with significant difference. Conclusion Effect of arthroscopic application with anchor fixation method in the treatment of recurrent dislocation of the shoulder joint is significant.%  目的探讨肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位的疗效。方法将在我院治疗的80名复发性肩关节脱位随机分为2组,常规组40例进行保守治疗,观察组40例行关节镜手术治疗。观察手术效果等临床指标。结果观察组总有效率为95%,优于常规组82.5%,差异有统计学意义(P<0.05)。结论肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位的疗效显著。

  9. 等速训练对膝半月板损伤关节镜手术后膝关节功能恢复及关节周围肌肉力量的影响%The Impact of Knee Function and Muscles Strength of Isokinetic for Patients with Knee Meniscus after Arthroscopic Surgery

    Institute of Scientific and Technical Information of China (English)

    邵正海; 张玉发; 吕宏; 毕霞; 高亮亮; 刘小垒; 黄鑫凝

    2014-01-01

    目的:回顾性分析等速训练康复方案对膝半月板损伤患者术后关节功能恢复及关节周围肌肉力量的影响。方法:对25例膝半月板损伤患者关节镜术后采取等速康复训练,与对照组行常规训练进行比较。结果:经治疗二个疗程后,观察组单次最大做功、力矩加速能、屈膝伸肌峰力矩测试和平均做功率各指标均优于对照组(P<0.05),差异有统计学意义。结论:等速康复训练对膝半月板损伤关节镜手术后患者具有较好的改善,能够明显改善患者的预后状况,值得临床推广应用。%Objective:Retrospective analysis impact of knee function and muscles strength of Isokinetic for patients with knee meniscus after arthroscopic surgery. Methods:25 cases of arthroscopic knee meniscus injury patients were taken isokinetic rehabilitation after surgery, and the efficacy of the control group were compared. Results:After two courses of treatment, the maximum single acting, torque acceleration energy, knee extensor peak torque test and the average power of the observation group were all better than the control group(P<0.05). Conclusion:The isokinetic method for knee meniscus injury patients’ rehabilitation after arthroscopic surgery was helpfui and could significantly improve the patient's prognosis, worthy of clinical application.

  10. 关节镜下自体肌腱移植重建前交叉韧带术后并发症的研究进展%Research progress on the postoperative complications of arthroscopic anterior cruciate ligament reconstruction using autogenous tendon grafts

    Institute of Scientific and Technical Information of China (English)

    赵阳; 张春礼

    2015-01-01

    As an important therapy for anterior cruciate ligament ( ACL ) ruptures,ACL reconstruction using autogenous tendon grafts has been gradually accepted by the majority of doctors and patients,but there is a lack of an intensive study on the postoperative complications.Deep vein thrombosis ( DVT ),peripheral neuropathy and muscle weakness may be caused by the use of tourniquets.The joint infection rate after arthroscopic ACL reconstruction is about 0.3%-1.7%.The pollution of surgical tools and grafts is the main cause of postoperative knee infections.The infection chance will be increased due to soft tissue injuries in harvesting tendons and the use of internal fixation.Erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) are considered to be the effective laboratory indexes in early diagnosis of infections after ACL reconstruction.The application of sensitive antibiotics,repeated arthrocentesis and arthroscopic debridment are important and effective in the treatment of knee joint infections.Injuries of the infrapatellar branch of the saphenous nerve and the lateral sural cutaneous nerve may lead to sensory disability in the anterior region and the distal end of the affected knee.The choice of incision location and fixed position of the affected limb are related to nerve injuries.The incidence of cysts after ACL reconstruction is not high,and tibial tunnel cyst and cruciate ligament cyst are relatively common.The symptoms can be alleviated with the treatment of arthroscopic cystectomy.The incidence of postoperative fibrosis of the knee joint is 4%-35%,which is mainly associated with tunnel positioning,combined soft tissue injuries and postoperative rehabilitation exercise.

  11. 关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效%Arthroscopic surgery for treatment of acute patellofemoral joint impingent

    Institute of Scientific and Technical Information of China (English)

    李烨; 汤洁; 胡勇; 赵胜豪; 黎清波; 彭永海

    2012-01-01

    Objective To evaluate the clinical effects of arthroscopic technique in managing acute patellofemoral joint impingent syndrome.Methods Retrospective analysis was made on clinical data of 19 cases of patients with acute patellofemoral joint impact syndrome in orthopedic in our hospital from August 2006 to December 2009.Results 3 knees were done debridement in this group; 13 knees were done debridement + patella medial band suture;5 knees were done debridement + patella medial band suture + lateral with lysis.12 cases were torn out of 17 the intra-articular fracture of block.All patients did not occur to blood vessels,nerve damage and infection or other complications.All patients with follow-up period did not recur in the dislocation of the patella,without dislocation of the fear of weight-bearing exercises,12 months after operation were followed up for joint activity can resume normal,18 patients were followed up for 12 months after recovery to pre-injury exercise level,only 1 case after double knee injury exercise levels were affected,but did not affect their daily lives.Lysholm clinical scoring system to assess knee function excellent were 17 knees,good were 3 knees,excellent rate of 95.2%.Conclusion The method is simple and effective of arthroscopic treatment of acute patellofemoral joint impingement syndrome,should be used in clinical practice.%目的 探索膝关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效.方法 回顾性分析2006年8月至2009年12月该院骨科采用膝关节镜治疗急性滑脱性髌股关节撞击综合征19例患者的临床资料.结果 本组3膝行清理术;13膝行清理术加髌骨内侧支持带缝合术;5膝行清理术加髌骨内侧支持带缝合术加外侧支持带松解术.全部患者均未发生血管、神经损伤和感染等并发症,无术后关节内出血而再次手术者.全部患者随访期内未再发生髌骨脱位,负重练习后无脱位恐惧感,术后12个月复诊时关

  12. 关节镜下关节囊松解治疗原发性冻结肩的疗效观察%The Efficacy of Arthroscopic Arthrolysis for Frozen Idiopathic Frozen Shoulder

    Institute of Scientific and Technical Information of China (English)

    曹亮波; 刘亚; 李军磊; 郑兆君

    2013-01-01

    Objective To evaluate the results of arthroscopic capsular release for the treatment of idiopathic frozen shoulder . Methods From October 2010 to December 2011,13 cases of patients with primary frozen shoulder after conservative treatment for 3 months or more invalid line of shoulder were taken endoscopic joint capsular release treatment and followed up for 8 to 12 months.The American Shoulder and Elbow Surgeons the-standard shoulder score(ASES),the shoulder joint active/passive activities range(ROM),visual analogue scale(VAS) were chosen to be the evaluation index .All patients had no statistically significant differences in age ,gender,disease duration and stage baseline data.Results Patients with shoulder pain eased significantly or disappeared ,VAS pain score decreased from 5.5 ±4.8 points preoperatively to 1.6 ±2.0,shoulder mobility function significantly improved compared with preoperative ,the shoulder joint ASES score improved from 45.0 ±18.0 points preoperatively to 94.0 ±21.0 minutes,and no patients had complications.Conclusion Arthroscopic capsular release is a safe and effective surgical procedure in the management of idiopathic frozen shoulder unresponsive to conservative treat -ment.It has advantages of little invasive ,better recovery,less operation time and less complications .%  目的观察原发性冻结肩的患者行关节镜下肩关节囊松解手术的疗效.方法自2010年10月~2011年12月选择经保守治疗3个月以上无效的原发性冻结肩患者13例,行肩关节镜下关节囊松解治疗,术后随访8~18个月.评价指标采用美国肩肘外科-标准肩关节评分(ASES)、肩关节主动/被动活动范围(ROM)、视觉疼痛评分(VAS)等.所有患者在年龄、性别、病程及分期等基线资料差异无统计学意义.结果患者肩关节疼痛明显缓解或消失,VAS疼痛评分由术前的(5.5±4.8)分降低到(1.6±2.0)分,肩关节活动功能较术前明显改善,肩关节ASES评分由术前的(45.0

  13. Resultados do procedimento artroscópico de "remplissage" na luxação anterior recidivante do ombro Results from filling "remplissage" arthroscopic technique for recurrent anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitelli

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado clínico da técnica de "remplissage" associada ao reparo da lesão de Bankart (BK para o tratamento da luxação anterior recidivante do ombro. MÉTODOS: Nove pacientes (10 ombros, com seguimento médio de 13,7 meses, apresentaram luxação traumática anterior recidivante do ombro. Todos tinham lesão de BK associada à lesão de Hill e Sachs (HS, com sinal do "encaixe". O defeito das lesões de HS foi medido e apresentava em média 17,3% (7,7% a 26,7% de perda óssea em relação ao diâmetro da cabeça do úmero. Todos foram submetidos ao reparo artroscópico da lesão de BK associado ao preenchimento ("remplissage" da lesão de HS pela tenodese do infraespinal. RESULTADOS: O escore de Rowe variou de 22,5 (10 a 45 no período pré-operatório para 80,5 (5 a 100 no período pós operatório (p OBJECTIVE: To evaluate the clinical result from the filling ("remplissage" technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation. METHODS: Nine patients (10 shoulders, with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7% in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus. RESULTS: The Rowe score ranged from 22.5 (10 to 45 before the operation to 80.5 (5 to 100 after the operation (p < 0.001. The UCLA score ranged from 18.0 (8 to 29 to 31.1 (21 to 31 (p < 0.001. The measurements of external and internal rotation at abduction of 90º after the operation were 63.5º (45º to 90º and 73º (50º to 92º respectively. Two patients presented recurrence (one with dislocation and the other

  14. Resultado funcional do tratamento artroscópico da instabilidade do ombro sem a lesão do lábio da glenóide Functional results of arthroscopic treatment of shoulder instability without glenoid labral lesion

    Directory of Open Access Journals (Sweden)

    Waldo Lino Júnior

    2007-07-01

    Full Text Available OBJETIVO: Tratar a instabilidade anterior e ântero-inferior do ombro sem lesão do lábio da glenóide por via artroscópica por meio de capsulorrafia térmica e fechamento do espaço rotador e avaliar os resultados quanto à estabilidade e à melhora funcional. MÉTODOS: Entre janeiro de 1998 e junho de 2002, 11 pacientes foram submetidos a esse procedimento, imobilizados por cinco semanas e após tratados por fisioterapia. Todos os pacientes foram avaliados no pré e pós-operatório pelas escalas de Neer, Rower e UCLA e, no pós-operatório, pela escala de ASES. RESULTADOS: Durante o período de seguimento entre 46 e 97 meses média de 75,54 meses todos os ombros permaneceram estáveis. Comparando-se a evolução do pré ao pós-operatório, houve melhora de acordo com a escala de Neer, na qual nenhum paciente apresentou resultado satisfatório no pré-operatório e oito tiveram resultado satisfatório no pós-operatório. Segundo a escala de Rowe, a média pré-operatória foi de 36,8 e, no pós-operatório, de 81,6 pontos. Conforme a escala da UCLA, a média no pré-operatório foi de 23,45 e, no pós-operatório, de 31,18 pontos. De acordo com todas essas escalas houve melhora estatisticamente significativa (p = 0,05. A escala da ASES mostrou média pós-operatória de 77,2 pontos. CONCLUSÃO: O procedimento artroscópico analisado confere estabilidade e melhora funcional.OBJECTIVE: Anterior and anterior-lower instability of the shoulder without a glenoid labral lesion was arthroscopically treated by thermal capsulorrhaphy and closing of the rotator space, and results were evaluated for stability and functional improvement. METHODS: From January 1998 to June 2002, 11 patients were submitted to this procedure, immobilized for five weeks, and then treated by physiotherapy. All patients were evaluated pre- and post-operatively by the Neer, Rower, and UCLA scale, and in the post-operative period, by the ASES scale. RESULTS: During the follow

