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Sample records for arthroscopic knee surgery

  1. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; 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....... 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...... STUDIES: Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed...

  2. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; 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 and...

  3. 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

  4. 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

    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...... thresholds (P > 0.08) in the burn area before surgery compared to after surgery. CONCLUSION: Arthroscopic knee surgery did not modify nociceptive responses to a contralaterally applied experimental burn injury....... 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...

  5. 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 .

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

    DEFF Research Database (Denmark)

    Espelund, M; Fomsgaard, J S; Haraszuk, J; Dahl, J B; Mathiesen, O

    2014-01-01

    for minor knee surgery were enrolled in this placebo-controlled, blinded trial. The patients were randomised to receive an ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 36) or saline (n = 35) in addition to a basic analgesic regimen with paracetamol and ibuprofen. Primary outcome measure was pain...... observed for any other outcome. CONCLUSION: No significant analgesic effect of the ACB could be detected after minor arthroscopic knee surgery with a basic analgesic regimen with acetaminophen and ibuprofen, except from a minor reduction in immediate requirements for supplemental opioids. Clinicaltrials...

  7. 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...... opposite study medication, according to randomization. Primary outcome was pain during 45 degrees active flexion of the knee at 45 min after the first block, assessed on a 0-100 mm visual analogue scale. Secondary outcome measures were: pain at rest and during flexion of the knee, worst pain experienced...... subjects with moderate to severe pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB with the...

  8. 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.

  9. 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...

  10. 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 arthroscopy...... 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...... return to work after knee and ankle arthroscopy with the use of oral NSAIDs combined with bupivacaine plus morphine or combined with bupivacaine, morphine plus steroid....

  11. Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2012-03-01

    Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Comparison of Anesthesia Quality for Arthroscopic Knee Surgery: Combined Sciatic Femoral Block and Unilateral Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Sinem Sarı

    2015-08-01

    Full Text Available Objective: We aimed to evaluate the quality of anesthesia of combined sciatic and femoral 3-in-1 nerve blocks (CSFB and unilateral spinal anesthesia technique with low-dose levobupivacaine in outpatients undergoing knee arthroscopy surgery. Materials and Methods: Forty American Society of Anesthesiologists (ASA physical status I-II patients were randomly allocated into two groups and unilateral spinal anesthesia with low-dose levobupivacaine (group S, n=20 or CSFB (group B, n=20 was performed. Besides the quality of anesthesia, anesthetic effectiveness, hemodynamic values, duration of the technique application, maximum motor and sensorial block levels and durations, the first analgesics need, and total analgesic consumptions during postoperative 24 hours and determined complications were compared between the two groups. Results: The quality of anesthesia was better in group S, no patient received either sedation or analgesic intraoperatively while first analgesic need and number of patient was higher (p=0.014, p<0.001, p=0.032 respectively. The duration of technical application was shorter while maximum motor and sensorial block levels were higher in group S (p<0.0001, p=0.008, p<0.001 respectively. Motor block duration was significantly longer in group B (p<0.0001. Conclusion: We concluded that CSFB practice is an effective anesthetic alternative for unilateral spinal anesthesia. Introduction

  14. Use of acupuncture after arthroscopic knee surgery and its relationship to pain, physical activity and need of walking aid Acupuntura em relação a dor, atividade física e a necessidade de apoio para a marcha, no pós-operatório das cirurgias artroscópicas no joelho

    OpenAIRE

    Rassen Saidah; Alceu Gomes Chueire; Wilson Abou Rejaili; Nádia Regina Basso Peres; João Bosco Guerreiro da Silva; Fulvio Schiavo

    2003-01-01

    The purpose of this study was to evaluate the efficacy of Acupuncture in the postoperative arthroscopic knee surgery, using "The Opposite Side" technique from the Traditional Chinese Medicine. The 36 pain in the knee were grouped according to the disorders found during the arthroscopic surgery: 50% with isolated lesion of the medial meniscus, 19.44% with lesion of the medial meniscus associated to knee arthrosis ,11.11% with lesion of lateral meniscus associated to knee arthrosis, 8.33% with ...

  15. 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.

  16. Knee hemarthrosis after arthroscopic surgery in an athlete with low factor XIII activity

    Directory of Open Access Journals (Sweden)

    Tsujii Akira

    2012-10-01

    Full Text Available Abstract We report a thirteen-year-old tennis player with knee hemarthrosis caused by low factor XIII activity. She visited our hospital because of medial peripatellar pain for two years. Although there was no abnormal sign in X-ray or MRI, diagnostic arthroscopy was performed. It revealed some cartilage debris, medial plica and complete septum of suprapatellar plica. Removing the debris by washing out and resecting the medial plica, she could return to play tennis without perioperative symptom. Two months after the first operation, her knee got swelling without any apparent cause. Since 20 ml blood was aspirated twice and MRI revealed suprapatellar mass, we performed arthroscopy again. Suprapatellar mass was old blood clot covered with complete suprapatellar plica. Resection of suprapatellar plica and washing out blood clot were performed, and severe postoperative hemarthrosis was progressively occurred. As factor XIII level was 54% preoperatively, we diagnosed that this condition was caused by low activity level of the factor and administered factor XIII concentrates. The level got improved to 129% and then hemarthrosis gradually relieved. She had no signs of recurrence. We should keep in mind of low factor XIII activity case in case of unexplained postoperative hemarthrosis after arthroscopy because consumption of the factor might promote this condition.

  17. 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.

  18. 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

    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...... initiation were 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 < 0.0001), favoring the exercise group. Patients in......) with a symptomatic, unilateral, magnetic resonance imaging-verified degenerative meniscus tear and no or mild radiographic osteoarthritis were randomly assigned to a supervised neuromuscular and strength exercise program or arthroscopic partial meniscectomy. Outcomes assessed 3 mos after intervention...

  19. Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study

    OpenAIRE

    Dutka, Julian; Skowronek, Michał; Skowronek, Paweł; Dutka, Łukasz

    2011-01-01

    Introduction Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions. Aim The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result. Material and methods In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clini...

  20. Knee microfracture surgery

    Science.gov (United States)

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  1. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

    International Nuclear Information System (INIS)

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

  2. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Thorlund, J B; Holsgaard-Larsen, A; Creaby, M W;

    2016-01-01

    25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra......OBJECTIVE: Patients undergoing arthroscopic partial meniscectomy (APM) are at increased risk of knee osteoarthritis (OA). Meniscal damage and/or surgery may alter knee joint loading to increase OA risk. We investigated changes in knee joint loading following medial APM surgery, compared with the...... contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI...

  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. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome to this ... surgery, demonstrating the role of the NexGen LCCK Knee Revision System. If we could go to the ...

  5. Pseudoaneurisma de artéria genicular após cirurgia artroscópica de joelho: Relato de dois casos Geniculate artery pseudoaneurysm after arthroscopic knee surgery: Two case reports

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome ... the role of the NexGen LCCK Knee Revision System. If we could go to the slides, please. ...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. 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...

  13. 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

  14. 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.

  15. 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)

  16. Revision Knee Surgery

    Medline Plus

    Full Text Available ... Tiarina [PH], Angie Weems [PH], and to my right, Roya Royo [PH]. Elise Bond Is our circulator. ... female, five- three, 274 pounds, who had this right knee replacement performed approximately ten years ago. Initially ...

  17. Revision Knee Surgery

    Medline Plus

    Full Text Available ... and I will ream. Now this was a hybrid knee it looked like on the radiograph; is ... that’s surprising though, we’re almost doing a hybrid cement technique. Where there is no TM or ...

  18. Revision Knee Surgery

    Medline Plus

    Full Text Available ... instruments or that allow for abbreviated surgical technique. These instruments allow us to use the LCCK implants, ... the knee. When she presented to me with these X-rays, my first concern was infection because ...

  19. Revision Knee Surgery

    Medline Plus

    Full Text Available ... LPS flex to LCCK components, to even a rotating hinge knee arthroplasty, and finally, to the segmental ... I think the interface stresses, even with the rotating hinges, are higher, and so I want fixation ...

  20. Revision Knee Surgery

    Medline Plus

    Full Text Available ... equally bad. Right. So what about you rehab process for this knee? Does it change in any manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  1. Getting your home ready - knee or hip surgery

    Science.gov (United States)

    ... Hip joint replacement Knee arthroscopy Knee joint replacement Knee microfracture surgery Patient Instructions ACL reconstruction - discharge Hip fracture - discharge Hip or knee replacement - after - what to ...

  2. 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...

  3. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Functional limitations exist postmeniscectomy, but preoperative data are scarce. PURPOSE: To examine knee function, knee muscle strength and performance in middle-aged patients with degenerative meniscal tears, eligible for arthroscopic partial meniscectomy. STUDY DESIGN: Cross......-sectional study. METHODS: Eighty-two participants with MRI verified degenerative meniscal tear (35% women, mean age 49 years) answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and were tested for isokinetic knee muscle strength and lower extremity performance (one-leg hop for distance, 6 m timed...

  4. Revision Knee Surgery

    Medline Plus

    Full Text Available ... and floating, which would probably not provide any benefit. Yeah, which is equally bad. Right. So what about you rehab process for this knee? Does it change in any manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  5. Preoperative Gabapentin Decreases Anxiety and Improves Early Functional Recovery From Knee Surgery

    OpenAIRE

    Ménigaux, Christophe; Adam, Frédéric; Guignard, Bruno; Sessler, Daniel I.; Chauvin, Marcel

    2005-01-01

    Gabapentin has antihyperalgesic and anxiolytic properties. We thus tested the hypothesis that premedication with gabapentin would decrease preoperative anxiety and improve postoperative analgesia and early postoperative knee mobilization in patients undergoing arthroscopic anterior cruciate ligament repair under general anesthesia. Forty patients were randomly assigned to receive 1200 mg oral gabapentin or placebo 1-2 h before surgery; anesthesia was standardized. Patients received morphine, ...

  6. 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 (pperformance 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

  7. 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.

  8. 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

  9. Use of acupuncture after arthroscopic knee surgery and its relationship to pain, physical activity and need of walking aid Acupuntura em relação a dor, atividade física e a necessidade de apoio para a marcha, no pós-operatório das cirurgias artroscópicas no joelho

    Directory of Open Access Journals (Sweden)

    Rassen Saidah

    2003-01-01

    Full Text Available The purpose of this study was to evaluate the efficacy of Acupuncture in the postoperative arthroscopic knee surgery, using "The Opposite Side" technique from the Traditional Chinese Medicine. The 36 pain in the knee were grouped according to the disorders found during the arthroscopic surgery: 50% with isolated lesion of the medial meniscus, 19.44% with lesion of the medial meniscus associated to knee arthrosis ,11.11% with lesion of lateral meniscus associated to knee arthrosis, 8.33% with isolated lesion of lateral meniscus of the knee, 2.77% lesion of both isolated meniscus, 2.77%with lesion of both isolated meniscus, 2.77% with chrondomalacia patella, and 2.77% were free body carrier. Group I, 18 patients (Acupuncture were submitted to 20 acupuncture session. Contralateral points of acupuncture were performed in the injured knee. Group II, 18 patients (Physiotherapy were submitted to 20 physiotherapy sessions under the administration of nonsteroidal anti-inflammatory agents. The non-parametrical analysis of the results showed that either the subjective data (pain intensity, difficulty in walking, in crouching, on going upstairs/downstairs, on running, on using some support walking presented good results in the majority of the studied parameters. Although, the results of the treatment were similar, the acupuncture showed better results since it presented earlier improvement than the physiotherapy.O presente estudo teve a finalidade de avaliar a eficácia da Acupuntura no pós-operatório das cirurgias artroscópicas no joelho utilizando-se a técnica "ao oposto" da Medicina Tradicional Chinesa. Os 36 pacientes portadores de gonalgias foram distribuídos conforme a patologia encontrada nas artroscopias cirúrgicas: 50,0% tinham lesão do menisco medial isolada, 19,44% lesão meniscal medial associada à artrose de joelho, 11,11% lesão meniscal lateral associada à artrose de joelho, 8,33% lesão meniscal lateral isolada de joelho, 2

  10. 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

  11. Knee extensor muscle strength in middle-aged and older individuals undergoing arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Juhl, Carsten B; Lund, Hans;

    2015-01-01

    moderate reduction was again apparent at 4 years post-APM (SMD: -0.56, (-1.20-0.08) compared to controls. CONCLUSIONS: Our findings suggest that middle-aged and older individuals undergoing APM have reduced knee extensor muscle strength in the operated leg compared to control data. As meniscus pathology...... extensor strength in people undergoing an arthroscopic partial meniscectomy (APM). METHODS: Six databases (MEDLINE, CINAHL, SportDISCUS, EMBASE, PEDro and AMED) were searched up to June 22(nd) , 2014. Studies that measured knee extensor muscle strength in people aged 30 years and older undergoing APM for a...

  12. 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.

  13. Combined arthroscopic gross total synovectomy and radiotherapy for diffuse pigmented villonodular synovitis of the knee: a report of 2 cases

    International Nuclear Information System (INIS)

    Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy

  14. Combined arthroscopic gross total synovectomy and radiotherapy for diffuse pigmented villonodular synovitis of the knee: a report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Sei Kyung; Kim, Jae Hwa; Ha, Doo Hoe; Kang, Hae Youn; Chong, So Young; Shin, Hyun Soo [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2006-09-15

    Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

  15. A CLINICAL STUDY OF ARTHROSCOPIC MANAGEMENT OF ANTERIOR C RUCIATE LIGAMENT INJURIES OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Paragjyoti

    2015-09-01

    Full Text Available BACKGROUND : Anterior C ruciate L igament (ACL tear is a common sports injury of the knee. There are a lot of controversies related to the management of this injury and more than 2000 papers have been published on the various aspects of the topic. Arthroscopic reconstruction of the ACL with autogenous graft material is widely used nowadays. The two most commonly used grafts are the central one - third of the patellar ligament (bone - tendon - bone, BTB and the hamstring tendon ( S emitendinosus - gracilis, STG construct but the former graft leads to increased donor site morbidity & hurdles in postoperative rehab & pain. The aim of the study is to study the Arthroscopic management of anterior cruciate ligament injury of knee joint using quadrupled hamstring graft. METHOD: The study was carried out on 30 cases of anterior cruciate ligament injury of knee joint attending the OPD and emergency of department of Orthopaedics, Silchar Medical College & Hospital who met the inclusion criteria. An informed consent was obtained from each patient prior to participation in the study. All the patients were examined in detail and worked up to obtain pre - anaesthetic clearance. X - rays and MRI were done routinely in all the cases. Clinical and radiological parameters were recorded. Arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstring graft was done in all the patients. Concomitant meniscal inju ries were treated according to the merit of the injury. Patients were followed up at regular intervals and outcome variables were assessed and recorded. RESULTS: Results of our study clearly showed that arthroscopic ACL reconstruction using quadrupled hamstring graft is a safe, effective and reproducible procedure in restoring knee function with minimal donor site morbidity. At follow up evaluation, all patients had good outcomes in terms of clinical stability, range of motion and general symptoms. CONCLUSION: From the results in this study

  16. 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

  17. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study

    OpenAIRE

    Anthony Davis; Chinn, David J; Sunil Sharma

    2013-01-01

    Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD) surgery. Methods: Forty consenting patients with American Society of Anest...

  18. 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

  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. The efficacy of arthroscopy knee surgery for knee lesion%关节镜下手术治疗膝关节病损

    Institute of Scientific and Technical Information of China (English)

    谢贵杰; 胡召云

    2009-01-01

    Objective To summarize the efficacy of arthroscopy knee surgery for knee lesion. Methods Between April 2006 and December 2008, 101 cases with knee lesion underwent arthroscopy knee surgery were analyzed retrospectively. Of these patients, 75 were di-agnosed with knee meniscus injury, 11 had synovitis, 6 had osteochondritis, 3 had gout, 3 had septic knee, and 3 had intra -articular free.Results All patients were followed up at 1-18 months postoperatively, with a mean follow-up of 9 months. Excellent and good rate was 96%. Conclusion Arthroscopic surgery technology pioneered a new concept and new method for the treatment of knee joint. Arthroscopic technology make the complicated knee surgery has the advantages of minimal invasive, simple and shortened postoperative recovery cycle,which can improve the efficacy of treatment and the levels of diagnosis and treatment of knee lesions.%目的 总结关节镜下手术治疗膝关节病损的效果.方法 应用关节镜手术治疗膝关节病损101例,其中膝半月板损伤75例,滑膜炎11例,骨关节炎6例,痛风3例,化脓性膝关节炎3例,关节内游离3例.结果 全部患者均获得随访,术后随访时间1~18个月,平均9个月,术后优良率96%.结论 关节镜技术使复杂的膝关节手术实现了微创、简捷,有效缩短术后恢复周期,提高了对膝关节病损的诊治水平和疗效.

  1. A case of intra-articular ganglion cysts of the knee joint: correlation between arthroscopic and magnetic resonance imaging

    OpenAIRE

    Kodaira, Sayaka; Nakajima, Takahito; Takahashi, Ryosuke; Moriya, Shingo; Nakagawa, Tomoyuki; Ohtake, Hidenori; Tsushima, Yoshito

    2016-01-01

    Background Intra-articular ganglion cysts of the knee are rare. Here we report a case of an arthroscopically confirmed ganglion cyst arising from the posterior cruciate ligament (PCL) along with preoperative magnetic resonance imaging (MRI) findings. Case presentation A 39-year-old female admitted a hospital with left knee pain with flexion and extension. MRI revealed a cystic lesion along the PCL. The lesion exhibited slight but homogeneous hyperintensity on T1 weighted images. Thin septals ...

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

    Directory of Open Access Journals (Sweden)

    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

  4. Is Surgery Always Needed for Meniscal Tears of the Knee?

    Science.gov (United States)

    ... A meniscal tear is a common and disabling knee injury affecting many Americans at some point in their ... Services, or federal policy. More Health News on: Knee Injuries and Disorders Surgery Recent Health News Related MedlinePlus ...

  5. 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...

  6. 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...

  7. 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.

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

    OpenAIRE

    Ilse Degreef; Luc De Smet

    2011-01-01

    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 a...

  9. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    OpenAIRE

    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 prof...

  10. Quantitative magnetic resonance imaging as marker of synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy: a one year follow up study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Ejbjerg, B; Stoltenberg, M; Gideon, P; Volck, B; Skov, K; Jensen, Claus Hjorth; Lorenzen, I

    2001-01-01

    OBJECTIVES: By repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy in patients with rheumatoid arthritis (RA) and other (non-RA) causes of persistent knee joint synovitis. METHODS: Contrast enhanced...... MRI was performed in 15 knees (nine RA, six non-RA) before and one day, seven days, two months, and 12 months after arthroscopic synovectomy. Synovial membrane volumes, joint effusion volumes, and cartilage and bone destruction were assessed on each MRI set. Baseline microscopic and macroscopic...... assessments of synovitis and baseline and follow up standard clinical and biochemical examinations were available. RESULTS: Synovial membrane and joint fluid volumes were significantly reduced two and 12 months after synovectomy. However, MRI signs of recurrent synovitis were already present in most knees at...

  11. Mechanisms of improved knee flexion after rectus femoris transfer surgery

    OpenAIRE

    Fox, Melanie D.; Reinbolt, Jeffrey A.; Õunpuu, Sylvia; Delp, Scott L.

    2009-01-01

    Rectus femoris transfer is frequently performed to treat stiff-knee gait in subjects with cerebral palsy. In this surgery, the distal tendon is released from the patella and re-attached to one of several sites, such as the sartorius or the iliotibial band. Surgical outcomes vary, and the mechanisms by which the surgery improves knee motion are unclear. The purpose of this study was to clarify the mechanism by which the transferred muscle improves knee flexion by examining three types of trans...

  12. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study

    Science.gov (United States)

    Davis, Anthony

    2013-01-01

    Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD) surgery. Methods: Forty consenting patients with American Society of Anesthesiologists (ASA) grade 1-2 presenting for elective ASD surgery were recruited. Patients’ electrical pain thresholds were measured preoperatively using a PainMatcher® (Cefar Medical AB, Lund, Sweden) device. Following surgery under general anaesthesia, the maximum pain experienced at rest and movement was recorded using a visual analogue scale until the end of postoperative day four. Results: In univariate analyses (t-test), the postoperative pain experienced (Area Under Curve) was significantly greater in patients with a low pain threshold as compared with a high pain threshold at both rest (mean 12.5, S.E. 1.7 v mean 6.5, S.E.1.2. P=0.008) and on movement (mean 18.7, S.E. 1.5 v mean 14.1, S.E.1.4. P=0.031). In multivariate analyses, adjusting for additional extra analgesia, the pain experienced postoperatively was significantly greater in the low pain threshold group both at rest (mean difference 4.9, 95% CI 1.5 to 8.4, P=0.007) and on movement (mean difference 4.1, 95%CI 0.03 to 8.2, P=0.049). Conclusions: Preoperative pain threshold can predict postoperative pain level following ASD of the shoulder. Trial registration: Clinicaltrials.gov identifier: NCT01351363 Level of Evidence: II PMID:24358863

  13. Thromboprophylaxis for hip and knee surgery: critical appraisal of rivaroxaban

    OpenAIRE

    Erica Romualdi; Francesco Dentali; Alessandro Squizzato; et al

    2010-01-01

    Erica Romualdi, Francesco Dentali, Alessandro Squizzato, Walter AgenoDepartment of Clinical Medicine, University of Insubria, Varese, ItalyAbstract: Major orthopedic surgery, including total knee replacement surgery (TKR) and total hip replacement (THR) surgery, is associated with a high risk of venous thromboembolism (VTE). In the absence of prophylactic strategies, the overall incidence of VTE can range between 40% and 60%. Over the last years, the use of anticoagulant drugs such as unfract...

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Does knee replacement surgery lead to chronic limb ischemia?

    Science.gov (United States)

    Dawson, Alan G; Bachoo, Paul; Sutherland, Alasdair G

    2010-12-01

    Total knee replacement (TKR) may be associated with chronic limb ischemia (CLI) due to arterial injury intraoperatively. The aim of this study was to determine the incidence of CLI after TKR surgery. Patients who received a unilateral TKR in 2003-2004 were identified from our database. Patients with diabetes mellitus and preexisting peripheral arterial disease were excluded. Patient assessment was by collection of demographic details, completion of the Oxford Knee Score, Short Form-12 Health Survey, and King's College Hospital's Vascular Quality of Life Questionnaire, and measurement of the ankle brachial pressure index (ABPI). Of the 209 eligible patients, 86 (41%) participated (median age, 73 years; 50% male). Five (5.8%) patients had a reduced ABPI compared with population norms of 4.6 to 7%. Patients with reduced ABPI measurements had higher Oxford Knee Scores, but no relationships between other variables were demonstrated. TKR surgery does not appear to increase the risk of CLI. PMID:21446628

  17. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    Directory of Open Access Journals (Sweden)

    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.

  18. Grading Anterior Cruciate Ligament Graft Injury after Ligament Reconstruction Surgery: Diagnostic Efficacy of Oblique Coronal MR Imaging of the Knee

    International Nuclear Information System (INIS)

    Objective : The purpose of this study was to evaluate the diagnostic efficacy of using additional oblique coronal MRI of the knee for grading anterior cruciate ligament (ACL) graft injury after ligament reconstruction surgery. Materials and Methods : We retrospectively reviewed 51 consecutive MR knee examinations of 48 patients who underwent both ACL reconstruction and follow-up arthroscopy. The MR examinations included the orthogonal axial, sagittal, coronal images and the oblique coronal T2-weighted images, which were oriented in parallel with the course of the femoral intercondylar roof. Two radiologists independently evaluated the status of the ACL grafts with using the routine knee MRI and then with adding the oblique coronal imaging. The severity of ACL graft injury was graded using a 3-point system from MR images as intact, partial tear or complete tear, and the results were compared with the arthroscopic results. Weighted kappa statistics were used to analyze the diagnostic accuracies of the knee MRI with and without the additional oblique coronal imaging. For each evaluation, the observers reported a confidence level for grading the ACL graft injuries in the two imaging groups. Result : The weighted kappa values according to the routine knee MRI were 0.555 (reader 1) and 0.515 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.666 (reader 1) and 0.611 (reader 2). The mean confidence levels by each reader were significantly higher (p < 0.01, paired t-test) with the additional oblique coronal imaging than by using the routine knee MRI alone. Conclusion : The additional use of oblique coronal MRI of the knee improves both the diagnostic accuracy and confidence for grading ACL graft injury

  19. Grading Anterior Cruciate Ligament Graft Injury after Ligament Reconstruction Surgery: Diagnostic Efficacy of Oblique Coronal MR Imaging of the Knee

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Gyu; Hong, Sung Hwan; Choi, Ja Young; Jun, Woo Sun; Choi, Jung Ah; Park, Eun Ah; Kang, Heung Sik; Kwon, Jong Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Objective : The purpose of this study was to evaluate the diagnostic efficacy of using additional oblique coronal MRI of the knee for grading anterior cruciate ligament (ACL) graft injury after ligament reconstruction surgery. Materials and Methods : We retrospectively reviewed 51 consecutive MR knee examinations of 48 patients who underwent both ACL reconstruction and follow-up arthroscopy. The MR examinations included the orthogonal axial, sagittal, coronal images and the oblique coronal T2-weighted images, which were oriented in parallel with the course of the femoral intercondylar roof. Two radiologists independently evaluated the status of the ACL grafts with using the routine knee MRI and then with adding the oblique coronal imaging. The severity of ACL graft injury was graded using a 3-point system from MR images as intact, partial tear or complete tear, and the results were compared with the arthroscopic results. Weighted kappa statistics were used to analyze the diagnostic accuracies of the knee MRI with and without the additional oblique coronal imaging. For each evaluation, the observers reported a confidence level for grading the ACL graft injuries in the two imaging groups. Result : The weighted kappa values according to the routine knee MRI were 0.555 (reader 1) and 0.515 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.666 (reader 1) and 0.611 (reader 2). The mean confidence levels by each reader were significantly higher (p < 0.01, paired t-test) with the additional oblique coronal imaging than by using the routine knee MRI alone. Conclusion : The additional use of oblique coronal MRI of the knee improves both the diagnostic accuracy and confidence for grading ACL graft injury.

  20. MR imaging of the postoperative knee.

    Science.gov (United States)

    Gnannt, Ralph; Chhabra, Avneesh; Theodoropoulos, John S; Hodler, Juerg; Andreisek, Gustav

    2011-11-01

    Advances in orthopedic and arthroscopic surgical procedures of the knee such as, knee replacement, ligamentous reconstruction as well as articular cartilage and meniscus repair techniques have resulted in a significant increase in the number of patients undergoing knee arthroscopy or open surgery. As a consequence postoperative MR imaging examinations increase. Comprehensive knowledge of the normal postoperative MR imaging appearances and abnormal findings in the knee associated with failure or complications of common orthopedic and arthroscopic surgical procedures currently undertaken is crucial. This article reviews the various normal and pathological postoperative MR imaging findings following anterior and posterior cruciate ligament, medial collateral ligament and posterolateral corner reconstruction, meniscus and articular cartilage surgery as well as total knee arthroplasty with emphasis on those surgical procedures which general radiologists will likely be faced in their daily clinical routine. PMID:22002752

  1. Perioperative glucocorticoids in hip and knee surgery - benefit vs. harm?

    DEFF Research Database (Denmark)

    Lunn, T H; Kehlet, H

    2013-01-01

    Glucocorticoids are frequently used to prevent post-operative nausea and vomiting (PONV), and may be part of multimodal analgesic regimes. The objective of this review was to evaluate the overall benefit vs. harm of perioperative glucocorticoids in patients undergoing hip or knee surgery. A wide...... glucocorticoid administration analogous to > 10 mg or ≤ 10 mg dexamethasone, and local glucocorticoid administration. Seventeen studies with data from 1081 patients were included in the final qualitative synthesis. Benefit (of any kind) with glucocorticoid vs. placebo was reported in 15 studies. PONV was reduced......-analysis was performed. In conclusion, in addition to PONV reduction with low-dose systemic glucocorticoid, this review supports high-dose systemic glucocorticoid to ameliorate post-operative pain after hip and knee surgery. However, large-scale safety and dose-finding studies are warranted before final...

  2. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Duff Jed

    2012-07-01

    Full Text Available Abstract Background Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time. Method/Design The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. Australian New Zealand Clinical Trials Registry number ACTRN12610000591055

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Reactive synovitis of the knee joint: MR imaging appearance with arthroscopic correlation

    International Nuclear Information System (INIS)

    Objective. To evaluate the use of routine MR imaging sequences in detecting and characterizing secondary reactive synovitis of the knee joint using arthroscopy as the standard of reference.Design and patients. Fifty consecutive patients with a history of knee pain who were referred for MR imaging and subsequently underwent arthroscopy of the knee comprised the study group. MR images were evaluated for the presence and appearance of synovitis reflected in synovial thickening and irregularity. Synovial thickening was graded on MR imaging as follows: 0=normal, 1=thin line of increased signal intensity, 2=increased signal intensity with frond-like or hair-like projections and a granular appearance of joint fluid. Standard knee imaging protocols were used.Results. The sensitivity, specificity, and accuracy of MR imaging in detecting synovitis compared with arthroscopy were 88%, 97%, and 95%, respectively. Grade 1 synovitis was best seen on proton-density-weighted images, demonstrating increased signal intensity of the synovium against the relatively low signal intensity of the joint fluid. Grade 2 synovitis was best seen on proton-density images and T2-weighted spin echo and fast spin echo images with fat saturation, demonstrating a granular and linear hair-like appearance of joint fluid. Axial and sagittal imaging planes were most helpful in the diagnosis of synovitis.Conclusion. Routine MR pulse sequences are useful in identifying the presence and extent of synovial abnormalities. The detection of different stages of synovial pathology should become an important part of the evaluation of the post-traumatic patient as treatment may be altered as a result. (orig.)

  5. Arthroscopic subacromial decompression

    OpenAIRE

    Akpinar, Sercan; Demirhan, Mehmet

    2004-01-01

    Arthroscopic subacromial decompression is the arthroscopic equivalent of a standart open procedure. Although technically demanding, it has several advantages to the open procedure. Overall it facilitates early and rapid rehabilitation. The results in stage II and in selected stage III patients are equal or better than those achieved through open surgery. In this study we reviewed the literature with our small case group experience.

  6. Arthroscopic microdiskectomy.

    Science.gov (United States)

    Kambin, P

    1991-03-01

    Arthroscopic microdiskectomy through a posterolateral approach has opened a new window of opportunity in the treatment of lumbar disk disorders. Radiographic identification of the triangular working zone has permitted the safe introduction of instruments with an external diameter of 7-8 mm into the intervertebral disk. The technique allows not only evacuation and decompression of contained herniated disks, but also the introduction of instruments for decortication of the vertebral plates and bone grafting for percutaneous interbody fusion. Endoscopic laser nucleolysis, currently under investigation, may also enhance existing technological achievement in the field of minimal-intervention spinal surgery. Arthroscopic microdiskectomy has proven to be safe, effective, and cost efficient. In properly selected patients, satisfactory results of approximately 85% have been realized. PMID:1857361

  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. 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。

  9. Comparison of the postoperative analgesic effects of naproxen sodium and naproxen sodium-codeine phosphate for arthroscopic meniscus surgery

    Directory of Open Access Journals (Sweden)

    Cagla Bali

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs are frequently used to control arthroscopic pain. Addition of oral effective opioid "codeine" to NSAIDs may be more effective and decrease parenteral opioid consumption in the postoperative period. The aim of this study was to compare the efficacy and side effects of naproxen sodium and a new preparation naproxen sodium-codeine phosphate when administered preemptively for arthroscopic meniscectomy. METHODS: Sixty-one patients were randomized into two groups to receive either oral naproxen sodium (Group N or naproxen sodium-codeine phosphate (Group NC before surgery. The surgery was carried out under general anesthesia. Intravenous meperidine was initiated by patient-controlled analgesia (PCA for all patients. The primary outcome measure was pain score at the first postoperative hour assessed by the Visual Analogue Scale (VAS. Sedation assessed by Ramsey Sedation Scale, first demand time of PCA, postoperative meperidine consumption, side effects and hemodynamic data were also recorded. RESULTS: The groups were demographically comparable. Median VAS scores both at rest and on movement were significantly lower in Group NC compared with Group N, except 18th hour on movement (p 0.05. CONCLUSIONS: The combination of naproxen sodium-codeine phosphate provided more effective analgesia than naproxen sodium and did not increase side effects.