  15. 关节镜下应用LARS人工韧带同时重建前、后交叉韧带%Reconstruction of combined anterior cruciate ligament and posterior cruciate ligament injuries by using LARS artificial ligament under arthroscope

    Institute of Scientific and Technical Information of China (English)

    康一凡; 王谦

    2008-01-01

    Objective To explore the treatment method and clinical effect of LARS artificial ligament in treatment of combined anterior cruciate ligament(ACL) and posterior crueiate ligament (PCL) injuries of the knee under arthroscope. Methods Thirteen cases of ACL and PCL injuries were reconstructed with LARS ligament. The patients were followed up for 12-36 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for functional evaluation. In the meantime, KT-1000 was employed to check anterior and posterior laxation of the knee. Results No knee infection or limitation of knee extension occurred. Knee flexion was 105° -125° (average 117°). At termination of follow up, 10 cases (77%) was graded as A and 3 (23%) as B according to IKDC. KT-1000 examination at 25° flexion showed that the difference of anterior laxation was less than 2 mm in 12 cases and 3-5mm in 1. KT-1000 examination at 70°flexion showed that the difference of anterior laxation was less than 2mm in 12 cases and 2-4 mm in 1. The Lysholm score was (63.8±2.9) points (49459 points) before operation and (91.1 ±2.7) points (88-95 points) at follow up, with statistical difference (P <0.01). Conclusion Reconstruction of ACL and PCL by using LARS ligament under arthroscope is a kind of minimally invasive, safe and effective method to treat ACL and PCL injuries of the knee, with good short term outcome.%目的 探讨关节镜下应用LARS人工韧带重建前交叉韧带(ACL)、后交叉韧带(PCL)同时损伤的方法及疗效. 方法 关节镜下同时重建13例ACL、PCL损伤的患者,重建材料采用LARS人工韧带.术后随访12~36个月,采用国际膝关节文件编制委员会(IKDC)韧带标准评价表和Lysholm膝关节功能评分表评估患膝功能,通过KT-1000检查膝关节前后松弛度.结果 术后无膝关节感染发生;均无伸膝受限,屈膝活动度105°~125°,平均117°.术后随访时IKDC评分:A类10例(77%),B类3例(23%).

  16. The Clinical Study on Arthroscope Combined with limited Open Treating Knee Multiple Ligament Injury%关节镜结合有限切开治疗膝关节多韧带损伤

    Institute of Scientific and Technical Information of China (English)

    彭永海; 张青松; 李烨; 胡勇; 汤洁

    2012-01-01

    目的:探讨应用关节镜结合有限切开治疗膝关节多韧带损伤的方法和近期疗效.方法:膝关节多韧带损伤患者25例,采用关节镜下异体胫前肌腱重建前后交叉韧带,同时有限切开修复关节周围韧带,处理合并的半月板软骨损伤.术前按照国际膝关节文献委员会(IKDC)综合评价患膝功能均为D级,Lysholm评分平均为(35.0±1.4)分.结果:25例患者术后获24~30个月(平均27.4个月)随访,患膝功能均明显改善.末次随访时IKDC综合评价结果:A级10个(40%),B级12个(48%),C级3个(12%),Lysholm评分平均为(92±1.8)分,与术前相比差异有统计学意义(P<0.01).结论:关节镜下同种异体胫前肌腱重建前后交叉韧带结合有限切开修复关节周围韧带,可以明显改善膝关节功能,临床疗效较好.%Objective:To discuss the treatment methods and short term effect of arthroscope combined with limited open treating knee joint multiple ligament injury. Method:25 cases of ACL and PCL injury were reconstructed with anterior tibial tendon allograft under arthroscope, while repaired the ligaments around the knee and meniscus cartilage through mini - open approach. According to the International Knee Documentation Committee (IKDC) standard, the knee function was class D and Lysholm average score was (35 ± 1.4) before operation. Results:After surgery the 25 patients were followed - up about 24 - 30 months (average 27. 4 months), The knee function of all patients were improved significantly. At termination of follow-up, IKDC score was graded as A in ten cases (40%) , B in twelve cases (48%) , and C in threee cases (12%). Lysholm average score was (92±1. 8). Compared with preoperation, the IKDC and Lysholm score showed significant changes (P<0. 01). Conclusion:Reconstruction of ACL and PCL with anterior tibial tendon allograft under Arthros-copy through mini-open approach can significantly improve the knee function The clinical efficacy is better.

  17. 关节镜下保留残端的后交叉韧带重建术%Arthroscopic reconstruction of posterior cruciate ligament with preservation of the remnants

    Institute of Scientific and Technical Information of China (English)

    王建华; 张强; 李学举; 鲍玉松; 李勇; 朱喆; 高鸿祥

    2009-01-01

    Objective To evaluate the technique and outcome of arthroscopic reconstruction of posterior cruciate ligament(PCL)with preservation of the remnants.Methods From January 2006 to January 2009.16 knees in 16 patients with PCL tear were verified with arthroscopy.All the damaged PCL were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy without remove of the remnants of PCL.Endo-button and Bio-absorbabh interference screw were used for direct anatomic fixation of the reconstructed ligament.Results No severe complication occurred in early stage after operation in the 16 patients.All of them were followed up from 4 to 14 months with an average of (7.4±2.1)months.Lysholm score was remarkable improved from mean(61.3±8.7)preoperative scores to mean(91.7±6.3)scores at the latest follow up(P<0.05).Furthermore,there was a significant improvement in IKDC scofe from abnormal (grade C)in 9 knees and severely abnormal (grade D)in 7 knees preoperatively to normal(grade A)in 11 knees,nearly normal(grade B)in 5 knees at the follow up.All of the 16 patients returned to the same sports level before injury.Conclusion Arthroscopic reconstruction of PCL with preservadon of the remnants has advantages of minimal inmmrticular interference,and potential facility to revagculization and reinnervation of the reconstlucted ligament.%目的 评估关节镜下保留残端的后交叉韧带(PCL)重建的技术和效果.方法 2006年1月至2009年1月,16例(16膝)患者经关节镜检查证实为PCL断裂.关节镜下对原PCL残端不做切除,采用自体四股腘绳肌腱两切口法,单柬重建PCL,采用悬吊钢板和生物可吸收挤压螺钉解剖复位固定重建韧带.结果 本组术后早期均未发生严重并发症.术后随访4~14个月,平均(7.4±2.1)个月,Lysholm膝关节功能评分由术前平均(61.3±8.7)分,提高至随访时的(91.7±6.3)分(P<0.05).国际膝关节文件编制委员会(IKDC)综合评定由

  18. 关节镜下异体韧带移植重建断裂前交叉韧带10例%Arthroscopically assisted allograft reconstruction of anterior cruciate ligament rupture: A primary report of ten cases

    Institute of Scientific and Technical Information of China (English)

    张春礼; 李明全; 朱庆生

    2001-01-01

    目的回顾性总结采用异体韧带重建膝关节前交叉韧带的临床初步疗效. 方法对10例采用关节镜技术移植异体韧带重建损伤前交叉韧带进行了5~11 mo,平均8 mo的随访评估. 结果所有患者症状均有缓解,关节稳定性恢复,取得了满意的临床疗效. 临床观察免疫排斥反应轻微甚至无法觉察. 部分移植韧带,特别是在术后6 mo,逐渐略有松弛,但并未影响近期疗效. 结论异体韧带移植是一种可行的重建损伤前交叉韧带的一种选择,但远期结果需要进一步观察.%AIM To evaluate the early result of allograft reconstruction of anterior cruciate ligament for ACL deficiency knee. METHODS Ten cases of ACL reconstruction operated upon with allografts assisted with arthroscopic technique were followed-up for 5 to 11 mo, mean 8 mo. RESULTS All patients had a quite satisfactory result with relief of symptoms and restoration of knee stability, immunologic rejective reaction was minimal, even invisible, but some grafts were gradually becoming a little laxity, particularly when 6 months postoperation, whereas it has not affected the primary results. All of them have gone back to their preinjury job. CONCLUSION Allograft is one of acceptable alternatives of reconstruction of torn ACL, but the long-term results still needs a further observation.

  19. Early efficacy of arthroscopic posterior cruciate ligament reconstruction with tendon through remnant fiber slit%关节镜下穿残段正中重建后交叉韧带的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    高京平; 高志增; 汪耀军

    2016-01-01

    目的:介绍肌腱穿残段正中劈裂缝后交叉韧带(PCL)的镜下重建手术方法,评估术后膝关节功能及本体感觉恢复情况。方法2012年8月-2014年3月,17例符合入选标准的PCL损伤患者采用了穿残段正中劈裂缝的PCL镜下解剖单束式重建手术,术中以悬吊钢板和生物可吸收挤压螺钉为肌腱固定方式。对患者术前及术后12个月的Lysholm及国际膝关节文献委员会(IKDC)的主观评分和KT-1000(关节活动测量仪, PMENT NO 4.563555,MEDmetric Corporation,San Diego,California,美国)测量值对照来评估膝关节功能恢复情况,对照患者术后12个月的双膝被动重新定位(PRP)值及被动运动察觉阈值(TTDPM)评估膝关节本体感觉。结果所有患者在12个月的随访期内均无严重并发症出现。主观评分结果显示:Lysholm评分从平均(54.41±8.00)分增高到随访12个月后的(90.12±2.69)分(0.05)。结论采用关节镜下经残段正中劈裂缝PCL保残重建术能够有效地恢复膝关节的稳定性及改善膝关节功能。保留PCL残段与滑膜可能有益于本体感觉的恢复及重建肌腱的愈合。%Objectives To introduce arthroscopic posterior cruciate ligament (PCL) reconstruction with the tendon through the middle gap of remnant fiber and evaluate the recovery of postoperative knee function and the preliminary proprioception. Methods 17 cases of eligible patients of posterior cruciate ligament ruptures were performed arthro-scopic Single-beam type anatomical reconstruction with the tendon throung the middle gap of remnant fiber from August 2012 to March 2014. The tendon is fixed in operation through suspension of end-button and extrusion of bioabsorbable interference screw. The recovery of Knee function is assessed with comparative analyzing the preoper-ative and postoperative Lysholm and The International Knee Documentation Committee knee nation form (IKDC) subjective

  20. Efficacy of Arthroscopic Resection of the Subacromial Bursa in Treatment of Simple Subacromial Bursitis%关节镜下切除肩峰下滑囊治疗单纯肩峰下滑囊炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘玉健; 潘昭勋; 崔岩; 翟龙地; 曲连军

    2013-01-01

    Objective To evaluate the efficacy of arthroscopic resection of the subacromial bursa in treat-ment of simple subacromial bursitis.Methods From January 2006 to January 2012,40 cases of recurrent subacromial bursitis were treated in our department including 28 men and 10 women,aged 20~65 years old,an average of 43.All pa-tients had no history of trauma,diagnosed with simplex subacromial bursitis exact ,had the symptoms of shoulder pain or discomfort,muscle restricted activities,pain arc positive,Neer sign weakly positive.MRI scans showed high signal in the SAB in T1,X-ray showed shoulder was normal or mild degeneration .All the patients were randomly divided into group A and group B.The treatment of group A(observe group) was arthroscopic SAB resection .The treatment of group B(control group) was injection of hormones and anesthetics ,EMS and conventional shoulder functional exercise .All patients were observed and recorded VAS before and after treatment for 1 month,3months,1 year and 2 years.Results The VAS score of two groups after treatment for 1 month and 3 months was not significantly different (P>0.05).The VAS score of two groups after treatment for 1 year and 2 years had significant difference (P<0.01),and VAS score of group A was less than group B.Conclusion The arthroscopic resection of SAB is an effective treatment for simple subacromial bursitis and long-term efficacy is superior to conservative treatment .%  目的 观察关节镜下切除肩峰下滑囊(SAB)治疗单纯肩峰下滑囊炎的疗效。方法 我院自2006年1月~2012年1月收治40例单纯肩峰下滑囊炎的患者,其中男28例,女12例,年龄20~65岁,平均43岁。所有患者均无明显外伤史。所有患者诊断单纯肩峰下滑囊炎,确切排除其他疾病引起的肩峰下滑囊炎。患肩上举、外展困难并疼痛或不适,疼痛反应弧症阳性,Neer症弱阳性。 MRI示肩峰下滑囊T1高信号,X线示患肩无异常或轻度退变。