  10. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

    Directory of Open Access Journals (Sweden)

    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

  11. Perioperative pain management in hip and knee replacement surgery.

    Science.gov (United States)

    Barrington, John W; Halaszynski, Thomas M; Sinatra, Raymond S; Expert Working Group On Anesthesia And Orthopaedics Critical Issues In Hip And Knee Replacement Arthroplasty, For The

    2014-04-01

    Many patients who undergo hip or knee replacement surgery today experience high levels of postoperative pain. Data from clinical studies and analyses of hospital records have demonstrated that severe postoperative pain is associated with an increased risk for complications, slowing of the rehabilitation process, delayed return to normal functioning, progression to persistent pain states, prolonged length of hospital stay, elevated rates of readmission, and higher overall costs. Orthopedic surgeons may now play a more active role in reducing the severity of pain following surgery, decreasing both opioid use and the incidence of opioid-related adverse events, and eliminating breakthrough pain and analgesic gaps. The benefits of multimodal regimens that include a combination of agents acting synergistically have been established unequivocally, and many analgesic and anesthetic agents are now available, as well as treatment options that differ according to route of administration. It is therefore possible to individualize treatment based on the type of procedure and patient need. One exciting advance that offers effective, safe, and efficient analgesia for many kinds of surgical procedures is the introduction of an extended-release local anesthetic (liposomal bupivacaine) for infiltration. This new option, which can be administered directly into the knee or hip by an orthopedic surgeon, is an example of the changing paradigm in perioperative analgesia, where commitment, communication, and coordination across all members of the clinical care team- including the surgeon, anesthesiologist, pharmacist, physical therapist, and nursing staff-are fundamental elements of an improved standard of care. An Expert Working Group on Anesthesia and Orthopaedics: Critical Issues in Hip and Knee Replacement Arthroplasty (April 13, 2013; Dallas, Texas) evaluated current approaches to perioperative pain management and proposed new regimens to help achieve optimal outcomes in these

  12. 21 CFR 888.1100 - Arthroscope.

    Science.gov (United States)

    2010-04-01

    ... ORTHOPEDIC DEVICES Diagnostic Devices § 888.1100 Arthroscope. (a) Identification. An arthroscope is an... accessories also is intended to perform surgery within a joint. (b) Classification. (1) Class II...

  13. 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

  14. 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)

  15. Ganglion cyst of the Hoffa's fat pad of the knee joint

    OpenAIRE

    Bagul, Rahul R; Savaskar, Vivek; MALHOTRA, ROHIT; Patel, Sachin

    2014-01-01

    We report a rare case of ganglion cyst of Hoffa's fat pad of knee joint. These lesions are asymptomatic in most cases and are often misdiagnosed as meniscal or ligamentous lesions of the knee joint. The final diagnosis was done with magnetic resonance imaging (MRI) of the knee joint, and the lesion was treated with surgery. It was not possible to resect the lesion through arthroscope, so open resection and complete excision of the cyst was done.

  16. Performance of medical students on a virtual reality simulator for knee arthroscopy: an analysis of learning curves and predictors of performance

    OpenAIRE

    Rahm, Stefan; Wieser, Karl; Wicki, Ilhui; Holenstein, Livia; Fucentese, Sandro F.; Gerber, Christian

    2016-01-01

    Background Ethical concerns for surgical training on patients, limited working hours with fewer cases per trainee and the potential to better select talented persons for arthroscopic surgery raise the interest in simulator training for arthroscopic surgery. It was the purpose of this study to analyze learning curves of novices using a knee arthroscopy simulator and to correlate their performance with potentially predictive factors. Methods Twenty medical students completed visuospatial tests ...

  17. 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

  18. A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

    OpenAIRE

    Eyup Horasanli; Mehmet Gamli; Yasar Pala; Mustafa Erol; Fazilet Sahin; Bayazit Dikmen

    2010-01-01

    OBJECTIVES: The efficacy of combined lumbar plexus-sciatic nerve blocks was compared to epidural anesthesia in patients undergoing total knee surgery. PATIENTS AND METHODS: The study included 80 American Society of Anesthesiologists (ASA) Physical Status I-III patients (age range 18 to 65) undergoing knee surgery. The patients were randomly divided into one of two groups. Epidural anesthesia was performed in the epidural anesthesia (EA) group (n=40), and the lumbar plexus and sciatic nerves w...

  19. Anti-inflammatory effect of peripheral nerve blocks after knee surgery: clinical and biologic evaluation. : Postoperative peripheral nerve blocks reduce clinical inflammation after total knee arthroplasty

    OpenAIRE

    Martin, Frédéric; Martinez, Valéria; Mazoit, Jean Xavier; Bouhassira, Didier; Cherif, Kamel; Gentili, Marc Edouard; Piriou, Philippe; Chauvin, Marcel; Fletcher, Dominique

    2008-01-01

    BACKGROUND: Nerve blocks provide analgesia after surgery. The authors tested whether nerve blocks have antiinflammatory effects. METHODS: Patients had combined sciatic (single-shot) and continuous femoral block (48 h) (block group) or morphine patient-controlled analgesia after total knee arthroplasty. Pain at rest and upon movement was monitored at 1 (D1), 4 (D4), and 7 days (D7) and 1 (M1) and 3 months (M3) after surgery. Knee inflammation was evaluated (skin temperature, knee circumference...

  20. 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.

  1. Arthroscopic excision of giant cell tumor of the tendon sheath in the knee mimicking patellar tendinopathy: A case report

    Science.gov (United States)

    GAO, KAI; CHEN, JIWU; CHEN, SHIYI; LI, YUNXIA

    2016-01-01

    Giant cell tumor of the tendon sheath (GCTTS) predominantly occurs in the tendon sheaths of the hand, but rarely in those of the knee. The current study reports the case of a 36-year-old male patient presenting with anterior knee pain. The patient was ultimately diagnosed with GCTTS in the knee mimicking patellar tendinopathy. To the best of our knowledge, this is the first case of its kind. Magnetic resonance imaging revealed a well-defined oval intra-articular lesion located at the proximal segment of the infrapatellar fat pad. The lesion was completely excised under arthroscopy and pathological examination confirmed the diagnosis of GCTTS. There was no evidence of recurrence at the 2-year follow-up examination. The findings of the present study suggest that, despite its rarity, GCTTS should be considered in the differential diagnosis of patellar tendinopathy. PMID:27123148

  2. MR imaging of the knee following cruciate ligament reconstruction and meniscal surgery

    International Nuclear Information System (INIS)

    Due to the increasing number of surgical procedures performed on the knee, MR imaging of the postoperative knee has gained more and more importance. For the evaluation of anterior cruciate ligament grafts and postoperative menisci, basic knowledge of surgical techniques is essential in order to differentiate normal postoperative findings from transplant failure, retears, and complications. This article reviews technical aspects of MR imaging following knee surgery, basic principles of operative techniques for anterior cruciate ligament reconstruction and therapy of meniscal tears, normal postoperative findings, MR imaging criteria for recurrent lesions, and findings with typical complications. (orig.)

  3. Thromboprophylaxis in orthopaedic surgery

    OpenAIRE

    Büller, H.R.; Verheyen, C C P M; Ettema, H.B.; Struijk-Mulder, M.C.

    2014-01-01

    This thesis describes the use of thromboprophylatic modalities after total hip and total knee arthroplasty by Dutch orthopedic departments over a period of ten years and several uncertainties regarding thromboprophylaxis in other areas of orthopedic surgery. In this thesis some of these uncertainties are addressed: the incidence of venous thromboembolism after arthroscopic cruciate ligament reconstruction, lower extremity amputation, and shoulder arthroplasty and a case of pulmonary embolism ...

  4. Who should have knee joint replacement surgery for osteoarthritis?

    DEFF Research Database (Denmark)

    Dieppe, Paul; Lim, Keith; Lohmander, Stefan

    2011-01-01

    Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10-20% of peo...... percentage of the variance with this technique. Finally, we propose use of the 'capacity to benefit framework' to attempt providing guidance to both patients and healthcare professionals....

  5. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Science.gov (United States)

    Muhly, Wallis T; Gurnaney, Harshad G; Ganesh, Arjunan

    2015-01-01

    The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs) for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation. PMID:26609245

  6. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Directory of Open Access Journals (Sweden)

    Muhly WT

    2015-11-01

    Full Text Available Wallis T Muhly, Harshad G Gurnaney, Arjunan GaneshDepartment of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USAAbstract: The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation.Keywords: pediatric surgery, regional anesthesia, analgesia, knee surgery

  7. 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.

  8. Technical considerations in total knee surgery. Management of patella problems.

    Science.gov (United States)

    Goldberg, V M; Figgie, H E; Figgie, M P

    1989-04-01

    Patellofemoral symptoms are now the most common cause of aseptic knee revision; however, the majority of patello-femoral problems are self-limited and may be managed symptomatically and nonoperatively. A trial of anti-inflammatory medications, stretching exercises, and appropriate bracing is always indicated. Patellofemoral symptoms are usually related to mechanical malalignment of all three components of the total knee arthroplasty. Attention to the fundamental principles of total knee arthroplasty, including restoration of the bony mechanical alignment, soft tissue stability, and maintenance of the anatomic joint line, prevents many of the problems. Meticulous preoperative planning and anatomic placement of the component parts are important for a satisfactory long-term outcome. Present research is directed to providing kinematic analysis of the patellofemoral tracking mechanism and to minimizing patellofemoral contact stresses with appropriate new designs. PMID:2646562

  9. Treatment choice for osteoarthritis of the knee joint according to semi-automatic MRI based assessment of disease severity

    International Nuclear Information System (INIS)

    Objective assessment of disease severity of osteoarthritis of the knee joint (OA knee) is fundamental to establish adequate treatment system. Regrettably, there is no such a reliable system. Grading system based upon X-ray findings or measurement of joint space narrowing is widely used method for this purpose but they are still far from satisfaction. Our previous study elucidated that measuring irregularity of the contour of the femoral condyle on MRI (irregularity index) using newly developed software enabled us to assess disease severity of OA objectively. Advantages of this system are expressing severity by metric variable and semi-automatic character. In the present study, we examined relationship between treatment selection and irregularity index. Sixty-one medial type OA knees that received total knee arthroplasty (TKA), arthroscopic surgery (AS), and conservative treatment (CT) were involved. Their x-ray grading, irregularity index were recorded at the time of corresponding treatment. Irregularity index of each group were compared. As for AS group, pre- and post-operative knee score employing JOA score were also examined to study relationship between irregularity index and improvement of knee score. All the four parameters that represent irregularity of femoral condyle were significantly higher in TKA group than in AS group, whereas no significant difference was observed between AS group and CT group. Negative correlation was observed between irregularity index and improvement of knee score after arthroscopic surgery. Although treatment selection was determined by skillful knee surgeon in this series, irregularity index could indicate adequate timing of TKA. It also served as an indicator to predict outcome of arthroscopic surgery, and could be used as to show limitation of arthroscopic surgery. Our new system to assess disease severity of OA knee can serve as an index to determine treatment options. (author)

  10. The first clinical application of a "hands-on" robotic knee surgery system.

    Science.gov (United States)

    Jakopec, M; Harris, S J; Rodriguez y Baena, F; Gomes, P; Cobb, J; Davies, B L

    2001-01-01

    The performance of a novel "hands-on" robotic system for total knee replacement (TKR) surgery is evaluated. An integrated robotic system for accurately machining the bone surfaces in TKR surgery is described. Details of the system, comprising an "active constraint" robot, called Acrobot, a "gross positioning" robot, and patient clamps, are provided. The intraoperative protocol and the preoperative, CT-based, planning system are also described. A number of anatomical registration and cutting trials, using plastic bones, are described, followed by results from two preliminary clinical trials, which demonstrate the accuracy achieved in the anatomical registration. Finally, the first clinical trial is described, in which the results of the anatomical registration and bone cutting are seen to be of high quality. The Acrobot system has been successfully used to accurately register and cut the knee bones in TKR surgery. This demonstrates the great potential of a "hands-on" robot for improving accuracy and increasing safety in surgery. PMID:11954064

  11. MR-specific staging of chondromalacia patellae using a special knee compressor: Comparison with arthroscopic findings. MRT-spezifische Einteilung der Chondromalacia patellae unter Zuhilfenahme eines speziellen Kniekompressors: Gegenueberstellung mit dem arthroskopischen Befund

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, R. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany)); Radmer, S. (Orthopaedisches Fachinst., Berlin (Germany)); Koenig, H. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany)); Wolf, K.J. (Klinik fuer Radiologie, Abt. Radiologische Diagnostik, Universitaetsklinik Steglitz, FU Berlin (Germany))

    1993-12-01

    The present study proposes a new MRI-specific staging of chondromalacia patellae (CMP) which is based on cartilage thickness decrease and signal intensity behaviour under compression as well as cartilage morphology in the plain image. The investigation was performed in 30 patients with varying knee complaints who underwent arthroscopy after MR imaging. It was demonstrated that three CMP stages can already be differentiated by MRI under compression in arthroscopically healthy cartilage. This proves a marked improvement in the early diagnosis of CMP. (orig.)

  12. 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.

  13. Effect of preoperative education of patients before hip or knee replacement surgery: A systematic review

    DEFF Research Database (Denmark)

    Aydin, Dogu; Klit, Jakob; Husted, Henrik;

    2013-01-01

    Background Total hip (THA) and knee arthroplasty (TKA) are standard procedures for treatment of end stage osteoarthritis, and much is done to optimize results. It is usually hypothesized that education of patients before surgery reduces anxiety, secures more realistic patient expectations and...

  14. 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

  15. 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.

  16. Tromboembolia pulmonar após videoartroscopia de ombro Thromboembolic complication after arthroscopic shoulder surgery

    Directory of Open Access Journals (Sweden)

    Fabio Farina Dal Molin

    2010-06-01

    Full Text Available Embora fenômenos tromboembólicos sejam complicações frequentes em cirurgias dos membros inferiores, apenas dois relatos de casos de tromboembolia pulmonar após artroscopia de ombro são encontrados na literatura. É descrito o caso de uma paciente com 76 anos com embolia pulmonar bilateral após artroscopia cirúrgica do ombro. Não foram encontradas anormalidades vasculares e nenhuma origem do trombo foi detectada, ficando desconhecida a causa exata responsável pela tromboembolia.Though thromboembolisms are frequent complications of surgery of the lower extremities, only two cases of pulmonary thromboembolism after shoulder arthroscopy are found in the literature. We describe the case of a 76-year-old patient with pulmonary embolism in both lungs after shoulder arthroscopy. No vascular abnormalities nor the origin of the thrombus was detected. The etiology of the thromboembolism remains unknown.

  17. Multiple-ligament injured knee

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    Objective: To explore the clinical characteristic of the multiple-ligament injured knee and evaluate the protocol,technique and outcome of treatment for the multipleligament injured knee.Methods: From October 2001 to March 2005, 9 knees with combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in 9 patients were identified with clinical and arthroscopic examinations. Of them, 5 knees were combined with ruptures of posteromedial corner (PMC) and medial collateral ligament (MCL), 4 with disruptions of posterolateral corner ( PLC), 2 with popliteal vascular injuries and 1 with peroneal nerve injuries. Six patients were hospitalized in acute phase of trauma, 2 received repairs of popliteal artery and 4 had repairs of PMC and MCL. Reconstructions of ACL and PCL with autografts under arthroscope were performed in all patients at 4 to 10 weeks after trauma,including reconstruction of PLC with the posterior half of biceps femoris tendon tenodesis in 4 patients and reconstructions of PMC and MCL with femoral fascia in 1 patient.Results: No severe complications occurred at early stage after operation in the 9 patients. All of them were followed up for 10-39 months with an average of 23. 00 months ± 9.46 months. Lysholm score was 70-95 with an average of 85.00 ± 8.29. International Knee Documentation Committee (IKDC) score was from severely abnormal (Grade D) in 9 knees at initial examination to normal (Grade A) in 2 knees, nearly normal (Grade B ) in 6 knees and abnormal in 1 knee at the last follow-up. Of the 9 patients, 7 returned to the same activity level before injury and 2 were under the level.Conclusions: The multiple-ligament injured knee with severe instability is usually combined with other important structure damages. Therefore, careful assessment and treatment of the combined injuries are essential. Reconstructions of ACL and PCL under arthroscope, combined with repairs or reconstructions of the extraarticular ligaments

  18. Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery

    International Nuclear Information System (INIS)

    Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cranially and abaxially and its torn edges were debrided. Radiographically, 6 cases had proliferative new bone on the cranial aspect of the intercondylar eminence of the tibia and 3 had calcified soft tissue densities in the cranial, medial or lateral femorotibial joint. Following surgery and a 6 month period of rest and controlled exercise, 3 horses returned to full competition work, one was usable for hacking, 2 are convalescing and one is lame after one year. It is postulated that this could be a characteristic meniscal injury in horses which can benefit from arthroscopic surgery. Better techniques for accessing the body and caudal pole of the menisci are needed if a more complete diagnosis and treatment of meniscal injuries are to be achieved

  19. Micro fracture surgery combined with sodium hyaluronate injection on repairing knee joint cartilage injury%微骨折术联合玻璃酸钠注射修复膝关节软骨损伤

    Institute of Scientific and Technical Information of China (English)

    付昌马; 钱春生; 章有才; 刘群; 周思启; 杨祖华

    2013-01-01

    Objective To research microfracture surgery combined with sodium hyahuronate injection repair knee cartilage injury patient outcomes,and analyse arthroscopic cartilage damage outerbridge grading cartilage damage in patients with or without a merger meniscus injury,whether the merger withinthe sideslip film folds of the treatment effect.Methods To select forty patients with knee cartilage damage who accepted arthroscopic surgery treatment in the third people' s hospital of hefei from april 2011 to January 2012,the trauma caused by cartilage damage in 9 cases,cartilage damage caused by arthritis in 31 cases.Divided them into three groups based on outerbridge different grade.Using two sample t-test to test knee function Lysholm score between each group before and after surgery,the knee function lysholm score before and after whether combined with the merger meniscus injury surgery,knee function Lysholm score before and after whether the merger medial synovial plica surgery and knee function Lysholm score before and after surgery in 40 cases of knee cartilage dmage used two sample t-test to compare.Results Knee cartilage injury patients included in the study,40 patients were involved in the result analysis,statistical results in the first three months of follow-up:①There had significant differences with knee function Lysholm score before and after surgery between each group (P <0.05).②The knee function Lysholm scores were significant different before and after whether combined with the merger meniscus injury surgery (P < 0.05).③There had significant differences with the knee function Lysholm score before and after whether the merger medial synovial plica surgery (P < 0.05).④The differences of knee function Lysholm score before and after surgery in 40 cases of knee cartilage damage patients was statistically significant(P < 0.05).Conclusions It would be receive a satisfactory therapeutic effect of micro fracture surgery combined with sodium hyaluronate

  20. Osteonecrosis of the knee: review

    Science.gov (United States)

    Karim, Ammar R.; Cherian, Jeffrey J.; Jauregui, Julio J.; Pierce, Todd

    2015-01-01

    Osteonecrosis is a devastating disease that can lead to end-stage arthritis of various joint including the knee. There are three categories of osteonecrosis that affect the knee: spontaneous osteonecrosis of the knee (SONK), secondary, and post-arthroscopic. Regardless of osteonecrosis categories, the treatment of this disease aims to halt further progression or delay the onset of end-stage arthritis of the knee. However, once substantial joint surface collapse has occurred or there are sign of degenerative arthritis, joint arthroplasty is the most appropriate treatment option. Currently, the non-operative treatment options consist of observation, non-steroidal anti-inflammatory drugs (NSAIDs), protected weight bearing, and analgesia as needed. Operative interventions include joint preserving surgery, unilateral knee arthroplasty (UKA), or total knee arthroplasty (TKA) depending on the extent and type of disease. Joint preserving procedures (i.e., arthroscopy, core decompression, osteochondral autograft, and bone grafting) are usually attempted in pre-collapse and some post-collapse lesions, when the articular cartilage is generally intact with only the underlying subchondral bone being affected. Conversely, after severe subchondral collapse has occurred, procedures that attempt to salvage the joint are rarely successful and joint arthroplasty are necessary to relieve pain. The purpose of this article is to highlight the recent evidence concerning the treatment options across the spectrum of management of osteonecrosis of the knee including lesion observation, medications, joint preserving techniques, and total joint arthroplasties. PMID:25705638

  1. Pseudoaneurysm after arthroscopic procedure in the knee☆

    Science.gov (United States)

    Filho, Edmar Stieven; Isolani, Guilherme Rufini; Baracho, Filipe Ribas; de Oliveira Franco, Ana Paula Gebert; Ridder Bauer, Luiz Antônio; Namba, Mario

    2015-01-01

    The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures. PMID:26229905

  2. Prediction of post-operative pain following arthroscopic subacromial decompression surgery: an observational study [v1; ref status: indexed, http://f1000r.es/9s

    Directory of Open Access Journals (Sweden)

    Anthony Davis

    2013-02-01

    Full Text Available Background: Arthroscopic shoulder surgery is increasingly performed as a day case procedure. Optimal post-operative pain relief remains a challenge due to considerable variations in the level of pain experienced between individuals. Our aim was to examine whether the preoperative electrical pain threshold was a strong predictor of elevated postoperative pain levels following arthroscopic subacromial decompression (ASD surgery. Methods: Forty consenting patients with American Society of Anesthesiologists (ASA grade 1-2 presenting for elective ASD surgery were recruited. Patients’ electrical pain thresholds were measured preoperatively using a PainMatcher® (Cefar Medical AB, Lund, Sweden device. Following surgery under general anaesthesia, the maximum pain experienced at rest and movement was recorded using a visual analogue scale until the end of postoperative day four. Results: In univariate analyses (t-test, the postoperative pain experienced (Area Under Curve was significantly greater in patients with a low pain threshold as compared with a high pain threshold at both rest (mean 12.5, S.E. 1.7 v mean 6.5, S.E.1.2. P=0.008 and on movement (mean 18.7, S.E. 1.5 v mean 14.1, S.E.1.4. P=0.031. In multivariate analyses, adjusting for additional extra analgesia, the pain experienced postoperatively was significantly greater in the low pain threshold group both at rest (mean difference 4.9, 95% CI 1.5 to 8.4, P=0.007 and on movement (mean difference 4.1, 95%CI 0.03 to 8.2, P=0.049. Conclusions: Preoperative pain threshold can predict postoperative pain level following ASD of the shoulder. Trial registration: Clinicaltrials.gov identifier: NCT01351363 Level of Evidence: II

  3. 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 ...

  4. Decision-making regarding total knee replacement surgery: A qualitative meta-synthesis

    Directory of Open Access Journals (Sweden)

    Ong Bie

    2007-04-01

    Full Text Available Abstract Background Knee osteoarthritis is a highly prevalent condition that can result in disability and reduced quality of life. The evidence suggests that total knee replacement surgery (TKR is an effective intervention for patients with severe knee problems, but there is also an unmet need for this treatment in the UK. To help understand the reason for this unmet need, the aim of this study was to explore the factors that influence the decision-making process of TKR surgery by synthesising the available evidence from qualitative research on this topic. Methods A meta-synthesis was undertaken. This involved sevens steps: getting started, deciding what is relevant to the initial interest, reading the studies, determining how the studies are related, translating the studies into one another, synthesising translations, and finally, expressing the synthesis. Second-order and third-order interpretations regarding decision-making in TKR surgery were drawn from the literature. Results Ten qualitative studies were found and are included in the synthesis. The evidence suggests that social and cultural categories of aging have shaped the expectation of knee osteoarthritis, and this in turn shapes patients' expectations of treatment options. The role of the health care professional was the strongest theme to emerge across all ten studies. Coping strategies and life context determine short and longer-term outcomes of TKR. Conclusion The decision-making process regarding TKR surgery is extremely complex, as patients have weigh up numerous considerations before they can make a decision about surgery. By synthesising ten qualitative studies, we have illuminated the importance of the health care professional during this process.

  5. Porous tantalum in reconstructive surgery of the knee: a review.

    Science.gov (United States)

    Levine, Brett; Sporer, Scott; Della Valle, Craig J; Jacobs, Joshua J; Paprosky, Wayne

    2007-07-01

    Porous tantalum represents an alternative metal for primary and revision total knee arthroplasty (TKA) with several unique properties. Tantalum is a transition metal, which in its bulk form has shown excellent biocompatibility and is safe to use in vivo as evidenced by its current application in pacemaker electrodes, cranioplasty plates, and as radiopaque markers. Current designs for orthopedic implants maintain a high volumetric porosity (70%-80%), low modulus of elasticity (3 MPa), and high frictional characteristics, making this metal conducive to biologic fixation. The low modulus of elasticity of such components allows for more physiologic load transfer and relative preservation of bone stock. Its more bioactive nature and ingrowth properties have led to its use in primary as well as revision knee components with good early clinical results reported. In revision arthroplasty, it has been used as a structural bone graft substitute. Formation of a bone-like apatite coating in vivo affords strong fibrous ingrowth properties and allows for substantial soft-tissue attachment with the potential for use in cases such as mega-prostheses and patella salvage. Although porous tantalum is in its early stages of evolution, the initial clinical data and basic science studies support its use as an alternative to traditional orthopedic implant materials. PMID:17665779

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

    Science.gov (United States)

    Zhao, Gang; Liu, Yujie; Yuan, Bangtuo; Shen, Xuezhen; Qu, Feng; Wang, Jiangtao; Qi, Wei; Zhu, Juanli; Liu, Yang

    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. PMID:25563318

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

    Directory of Open Access Journals (Sweden)

    Gang Zhao

    2015-01-01

    Full Text Available 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.

  8. Sinovite Vilonodular Pigmentada Localizada do joelho: tratamento por via artroscópica Localized Pigmented Villonodular Synovitis of the knee: an arthroscopic treatment

    Directory of Open Access Journals (Sweden)

    Arnaldo José Hernandez

    2005-01-01

    Full Text Available Os autores apresentam sete pacientes portadores de Sinovite Vilonodular Pigmentada Localizada (SVNPL tratados através de ressecção artroscópica, entre o período de junho de 1994 e Outubro de 2001. À avaliação inicial, os sintomas variaram desde dor difusa, até um aumento do volume localizado, com ou sem bloqueio mecânico do movimento articular. A ressonância magnética auxiliou na localização das lesões e no controle pós-operatório. O diagnóstico foi confirmado pelo exame anatomo-patológico. Na última avaliação nenhum dos pacientes apresentou recidivas dos sintomas do pré-operatório, nem no exame por imagem com ressonância magnética. Apesar da casuística pequena, própria dessa afecção, os autores acreditam que a excisão artroscópica da SVNPL é um método eficaz, de baixa morbidade, proporciona remissão dos sintomas e com pouca possibilidade de recidivas.The authors present a series of seven case reports of Localized Pigmented Villonodular Synovitis (LPVNS treated by arthroscopy resection between June of 1994 and October of 2001. At the baseline evaluation, symptoms ranged from diffuse pain to localized swelling of the knee, with or without mechanical blockage of the joint. Magnetic Resonance helped in localizing the lesion and in the follow up evaluation. Diagnosis was confirmed through anatomicopathological examination. By the end point evaluation, none of the patients presented recurrence of the pre-operative symptoms referred before. Magnetic resonance imaging also showed absence of symptoms. Despite of the small number of patients, typical of this affection, the authors believe that arthroscopic excision of the LPVNS is an effective method, with low morbidity, providing remission of the symptoms and a low recurrence potential.

  9. Intravenous dex medetomidine or propofol adjuvant to spinal anesthesia in total knee replacement surgery

    International Nuclear Information System (INIS)

    The purpose of this study was to compare effect of intravenous dex medetomidine with the intravenous propofol adjuvant to spinal intrathecal anesthesia on the duration of spinal anesthesia and hemodynamic parameters during total knee replacement surgery. Supplementation of spinal anesthesia with intravenous dexemedetomidine or propofol produces good sedation levels without significant clinical hemodynamic changes. Adding dex medetomidine produces significantly longer sensory and motor block than propofol . (authors).

  10. Effect of saphenous nerve block for postoperative pain on knee surgery: a meta-analysis

    OpenAIRE

    Jin, Shu-Qing; Ding, Xi-Bing; Tong, Yao; Ren, Hao; Chen, Zhi-Xia; Wang, Xin; Li, Quan

    2015-01-01

    Early post-operative mobilization is important both to reduce immobility-related complications and to get the best functional result following surgery on knee. We hypothesized that saphenous nerve block would reduce pain in this patient category compared with placebo injection. In this study, two reviewers independently searched the databases of PubMed, EMBASE, and Cochrane Library (last performed on 12 October, 2014) to retrieve eligible randomized controlled clinical trials. The primary out...

  11. 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生率,关节镜直视下进行骨折复位可以达到更好的复位效果。%Objective To evaluate the effectiveness of arthroscope-assisted technique in treating knee or knee peripheral fractures with injury of menisci and ligaments. Methods From January 2011 to January 2013,arthroscope-assisted surgical tech-nique was performed in 25 cases with knee or knee peripheral fractures,then internal fixation was perform under arthroscope. The evaluation of knee function was taken with HSS score system after fracture healing. Results All cases were followed up for 12-36 month( mean,14. 2 month) . By the HSS score system for the knee,16 patients were rated as excellent,8 as good and one as fair, and the excellent and good rate was 92. 3%,there were no failure of internal fixation,deformity of the knee,or traumatic knee oste-oarthritis. Conclusion As for knee or knee peripheral fractures,arthroscope-assisted technique can get more accuracy diagnosis and treatment for injury of menisci and ligaments,decrease complication,provide fine monitoring for reliable fracture fixation.

  12. 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.

  13. Emergency arthroscopic debridement and reduction associated with the second stage ligament reconstruction for the treatement of acute posterolateral rotatory dislocation of knee%急诊关节镜下清创复位联合二期韧带重建治疗急性膝关节后外侧旋转脱位

    Institute of Scientific and Technical Information of China (English)

    何锐; 杨柳; 郭林; 陈光兴; 段小军; 戴刚

    2012-01-01

      Objective To discuss the curative effect of emergency arthroscopic debridement and reduction associated with the second stage anterior cruciate ligament (ACL) reconstruction for acute posterolateral rotatory dislocation of knee. Methods The retrospective study involved 3 patients with acute posterolateral rotarory dislocation treated in Southwest Hospital of Third Military Medical University from September 2007 to August 2008. Emergency arthroscopy was taken to reduce the knee and debride articular cavity. One case with medial collateral ligment (MCL) rupture was repaired and another 2 cases with MCL partialy injury accepted conservative treatment of hinge knee orthosis until natural healing. Three months later, ACL reconstruction with LARS artificial ligament were performed for all patients. The range of motion (ROM) of knee and Lysholm scores were observed during the follow-up. Results The mean duration of follow-up was 15 months. No anterior knee instability had happened. Results of anterior drawer test and talar tilt test were negative, no heteropic ossification was found in 3 patients, the ROM were 0°-130° , 0°-120° and 0°-130° in 3 months after reconstruction surgery, and the Lysholm score were 91 point, 98 point and 94 point in 12 months afier reconstruction. Conclusion Emergency arthroscopic reduction and debridement associated with standard ACL reconstruction results in good curative outcomes for acute posterolateral rotatory dislocation of knee.%  目的总结急诊关节镜下复位清创联合二期韧带重建手术在急性膝关节后外侧旋转脱位治疗中的效果.方法回顾性分析2007年9月至2008年8月第三军医大学西南医院收治的3例急性膝关节后外侧旋转脱位患者的临床资料,3例患者均急诊行关节镜手术清创+复位治疗,其中1例内侧副韧带(MCL)Ⅲ度损伤患者行MCL修补缝合术;2例MCLⅡ度损伤患者佩戴铰链支具保守治疗.术后3个月,3例患者接受LARS人

  14. Development of a Wearable Assist Robot for Walk Rehabilitation After Knee Arthroplasty Surgery

    Science.gov (United States)

    Terada, H.; Zhu, Y.; Horiguchi, K.; Nakamura, M.; Takahashi, R.