  1. Arthroscopic femoral osteoplasty for cam-type femoroacetabular impingement%关节镜下股骨头颈成形术治疗凸轮型股骨髋臼撞击症

    Institute of Scientific and Technical Information of China (English)

    吴子英; 陈疾忤; 陈世益; 李云霞; 李宏云; 曹深诚

    2012-01-01

    Objective To evaluate the feasibility and clinical effectiveness of arthroscopic femoral osteoplasty for cam-type femoroacetabular impingenent(FAI).Methods From October 2007 to April 2009,31 patients with cam-type FAI underwent hip arthroscopy,including 12 males and 19 females with an average age of 34.1 years(range,18-45).Physical examination,X-ray,3D-CT scans were carried out preoperatively to make the definite diagnosis.All patients were treated with hip arthroscopic debridement and femoral osteoplasty.The patients were followed-up at 1 month,3 months,6 months,1 year,and every year post operation.Outcomes were measured with pain visual analogue scale(VAS),ROM of hip,impingement tests,α angle and modified Harris hip score at final follow-up.Results All patients were followed up for average 22.7 months(range,18-36).At final follow-up,impingement tests among all patients were negative,the range of flexion increased from 101.0°±14.2° to 121.0°±11.7°,the range of internal rotation in a position of 90° flexion increased from 5.0°±9.8° to 30.1°±12.7°,α angle decreased from 74.2°±10.7° preoperatively to 44.7°±8.3°,VAS pain score decreased from 6.1±1.1 preoperatively to 0.9±0.7,modified Harris hip score improved from 41.2±5.7 preoperatively to 73.6±4.1,all differences were statistically significant.Conclusion Arthroscopic femoral osteoplasty for cam-type FAI can win the satisfactory achievements for complete excision of bony prominence at anterior-lateral femoral head-neck junction,restoration of the femoral offset,significant relief of clinical symptoms and improvement of hip range of motion.%目的 探讨髋关节镜下股骨头颈成形术治疗凸轮(Cam)型股骨髋臼撞击症的可行性及临床疗效.方法 2007年10月至2009年4月收治Cam型股骨髋臼撞击症患者31例,男12例,女19例;年龄18~45岁,平均34.1岁.术前行体格检查、X线摄片和三维CT明确诊断.所有病例均行髋关节镜下关节清理

  2. Diagnostic classification and stage-adapted treatment of infection following arthroscopic anterior cruciate ligament reconstruction%前交叉韧带重建术后感染的诊断分型与分期治疗

    Institute of Scientific and Technical Information of China (English)

    徐青镭; 李飞; 邵顺健; 王颖; 王连嘉

    2012-01-01

    Objective To discuss the self-developed diagnostic classification and stage-adapted treatment of infection after anterior cruciate ligament (ACL) reconstruction.Methods Eleven cases of infection after arthroscopic ACL reconstruction were treated in our department from October 2002 to December 2010.They were 8 men and 3 women,28.8 years of age on average (from 18 to 45 years).Infection was definitely diagnosed in 1 to 64 weeks (average,7.7 weeks).On the basis of literature review,we developed a diagnostic classification system which divides infections into 3 types according to clinical manifestations and used it to establish the diagnoses of infection.We had 5 cases of type Ⅰ (acute infectious synovitis),3 cases of type Ⅱ (extra-articular infection) and 3 cases of type Ⅲ (septic arthritis) of which 2 were type ⅢA with positive culture results and one was type Ⅲ B with negative culture result.Staged-adapted treatment algorithms were adopted based on the clinical classification of the patients,including early administration of intravenous antibiotics,arthroscopic debridement and irrigation with graft retention,as well as radical open debridement with graft and hardware removal.Results Follow-ups of 5.2 years on average (from 2.5 to 8.0 years)showed that all the 11 cases of infection were cured,but 3 cases had limited extension (one case of type Ⅰ and 2 cases of type ⅢA).The Lysholm scores at the last follow-up ranged from 76 to 93 points (average,82 points).In anterior laxity of the knee joint,the KT-1000 examinations showed 2 cases had side to side difference <2 mm,6 cases had side to side difference of 3 mm and 3 cases had side to side difference > 3 mm.Conclusions Infection after arthroscopic ACL reconstruction can be classified according to its early clinical manifestations.Our classification system may lead to better stage-adapted treatment of the infection.%目的 探讨前交叉韧带(ACL)重建术后感染的诊断分

  3. Avaliação dos resultados da sinovectomia por via artroscópica do cotovelo em pacientes portadores de artrite reumatoide Assessment of arthroscopic elbow synovectomy outcomes in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2009-01-01

    Full Text Available OBJETIVO: Rever os resultados funcionais da sinovectomia por via artroscópica de cotovelo em pacientes com artrite reumatoide. Métodos: Entre maio de 1999 e dezembro de 2005, 15 pacientes foram submetidos à sinovectomia do cotovelo pela técnica artroscópica. Três casos eram bilaterais, totalizando 18 cotovelos. Dois pacientes eram do sexo masculino e 13 do feminino. A média da idade era de 44 anos e cinco meses. O tempo médio de diagnóstico prévio da doença foi de seis anos e oito meses. Todos os pacientes tinham dor no período pré-operatório e em sete cotovelos havia instabilidade. A média das mobilidades articulares no período pré-operatório foi: flexão de 118º, extensão de -24º, supinação de 80º e pronação de 71º. Resultado: O seguimento pós-operatório médio foi de 39 meses. A média da mobilidade articular pós-operatória de flexão foi de 133º, extensão de -20º, supinação de 84º e pronação de 78º. Em nove cotovelos (50% houve melhora do arco de movimento pós-operatório para amplitude de movimento funcional. Doze casos (66,6% apresentaram resolução ou melhora da dor para um nível que não interferisse nas atividades de vida diária. Pelo método de avaliação de Bruce, os resultados foram: sete excelentes, três bons, dois regulares e seis ruins, com média de 85,5 pontos. Ocorreu recidiva da sinovite em seis casos (33,3% e a progressão para osteoartrose em quatro (22,2%. CONCLUSÃO: A sinovectomia por via artroscópica do cotovelo em pacientes com artrite reumatoide propicia melhora da dor em 66,6% dos casos, porém, não leva a melhora significativa do arco de movimento.OBJECTIVE: To review functional outcomes of arthroscopic elbow synovectomy in patients with rheumatoid arthritis. Methods: Between May 1999 and December 2005, 15 patients were submitted to elbow synovectomy using an arthroscopic approach. Three cases were bilateral, totaling 18 elbows. There were two male and 13 female

  4. 关节镜下保留残端重建前交叉韧带与不保留残端重建的Meta分析%Preserving-remnantversusremoving-remnant for arthroscopic anterior cruciate ligament reconstruction:aMeta-analysis

    Institute of Scientific and Technical Information of China (English)

    张磊; 谢崇新; 白靖平

    2016-01-01

    BACKGROUND:There are controversies about preserving the remnant in the anterior cruciate ligament reconstruction procedure because of its uncertain therapeutic effects. OBJECTIVE:Tocompare the efficacy and safety of preserving-remnant with removing-remnant for arthroscopic anterior cruciate ligament reconstruction using a meta-analysis. METHODS:A computer-based online search was conducted in PubMed,Embase,the Cochrane Library, CDSR, CBM, and CNKI databases by using the English key wordsof “anterior cruciate ligamentAND remnant (OR stump)ANDrandomized controled trial (RCT)ORquasi-RCT” and the Chinese key words of“anterior cruciate ligament reconstruction, preserving-remnant, removing-remnant” to screen the relevant articles publishedfrom 1995 to July 2015. Meta-analysis was performed using Review Manager 5.3 software. RESULTS AND CONCLUSION:A total of 13 randomized controled trials were included. The meta-analysis resultsshowed that there were no statisticaly significant differences in KT1000/2000 scores (OR=-0.28, 95%CI:-0.76-0.20,P=0.25), the good rate of synoveal coverage (OR=-0.30, 95%CI:-0.30-0.90,P=0.32), and the incidence of cyclops leions (OR=0.87,95%CI: 0.63-2.90,P=0.44). Postoperative Lysholm scores (OR=2.45, 95%CI: 0.52-4.39,P=0.01), proprioceptive function (OR=-1.72, 95%CI:-3.32 to 0.13,P=0.03), tunnel enlargement (OR=-0.66, 95%CI:-1.08 to-0.23,P=0.002) in preserving-remnant were superior to removing-remnant for arthroscopic anterior cruciate ligament reconstruction. These results suggest that both preserving-remnantandremoving-remnant for arthroscopic anterior cruciate ligament reconstructioncanobtain satisfactory antero-posterior stability of the knee. Preserving-remnant exhibits superiority in post-operative scores of the knee, proprioceptive function, tunnel enlargement.Furtherhigh-quality randomized controled trials are warranted because of some low-quality studies and the existing biases.%背景:对于前交叉韧带重建过程中是否

  5. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明

    2013-01-01

    目的:研究关节镜下缝线钢板增强喙锁韧带术治疗肩锁关节脱位的近期治疗效果。方法2010年3月至2011年3月,在关节镜下使用膝关节韧带重建技术的缝线钢板(德国 ASCULAP 公司, B′BRAUN)增强重建喙锁韧带(三角韧带与斜方韧带),治疗 Rockwood Ⅲ型9例、Ⅴ型3例新鲜肩锁关节脱位。行 X线片、美国肩肘关节外科医师(America Shoulder Elbow Surgeons,ASES)评分和 Constant 评分,随访12~18个月。结果 ASES 评分:术前28.7分,术后86.9分;Constant 评分:术前24分,术后91分。治疗组 X线片显示,肩锁关节复位良好。术后1年,91.7%(11/12)病例获得满意治疗效果,83.3%(10/12)恢复到术前运动水平,仅有1例出现肩锁关节半脱位。结论关节镜下缝线钢板喙锁韧带增强术治疗肩锁关节脱位,早期可以获得满意的治疗效果,术后复位良好,并发症少。%Objective Acromioclavicular joint dislocation is commonly seen in shoulder joint injuries. Dysfunction as well as pain and discomfort usually occurred when the integrity of shoulder is damaged,for the acromioclavicular (AC)joint is involved in the connection between the scapula and the body as well as the activities of shoulder joint.Therefore,a consensus has been reached to treat severe AC joint dislocation by surgery.Based on different anatomical and functional cognition,methods for AC joint dislocation are various,which are typically performed by incision to reconstruct its stability and restore function.Attempts had been made by many doctors in the reconstruction of AC joint dislocation with the development of arthroscopy.From March 2010 to March 2011,obvious therapeutic effect was obtained in treating Rockwood type Ⅲ and Ⅴ AC joint dislocation arthroscopically with the suture plate used for the reconstruction of ligaments of knee joint to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament).Methods From March 2010 to March 2011