    In Japan, it is popular that the disease knee joints will be replaced to artificial joints by surgery. And we have to assist so many patients for walk rehabilitation. So, the wearable assist robot has been developed. This robot includes the knee motion assist mechanism and the hip joint support mechanism. Especially, the knee motion assist mechanism consists of a non-circular gear and grooved cams. This mechanism rotates and slides simultaneously, which has two degree-of-freedom. Also, the hip joint support mechanism consists of a hip brace and a ball-joint. This mechanism can avoid motion constraints which are the internal or external rotation and the adduction or abduction. Then, the control algorithm, which considers an assisting timing for the walk rehabilitation, has been proposed. A sensing system of a walk state for this control system uses a heel contacts sensor and knee and hip joint rotation angle sensors. Also, the prototype robot has been tested. And it is confirmed that the assisting system is useful.

  15. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    Science.gov (United States)

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Seasonality of service provision in hip and knee surgery: A possible contributor to waiting times? A time series analysis

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2006-03-01

    Full Text Available Abstract Background The question of how best to reduce waiting times for health care, particularly surgical procedures such as hip and knee replacements is among the most pressing concern of the Canadian health care system. The objective of this study was to test the hypothesis that significant seasonal variation exists in the performance of hip and knee replacement surgery in the province of Ontario. Methods We performed a retrospective, cross-sectional time series analysis examining all hip and knee replacement surgeries in people over the age of 65 in the province of Ontario, Canada between 1992 and 2002. The main outcome measure was monthly hospitalization rates per 100 000 population for all hip and knee replacements. Results There was a marked increase in the rate of hip and knee replacement surgery over the 10-year period as well as an increasing seasonal variation in surgeries. Highly significant (Fisher Kappa = 16.05, p 2Autoreg = 0.85 seasonality was identified in the data. Conclusion Holidays and utilization caps appear to exert a significant influence on the rate of service provision. It is expected that waiting times for hip and knee replacement could be reduced by reducing seasonal fluctuations in service provision and benchmarking services to peak delivery. The results highlight the importance of system behaviour in seasonal fluctuation of service delivery.

  18. Arthroscopic Bioabsorbable Screw Fixation of Unstable Osteochondritis Dissecans in Adolescents: Clinical Results, Magnetic Resonance Imaging, and Second-Look Arthroscopic Findings

    Science.gov (United States)

    Chun, Keun Churl; Kim, Kwang Mee; Jeong, Ki Joon; Lee, Yong Chan; Kim, Jeong Woo

    2016-01-01

    Background This study aimed to evaluate the clinical and radiological outcomes of arthroscopic bioabsorbable screw fixation in osteochondritis dissecans (OCD) in adolescent patients with unstable lesions causing pain. Methods The study included 11 patients (10 males and 1 female) with OCD who underwent arthroscopic bioabsorbable screw fixation between July 2007 and February 2014 and were available for follow-up for more than 12 months. The mean age at diagnosis was 16.3 years (range, 11 to 19 years), and the average follow-up period was 51 months (range, 12 to 91 months). Clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, and International Knee Documentation Committee (IKDC) score measured before surgery and at follow-up. Functional evaluation was made using the Tegner activity scale. Magnetic resonance imaging (MRI) and second-look arthroscopy were performed at the 12-month follow-up. Results Between the preoperative assessment and follow-up, improvements were seen in the KOOS (range, 44.9 to 88.1), Lysholm knee score (range, 32.6 to 82.8), and IKDC score (range, 40.8 to 85.6). The Tegner activity scale also improved from 2.8 to 6.1. Based on postoperative MRI, there were eight Dipaola grade I cases and three grade II cases. No complications due to fixation failure developed in any case. Second-look arthroscopy at 12 months postoperatively revealed that the lesion was covered with cartilage in all cases. Conclusions For unstable OCD lesions causing pain in adolescents, arthroscopic bioabsorbable screw fixation provided favorable outcomes with reduced pain and restoration of movement. Therefore, it should be considered as an effective treatment for OCD. PMID:26929800

  19. Comparative study on early period of recovery between minimally invasive surgery total knee arthroplasty and minimally invasive surgery-quadriceps sparing total knee arthroplasty in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    YU Jia-kuo; YU Chang-long; AO Ying-fang; GONG Xi; WANG Yong-jian; WANG Shu; XING Xie; CHEN Lian-xu; JU Xiao-dong

    2008-01-01

    Background Different kinds of minimally invasive surgery (MIS) procedures have now been used in total knee arthroplasty (TKA). Compared with traditional TKA procedure with a long skin incision, clinical studies showed MIS procedures had some advantages. Quadriceps sparing (QS) procedures are the most minimally invasive MIS procedure until now. This study was aimed to find the insertion types for Chinese patients' vastus medialis and if the QS procedure had some advantages in patients' early recovery.Methods Between February 2006 and May 2007, 120 consecutive patients underwent unilateral primary TKA under general anesthesia, among whom 14 patients were lost to follow-up, the remaining 106 cases were enrolled in this study. Among the 106 cases there were 85 right knees, 21 left knees (15 men and 91 women, with a mean age of 65.1±7.4 years); osteoarthritis in 97 patients (91.5%) and rheumatoid arthritis in 9 patients (8.5%). MIS TKA was performed in 49 cases (MIS TKA group), while MIS-QS TKA in 57 cases (MIS-QS TKA group). During the operation, the type Ⅰ, Ⅱ and Ⅲ insertions of the vastus medialis for all patients were recorded. Each knee was rated post-operatively according to the Hospital of Special Surgery (HSS) scoring system. Clinical follow-up was undertaken at 1 week, 2, 6, 12 and 24 weeks. Operating time and complications were recorded.Results There was no statistically significant difference between the two groups for gender distribution, age, left or right knee incidence, pre-operative diagnosis, incidence of varus or valgus deformity. Of the 106 cases there was 1 (0.9%) case with a type Ⅰ insertion of the vastus medialis, 4 (3.8%) cases with type Ⅱ insertions, 101 (95.3%) cases with type Ⅲ insertions. The HSS scoring was significantly different between the MIS-QS TKA group and MIS TKA group within the first two weeks post operation. From 2 weeks later to 24 weeks, no significant difference was found. The average operating time was (53.3±12

  20. Recurrent locked knee caused by an impaction fracture following inferior patellar dislocation: a case report

    Directory of Open Access Journals (Sweden)

    Sutcliffe William

    2011-08-01

    Full Text Available Abstract Introduction Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy. Case presentation We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients. Conclusions This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.

  1. Radial tear of posterior horn of the medial meniscus and osteonecrosis of the knee

    International Nuclear Information System (INIS)

    We studied the relation between a radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee. Thirty-eight knees of 37 patients were diagnosed as medial meniscus tear and received arthroscopic knee surgery. We divided them into two groups: knees having radial tear of the posterior horn of the medial meniscus (posterior horn group) and knees containing radial tear except for posterior horn, horizontal tear, degenerative tear, and flap tear of the medial meniscus (non-posterior horn group). The posterior horn group consisted of 14 knees (average age: 65.1 years old) and the non-posterior horn group consisted of 24 knees (average age: 59.6 years old). All cases underwent MRI before arthroscopy. MRI findings were classified into three types (typical osteonecrosis, small osteonecrosis, and non-osteonecrosis). In the posterior horn group, typical osteonecrosis were five knees and small osteonecrosis were five knees, while in the non-posterior horn group only three knees were small osteonecrosis. These findings suggest the relevance between radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee (Mann-Whitney test p<0.01). The etiology of spontaneous osteonecrosis of the knee joint is unknown, however one etiology could be the radial tear of the posterior horn of the medial meniscus. (author)

  2. Kinematic Analysis of Cpm Machine Supporting to Rehabilitation Process after Surgical Knee Arthroscopy and Arthroplasty

    Directory of Open Access Journals (Sweden)

    Trochimczuk R.

    2014-11-01

    Full Text Available Existing commercial solutions of the CPM (Continuous Passive Motion machines are described in the paper. Based on the analysis of existing solutions we present our conceptual solution to support the process of rehabilitation of the knee joint which is necessary after arthroscopic surgery. For a given novel structure we analyze and present proprietary algorithms and the computer application to simulate the operation of our PCM device. In addition, we suggest directions for further research.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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。

  5. 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...

  6. Knee arthroscopy - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on ... had surgery to check for problems in your knee (knee arthroscopy). You may have been checked for: ...

  7. Traumatic knee extension deficit (the locked knee)

    DEFF Research Database (Denmark)

    Helmark, I C; Neergaard, K; Krogsgaard, M R

    2007-01-01

    In the present study we investigated the validity of magnetic resonance imaging (MRI) and arthroscopy in knees with acute, traumatic extension deficit (the "locked knee"), and evaluated whether arthroscopy of knees with no mechanical pathology could be avoided by MRI evaluation. The study consist......-handle lesion and one pathological synovial plica). MRI of the knee with acute, traumatic extension deficit is in the acute or subacute phase a safe method to identify the patients that have a mechanical reason for locking and therefore can benefit from arthroscopic treatment....

  8. Septic arthritis of the knee: Presentation of a novel irrigation-suction system tested in a cadaver study

    Directory of Open Access Journals (Sweden)

    Weise Kuno

    2011-08-01

    Full Text Available Abstract Background The established treatment for bacterial arthritis of the knee joint is arthroscopic surgery with irrigation and debridement. The aim of this article is to summarize the relevant data in treating bacterial arthritis of the knee joint, and based on these findings to present a novel irrigation suction system, tested in a cadaver study, as an additional tool in the postoperative treatment phase of arthroscopic surgery for knee joint infections. Method The novel automated irrigation-suction system presented here was compared to conventional continuous suction irrigation in a total of six knee joints. All knee joints were filled with 80 ml methylene blue stain and rinsed by two different methods. Fluid specimens were taken after ten and twenty minutes to be compared by photometric extinction measurement at a wave length of 500 nm. Results After ten minutes, the average extinction was e1C = 0.8 for the continuous suction irrigation and e1N = 0.4 for the novel irrigation-suction system. After twenty minutes, we recorded an average extinction of e2C = 0.3 for continuous suction irrigation and e2N = 0.001 for the novel irrigation-suction system. The students t-test revealed superior results after ten and twenty minutes of washing out the knee joints with a p Conclusion A novel irrigation-suction system may be an effective tool for postoperative knee joint irrigation in arthroscopic therapy for bacterial arthritis of the knee. Further animal studies are needed to verify the effects in vivo.

  9. Navigated revision knee arthroplasty using a system designed for primary surgery.

    Science.gov (United States)

    Massin, Philippe; Boyer, Patrick; Pernin, Jerome; Jeanrot, Cecile

    2008-07-01

    While navigation is now recognized as an efficient tool for improving femoro-tibial alignment of primary knee prostheses, its use in revision surgery has not yet been fully evaluated. We describe a procedure based on a bone morphing acquisition performed on the surface of the original implants, followed by a dependant bone cut sequence (tibia first). Using the current system, a preoperative CT-scan measurement of the original femoral component was required. Knee balancing was achieved using spacer blocks, with the trial tibial component and the original femoral component still in place. Preliminary experience from 19 cases, some with severe bone loss requiring reconstruction, is reported. A retrospective comparison to 10 non-navigated revision cases performed concomitantly by the same operating surgeon was carried out. Although there was no significant difference in the number of outliers for the two series, navigation appeared to be a valuable aid in reconstructing both bone extremities, while controlling the level of the joint line. However, definitive validation requires further prospective and comparative investigations in larger series. PMID:18622792

  10. Total hip and knee replacement surgery results in changes in leukocyte and endothelial markers

    Directory of Open Access Journals (Sweden)

    Maclean Kirsty M

    2010-01-01

    Full Text Available Abstract Background It is estimated that over 8 million people in the United Kingdom suffer from osteoarthritis. These patients may require orthopaedic surgical intervention to help alleviate their clinical condition. Investigations presented here was to test the hypothesis that total hip replacement (THR and total knee replacement (TKR orthopaedic surgery result in changes to leukocyte and endothelial markers thus increasing inflammatory reactions postoperatively. Methods During this 'pilot study', ten test subjects were all scheduled for THR or TKR elective surgery due to osteoarthritis. Leukocyte concentrations were measured using an automated full blood count analyser. Leukocyte CD11b (Mac-1 and CD62L cell surface expression, intracellular production of H2O2 and elastase were measured as markers of leukocyte function. Von Willebrand factor (vWF and soluble intercellular adhesion molecule-1 (sICAM-1 were measured as markers of endothelial activation. Results The results obtained during this study demonstrate that THR and TKR orthopaedic surgery result in similar changes of leukocyte and endothelial markers, suggestive of increased inflammatory reactions postoperatively. Specifically, THR and TKR surgery resulted in a leukocytosis, this being demonstrated by an increase in the total leukocyte concentration following surgery. Evidence of leukocyte activation was demonstrated by a decrease in CD62L expression and an increase in CD11b expression by neutrophils and monocytes respectively. An increase in the intracellular H2O2 production by neutrophils and monocytes and in the leukocyte elastase concentrations was also evident of leukocyte activation following orthopaedic surgery. With respect to endothelial activation, increases in vWF and sICAM-1 concentrations were demonstrated following surgery. Conclusion In general it appeared that most of the leukocyte and endothelial markers measured during these studies peaked between days 1

  11. Significant Weight Loss May Delay or Eliminate the Need for Total Knee Replacement

    OpenAIRE

    Jeffrey H. DeClaire; Savich, Tatjana T.; B. S. Adrienne LeGasse Montgomery; Olayinka K. Warritay

    2014-01-01

    A 48-year-old morbidly obese woman with a left medial meniscal tear and moderately severe degenerative joint disease (DJD) reported for 14-month follow-up visit from arthroscopic surgery. She reported a resolution of pain, swelling and an improved range of motion (ROM). The patient was first evaluated 14 months ago, and at that time was considered a strong candidate for total knee replacement due to her limited (ROM), knee pain, swelling and functional impairment. At a 3 month visit prior to ...

  12. Concomitant ligamentous and meniscal injuries in floating knee

    OpenAIRE

    Liu, Ya; Jun ZHANG; Zhang, Shu; Li, Rui; Yue, Xianhu

    2015-01-01

    Background: To identify and characterize the concomitant ligamentous and meniscal injuries in floating knee. Methods: A total of 37 cases of floating knee were enrolled. Arthroscopic or open surgical examination of the knee, Lachman test, posterior drawer’s test, and varus and valgus stress tests under anesthesia were carried out to determine the incidence of knee injury. Results: Through arthroscopic and open surgical examinations, a medial meniscal tear was detected in 14 (37.8%) cases and ...

  13. Effects of sex and lower extremity alignment on orientation of the knee joint line in knee surgery

    Institute of Scientific and Technical Information of China (English)

    ZENG Yi-ming; WANG You; ZHU Zhen-an; DAI Ke-rong

    2012-01-01

    Background Determination of the proper orientation of the knee articular surface is required both for correction of knee malalignment by osteotomy and for correct component alignment in knee arthroplasty.We sought to determine whether the patients' sex and lower extremity alignment (hip-knee-ankle angle) affects proper knee realignment in osteotomy or component alignment in total knee arthroplasty.Methods We examined 199 healthy adult knees with malalignment of <5° to determine the mechanical medial distal femoral angle,mechanical medial proximal tibial angle,surgical transepicondylar axis angle,and discrepancies between bone-cut orientations of osteotomy or total knee arthroplasty and the joint line of the distal femoral condyles,posterior femoral condyles and proximal tibial plateaus,using a three-dimensional computed tomography model.Results The mean mechanical medial distal femoral angle and mean mechanical medial proximal tibial angle were (94.4±1.9)° and (87.6±1.8)° respectively for women and (93.8±2.0)° and (87.1±.1.4)° respectively for men.The surgical transepicondylar axis angle was (2.9±1.6)° for women and (3.2±1.7)° for men.Independent of sex,the hip-knee-ankle angle was closely related to the mechanical medial distal femoral angle and mechanical medial proximal tibial angle,but not to the surgical transepicondylar axis angle.A slightly more valgus alignment of the knee and a more valgus angulation of the distal femoral joint line were found in women,whereas a more varus angulation of the proximal tibial joint line was found in men.Sex had the greatest effect on knee joint line orientation when the lower extremity was valgus in alignment.Conclusions A more valgus femoral joint line can be expected in women and in persons with valgus lower extremity alignment; a more varus tibial joint line can be found in men and in persons with varus lower extremity alignment.