  6. 关节镜下保留残迹的后交叉韧带重建%Arthroscopic posterior cruciate ligament (PCL) reconstruction with retention of PCL remnant

    Institute of Scientific and Technical Information of China (English)

    孙磊; 田敏; 宁廷民; 张红; 宁志杰; 马清元

    2008-01-01

    Objective To evaluate the skill and outcome of arthroscopic reconstruction of posterior cruciate ligament (PCL) with retention of PCL remnant. Methods From April 2004 to June 2006, 38 patients (38 knees) with PCL deficiency were verified by clinical and arthroscopic examinations. Of them, there were 9 knees combined with disruption of the posterolateral comer, 6 with rupture of the posteromedial corner, 8 with lateral meniscus tear and 4 with medial meniscus tear. With reservation of PCL remnant and synovium, all the impaired PCLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy. Interference screws were used for direct anatomic fixation of the reconstructed ligament. Results No severe comphcations occurred at early stage after operation in all 38 patients who were followed up for 12-37 months (average 20.79 months). Lysholm score was improved significandy from 40-70 points (mean 51.32 pints) before operation to 70-100 pints (mean 92.37 points) at the latest follow up (t=-30.14, P<0.01). According to International Knee Documentation Committee (IKDC) score, there was a remarkable improvement from 16 abnormal knees (grade C) and 22 severely abnormal knees (grade D) preoperatively to 18 normal knees ( grade A), 18 nearly normal knees (grade B) and 2 abnormal knees at the latest follow up (Z=-6.00, P <0.01). Of 38 patients, 36 returned to normal sports level but 2 degraded level of sports. Conclusions Arthroscopic PCL reconstruction with retention of PCL remnants is a feasible technique, with satisfactory outcome. Preservation of PCL remnants and synovium may be beneficial to biological incorporation and reinnervation of the reconstructed ligament.%目的 评估关节镜下保留残迹的膝后交叉韧带(PCL)单束重建的技术和效果.方法 自2004年4月至2006年6月,38例(38膝)患者经临床和关节镜检查证实为PCL功能不全,其中9膝伴后外侧角损伤,6膝伴后内侧角损伤,8

  7. Effect of isokinetic training on the function recovery of knee meniscus injuries following arthroscope%关节镜术后等速训练对膝半月板损伤恢复的影响

    Institute of Scientific and Technical Information of China (English)

    李兴海; 任延波; 席国平

    2006-01-01

    training on the functional recovery of knee flexors and extensors and the muscle force around the joint after knee meniscus injuries receiving arthroscopy.DESIGN: Case-control observation SETTING: Department of Police Training, Liaoning Advanced Police Officer School PARTICIPANTS: A total of 20 patients with acute meniscus injury of lateral knee joint were selected from the Department of Surgery, Affiliated Hospital of Dalian Medical University between September 2004 and January 2005. They were randomly divided into experimental group and control group,including 11 cases respectively. METHODS: All the patients were treated with arthroscope operation, additionally the control patients received routine blocking, physiotherapy and massage, etc. To recover the function. From the 2nd to 4th days postoperative, the patients of experimental group began to carry out the functional rehabilitation, and received isokinetic exercise in both knees flexors and extensors with the Cybex-6000 isokinetic dynamometer 3 weeks later.MAIN OUTCOME MEASURES: Peak torque values, total work, torque accelerating energy and average power in both knee flexors and extensors at different angular velocities [60, 120 and 180(°)/s].RESULTS: A total of 22 patients were involved in the result analysis.①After arthroscope operation and isokinetic training, the range of joint movement were extended, and the maximum flexion angle changed from (132±25)° to (158±21)°. There were significant differences before and after training by t test (P < 0.01).②The experimental group had statistical significance compare with control group in the test index at 60, 120 and 180(°)/s(P < 0.05).CONCLUSION: The arthroscope combining with isokinetic training can speed up the rehabilitation after knee meniscus injury, enhance the muscle force around knee joint and maintain the stability of knee joint and motor ability.

  8. The Arthroscopic Treatment of Patients with Traumatic Synovitis of Knee joint Surgery Nursing Management%膝关节镜治疗创伤性膝关节滑膜炎手术患者的护理管理

    Institute of Scientific and Technical Information of China (English)

    宋友友

    2015-01-01

    目的:观察膝关节镜治疗创伤性膝关节滑膜炎手术患者的护理管理。方法将该院2014年2月—2015年9月收治的72例创伤性膝关节滑膜炎患者随机分为两组,对照组和观察组各36例,均采用膝关节镜手术治疗。对照组给予常规护理,观察组在常规护理的基础上给予综合护理。分别于护理前和护理后,检测患者的膝关节周径、膝关节屈伸度,评估疼痛程度,并检测患者膝关节液中炎症因子,分析两组的临床护理疗效。结果观察组的总有效率为97.22%,明显高于对照组的66.67%,差异无统计学意义(P﹤0.05);两组患者护理前的膝关节周径、膝关节屈伸度和VAS评分对比,差异无统计学意义(P﹥0.05);观察组患者护理后的膝关节周径、膝关节屈伸度和VAS评分分别为(33.08±2.25)cm、(88.69±17.64)o、(2.97±0.82)分,明显优于对照组的(37.38±3.41)cm、(77.66±16.95)°、(5.83±1.31)分,差异具有统计学意义(P﹤0.05);两组患者护理前的IL-1、IL-6和TNF-α对比,差异无统计学意义(P﹥0.05);观察组患者护理后的IL-1、IL-6和TNF-α分别为(18.47±6.82)pg/mL、(42.18±7.50)pg/mL、(8.29±2.54)pg/mL,明显优于对照组的(32.46±6.70)pg/mL、(53.28±7.83)pg/mL、(12.38±2.91)pg/mL,差异具有统计学意义(P﹤0.05)。结论给予膝关节镜治疗创伤性膝关节滑膜炎手术患者科学的综合护理,疗效确切,有利于患者膝关节功能恢复,值得推广应用。%Objective to observe the arthroscopic treatment of patients with traumatic synovitis of knee joint surgery nursing management. Methods from February 2014 to september 2015, 72 patients with traumatic synovitis of knee joint were ran-domly divided into two groups, control group and observation group 36 cases, adopt the arthroscopic surgery. Control group given conventional nursing, the observation group on the basis of conventional nursing care to comprehensive care. In nurs-ing before and after

  9. Clinical Research on Arthroscopic Reset in the Treatment of Fracture within the Knee Joint%关节镜下复位与内固定术配合中药治疗膝关节内骨折临床研究

    Institute of Scientific and Technical Information of China (English)

    王冠军

    2013-01-01

    Objective:To investigate the the clinical effect of arthroscopic reset and internal fixation combined with oral administration of Chinese medicine for the treatment of fracture within the knee joint.Methods:46 cases of fracture within the knee joint were randomly divided into the treatment group and the control group with 23 cases in each group.Patients in the treatment group were treated with arthroscopic reset and internal fixation combined with oral administration of Chinese medicine,at the same time combined with exercise care treatment;patients of the control group were treated with arthroscopic reset and internal fixation combined with conventional treatment of recovery exercise.In the treatment process,the recovery condition and the therapeutic efficacy of patients in both groups were recorded to observe the clinical effect of arthroscopic treatment of knee fracture.Results:Comparison between the therapeutic efficacy of patients in the treatment group and the control group,showed that the difference was statistically significant,P < 0.05,and recovery of the treatment group was more desirable.ROM assessment in the treatment group showed 18 cases achieved excellent therapeutic efficacy,3 cases achieved good therapeutic efficacy,and 2 cases achieved medium therapeutic efficacy,no case with poor therapeutic efficacy; ROM assessment in the control group showed 7 cases achieved excellent therapeutic efficacy,5 cases achieved good therapeutic efficacy,3 cases achieved medium therapeutic efficacy and 8 cases achieved poor therapeutic efficacy.Conclusion:Arthroscopic treatment of fracture within the knee joint can effectively help patients achieve the desired therapeutic effect.%目的:探讨关节镜下复位与内固定术配合中药口服治疗膝关节内骨折的临床疗效.方法:将46例膝关节内骨折患者随机分为治疗组与对照组各23例,治疗组患者使用关节镜下复位与内固定术配合中药口服,同时加恢复锻炼治疗;

  10. 关节镜治疗后镇痛:布比卡因关节腔内注射随机安慰剂对照的Meta分析%Analgesia after arthroscopic surgery:Randomly controlled Meta-analysis on intra-articular injection of bupivacaine placebo

    Institute of Scientific and Technical Information of China (English)

    杨拓; 高曙光; 罗伟; 李宇晟; 熊依林; 孙金鹏; 雷光华

    2013-01-01

    BACKGROUND:Pain after arthroscopic treatment can not only affect the patient’s life quality, and is not conducive to the early reasonable exercise and functional recovery of the patients after treatment. Up to 2012, there are 18 randomized placebo-control ed trials on intra-articular injection of bupivacaine for analgesia after arthroscopic surgery, but the results are different. OBJECTIVE:To examine the efficacy and safety of intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery through randomized placebo-control ed trials. METHODS:The MEDLINE database, Cochrane Central Register and Google Scholar database were retrieved for the randomized control ed trials on intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery up to April 2012. The key words were“bupivacaine, intra-articular, arthroscopic, postoperative pain, placebo”. RESULTS AND CONCLUSION:Eighteen studies (n=934) were included (461 cases in bupivacaine group and 473 cases in the placebo control group). The Meta-analysis results showed the visual analog scale score of the bupivacaine group was lower than that of the placebo control group (weighted mean difference:-1.39, 95%confidence interval:-2.17 to-0.61, P mean difference:157.72, 95%confidence interval:16.43 to 299.01, P  目的:通过随机安慰剂对照试验的Meta分析,检验关节镜治疗后关节腔内注射布比卡因镇痛的有效性和安全性。  方法:通过MEDLINE,Cochrane library,谷歌学术数据库检索截止至2012年4月有关使用布比卡因关节腔内注射用于关节镜治疗后镇痛的随机对照试验。检索关键词包括“布比卡因,关节腔内,关节镜,术后疼痛,安慰剂”。  结果与结论:Meta分析共纳入18篇文献(n=934)(布比卡因组461例,安慰剂对照组473例)。结果显示,布比卡因组的目测类比评分数值较安慰剂对照组低(WMD:-1.39,95%CI:-2

  11. Arthroscopic treatment for elevated lateral pressure syndrome with severe patellofemoral arthritis in old age%关节镜手术治疗老年性严重退行性髌骨外侧高压症

    Institute of Scientific and Technical Information of China (English)

    林建宁; 孙笑非; 阮狄克

    2012-01-01

    目的 探讨关节镜下外侧支持带松解加清理术治疗老年性严重退行性髌骨外侧高压症的方法 及疗效.方法 对59例髌骨外侧高压合并髌股关节软骨退变严重的老年患者行关节镜下清理术的同时用射频刀松解外侧支持带.45例切开外侧支持带纤维,不切断股外侧肌(有限松解组);14例切开外侧支持带纤维并切断股外侧肌(完全松解组).分别观察术后1、2年疼痛及上下楼改变情况和患者术后2年主观满意情况,术后股四头肌肌力恢复时间,手术前及手术后1、2年的Lysholm 评分.结果 59例患者症状均改善,Lysholm评分:术前平均64.2分±6.5分,术后2年提高到平均82.8分±4.6分(P0.05).有限松解组患者肌力恢复时间为6.5个月,完全松解组肌力恢复时间为9.1个月,两组比较差异有统计学意义(P 0. 05 ) Muscle strength returned to normal 6. 5 months postoperativey in group limited-release,9. 1 months in group total-release( P <0. 05 ). Subjective patient satisfaction rate was 91. 5% . Conclusions Arthroscopic lateral retinacular release and debridement surgery is an effective method for ELPS with severe patellofemoral arthritis in old age. Limited retinacular release is benefit to sooner recovery.

  12. Curative effect analysis of arthroscopic single band posterior cruciate ligament reconstruction%关节镜下单束重建后交叉韧带临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    王瑞; 徐斌; 徐洪港

    2013-01-01

    Objective To study the clinical curative effect for arthroscopic single band reconstruction of posterior cruciate ligamentwith autogenous semitendinosus and gracilies or allograft. Method 50 cases of injiued posterior cruciate ligament were reconstructed by means of semitendinosus and gracilies by autogenous or anterior tibial muscle' s tendon or achiles' s tendon by allograft fixed by endo-button system and bioabsorbable screw. Results Follow up time was 2.45 years on average for all 50 cases. Based on Lysholm score and on Tegner score to describe function of knee joint, the PCL reconstruction scores were 56. 4( Lysholm ), 3. 0( Tegner )on average before operation,and 80. 3( Lysholm ),6. 2( Tegner )on average after operation. Conclusions The bonding of four-stranded semitendinosus or allograft anterior tibial muscle are similar with anterior or posterior cruciate ligament and its strength are more stronger. Four-stranded construction and reliable fixation by absorbable screws and endo-button system is rigid with low complication.%目的 探讨、分析关节镜下利用自体腘绳肌及同种异体肌腱单束重建后交叉韧带的中期临床疗效.方法 关节镜下利用自体肌腱或异体胫前肌腱及跟腱辅以endo-button系统及生物型可吸收界面螺钉治疗50例膝关节后交叉韧带损伤患者.结果 所有患者平均随访2.45年,按Lysholm 膝关节功能评分与Tegner膝关节运动评分标准,术前患者术前平均56.4分(Lysholm),3.0分(Tegner),术后80.3分(Lysholm),6.2分(Tegner).结论 自体半腱肌、股薄肌与同种异体肌腱重建膝关节后交叉韧带强度好,植入后固定牢靠,术后并发症少.

  13. 膝关节损伤在关节镜下外科治疗的临床效果观察%Surgical Treatment Clinical Effect Observation of Knee Injury under Arthroscopic

    Institute of Scientific and Technical Information of China (English)

    崔德

    2013-01-01

    Objective arthroscopy technique was applied to patients with knee injuries carried out to study the clinical ef ect of treatment. Methods 86 cases of patients with knee injuries,and divided into control group and treatment group,43 cases in each group. The conventional operation method for the control group treatment; The arthroscopic technique is adopted to the treatment group patient treatment. Results the treatment group patients with knee joint injury il ness treatment ef ect is bet er than the control group; Operation time, length of hospital stay,postoperative knee function recovery is often shorter than the control group obviously; Perioperative adverse reaction rate was significantly lower than the control group. Conclusion arthroscopy technique was applied to the treatment of patients with knee injuries implementation ef ect is very obvious.%目的对应用关节镜技术对患有膝关节损伤的患者实施治疗的临床效果进行研究。方法抽取86例患有膝关节损伤的患者,分为对照组和治疗组,每组43例。采用常规手术方式对对照组实施治疗;采用关节镜技术对治疗组患者实施治疗。结果治疗组患者膝关节损伤病情治疗效果明显优于对照组;手术操作时间、术后住院时间、膝关节功能复常明显短于对照组;围术期不良反应率明显低于对照组。结论应用关节镜技术对患有膝关节损伤的患者实施治疗的临床效果非常明显。

  14. Avaliação dos resultados do reparo artroscópico de lesões do manguito rotador em pacientes com até 50 anos de idade Evaluation of the results from arthroscopic repair on rotator cuff injuries among patients under 50 years of age

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2011-01-01

    Full Text Available OBJETIVO: Avaliar o resultado do tratamento cirúrgico das lesões do manguito rotador (LMR por via artroscópica nos pacientes com até 50 anos de idade. MÉTODOS: Entre agosto de 1998 e dezembro de 2007 foram reavaliados 63 pacientes com LMR submetidos a este tratamento pelo Grupo de Ombro e Cotovelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médica da Santa Casa de São Paulo - "Pavilhão Fernandinho Simonsen". Foram incluídos no estudo todos os pacientes com LMR com idade até 50 anos e com seguimento mínimo pós-operatório de 24 meses. RESULTADOS: Pelos critérios de avaliação da UCLA, 59 (92% pacientes tiveram resultados excelentes e bons; cinco (8%, regulares; e nenhum ruim. A amplitude média dos movimentos na avaliação pós-operatória foi de 145˚ na elevação, 47˚ na rotação lateral e de T10 na rotação medial. Os resultados insatisfatórios estiveram associados com o tempo prolongado da lesão, demonstrando uma relação estatisticamente significante. CONCLUSÃO: O reparo artroscópico da LMR nos pacientes jovens traz resultados bons e excelentes na maioria dos pacientes.OBJECTIVE: To assess the results from arthroscopic surgical treatment of rotator cuff injuries among patients under 50 years of age. METHODS: Sixty-three patients with rotator cuff injuries who underwent arthroscopic surgical treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, in the Fernandinho Simonsen wing of Santa Casa Medical School, São Paulo, between August 1998 and December 2007, were reassessed. The study included all patients with rotator cuff injuries who were under 50 years of age and had been followed up postoperatively for at least 24 months. RESULTS: According to the UCLA evaluation criteria, 59 patients (92% showed excellent and good results; five (8% showed fair results; and none showed poor results. The postoperative evaluation showed that the mean range of

  15. Avaliação funcional dos pacientes submetidos ao desbridamento artroscópico para tratamento das rupturas extensas e irreparáveis do manguito rotador Functional evaluation of patients who have undergone arthroscopic debridement to treat massive and irreparable tears of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Marco Antônio de Castro Veado

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes submetidos ao desbridamento artroscópico das lesões extensas e irreparáveis do manguito rotador. Métodos: Foram operados 27 pacientes no período de 2003 a 2007, sendo avaliados 22 desses. O procedimento cirúrgico consistiu de desbridamento artroscópico do coto dos tendões envolvidos, bursectomia, remoção do osteófito acromial e, eventualmente, tenotomia do bíceps e tuberoplastia. RESULTADOS: No pré-operatório todos apresentavam envolvimento dos tendões do supra e infraespinal. Na avaliação pós-operatória, 14 pacientes estavam com o redondo menor íntegro e três com ruptura parcial do subescapular. Houve melhora dos critérios da UCLA de 15 no pré-operatório para 31 no pós. Não houve melhora de força muscular, porém ocorreu redução da dor. Conclusão: Desbridamento artroscópico é um procedimento indicado para pacientes idosos com ruptura irreparável do manguito rotador, que tenham boa ADM, baixa demanda funcional e com o principal objetivo de reduzir a dor.OBJECTIVE: To evaluate the results in patients who have undergone arthroscopic debridement of massive and irreparable injury of the rotator cuff. METHODS: 27 patients were operated in the period from 2003 to 2007, during which 22 of them were evaluated. The procedure used consisted of arthroscopic debridement of the related tendons of the residual limb, bursectomy, acromial osteophyte removal, and eventually, biceps tenotomy and tuberoplasty. RESULTS: All patients showed involvement of the supraspinatus and infraspinatus tendons in the preoperative stage. In the postoperative evaluation, 14 patients had an teres minor muscle, and 3 had partial tears of the subscapularis tendon. There was an improvement in the UCLA criteria from 15 preoperatively to 31 postoperatively. There was no improvement in muscular strength, but there was a reduction in the pain. CONCLUSION: Arthroscopic debridement is a recommended procedure for

  16. 关节镜辅助下一期修复重建膝关节三联损伤疗效观察%Clinical effect of one-stage arthroscopically assisted repair and reconstruction on Triplicate injuries of knee joint

    Institute of Scientific and Technical Information of China (English)

    何建华; 谢水华; 王小鹏; 丁浩

    2015-01-01

    目的:探讨关节镜下一期修复重建膝关节三联损伤(前交叉韧带,内侧副韧带和内侧半月板损伤)的方法及效果。方法2009年10月-2014年6月,对21例膝关节三联损伤患者采用一期关节镜下手术,取腘绳肌腱(或同种异体肌腱)重建前交叉韧带,止点重建或缝合修复治疗内侧副韧带损伤,一期缝合或修整损伤的内侧半月板。结果术后均获随访6-30个月,平均16个月,术前Lysholm膝关节功能评分为(40.4±15.8)术后末次随访为(84.5±12.8),有显著改善。患者在0°和20°应力测试时稳定性均完全恢复。结论膝关节三联损伤可以一期在关节镜下完成重建及修复,早期有效恢复膝关节稳定性。%Objective To investigate one-stage arthroscopic repair and reconstruction of the triplicate Injuries of knee joint (anterior cruciate ligament,medial collateral ligament and medial meniscus). Methods From October 2009- June 2014,21 cases of knee joint injury were treated as taking arthroscopic operation with one stage ,The ACL was reconstructed using the hamstring tendon autograft (or tendon allograft),medial collateral ligament was repaired and reconstruction of the interdictory point,One-stage suture or trimmed medial meniscus injury. Results All cases were followed up for 6-30 months,average 16 months,Accord-ing to the Lysholm scale of knee function,preoperative was (40.4+15.8),the last follow-up was (84.5+12.8) after operation,has im-proved significantly. Patients with stress test stability were recovered in 0 degree and 20 degree. Conclusion The triplicate In-juries of knee joint can be reconstructed and repaired for one stage under the arthroscope ,early and effective recovery of knee joint stability.

  17. 关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带的临床研究%Clinical study of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    苑广科; 韦良心; 焦兆德; 殷鹏

    2014-01-01

    Objective To explore the treatment method and clinical effect of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament (ACL). Methods A total of 32 cases undergone arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament were in this study. Preoperative and postoperative follow-up and Lysholm score were applied in the analysis of knee joint function and curative effect. Results The result of Lysholm score showed that there were 31 good cases (96.9%) and 1 fair case (3.1%). The good rate was 96.9%. Conclusion The surgery of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament can effectively recover the stability and knee function in anterior-posterior dimension and spin. This reconstruction is close to the reconstruction of anatomic biomechanics. The application of tendon allograft transplant can reduce operation time and trauma, and it is a good choice for double-bundle anterior cruciate ligament reconstruction.%目的:探讨关节镜下应用同种异体跟腱四骨道双束解剖重建前交叉韧带(ACL)的手术方法和临床疗效。方法32例采用关节镜下同种异体跟腱四骨道双束解剖重建方法的前交叉韧带损伤患者,通过术前及术后随访, Lysholm评分表进行膝关节功能的评估和疗效分析。结果按照Lysholm评分表,31例患者(96.9%)分级评价优良,1例一般(3.1%),优良率达到96.9%。结论关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带,能够有效的恢复膝关节的前后向及旋转稳定性,更接近于解剖生物力学重建,同种异体跟腱移植物的应用可以缩短手术时间,减少创伤,是双束解剖重建ACL的良好选择之一。

  18. 关节镜下膝关节复合骨折内固定术36例围术期护理配合%Perioperative nursing care in the treatment of 30 patients with composite fracture of knee joint by arthroscopic internal fixation

    Institute of Scientific and Technical Information of China (English)

    孙波; 洪钦政; 于洁; 乌晓辉

    2012-01-01

    To explore the perioperative nursing methods in the treatment of patients with composite; fracture of knee joint by arthroscopic internal fixation. Methods:36 patients with composite fracture of knee joint were treated with arthroscopic internal fixation and preoperative,intraoperative nursing coordination was provided. Results:By following up for 10 to 22 months,no complications like infection, joint stiffness and bonc; nonunion occurred in any patients;fracture healing time was from 4 to 8 months; the; excellent and good rate; was 86. 1% according to Rasmmsse function scoring standard. Conclusion: The; arthroscopic internal fixation has the; advantages of little; trauma and less complication in the; tre;atme;nt of patie;nts with e'omposite; fracture; of kne;e; joint; skille;d and orde;rly nursing e'oordination ean shorte;n the; operation time;; e;arly postoperative; exe;re'ise; ean e;nsure; the; joint fune'tieonal re;e'erve;ry erf kne;e; joint as soon as possible;.%目的:探讨关节镜下膝关节复合骨折内固定术患者围术期护理方法.方法:对36例膝关节复合骨折患者进行膝关节镜下膝关节复合骨折内固定术,给予术前、术中及关节镜护理配合.结果:随访10~22个月,患者无手术感染、关节僵硬、骨不连等并发症发生;骨折愈合时间为4~8个月;按Rasmmsse功能评分标准,优良率86.1%.结论:关节镜引导下手术治疗膝关节复合骨折创伤小,并发症少;熟练有序的护理配合可以缩短手术时间;术后早期关节功能练习可保证关节功能尽快恢复.