  14. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    OpenAIRE

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigate...

  15. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    OpenAIRE

    Gavin Nimon; Joby Malal; Anand Pillai; Vivek Eranki

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Resul...

  16. 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.

  17. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V;

    2012-01-01

    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...

  18. 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

  19. No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide

    Directory of Open Access Journals (Sweden)

    Lars Hållström

    2014-01-01

    Full Text Available Nitric oxide donors and inhaled nitric oxide (iNO may decrease ischemia/reperfusion injury as reported in animal and human models. We investigated whether the attenuation of reperfusion injury, seen by others, in patients undergoing knee arthroplasty could be reproduced when patients had spinal anesthesia. 45 consecutive patients were randomized into three groups (n=15. Groups 1 and 3 were receiving iNO 80 ppm or placebo (nitrogen, N2 throughout the entire operation, and group 2 only received iNO in the beginning and at the end of the operation. Blood samples were collected before surgery, at the end of the surgery, and 2 hours postoperatively. Muscle biopsies were taken from quadriceps femoris muscle before and after ischemia. There were no increases in plasma levels of soluble adhesion molecules: ICAM, VCAM, P-selectin, E-selectin, or of HMGB1, in any of the groups. There were low numbers of CD68+ macrophages and of endothelial cells expression of ICAM, VCAM, and P-selectin in the muscle analyzed by immunohistochemistry, prior to and after ischemia. No signs of endothelial cell activation or inflammatory response neither systemically nor locally could be detected. The absence of inflammatory response questions this model of ischemia/reperfusion, but may also be related to the choice of anesthetic method EudraCTnr.

  20. Femoral fracture following knee ligament reconstruction surgery due to an unpredictable complication of bioabsorbable screw fixation: a case report and review of literature

    OpenAIRE

    Konan, Sujith; Haddad, Fares Sami

    2009-01-01

    We report an unusual case of femoral fracture from minimal trauma, due to the rapid disappearance of a bioabsorbable interference screw used for reconstruction of the posterolateral corner of the knee. The literature on bone tunnel fractures following knee ligament reconstruction surgery is also reviewed.

  1. Tourniquet-Related Iatrogenic Femoral Nerve Palsy after Knee Surgery: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Juan Mingo-Robinet

    2013-01-01

    Full Text Available Purpose. Tourniquet-induced nerve injuries have been reported in the literature, but even if electromyography abnormalities in knee surgery are frequent, only two cases of permanent femoral nerve palsies have been reported, both after prolonged tourniquet time. We report a case of tourniquet-related permanent femoral nerve palsy after knee surgery. Case Report. We report a case of a 58-year-old woman who underwent surgical treatment of a patella fracture. Tourniquet was inflated to 310 mmHg for 45 minutes. After surgery, patient complained about paralysis of the quadriceps femoris with inability to extend the knee. Electromyography and nerve conduction study showed a severe axonal neuropathy of the left femoral nerve, without clinical remission after several months. Discussion. Even if complications are not rare, safe duration and pressure for tourniquet use remain a controversy. Nevertheless, subtle clinical lesions of the femoral nerve or even subclinical lesions only detectable by nerve conduction and EMG activity are frequent, so persistent neurologic dysfunction, even if rare, may be an underreported complication of tourniquet application. Elderly persons with muscle atrophy and flaccid, loose skin might be in risk for iatrogenic nerve injury secondary to tourniquet.

  2. Dashboard (in the) knee.

    Science.gov (United States)

    Patel, M S; Qureshi, A A; Green, T P

    2015-03-01

    We present the case of a 19-year-old individual presenting to an orthopaedic outpatient clinic several months following a dashboard knee injury during a road traffic accident with intermittent mechanical symptoms. Despite unremarkable examination findings and normal magnetic resonance imaging, the patient was identified subsequently as having an intra-articular plastic foreign body consistent with a piece of dashboard on arthroscopic knee assessment, the retrieval of which resulted in a complete resolution of symptoms. PMID:25723676

  3. Impact of general versus epidural anesthesia on early post-operative cognitive dysfunction following hip and knee surgery

    Directory of Open Access Journals (Sweden)

    Mandal Sripurna

    2011-01-01

    Full Text Available Background : Post-operative cognitive dysfunction is the subtle cerebral complication temporally seen following surgery. The aim of this study was to compare the influence of either general anesthesia (GA or epidural anesthesia (EA on the early post-operative neurocognitive outcome in elderly (>59 years subjects undergoing hip and knee surgery. Methods : A total of 60 patients were recruited in a prospective, randomized, parallel-group study, comparable by age and sex. They were enrolled and randomized to receive either EA (n = 30 or GA (n = 30. All of them were screened using the Mini Mental State Examination (MMSE, with components of the Kolkata Cognitive Screening Battery. The operated patients were re-evaluated 1 week after surgery using the same scale. The data collected were analyzed to assess statistical significance. Results : We observed no statistical difference in cognitive behavior in either group pre-operatively, which were comparable with respect to age, sex and type of surgery. Grossly, a significant difference was seen between the two groups with respect to the perioperative changes in verbal fluency for categories and MMSE scores. However, these differences were not significant after the application of the Bonferroni correction for multiple analyses, except the significant differences observed only in the MMSE scores. Conclusions : We observed a difference in cognitive outcome with GA compared with EA. Certain aspects of the cognition were affected to a greater extent in this group of patients undergoing hip and knee surgery.

  4. 关节镜及术后功能锻炼在膝关节疾病诊治中的应用%Application of arthroscope and postoperative functional exercises in diagnosis and treatment of knee joint diseases

    Institute of Scientific and Technical Information of China (English)

    兰玉平; 殷光义; 刘德明; 王立; 赵晨阳; 王川; 陈力; 唐湘君; 王英

    2002-01-01

    1 Subject and method 1.1 Subject A cohort of 78 patients (aged 12 to 77 averaged 43, 33 male and 45 female) were involved.23 left knees and 56 right knees were included.In these disease,there were 26 knees with hypertrophic arthritis,48 knees with meniscus injury,3 knees with synovium plica syndrome,4 knees with rheumatoid arthritis,2 knees with injury of anterior cruciate ligament, 1 knee with injury of posterior cruciate ligament, 2 knees with gout arthritis, and 2 knees with other diseases (such as congenital anomaly).

  5. Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation

    Directory of Open Access Journals (Sweden)

    Moharra Montse

    2008-04-01

    Full Text Available Abstract Background Prioritisation instruments were developed for patients on waiting list for hip and knee arthroplasties (AI and cataract surgery (CI. The aim of the study was to assess their convergent and discriminant validity and inter-observer reliability. Methods Multicentre validation study which included orthopaedic surgeons and ophthalmologists from 10 hospitals. Participating doctors were asked to include all eligible patients placed in the waiting list for the procedures under study during the medical visit. Doctors assessed patients' priority through a visual analogue scale (VAS and administered the prioritisation instrument. Information on socio-demographic data and health-related quality of life (HRQOL (HUI3, EQ-5D, WOMAC and VF-14 was obtained through a telephone interview with patients. The correlation coefficients between the prioritisation instrument score and VAS and HRQOL were calculated. For the reliability study a self-administered questionnaire, which included hypothetic patients' scenarios, was sent via postal mail to the doctors. The priority of these scenarios was assessed through the prioritisation instrument. The intraclass correlation coefficient (ICC between doctors was calculated. Results Correlations with VAS were strong for the AI (0.64, CI95%: 0.59–0.68 and for the CI (0.65, CI95%: 0.62–0.69, and moderate between the WOMAC and the AI (0.39, CI95%: 0.33–0.45 and the VF-14 and the CI (0.38, IC95%: 0.33–0.43. The results of the discriminant analysis were in general as expected. Inter-observer reliability was 0.79 (CI95%: 0.64–0.94 for the AI, and 0.79 (CI95%: 0.63–0.95 for the CI. Conclusion The results show acceptable validity and reliability of the prioritisation instruments in establishing priority for surgery.

  6. Knee Function Assessment in Patients With Meniscus Injury

    Science.gov (United States)

    Naimark, Micah B.; Kegel, Gary; O’Donnell, Thomas; Lavigne, Stephanie; Heveran, Chelsea; Crawford, Dennis C.

    2014-01-01

    Background: Outcomes of meniscus surgery are typically assessed with patient questionnaires that help capture symptoms and functional limitations but may not provide an accurate representation of underlying joint health. There are currently no performance-based measures of knee function in patients with symptomatic meniscus injury. Purpose: To assess the reproducibility, response to partial meniscectomy, and correlation with patient-reported questionnaire outcomes of novel performance-based knee function tests. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A battery of 9 tests for activities that require knee movements essential for everyday living was developed. Intra- and interrater reproducibility was assessed in 50 meniscus tear patients completing the battery at 2 preoperative assessments with either the same or different examiners. Response to arthroscopic partial meniscectomy was evaluated in 35 of these patients 6 weeks after surgery. Subjects also completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires pre- and postoperatively. Results: The intrarater intraclass correlation coefficients (ICCs) were excellent for all tests (ICC > 0.8). Interrater ICC > 0.8 was observed for step-down, stair descent, star lunges, and timed treadmill travel. Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent. A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%). Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4). Conclusion: Performance-based knee function tests demonstrated good reproducibility and responsiveness in patients undergoing partial meniscectomy. Clinical Relevance: As both patient perception and functional

  7. The Influence of Age at Single-Event Multilevel Surgery on Outcome in Children with Cerebral Palsy Who Walk with Flexed Knee Gait

    Science.gov (United States)

    Svehlik, Martin; Steinwender, Gerhard; Kraus, Tanja; Saraph, Vinay; Lehmann, Thomas; Linhart, Wolfgang E.; Zwick, Ernst B.

    2011-01-01

    Aim: Information on the timing and long-term outcome of single-event multilevel surgery in children with bilateral spastic cerebral palsy (CP) walking with flexed knee gait is limited. Based on our clinical experience, we hypothesized that older children with bilateral spastic CP would benefit more from single-event multilevel surgery than younger…

  8. Which is your choice for prolonging the analgesic duration of single-shot interscalene brachial blocks for arthroscopic shoulder surgery? intravenous dexamethasone 5 mg vs. perineural dexamethasone 5 mg randomized, controlled, clinical trial.

    Science.gov (United States)

    Chun, Eun Hee; Kim, Youn Jin; Woo, Jae Hee

    2016-06-01

    The aim of this study was to compare the effect of intravenous (I.V.) dexamethasone with that of perineural dexamethasone on the prolongation of analgesic duration of single-shot interscalene brachial plexus blocks (SISB) in patients undergoing arthroscopic shoulder surgery. We performed a prospective, randomized, double-blind, placebo-controlled study. Patients undergoing elective arthroscopic shoulder surgery with ultrasound-guided SISB were enrolled and randomized into 2 groups. A total volume of 12 mL of the study drug was prepared with a final concentration of 0.5% ropivacaine. In the I.V. group, patients received SISB using ropivacaine 5 mg mL with normal saline (control) with dexamethasone 5 mg I.V. injection. In the perineural group, patients received SISB using ropivacaine 5 mg mL with dexamethasone 5 mg, with normal saline 1 mL I.V. injection. The primary outcome was the time to the first analgesic request, defined as the time between the end of the operation and the first request of analgesics by the patient. The secondary outcomes included patient satisfaction scores, side effects, and neurological symptoms. Patients were randomly assigned to 1 of the 2 groups using a computer-generated randomization table. An anesthesiologist blinded to the group assignments prepared the solutions for injection. The patients and the investigator participating in the study were also blinded to the group assignments. One hundred patients were randomized. Data were analyzed for 99 patients. One case in the I.V. group was converted to open surgery and was therefore not included in the study. Perineural dexamethasone significantly prolonged analgesic duration (median, standard error: 1080 minutes, 117.5 minutes) compared with I.V. dexamethasone (810 minutes, 48.1 minutes) (P = 0.02). There were no significant differences in side effects, neurological symptoms, or changes in blood glucose values between the 2 groups. Our results show that perineural

  9. Rationale and design of XAMOS: noninterventional study of rivaroxaban for prophylaxis of venous thromboembolism after major hip and knee surgery

    Directory of Open Access Journals (Sweden)

    Turpie AG

    2012-06-01

    Full Text Available Alexander GG Turpie,1 André C Schmidt,2 Reinhold Kreutz,3 Michael R Lassen,4 Waheed Jama,1,2 Lorenzo Mantovani,5 Sylvia Haas61Department of Medicine, Hamilton Health Sciences, General Division, Ontario, Canada; 2Bayer Healthcare Pharmaceuticals, Global Development, Berlin, Germany; 3Institut für Klinische Pharmakologie und Toxikologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany; 4Department of Orthopaedics, Spine Clinic, Clinical Trial Unit, Hørsholm Hospital, University of Copenhagen, Hørsholm, Denmark; 5Faculty of Pharmacy, Federico II University of Naples, Naples, Italy; 6Institut für Experimentelle Onkologie und Therapieforschung, TU München, GermanyAbstract: Venous thromboembolism is a frequent and potentially life-threatening complication of orthopedic surgery. Rivaroxaban is an oral direct factor Xa inhibitor, which was shown to be effective for the prevention of venous thromboembolism after elective hip and knee arthroplasty in the RECORD study program. Rivaroxaban has the potential to overcome the limitations of the current standards of care in the prevention of venous thromboembolism. XAMOS (Xarelto® in the prophylaxis of post-surgical venous thromboembolism after elective major orthopedic surgery of hip or knee is an international, noninterventional, parallel-group study to gain insight into the safety (major bleeding, side effects and effectiveness (prevention of symptomatic thromboembolic events of rivaroxaban in daily clinical practice. XAMOS will follow 15,000 patients after major orthopedic surgery in approximately 200 centers worldwide, with about 7500 patients receiving rivaroxaban and about 7500 standard of care. XAMOS will supplement the clinical data obtained in the Phase III RECORD 1, 2, 3, and 4 trials in which rivaroxaban was shown to be superior for the primary efficacy endpoints, and with a safety profile similar to that of enoxaparin after hip or knee replacement surgery. XAMOS was

  10. Open Versus Arthroscopic Tennis Elbow Release

    Science.gov (United States)

    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

  11. Medial release and lateral imbrication for intractable anterior knee pain: diagnostic process, technique, and results

    Directory of Open Access Journals (Sweden)

    Meldrum AR

    2015-01-01

    Full Text Available Alexander R Meldrum,1 Jeremy R Reed,2 Megan D Dash3 1Department of Surgery, Section of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada; 2Department of Surgery, University of Saskatchewan College of Medicine, Regina, SK, Canada; 3Department of Family Medicine, College of Medicine, University of Saskatchewan, Regina, SK, Canada Purpose: To present two cases of intractable patellofemoral pain syndrome treated with a novel procedure, arthroscopic medial release, and lateral imbrication of the patellar retinaculum. Patients and methods: This case series presents the treatment of three knees in two patients (one bilateral in whom an all-inside arthroscopic medial release and lateral imbrication of the patellar retinaculum was performed. Subjective measurement of pain was the primary outcome measurement, and subjective patellofemoral instability was the secondary outcome measurement. Results: Subjectively the two patients had full resolution of their pain, without any patellofemoral instability. Conclusion: Medial release and lateral imbrication of the patellar retinaculum is a new surgical procedure that has been used in the treatment of intractable patellofemoral pain syndrome. This is the first report of its kind in the literature. While outcome measurements were less than ideal, the patients had positive outcomes, both functionally and in terms of pain. Keywords: anterior knee pain syndrome, chondromalacia patellae, runners knee, patellar chondropathy, patellofemoral dysfunction, patellofemoral tracking disorder

  12. Total Knee Replacement

    Science.gov (United States)

    ... following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other ... to the final success of your surgery. To learn more about the full value of total knee ...