  19. Clinical Application and Curative Effect of Plasma Blade Combined Arthroscopic Surgery on Meniscus Lesions of 38 Cases%等离子刀联合关节镜治疗膝半月板损伤38例临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    张勇; 朱昊; 蒋定华; 黄立新; 孙树金; 董天华

    2015-01-01

    ObjectiveTo investigate the clinical application and curative effect of plasma blade combined arthroscopic surgery on meniscus lesions.Methods The data of surgical treatment in 38 patients with meniscal injury in 41 knees were retrospectively analyzed. The proper surgical procedures were selected respectively according to the injury position and the type of lesions. Lysholm score system was applied and the scores of pre- and post-operation were compared, all patients were followed up over 2 years.ResultsThese 38 patients with meniscal injury in 41 knees were conifrmed by arthroscopic surgery. All the surgeries were successful with no serious complications. All the patients were followed up for over 24 months. Their symptoms completely disappeared in 26 knees, improved in 13 knees in comparison with preoperative status. The effect in 2 knees was not satisfying. The excellent and good rate of the post-operative function was 95.12%.ConclusionThe meniscus injury cured under the combination of plasma blade and arthroscopic surgery is of the advantages of intuitive and accurate checking, simple procedures, less trauma, faster recovery, and the effect is more ideal.%目的:探讨应用等离子刀联合关节镜微创手术治疗半月板损伤的临床疗效。方法回顾性收集分析38例41膝半月板损伤患者的临床资料,根据半月板损伤部位及损伤类型,选择相应的关节镜手术方式予以治疗。术后2年以上随访观察,以Lysholm膝关节评分系统评价治疗效果。结果患者38例41膝半月板损伤术中均得到确诊。手术均获成功,未见严重并发症。术后2年随访,无失访病例。症状完全消失26膝,比术前好转13膝,效果一般2膝。优良率为95.12%。结论应用等离子刀联合关节镜治疗半月板损伤具有操作简便、创伤小、疗效确切、术后恢复快的特点。

  20. 膝关节后纵隔解剖特点及其在关节镜手术中的应用%ANATOMIC FEATURES OF POSTERIOR SEPTUM OF KNEE JOINT AND ITS APPLICATION IN POSTERIOR TRANS-SEPTAL PORTAL FOR ARTHROSCOPIC SURGERY

    Institute of Scientific and Technical Information of China (English)

    孙金鹏; 熊依林; 雷光华

    2013-01-01

    目的 总结膝关节后纵隔解剖特点及其在关节镜手术中,尤其是跨后纵隔通路建立中的应用. 方法 查阅近年国内外有关膝关节后纵隔及膝关节镜的文献,并进行归纳分析. 结果 后纵隔上部血管、神经较丰富,在胫骨平台水平与腘动脉紧邻:将膝关节后室分为较小的外室和较大的内室.膝关节镜下建立跨后纵隔通道时应屈膝90°,方向由外向内,从后纵隔中间靠下部穿过较安全. 结论 跨后纵隔通道使膝关节镜应用范围大大扩展,但通道建立方法并不统一,只有综合考虑后纵隔解剖学特点,才能减少手术并发症.%Objective To summarize the anatomic features of the posterior septum of the knee joint and its application in posterior trans-septal portal for arthroscopic surgery. Methods The literature related to posterior septum of the knee joint and arthroscopic surgery was extensively reviewed and analyzed. Results The posterior septum of the knee joint has more mechanoreceptors and blood vessels in the upper part, which are close to arteria popliteal at the tibial plateau level; the posterior compartment is divided into wider posteromedial and narrower posterolateral compartments. A safe arthroscopic trans-septal portal is established, in the knee flexion of 90°, in a lateral-to-medial direction, and with an inserting location below the middle of posterior septum. Conclusion The establishment method of posterior trans-septal portal is not uniform and all the features of posterior septum should be considered to decrease the complications.

  1. Liberação artroscópica do nervo supraescapular: técnica cirúrgica e avaliação de casos clínicos Arthroscopic release of the suprascapular nerve: surgical technique and evaluation of clinical cases

    Directory of Open Access Journals (Sweden)

    José Carlos Garcia Júnior

    2011-01-01

    Full Text Available OBJETIVO: Descrever uma técnica cirúrgica própria de descompressão artroscópica do nervo supraescapular (NSE e avaliar seus resultados preliminares. MÉTODOS: 10 ombros de nove pacientes foram operados com uma técnica que utiliza portais diferentes das técnicas conhecidas, não usa tração e faz uso de materiais disponíveis na rede pública de saúde. RESULTADOS: 10 ombros de nove pacientes, sendo oito à direita e dois à esquerda, com média de idade de 69,5 anos, apresentaram mudança no escore UCLA de 11,7 para 26,1 no seguimento de 16,6 meses de pós-operatório. O questionário SF-36 teve pontuação de 122,9 e a escala bruta de dor de 88%. CONCLUSÃO: A descompressão artroscópica do NSE, segundo a técnica descrita, é reprodutível e menos traumática que as técnicas abertas. Os pacientes obtiveram melhora em vários parâmetros avaliados, principalmente no que se refere à dor. A descompressão artroscópica do NSE pode ser uma opção terapêutica para a patologia compressiva do NSE.OBJECTIVE: To describe a specific surgical technique for arthroscopic decompression of the suprascapular nerve (SSN and evaluate its preliminary results. METHODS: Ten shoulders of nine patients were operated using a technique with portals differing from the already-known techniques, which did not use traction and made use of materials available within the public healthcare system. RESULTS: Among the ten shoulders of nine patients, eight were right shoulders and two were left shoulders. The mean age was 69.5 years. The UCLA score increased from 11.7 to 26.1 points over the postoperative follow-up of 16.6 months. The SF-36 questionnaire score was 122.9 and the raw pain scale value was 88%. CONCLUSION: Arthroscopic decompression of the SSN in accordance with the described technique is reproducible and less traumatic than the open techniques. The patients achieved improvements in many of the parameters evaluated, particularly with regard to pain

  2. 关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折%The Research about Figure of 8 Suture Fixation with Cannulated Screw and washer Under Arthroscopic in the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture

    Institute of Scientific and Technical Information of China (English)

    吴健

    2015-01-01

    Objective to analyze the value of figure of 8 suture fixation with cannulated screw and washer under arthroscopic in the treatment of anterior cruciate ligament tibial avulsion fracture. Methods the Lysholm knee score and the Lachman test negative rate of 68 cases of patients before and after surgical operation were compared to evaluate the value of the 8 suture fixation with cannulated screw and washer under arthroscopic. Results all fractures were healed well. Postoperative Lysholm score was (92.84+1.65),which was significantly higher than that before operation with score (28.46±1.37)(t=33.486,P=0.000). Postoperative Lachman negative rate was 0%,which was significantly lower than that before operation with 100.00% (χ2=36.942, P=0.000).Conclusion figure of 8 suture fixation with cannulated screw and washer under arthroscopic has good effect in the treatment of anterior cruciate ligament tibial avulsion fracture.%目的:分析关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折的价值。方法以68例患者为对象,比较患者术前、后Lysholm膝关节功能评分和Lachman试验阴性率。结果:所有患者骨折均愈合良好。术后Lysholm评分为(92.84±1.65)分,显著高于术前(28.46±1.37)的评分(t=33.486,P=0.000)。术后Lachman阴性率为0.00%,显著低于术前100.00%的阳性率(χ2=36.942,P=0.000)。结论关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折具有较好的近期疗效。

  3. 关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折%The Research about Figure of 8 Suture Fixation with Cannulated Screw and Washer Under Arthroscopic in the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture

    Institute of Scientific and Technical Information of China (English)

    吴健

    2015-01-01

    目的:分析关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折的价值。方法以68例患者为对象,比较患者术前、后Lysholm膝关节功能评分和Lachman试验阴性率。结果所有患者骨折均愈合良好。术后Lysholm评分为(92.84±1.65)分,显著高于术前(28.46±1.37)的评分(t=33.486,P=0.000)。术后Lachman阴性率为0.00%,显著低于术前100.00%的阳性率(c2=36.942,P=0.000)。结论关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折具有较好的近期疗效。%Objective to analyze the value of figure of 8 suture fixation with cannulated screw and washer under arthroscopic in the treatment of anterior cruciate ligament tibial avulsion fracture.Methods The Lysholm knee score and the Lachman test negative rate of 68 cases of patients before and after surgical operation were compared to evaluate the value of the 8 suture fixation with cannulated screw and washer under arthroscopic.Results all fractures were healed well. Postoperative Lysholm score was (92.84 +1.65), which was significantly higher than that before operation with score (28.46±1.37)(t=33.486,P=0.000). Postoperative Lachman negative rate was 0%, which was significantly lower than that before operation with 100.00% (c2=36.942,P=0.000).Conclusion figure of 8 suture fixation with cannulated screw and washer under arthroscopic has good effect in the treatment of anterior cruciate ligament tibial avulsion fracture.

  4. Analysis of Rehabilitation Intervention Effect on the Recovery of Arthroscopic Anterior Cruciate Ligament Reconstruction Function%康复干预对关节镜下前交叉韧带重建术后功能的恢复影响分析

    Institute of Scientific and Technical Information of China (English)

    许琛

    2015-01-01

    目的:探讨分析康复干预对关节镜下前交叉韧带(ACL)重建术后功能恢复的影响.方法:将2012年6月至2013年6月在我院骨科行关节镜下ACL重建术的120例患者随机分为对照组和干预组,每组60例,对照组进行常规治疗,干预组另进行康复治疗,应用Lysholm 膝关节功能评定标准对两组患者进行随访评分,比较手术后1年两组膝关节功能恢复情况.结果:术后1年干预组的优良率为91.67%明显优于对照组的66.67%,差异有统计学意义(P<0.05).结论;术后及早进行有系统的康复干预能显著改善关节镜下ACL重建术后患者膝关节功能恢复的情况.%Objective: To investigate the analysis of rehabilitation intervention on arthroscopic anterior cruciate ligament (ACL) recovery of postoperative functional reconstruction.Methods:120 patients were randomly divided in 2012 June to 2013 June in the department of orthopedics of our hospital underwent arthroscopic ACL reconstruction for the intervention group and control group, 60 cases in each group, the control group received routine treatment in the department of orthopedics, the intervention group was given rehabilitation intervention system on the basis of the control group, two groups of patients were followed up according to Lysholm knee function evaluation standard, the recovery of 1 years and two group of knee joint function after operation.Results:The rate of excellent and good after 1 years of intervention group was 91.67% higher than the control group 66.67%, the difference was statistically significant (P < 0.05).Conclusion:Postoperative early rehabilitation intervention system to patients with functional recovery of the knee arthroscopic reconstruction of ACL could significantly improve the situation.