  13. Osteotomy of the knee

    Science.gov (United States)

    ... is not affected unless you have had a knee injury in the past. Osteotomy surgery works by shifting ... M. Editorial team. Related MedlinePlus Health Topics Arthritis Knee Injuries and Disorders Browse the Encyclopedia A.D.A. ...

  14. 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

  15. 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;

  16. 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.

  17. 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...

  18. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2012-11-01

    Full Text Available Abstract Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1 comfortable health-related decision-makers; (2 unwavering in their views about procedure necessity and urgency; and (3 firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on

  19. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

    Science.gov (United States)

    2012-01-01

    Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes

  20. Traumatology of the knee joint - radiological and accident surgery aspects. Pt. 1

    International Nuclear Information System (INIS)

    Lesions of the knee joint are relatively frequent and are on the increase due to the increasing number of sports and traffic accidents. Violent force exercised on the knee can lead basically to two different kinds of injury sequels. As a rule, injuries to the bone do not present diagnostic problems if there is a clear break in continuity. On the other hand, it is often very difficult to detect chondral or osteochondral lesions and also certain types of longitudinal patellar fractures and fractures of the head of the tibia. Their visualisation requires more far-reaching diagnostic measures. Fundamentally more difficult to identify: the second group of lesions, namely, those of the internal structures of the knee, unless there is a marked instability which is usually accessible to clinical examination. Relatively slight osseous tears or ruptures of a ligament often remain unnoticed on the plain X-ray film. Other diagnostic techniques are imperative in such cases. The first part deals specifically with the radiological aspects of knee injuries. The majority of injuries close to the knee region can be visualized by making use of all techniques of roentgenology. However, if the examination methods get too costly and complicated without ensuring an absolutely safe diagnosis other techniques must be employed. An example in this regard are the chondral or osteochondral lesions. It is here that arthroscopy often yields better results while offering at the same time a possibility to remove individual small fragments. (orig.)

  1. Correlation between the result from arthroscopic reconstruction of the anterior cruciate ligament of the knee and the return to sports activity

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2014-06-01

    Full Text Available OBJECTIVE:To evaluate the return to pre-injury sports activity in a group of patients who underwent anterior cruciate ligament (ACL reconstruction, in relation to age, sex, body mass index (BMI and associations with upper-limb fractures.METHODS:A group of 265 patients who underwent ACL reconstruction using an ipsilateral graft from the thigh flexor tendons, between July 2000 and November 2007, was analyzed.RESULTS:A total of 176 patients was evaluated after a mean period of 34.95 ± 18.8 months (median: 31 months (interquartile range: 20-48 months. The minimum evaluation period was 12 months and the maximum was 87 months. The number of patients who returned to their sports activity prior to tearing the ACL was 121/176 (68.8%. Patients under 30 years of age more frequently returned to sports activity and this was considered significant: p = 0.016; odds ratio, OR = 0.44 (95% confidence interval, CI: 0.22-0.86. Returning to previous sports activity more frequently was not considered significant for male sex (p = 0.273, individuals with BMI < 25 (p = 0.280 or patients with an ACL injury unrelated to an initial traumatic episode with upper-limb fracturing (p = 0.353.CONCLUSIONS:The rate of return to the sports activity prior to ACL injury was 68.8%. It was found that patients under the age of 30 years had a significantly greater rate of return to sports activity after the surgery. In relation to sex, BMI and association with an initial traumatic episode of upper-limb fracturing, there was no statistical difference in the return to sports activity.

  2. Correlation between the result from arthroscopic reconstruction of the anterior cruciate ligament of the knee and the return to sports activity☆

    Science.gov (United States)

    Almeida, Alexandre; Valin, Márcio Rangel; Ferreira, Ramon; de Almeida, Nayvaldo Couto; Agostini, Ana Paula

    2014-01-01

    Objective To evaluate the return to pre-injury sports activity in a group of patients who underwent anterior cruciate ligament (ACL) reconstruction, in relation to age, sex, body mass index (BMI) and associations with upper-limb fractures. Methods A group of 265 patients who underwent ACL reconstruction using an ipsilateral graft from the thigh flexor tendons, between July 2000 and November 2007, was analyzed. Results A total of 176 patients was evaluated after a mean period of 34.95 ± 18.8 months (median: 31 months) (interquartile range: 20–48 months). The minimum evaluation period was 12 months and the maximum was 87 months. The number of patients who returned to their sports activity prior to tearing the ACL was 121/176 (68.8%). Patients under 30 years of age more frequently returned to sports activity and this was considered significant: p = 0.016; odds ratio, OR = 0.44 (95% confidence interval, CI: 0.22–0.86). Returning to previous sports activity more frequently was not considered significant for male sex (p = 0.273), individuals with BMI < 25 (p = 0.280) or patients with an ACL injury unrelated to an initial traumatic episode with upper-limb fracturing (p = 0.353). Conclusions The rate of return to the sports activity prior to ACL injury was 68.8%. It was found that patients under the age of 30 years had a significantly greater rate of return to sports activity after the surgery. In relation to sex, BMI and association with an initial traumatic episode of upper-limb fracturing, there was no statistical difference in the return to sports activity. PMID:26229807

  3. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Harald; Silbernagel, Karin; Thomeé, Roland; Roos, Ewa

    2008-01-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up...... to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with...... least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the...

  4. 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.

  5. Results of Adjusted-Dose Heparin for Thromboembolism Prophylaxis in Knee Replacement Compared to Those Found for its Use in Hip Fracture Surgery and Elective Hip Replacement

    OpenAIRE

    Yen, David; Weiss, William

    2007-01-01

    The purpose of this study was to compare the results of adjusted-dose heparin (ADH) in the prevention of thromboembolism in knee replacement with those obtained for its use hip fracture surgery and elective hip replacement. Ultrasound was used to diagnose deep vein thrombosis (DVT) and ventilation/perfusion (V/Q) scan to diagnose pulmonary embolus (PE).

  6. Knee joint replacement

    Science.gov (United States)

    Knee joint replacement is a surgery to replace a knee joint with a man-made joint. The artificial joint is called a prosthesis . ... cartilage and bone are removed from the knee joint. Man-made pieces are then placed in the ...

  7. 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.

  8. Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ilias Apostolos

    2011-08-01

    Full Text Available Abstract Introduction Large ganglionic cystic formations arising from the infrapatellar fat pad are quite uncommon and only a few are mentioned in the literature. An open excision in these cases is mandatory. Case presentation We report the case of a large infrapatellar fat pad ganglion in a 37-year-old Greek man with chronic knee discomfort. The ganglionic cyst originated from the infrapatellar fat pad and had no intrasynovial extension. The final diagnosis was determined with magnetic resonance imaging of the knee, and the lesion was treated with surgery. Conclusions These lesions are asymptomatic in most cases but often are misdiagnosed as meniscal or ligamentous lesions of the knee joint. Nowadays, the therapeutic trend for such lesions is arthroscopic excision, but when there is a large ganglion, as in this case report, the treatment should be an open and thorough resection. This report is intended mostly but not exclusively for clinical physicians and radiologists.

  9. Injuries to the Posterior Cruciate Ligament and Posterolateral Instabilities of the Knee

    Directory of Open Access Journals (Sweden)

    Ching-Jen Wang

    2002-05-01

    Full Text Available Unlike anterior cruciate ligament (ACL injury, disability from isolated posterior cruciateligament (PCL injury varies from no interference with life style to severe impairment ofdaily activities. Therefore, management of isolated PCL injuries remains controversial.High-energy vehicular accidents often cause more-serious PCL injuries, while less-severeinjuries result from low-energy trauma including sports. The natural history and prognosis ofPCL injury are correlated with the type and extent of instability and the development ofdegenerative changes in the knee. Indications for surgery include pain and instability of theknee.Arthroscopic single-bundle PCL reconstruction improved the function and stability ofthe knee with 77.4% satisfactory results in medium-term follow-up. Complete restoration ofligament stability was achieved in only 52% of knees, while 1/3 of the knees showed mildand 9.7% showed moderate residual ligament laxity. The incidence of degenerative changeswas 52%, and the rate was correlated with duration of injury and severity of ligament laxity.Therefore, the significance of PCL injury has been overly simplified, and the functional disabilityof knees with PCL injury underestimated. Early surgical reconstruction of knees withgrade III PCL injury is recommended.PCL injury is frequently associated with multiple ligamentous injuries. Combined PCLand posterolateral instabilities are serious knee injuries and frequently result in severe functionaldisability due to pain, instability, and degenerative changes in the knee. Unlike isolatedPCL injury, there is a consensus of opinion that surgical reconstruction is indicated inknees with combined PCL and posterolateral instabilities. Commonly employed methods ofreconstruction of the posterolateral corner include popliteus reconstruction, lateral collateralreconstruction or advancement, and a combination of the two. Combined arthroscopic PCLreconstruction and posterolateral reconstruction

  10. Analysis of Joint Sounds in the Diagnosis of Knee Disorders

    Science.gov (United States)

    2015-07-22

    Healthy Patients; No Knee Complaints; No Knee Injuries; No Knee Surgeries; No Neurological Problems; Patients Undergoing Knee Arthroscopy, Who Has a Pre-op MRI; Age Groups of 20,40 and 60 Years of Age.

  11. Significant Weight Loss May Delay or Eliminate the Need for Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Jeffrey H. DeClaire

    2014-01-01

    Full Text Available A 48-year-old morbidly obese woman with a left medial meniscal tear and moderately severe degenerative joint disease (DJD reported for 14-month follow-up visit from arthroscopic surgery. She reported a resolution of pain, swelling and an improved range of motion (ROM. The patient was first evaluated 14 months ago, and at that time was considered a strong candidate for total knee replacement due to her limited (ROM, knee pain, swelling and functional impairment. At a 3 month visit prior to her initial evaluation the patient voluntarily enrolled in a nutritional and exercise program overseen by a licensed personal trainer and kinesiologist. At her final evaluation 14 months later, it was noted that in addition to her improved knee symptoms, the patient lost 15% of her initial bodyweight and exhibited significant gains in quadriceps strength. Her clinical exam and imaging suggested an arrest of progression of her joint disease. It was decided mutually by the patient and physician that she was no longer a candidate for total knee replacement surgery. Although the association between her weight loss and her knee DJD can only be hypothesized, this case report may highlight the need to discuss weight loss as an alternative treatment modality for end stage DJD.

  12. Significant weight loss may delay or eliminate the need for total knee replacement.

    Science.gov (United States)

    DeClaire, Jeffrey H; Savich, Tatjana T; Montgomery, B S Adrienne LeGasse; Warritay, Olayinka K

    2014-05-01

    A 48-year-old morbidly obese woman with a left medial meniscal tear and moderately severe degenerative joint disease (DJD) reported for 14-month follow-up visit from arthroscopic surgery. She reported a resolution of pain, swelling and an improved range of motion (ROM). The patient was first evaluated 14 months ago, and at that time was considered a strong candidate for total knee replacement due to her limited (ROM), knee pain, swelling and functional impairment. At a 3 month visit prior to her initial evaluation the patient voluntarily enrolled in a nutritional and exercise program overseen by a licensed personal trainer and kinesiologist. At her final evaluation 14 months later, it was noted that in addition to her improved knee symptoms, the patient lost 15% of her initial bodyweight and exhibited significant gains in quadriceps strength. Her clinical exam and imaging suggested an arrest of progression of her joint disease. It was decided mutually by the patient and physician that she was no longer a candidate for total knee replacement surgery. Although the association between her weight loss and her knee DJD can only be hypothesized, this case report may highlight the need to discuss weight loss as an alternative treatment modality for end stage DJD. PMID:24932398

  13. Arthritic Pain Relief through Partial Knee Replacement

    Medline Plus

    Full Text Available ... to a full knee replacement, what are the risks of stiffness with a partial knee replacement? Yeah, also known as arthrofibrosis for the doctors out there, knee surgery has a very - on average a pretty high ...

  14. Bicompartmental knee arthroplasty

    OpenAIRE

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect o...

  15. 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

  16. Comparative safety and efficacy of antithrombotics in the management of venous thromboembolism after knee or hip replacement surgery: focus on rivaroxaban

    Directory of Open Access Journals (Sweden)

    Kwong LM

    2013-08-01

    Full Text Available Louis M KwongDepartment of Orthopedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USAAbstract: Routine thromboprophylaxis represents the current standard of care in the management of patients following total hip or knee replacement. Legacy agents used to address the issue of risk of venous thromboembolism present barriers to use, either by the need for monitoring and dose adjustment (warfarin or the need for injection (low molecular weight heparins and fondaparinux, or pose a risk of upper gastrointestinal bleeding (acetylsalicylic acid and all antithrombotic agents. The introduction of new pharmacologic agents in recent years has sought to address the issues of not only efficacy, but also safety, ease of use, and patient compliance. New orally administered agents, ie, apixaban, dabigatran, and rivaroxaban, have demonstrated various degrees of efficacy over enoxaparin while preserving safety. Indirect comparisons of the relative efficacies of apixaban, dabigatran, and rivaroxaban have shown rivaroxaban to be more efficacious than dabigatran and apixaban in reducing symptomatic and total venous thromboembolism following total hip or knee replacement surgery. A pooled analysis of the four RECORD (Regulation of Coagulation in Orthopedic Surgery to Prevent deep vein thrombosis and pulmonary embolism trials (two in total hip replacement and two in total knee replacement demonstrated rivaroxaban to be the first and only antithrombotic agent ever to demonstrate superiority in reducing symptomatic venous thromboembolism and all-cause mortality compared with another antithrombotic agent (enoxaparin. New oral antithrombotic agents have demonstrated efficacy in prophylaxis against venous thromboembolism following total hip or knee replacement surgery while preserving safety, with increased ease of administration of thromboprophylaxis for both the patient and the physician, which may contribute to improved compliance.Keywords: thromboprophylaxis

  17. 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...

  18. Orthopedic disorders of the knee in hemophilia: A current concept review

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-01-01

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  19. Orthopedic disorders of the knee in hemophilia: A current concept review.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; Valentino, Leonard A

    2016-06-18

    The knee is frequently affected by severe orthopedic changes known as hemophilic arthropathy (HA) in patients with deficiency of coagulation factor VIII or IX and thus this manuscript seeks to present a current perspective of the role of the orthopedic surgeon in the management of these problems. Lifelong factor replacement therapy (FRT) is optimal to prevent HA, however adherence to this regerous treatment is challenging leading to breakthrough bleeding. In patients with chronic hemophilic synovitis, the prelude to HA, radiosynovectomy (RS) is the optimal to ameliorate bleeding. Surgery in people with hemophilia (PWH) is associated with a high risk of bleeding and infection, and must be performed with FRT. A coordinated effort including orthopedic surgeons, hematologists, physical medicine and rehabilitation physicians, physiotherapists and other team members is key to optimal outcomes. Ideally, orthopedic procedures should be performed in specialized hospitals with experienced teams. Until we are able to prevent orthopedic problems of the knee in PWH will have to continue performing orthopedic procedures (arthrocentesis, RS, arthroscopic synovectomy, hamstring release, arthroscopic debridement, alignment osteotomy, and total knee arthroplasty). By using the aforementioned procedures, the quality of life of PWH will be improved. PMID:27335812

  20. Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

    Science.gov (United States)

    Pillai, Anand; Eranki, Vivek; Malal, Joby; Nimon, Gavin

    2012-01-01

    Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression. PMID:22649740

  1. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... Institute. We're going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing ... this point. And there is many recipes for MIS knee surgery as there are surgeons. What’s kind ...

  2. Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

    OpenAIRE

    Messeha, Medhat M.

    2016-01-01

    Background: Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries. Patients and Methods: Ninety patients who were undergoing electi...

  3. Financial analysis of revision knee surgery based on NHS tariffs and hospital costs: does it pay to provide a revision service?