  5. 膝关节镜下自体腘绳肌腱单束等长重建前交叉韧带疗效分析%Curative effects analysis of arthroscopic single-bundle anterior cruciate ligament reconstruction with autologous hamstring tendon

    Institute of Scientific and Technical Information of China (English)

    朱云华; 王晓东; 李玉前; 李宏斌

    2014-01-01

    目的:探讨关节镜下应用自体腘绳肌腱单束等长重建前交叉韧带的手术方法和疗效,提高前交叉韧带断裂患者的临床疗效。方法:膝关节前交叉韧带损伤患者22例,取自体半腱肌腱及股薄肌腱,在关节镜下使用Endobuttom钢板及可吸收挤压螺钉重建固定前交叉韧带和随访观察。结果:22例均获得随访6~18个月。膝关节功能良好,lysholm评分:术前(48.03±4.80)分,术后(91.23±4.05)分,术后评分明显高于术前(P<0.05)。结论:关节镜下应用自体腘绳肌腱单束等长重建前交叉韧带,微创、并发症少、疗效好,值得临床推广。%Objective: To ex plore the operative method and clinical effects of arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendon,and to improve the clinical efficacy. Methods: 22 patients with ACL injury underwent treatment in our department by ligament reconstruction with autologous semitendinosus-gracilis. Arthroscopic fixation was performed with endobuttom steel plate and absorbable crushing screw. Results: 22 cases were all followed up for 6~18 months. The total patients’ joint function obtained better recovery. Lysholm score before and after the operations were (48.03±4.80) and (91.23±4.05), which was statistically different(P<0.05). Conclusion:Arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon can lead to less invasion,fewer complications and better curative efficacy. It is worthy of wider clinical application.

  6. 关节镜下自体移植半腱肌和股薄肌重建前交叉韧带%Outcomes of arthroscopic reconstruction of anterior cruciate ligament with autografts from tendons of the semitendinosus-gracilis muscles

    Institute of Scientific and Technical Information of China (English)

    宣华兵; 董利军; 黄德刚; 贺华正; 杨昕

    2012-01-01

    Objective:To assess the clinical effects of reconstructing anterior cruciate ligament( ACL ) with the tendon autografts from the semiten-dinosus-gracilis muscles under arthroscope. Methods-. Between Sept. 2007 and May 2011 ,34 patients with ACL injury underwent treatment in our department by ligament reconstruction with autogenous Semite ndinosus-gracilis muscles. Arthroscopic fixation was performed in tibia epiphysis with sheathed absorbable crushing screw and in femur epiphysis with two transverse screws. All patients were observed for postoperative stability of the knees and treatment effects and followed up for functional recovery of the joint with Lysholm Knee Scoring Scale. Results: Follow-up ranging from 6 to 44 months showed that the total 34 patients obtained better recovery of joint function. Lysholm score before and after the surgery was 53.08 ±4.2 us. 92. 05 ±3.7, which was statistically different ( P < 0. 01 ). Conclusion : Arthroscopic reconstruction of ACL with autogenouseasy performance and fewer complications and thus, is worthy of widerclinical application.%目的:介绍关节镜下半腱肌股薄肌重建前交叉韧带(ACL)的手术方法和效果.方法:2007年9月~2011年5月我科共诊治34例ACL损伤患者,取自体半腱肌与股薄肌腱,在关节镜下使用带鞘可吸收挤压钉(Itrafix系统)固定胫骨端,使用2枚横向钉固定股骨端,重建ACL.观察固定后的稳定性和术后疗效.随访后用Lysholm评分标准评价手术前后关节功能.结果:本组34例,随访6~44个月.关节功能良好,Lysholm评分,术前53.08±4.2,术后92.05±3.7,术后评分明显提高,差异有统计学意义(P<0.01).结论:关节镜下重建前交叉韧带,疗效好,操作简单,并发症少,宜临床推广.

  7. 关节镜下经肌腱修补治疗关节侧肩袖部分损伤%Arthroscopic treatment of articular side partial tear of supraspinatus tendon by the trans-tendon approach

    Institute of Scientific and Technical Information of China (English)

    汪滋民; 李全; 王一; 沈锋; 许国星; 宋爽

    2014-01-01

    Background Partial rotator cuff tears result in pain and disfunction in patients.An previous study,the researchers measured the supraspinatus tendon of 1 7 corpses and came to a conclusion that the average thickness of the supraspinatus tendon was 1 2 mm.Divides the rotator cuff tears into partial articular tears,partial bursa tears and intra-tendon tears according to the inj ury sites. Based on the thickness of inj ured rotator cuff measured during the operation,the tears are divided into 3 degrees:Degree I (≤3 mm),Degree Ⅱ (3-6 mm)and Degree Ⅲ (≥ 6 mm),and the injured thickness of the Degree Ⅲ is more than 50%.Waibl et al put forward the concept of partial articular surface tendon avulsions(PASTA)and the trans-tendon approach to repair the inj ury.The PASTA has a high morbidity.Modi et al reviewed 100 cases who were all over 35 years old.They recieved an arthroscopic surgery for rotator cuff lesions.Waibl then found 62 cases had PASTA.Yamanaka et al followed 40 PASTA patients using arthrography,the average follow-up was 412 days.They found that the PASTA had a tendency to expand (53%)and to progress to full-thickness tears (28%).Take this into account,most scholars tend to endorse the decision that tears over degree Ⅲ must be repaired.The methods include the conventional repair after the conversion of the full-thickness tear and the direct repair of the tears using the tendon approach.Compared with the former,the tendon repair can save the residual normal rotator cuff tissue,and the length-tension balance after rotator cuff repair is simmilar to normal anatomy.Up to now,China is still lack of treatment reports for such reported inj uries.From March 2008 to July 2010,we had 12 cases of patients with PASTA who recieved the arthroscopic trans-tendon repair using the method improved by Lo.All patients were followed up for 1 2 months or more,and the results are as follows.Methods I.General Information:There are 1 2 cases in the group, including 5 males,7

  8. 急性滑脱性髌股关节撞击综合征的关节镜下治疗%The arthroscopic diagnosis and treatment of acute patellofemoral joint impingement syndrome

    Institute of Scientific and Technical Information of China (English)

    朱波; 赵力; 赵金岩; 王增亮

    2015-01-01

    目的 探讨急性滑脱性髌股关节撞击综合征的损伤机制、MRI诊断特征以及关节镜下诊治方法.方法 2005年9月至2012年10月应用改良髌内侧支持带紧缩缝合治疗急性滑脱性髌股关节撞击综合征46例,男9例,女37例;年龄15~31岁,平均21.6岁.术前常规行膝关节X线及MR检查,测量Q角、外侧髌股角及髌骨外移度.MRI髌内侧支持带损伤按照Schweitzer分级标准:Ⅰ度15例、Ⅱ度18例、Ⅲ度8例、Ⅳ度5例.手术于关节镜监视下施行,清除关节内积血,关节内探查,取出游离软骨和骨软骨碎片,软骨成形,修整损伤软骨面.对髌内侧支持带Ⅰ度损伤者行关节镜下清理及髌内侧支持带固缩.对髌内侧支持带Ⅱ~Ⅲ度损伤伴明显髌骨移位者采用改良髌内侧支持带紧缩缝合术,对受伤时间超过2周的9例同时行髌外侧支持带松解.对髌内侧支持带Ⅳ度损伤者行切开加固缝合.结果 急性滑脱性髌股关节撞击综合征的关节镜下表现包括关节内血肿46例、股骨外髁和髌骨内侧骨软骨损伤37例、游离体形成28例及髌内侧支持带撕裂46例.所有病例均获得随访,随访时间12~36个月,平均18.2个月,无感染、神经血管损伤和再脱位等并发症发生.手术前后Lysholm膝关节评分、Tegner膝关节运动水平评分、AAOS膝关节评分、外侧髌股角及髌骨外移度的差异有统计学意义,患者运动功能均较术前有所改善.结论 关节镜下改良髌内侧支持带紧缩缝合辅助髌外侧支持带松解术,是治疗急性滑脱性髌股关节撞击综合征髌内侧支持带Ⅱ~Ⅲ度损伤的有效方法,有利于恢复膝关节功能,近期疗效好.%Objective To explore the mechanism and characteristics of MRI of acute patellofemoral joint impingement syndrome as well as its arthroscopic diagnosis and treatment.Methods There were a total of 46 cases (9 males and 37 females)with acute patellofemoral joint impingement

  9. 关节镜下经肌腱修补治疗关节侧肩袖部分损伤%Arthroscopic treatment of articular side partial tear of supraspinatus tendon by the trans-tendon approach

    Institute of Scientific and Technical Information of China (English)

    汪滋民; 李全; 王一; 沈锋; 许国星; 宋爽

    2014-01-01

    .The PASTA has a high morbidity.Modi et al reviewed 100 cases who were all over 35 years old.They recieved an arthroscopic surgery for rotator cuff lesions.Waibl then found 62 cases had PASTA.Yamanaka et al followed 40 PASTA patients using arthrography,the average follow-up was 412 days.They found that the PASTA had a tendency to expand (53%)and to progress to full-thickness tears (28%).Take this into account,most scholars tend to endorse the decision that tears over degree Ⅲ must be repaired.The methods include the conventional repair after the conversion of the full-thickness tear and the direct repair of the tears using the tendon approach.Compared with the former,the tendon repair can save the residual normal rotator cuff tissue,and the length-tension balance after rotator cuff repair is simmilar to normal anatomy.Up to now,China is still lack of treatment reports for such reported inj uries.From March 2008 to July 2010,we had 12 cases of patients with PASTA who recieved the arthroscopic trans-tendon repair using the method improved by Lo.All patients were followed up for 1 2 months or more,and the results are as follows.Methods I.General Information:There are 1 2 cases in the group, including 5 males,7 females,whose ages are from 29 to 72 years old with the average age of 52.9± 13.3 years old.9 lesions were on the right shoulder,3 on the left shoulder,and nine on the dominant shoulder.6 patients had a history of trauma on their shoulders,of which 3 patients hit their shoulders on the ground and 3 hit their hands on the ground.All patients have a pain of the inj ured shoulder, night pain and most had a problem of shoulder mobility.The patients received the preoperative functional exercise,physical therapy,non-steroidal anti-inflammatory drug therapy and local steroid injection for 1 to 17 months (average 6 months).Physical examination was as follows:11 cases had front shoulder lateral tenderness,9 cases had positive Neer impingement signs,9 cases had positive Hawkins

  10. The arthroscopic treatment for children with tibial intercondylar eminence avulsion fractures:a report of 24 cases%关节镜治疗儿童胫骨髁间棘撕脱骨折24例分析

    Institute of Scientific and Technical Information of China (English)

    吴星火; 段德宇; 何宇; 方为志; 苏正兵; 孟春庆; 王洪; 杨述华

    2013-01-01

    Objective To explore minimally invasive treatment for tibial intercondylar eminence avulsion fractures under arthroscopy.Methods From Jan 2009 to Dec 2010,24 patient with skeletal immaturity (16 boys and 8 girls,8~ 14 years old) underwent the arthroscopic reduction and PDS-Ⅱ suture fixation of the anterior cruciate ligament or the avulsion fracture.Having taken the advantage of ACL-aimer,the sutures were pulled out and tied outside the joint accurately.According to the standard of International Knee Documentation Committee (IKDC),the Lysholm knee scoring method was used to measure the knee function preoperatively and postoperatively.Results Twenty-four patients were followed up for 6 to 30 months.All patient gained normal range of motion,and the X ray examination demonstrated bone union in all the cases.At the end of the follow-up,all the patients got improved range of movement without complications such as joint stiffness,joint relaxation,epiphyseal injury or malformations dysfunction.The mean Lysholm knee scores were improved from 48.6 ± 7.2 preoperatively to 94.5 ± 4.1 at the end of the follow-up period (P<0.001)and the mean IKDC subjective evaluation scores were increased from 53.5 ± 4.8 preoperatively to 92.8 ± 3.7 at the end of the follow-up period (P<0.001).Conclusions The arthroscopical operation with absorbable suture fixation,which leads to less trauma,is a simple and effective alternative for patients with the avulsion fracture of tibial intercondylar eminence.%目的 探讨经关节镜下骨折块复位,辅助PDS-Ⅱ丝线内固定治疗儿童胫骨髁间棘撕脱骨折的临床效果.方法 选择我院自2009年1月至2010年12月间胫骨髁间棘撕脱骨折的患儿24例(男16例,女8例,年龄8~14岁),采用经关节镜下骨折块复位,以类似成人前交叉韧带重建方式,自胫骨结节内上方1 cm(骨骺上方)以胫骨定位器定位,以直径1~1.2 mm克氏针钻孔,然后以16号腰穿针导入2根不可吸收的PDS-

  11. 关节镜下胫骨Inlay技术重建后十字韧带的近期疗效%Full arthroscopic dual-beam reconstruction of the posterior cruciate ligament using tibial Inlay technique

    Institute of Scientific and Technical Information of China (English)

    刘雪峰; 廉永云; 王鲲鹏; 刘全; 逯代锋; 周勇; 符利君; 赵承斌; 曲敬

    2012-01-01

    目的 探讨关节镜下胫骨Inlay技术双束重建后十字韧带(posterior cruciate ligament,PCL)的近期疗效.方法 2007年3月至2009年9月,采用关节镜下胫骨Inlay技术行双束PCL重建且随访超过1年的PCL损伤患者17例,男16例,女1例;年龄19~54岁,平均25岁.术前Lysholm膝关节评分(53.4±2.1)分;国际膝关节评分委员会(International Knee Documentation Committee,IKDC)分级C级7例,D级10例;后抽屉试验阳性17例.术中采用自行设计的胫骨后方倒打隧道钻具系统制作限深骨隧道.随访时行膝关节X线摄片和螺旋CT检查,观察嵌入骨栓的位置和愈合情况.末次随访时评估Lysholm膝关节评分、IKDC分级及后抽屉试验,比较与术前的稳定性差异.结果 17例患者均获得随访,随访时间12~28个月,平均17.8个月.末次随访时Lysholm膝关节评分(93.5±1.7)分,与术前比较差异有统计学意义(P=0.016);IKDC分级A级15例、B级2例,与术前比较差异有统计学意义(P=0.021);后抽屉试验阴性15例,弱阳性2例.术后12周X线片和螺旋CT示嵌入骨栓的位置满意,愈合良好.结论 胫骨后方倒打隧道钻具系统可以准确制作限深骨隧道,创伤小,使用这种钻具系统的PCL重建术近期疗效好.%Objective To investigate the recent effect of full arthroscopic dual-beam reconstruction of the posterior cruciate ligament(PCL)using tibial Inlay technique.Methods From March 2007 to September 2009,17 PCL injured patients underwent full arthroscopic dual-beam PCL reconstruction using Inlay technique,including 16 males and 1 female,with an average age of 25 years(range,19-54).Of all cases,Lysholm score was(53.4±2.1)points,International Knee Documentation Committee(IKDC)rated C in 7,D in 10,and posterior drawer test(+)in 17.We used self-designed tibia tunnel drill system to produce the deep-limited bone tunnel.Follow-up began at 12 months after operation.Evaluate Lysholm knee score,IKDC rating,and posterior

  12. Analysis on clinical efficacy of autogenous hamstring tendon for arthro-scopic anterior cruciate ligament (ACL) reconstruction%关节镜下应用自体腘绳肌腱重建前交叉韧带的临床分析

    Institute of Scientific and Technical Information of China (English)

    肖勍; 李清; 顾晓军

    2014-01-01

    目的:探讨关节镜下应用自体腘绳肌腱重建前交叉韧带的临床疗效。方法选取本院收治的60例膝关节前交叉韧带损伤患者,随机均分为对照组和观察组,对照组给予关节镜下异体肌腱前交叉韧带重建术,观察组给予关节镜下自体腘绳肌腱前交叉韧带重建术,术后追踪随访2年,比较两组患者手术前后患肢X线检查、Lysholm评分以及Tegner功能评分的差异。结果两组患者术后Lachman征和旋转移位试验均为阴性,术后X线检查无退行性改变,术后Lysholm评分和Tegner功能评分均显著高于术前(P0.05)。结论关节镜下应用自体腘绳肌腱重建前交叉韧带的疗效确切,与异体肌腱疗效相当,可有效恢复患者的膝关节功能,性价比更高,适合基层医院应用,值得临床推广使用。%Objective To investigate the clinical efficacy of autogenous hamstring tendon for arthroscopic anterior cru-ciate ligament (ACL) reconstruction.Methods 60 cases of front knee cruciate ligament injury in our hospital were ran-domly divided into control group and observation group.The control group were treated with tendon allograft for arthro-scopic ACL reconstruction.The observation group were treated with autogenous hamstring tendon for arthroscopic ACL reconstruction.All patients were followed up for 2 years.The limb X-ray examination,Lysholm score and Tegner function score before and after surgery of two groups were compared. Results The Lachman sign and rotating shift tests of two groups were both negative.X-ray examination postoperative had no degenerative changes.The Lysholm score and Tegner function score postoperative were significantly higher than preoperative (P0.05). Conclusion Autogenous hamstring tendon for arthroscopic ACL reconstruction has exact effect,which was equal to allogeneic tendon.It can effectively restore knee function with more cost-effective for primary hospital.It worthy of clinical

  13. One-stage arthroscopic reconstruction of anterior and posterior cruciate ligaments: A mid- and long-term curative effect of autograft versus allograft%关节镜下膝关节前后交叉韧带重建:自体移植与异体移植的中远期疗效对比

    Institute of Scientific and Technical Information of China (English)

    李卫平; 宋斌; 杨睿; 张正政; 王立晖

    2012-01-01

    BACKGROUND:Few studies on one-stage arthroscopic combined with arthroscopic reconstruction anterior crueiate ligament (ACL) and posterior cruciate ligament (PCL), especially on mid- and long-term follow-up.OBJECTIVE: To I ntroduce one-stage arthroscopic reconstruction of ACL and PCL, and to evaluate the mid- and long-termclinical curative effect.METHODS: From June 2002 to June 2007, 45 patients with ACL and PCL injuries received one-stage arthroscopicreconstruction. Totally 20 cases chosing autografts and 25 cases chosing allografts. The reconstruction with absorbable screwwas performed using the single-bundle ACL and PCL technique. Wound was treated simultaneously.RESULTS AND CONCLUSION: Totally 33 patients were followed up for 3 to 8 years. The range of motor was normal. Anteriordrawer test of 3 cases were mild-positive, posterior drawer test of 5 cases were mild-positive. LACHMAN test of 6 cases wasmild-positive, pivot shift test of 3 cases was mild-positive. Lysholm score and Larson score of autografts and allografts teamsafter 3 years construction were higher than those of before reconstruction (P 0.05). Eight cases were bone tunnel expansion,including 5 cases of ACL tibial segment, 3 cases of PCL tibial segment. Five cases suffered from hydrops articuli, and thentreated with paracentesis and clysis, none were broken again. It is indicated that one-stage arthroscopic reconstruction of ACLand PCL with autograft and allograft can both obtain satisfactory motion range, joint stability and well clinical effect of mid-andlong-term follow-up.%背景:关节镜下一期联合重建关节镜下前、后交叉韧带的文献报道不多,尤其是中长期随访研究.目的:关节镜下一期自体肌腱与同种异体肌腱重建前、后交叉韧带的中远期疗效比较.方法:自2002-06/2007-06对45例前后交叉韧带同时断裂患者行一期重建,20例选用自体移植物,25例选用异体移植物,以可吸收挤压钉固定行前后交叉韧带单束重

  14. All-arthroscopic rotator cuff repair versus mini-open for the treatment of rotator cuff injury:aMeta-analysis%全关节镜与小切口修复肩袖撕裂损伤的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王毅; 赵其纯

    2016-01-01

    BACKGROUND:There are controversies about the efficacy of al-arthroscopic rotator cuff repairversus mini-open for the treatment of rotator cuff injury. OBJECTIVE:To evaluate the efficacy of al-arthroscopic rotator cuff repairversusmini-open for the treatment of rotator cuff injury by conducting a meta-analysis. METHODS:A computer-based online search was conducted in PubMed, Embase, Cochrane Library and CBM databases from January 1966 to November 2015 to screen the relevant articles usingthe key words of“rotator cuff, arthroscopy, mini-open”. Meta-analysis was performed using Revman5.3 software. RESULTS AND CONCLUSION:A total of 11 studies, including 6randomized controled trialsand 5 cohort studies,were selected. The meta-analysis results showed that there were no significant differences in the function and strength of the shoulder joint, pain, motor range, recurrence of rotator cuff avulsion, the incidence rate of ankylosis between both two groups (P> 0.05). These results suggest that the efficacy of al-arthroscopic rotator cuff repair does not differ from those of mini-open for the treatment of rotator cuff injury. However arthroscopic rotator cuff repair induces less soft tissue injury and early incision pain, but better function recovery.%背景:对于全关节镜及小切口两种修复式的疗效比较,国内外尚有许多争议。  目的:对全关节镜及小切口两种方法治疗肩袖损伤的疗效进行荟萃分析。  方法:以“肩袖”、“关节镜”、“小切口”为检索词,计算机检索1966年1月至2015年11月PubMed, Embase,Cochrane图书馆和CBM,搜集所有的有关论研究。筛选并提取数据,采用Revman5.3软件进行荟萃分析。  结果与结论:共纳入11例研究,其中6例随机对照研究,5例队列研究,荟萃分析显示这两组肩关节功能、疼痛、活动范围、肩袖再撕裂率、关节僵硬发生率以及肩关节力量差异均无显著性意义(P>0

  15. The Application Value of Arthroscope-assisted Technique in Treating Knee or Knee Peripheral Fractures with Injury of Menisci and Ligaments%关节镜在诊断和处理膝关节周围骨折合并膝内结构损伤的应用

    Institute of Scientific and Technical Information of China (English)

    张定伟; 康斌; 王军; 石波; 唐诗添; 王陶; 谢明锐

    2014-01-01

    目的:评价膝关节镜在诊断和处理膝关节周围骨折合并膝内结构损伤的应用价值。方法2011年1月至2013年1月我院收治的25例膝关节周围骨折患者在骨折内固定术中常规进行关节镜检查,半月板修复成形、韧带修复重建,同时对关节面骨折复位情况直视下进行监测和评估。采用HSS膝关节功能评分标准,对患者术后膝关节功能进行评价。结果25例患者术后均获12~36个月随访,平均14.2个月,参照HSS膝关节功能评分标准,优16例,良8例,可1例,优良率92.3%,随访期内无内固定失效,膝内外翻畸形及深部感染等并发症。结论关节镜应用于膝关节周围骨折的处理,提高膝关节内结构合并损伤的诊断率,减少术后功能障碍的发