    Science.gov (United States)

    Kallala, R F; Vanhegan, I S; Ibrahim, M S; Sarmah, S; Haddad, F S

    2015-02-01

    Revision total knee arthroplasty (TKA) is a complex procedure which carries both a greater risk for patients and greater cost for the treating hospital than does a primary TKA. As well as the increased cost of peri-operative investigations, blood transfusions, surgical instrumentation, implants and operating time, there is a well-documented increased length of stay which accounts for most of the actual costs associated with surgery. We compared revision surgery for infection with revision for other causes (pain, instability, aseptic loosening and fracture). Complete clinical, demographic and economic data were obtained for 168 consecutive revision TKAs performed at a tertiary referral centre between 2005 and 2012. Revision surgery for infection was associated with a mean length of stay more than double that of aseptic cases (21.5 vs 9.5 days, p tariffs do not fully reimburse the increased costs of providing a revision knee surgery service. Moreover, especially as greater costs are incurred for infected cases. These losses may adversely affect the provision of revision surgery in the NHS. PMID:25628282

  4. Rivaroxaban: a review of its use for the prophylaxis of venous thromboembolism after total hip or knee replacement surgery.

    Science.gov (United States)

    Duggan, Sean T

    2012-02-01

    Rivaroxaban (Xarelto®), an oral oxazolidinone-based anticoagulant, is a potent, selective, direct inhibitor of factor Xa that is used in the prevention of venous thromboembolism (VTE) in adult patients after total hip replacement (THR) or total knee replacement (TKR) surgery. In large, clinical trials, oral rivaroxaban 10 mg once daily was more effective than subcutaneous enoxaparin 40 mg once daily in preventing postoperative VTE in patients undergoing THR or TKR surgery. Rivaroxaban was associated with significantly lower incidences of the primary endpoint, total VTE (composite of deep vein thrombosis, non-fatal pulmonary embolism, or death from any cause) compared with enoxaparin regimens across all studies. For example, in the largest trial in patients undergoing THR, total VTE occurred in 1.1% of rivaroxaban recipients and 3.7% of enoxaparin recipients (absolute risk reduction 2.6% [95% CI 1.5, 3.7]) in the modified intent-to-treat population. Notably, the greater efficacy of rivaroxaban was achieved without a significant increase in the incidence of major bleeding episodes compared with enoxaparin; bleeding events were the most frequently reported adverse events across clinical trials. Pyrexia, vomiting, nausea, and constipation were the most frequently reported of the non-bleeding treatment-emergent adverse events in rivaroxaban recipients and occurred at a similar rate to that with enoxaparin treatment. In addition, preliminary pharmacoeconomic analyses in Canada and the US indicate that rivaroxaban is a cost-saving treatment strategy versus enoxaparin. Although the position of rivaroxaban relative to other therapies remains to be fully determined, it is an effective option for the prophylaxis of VTE following THR and TKR. PMID:22272729

  5. MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions

    International Nuclear Information System (INIS)

    The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5 %, a specificity of 98.6 %, and an accuracy of 93.8 %. Extended-knee MR images indicated a sensitivity of 81.5 %, a specificity of 92.9 %, and an accuracy of 89.7 %. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet. (orig.)

  6. Impact of postoperative functional exercise on recovery of knee joint following knee arthroscopic meniscectomy%术后功能锻炼对膝关节镜下半月板部分切除术后关节功能恢复的作用

    Institute of Scientific and Technical Information of China (English)

    王健; 张伟; 孙水

    2003-01-01

    @@ INTRODUCTION It is well known that semilunar plate is capable of conducting load, absorbing concussion, stablilizing knee joit. Semilunar plate can conduct 40% -60% of load, increase contact area, and reduce pressure endured by cartilage of knee joint.

  7. 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.

  8. Synovial Hemangioma in the Knee: MRI Findings

    Directory of Open Access Journals (Sweden)

    Harun Arslan

    2015-01-01

    Full Text Available Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.

  9. Arthroscopic tibiotalar and subtalar joint arthrodesis.

    Science.gov (United States)

    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

  10. Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction

    Czech Academy of Sciences Publication Activity Database

    Machoň, V.; Šedý, Jiří; Klíma, K.; Hirjak, D.; Foltán, R.

    2012-01-01

    Roč. 41, č. 1 (2012), s. 109-113. ISSN 0901-5027 R&D Projects: GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant ostatní: GA MŠk(CZ) 1M0538 Institutional research plan: CEZ:AV0Z50390703 Keywords : temporomandibular joint * arthroscopic lysis * arthroscopic lavage Subject RIV: FJ - Surgery incl. Transplants Impact factor: 1.521, year: 2012

  11. Diagnostic performance of CUBE MRI sequences of the knee compared with conventional MRI

    International Nuclear Information System (INIS)

    Aim: To evaluate the efficacy and efficiency of three-dimensional (3D) fast spin-echo (FSE) with variable flip angle (“CUBE”) magnetic resonance imaging (MRI) in knee imaging as compared with conventional MRI. Materials and methods: Twenty-nine patients (single knee) with joint injuries of varying degrees were enrolled in this study between January, 2011 and December, 2011. All patients underwent conventional MRI and a fat-suppressed CUBE MRI sequence. All patients subsequently underwent knee arthroscopic surgery performed by an experienced orthopaedic surgeon within 2 weeks after the MRI examinations. With standard reference provided by arthroscopic results, the sensitivity, specificity, and accuracy of both the CUBE and conventional MRI techniques were calculated for detecting cartilage lesions, meniscus tears, and anterior cruciate ligament injuries, respectively. A chi-square test was used for statistical analysis with a level of significance of p < 0.05. Results: For the evaluation of articular cartilage lesions, the CUBE sequence had higher sensitivity (70.9% versus 50.6%, p < 0.01), higher specificity (72.6% versus 58.9%, p < 0.05), and higher accuracy (71.8% versus 55.2%, p = 0.001) than conventional MRI. For the evaluation of meniscus tears, CUBE and conventional MRI had similar sensitivity, specificity, and accuracy (p = 0.20–0.55). Similarly, there was no significant difference in sensitivity, specificity, or accuracy between CUBE imaging and conventional imaging in the detection of anterior cruciate ligament injuries (p = 0.13–0.65). Conclusion: CUBE MRI has similar or superior sensitivity, specificity, and accuracy to a conventional imaging protocol in the comprehensive evaluation of knee joint injuries.

  12. 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.

  13. Runner's Knee

    Science.gov (United States)

    ... Without Pain? Jumper's Knee Knee Injuries Anterior Cruciate Ligament (ACL) Injuries Knee Injury: Caroline's Story Medial Collateral Ligament (MCL) Injuries Sports and Exercise Safety Repetitive Stress Injuries Bursitis ...

  14. 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

  15. Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery

    Directory of Open Access Journals (Sweden)

    Recep Aksu

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine. METHODS: In the first group of patients 20 mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB were applied, while 20 mL 0.25% bupivacaine was given via intra-articular (IA administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA with morphine was used in all three groups for postoperative analgesia. RESULTS: In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24 h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6 h and the same was true for total morphine consumption in 24 h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2 h and lower than the control group in the 4th and 6th hours (p < 0.05. In the IA group, VASr and VASm scores in the 2nd, 4th and 6th hours were lower than in the control group (p < 0.05. CONCLUSION: Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.

  16. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Nasir; Shepel, Michael; Leswick, David A.; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Royal University Hospital, and College of Medicine, Saskatoon, Saskatchewan (Canada)

    2014-04-15

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  17. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee?

    International Nuclear Information System (INIS)

    The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings. (orig.)

  18. Arthrodiatasis for management of knee osteoarthritis.

    Science.gov (United States)

    Aly, Tarek A; Hafez, Kamal; Amin, Osama

    2011-08-01

    Osteoarthritic disease is the result of mechanical and biological events that destabilize the normal processes of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. Osteoarthritis of the knee can cause symptoms ranging from mild to disabling. Initial management of most patients should be nonoperative, but because of the progressive nature of the disease, many patients with osteoarthritis of the knee eventually benefit from operative treatment. Various procedures have been described for treatment of the osteoarthritic knee, ranging from arthroscopic lavage and debridement to total knee arthroplasty. The aim of this study was to evaluate the clinical results of distraction arthroplasty combined with arthroscopic lavage and drilling of cartilage defects for treatment of osteoarthritis of the knee. Nineteen patients (15 women and 4 men; age range, 39-65 years) were operated on. Pre- and postoperative findings were compared. A control group comprising 42 patients treated with only arthroscopic procedures was evaluated for comparison. Follow-up ranged from 3 to 5 years. Results were evaluated both clinically and radiologically postoperatively and throughout the follow-up period. Clinically, pain and walking capacity improved in most patients. Radiologically, joint space widening and improvement of the tibiofemoral angle was noted in nearly all patients. PMID:21815573

  19. Arthroscopic treatment for chronic lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. Arthroscopic findings in patients with painful wrist ganglia.

    Science.gov (United States)

    Povlsen, B; Peckett, W R

    2001-09-01

    The aetiology of painful dorsal wrist ganglia remains obscure. In a prospective study we investigated the link between a painful dorsal wrist ganglion and wrist joint abnormality with wrist arthroscopy before excision of the ganglion. Of 16 wrists arthroscoped 12 were abnormal, 10 had an abnormal scapholunate joint, and two had abnormal lunatetriquetral joints. We think that painful dorsal wrist ganglia, like popliteal cysts in the knee, are markers of underlying joint abnormalities. Surgeons who treat painful ganglia should be aware of a possible underlying cause so that they can target treatment more accurately, particularly in recurrent cases and those patients with persistent wrist pain after excision of the ganglion. PMID:11680404

  2. The diagnostic value of the early rheumatoid arthritis classification criteria and clinical efficacy of knee arthroscopic synovectomy for early RA%膝关节镜滑膜切除术对早期类风湿关节炎分类标准诊断价值的评估及疗效分析

    Institute of Scientific and Technical Information of China (English)

    蒋煜青; 黄健; 郭伟康; 武兴国; 赖兵

    2015-01-01

    目的 评估早期类风湿关节炎(RA)分类标准对早期RA分类诊断的价值,同时对膝关节镜滑膜切除术治疗早期RA的临床疗效进行分析.方法 对62例具有明确关节炎表现、年龄>16岁、病程<1年的患者行膝关节镜滑膜切除术,术后结合滑膜形态改变及病理、生化免疫学检验和影像MRI检查明确RA诊断,与术前早期RA诊断比较.于术后第3个月、1年后分两次随访,比较治疗前后HAQ评分、Lysholm评分、血沉(ESR)、C反应蛋白(CRP)等指标.结果 早期RA分类标准对RA诊断的敏感性81.58%、特异性91.67%.38例RA患者及24例非RA患者术后第3个月及1年后各项指标与术前相比均明显改善,差异有统计学意义(P<0.01).RA患者术后第3个月与术后1年组间所有指标差异均有统计学意义(均P<0.01).结论 早期RA分类标准简便、实用,有利于RA早期诊断,值得临床应用.RA诊断明确后应早期行膝关节镜滑膜切除术,可有效缓解患膝症状、改善功能,提高患者生活质量,改善全身健康状况,且能打断RA病理进程,有效维持术后疗效.%Objective To evaluate the diagnostic value of the early rheumatoid arthritis (RA) classification criteria for early RA and to assess the clinical efficacy of knee arthroscopic synovectomy for RA.Methods A total of 62 patients who had arthritic complaints with disease duration less than one year were treated with knee arthroscopic synovectomy.Patients were diagnosed as RA confirmed by changes of synoviomorphous under arthroscopy,synovial biopsy,immunological biochemical laboratory and MRI,and compared with the preoperative ERA diagnosis.The efficacy was assessed at the third months and more than 12 months after operation,including Health Assessment Questionnaire (HAQ),Lysholm score,laboratory parameters of erythrocyte sedi-mentation rate (ESR) and C-reactive protein (CRP).Results The sensitivity and specificity in the early RA classification criteria

  3. Usefulness of the anterior surface and supracondylar region of the femur as a landmark for femoral rotational alignment in knee surgery

    International Nuclear Information System (INIS)

    We investigated the possibility that a line tangential to the anterior surface of the femur could serve as a landmark for rotational alignment of the femoral component in total knee arthroplasty (TKA). The subjects were 37 women treated with TKA for medial knee osteoarthritis. Before surgery X-ray films and computed tomography scans were obtained. The three axes -the posterior condylar axis, the transepicondylar axis, and the anterior surface at the supracondyle- were constructed on each CT scan, and the angles between two axes were measured with the X-Caliper system. The results obtained from 35 subjects showed that the angle between the transepicondylar axis and the posterior condylar axis ranged from 3.1 to 10.7 degrees and bad a mean value of 6.35±1.93 degrees. The angle between the transepicondylar axis and the anterior femoral surface at the supracondyle ranged from 6.1 to 15.4 degrees and had a mean value of 11.21±2.48 degrees. The anterior surface was internally rotated relative to the posterior condylar axis in all cases, and its value indicated the degree of anterolateral notching. The anterior femoral surface at the supracondylar level is easy to identify during surgery. Thus, it may be a useful landmark for determining the correct rotational alignment of the femoral component in TKA. (author)

  4. Therapeutic potential of rivaroxaban in the prevention of venous thromboembolism following hip and knee replacement surgery: a review of clinical trial data

    Directory of Open Access Journals (Sweden)

    Kwong LM

    2011-07-01

    Full Text Available Louis M KwongDepartment of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, USAAbstract: Rivaroxaban (Bayer AG, Leverkusen, Germany is a highly selective direct inhibitor of factor Xa. It has completed Phase III clinical trials evaluating its efficacy and safety against enoxaparin in the prophylaxis against venous thromboembolism (VTE in orthopedic patients following primary total hip and total knee arthroplasty. Rivaroxaban has been extensively studied worldwide in 12,729 patients in the Regulation of Coagulation in Major Orthopedic Surgery Reducing the Risk of DVT and PE (RECORD program. Pivotal clinical trials have demonstrated the superior efficacy in reducing total VTE in comparison with both the North American and European regimens of enoxaparin. Safety of the drug was found to be excellent, with no demonstrable cardiovascular or hepatic effects and no statistically significant increase in major bleeding. A pooled analysis of data collected on the patients from the four RECORD trials revealed rivaroxaban to be the first antithrombotic agent to demonstrate superiority over another antithrombotic (enoxaparin in reducing symptomatic VTE and all-cause mortality. While there was a significant difference in the composite safety endpoint of major and clinically relevant nonmajor bleeding in the pooled analysis with the use of rivaroxaban compared with enoxaparin, there was no significant difference in major bleeding or in any other bleeding.Keywords: rivaroxaban, venous thromboembolism, hip replacement, knee replacement

  5. Intraoperative Low-Dose Ketamine Infusion Reduces Acute Postoperative Pain Following Total Knee Replacement Surgery: A Prospective, Randomized Double-Blind Placebo-Controlled Trial

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. Study Design: A randomized, double-blind comparative study. Place and Duration of Study: Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Methodology: Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6.25 g/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Results: Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Conclusion: Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects. (author)

  6. Arthroscopic hip labral repair.

    Science.gov (United States)

    Philippon, Marc J; Faucet, Scott C; Briggs, Karen K

    2013-05-01

    Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature. PMID:23875153

  7. 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...

  8. Revision Knee Surgery

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  11. Revision Knee Surgery

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  14. Revision Knee Surgery

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    Full Text Available ... abbreviated surgical technique. These instruments allow us to use the LCCK implants, which have a long-term ... appear to be big enough to necessitate the use of trabecular metal cones. I think we should ...

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  17. Revision Knee Surgery

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  1. Revision Knee Surgery

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    Full Text Available ... or wrong, is kind of a standard low molecular weight heparin, which we began within the 12 to ... patient, I’ll put them on a low molecular weight Heparin. My preference is Arixtra. It seems to ...

  2. Revision Knee Surgery

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    Full Text Available ... defect, but it doesn’t appear to be big enough to necessitate the use of trabecular metal ... little of bone anteriorly but not getting into big bone resections posteriorly. The nice thing about that ...

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    Full Text Available ... I’ll tell you about the case. The patient is SJ, a 64-year-old female, five- ... use the titanium augments. If it’s a younger patient, I’ll use the tantalum augment if I ...

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The anesthesiologists do a great job with the spinals and a single shot of ...

  6. Revision Knee Surgery

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    Full Text Available ... so three plus two is five, and that’s what your augment is going to be. Yeah. And of ... t want to cement to that. Rongeur. So what’s your post-op pain protocol? We heard from an ...

  7. Revision Knee Surgery

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    Full Text Available ... get rid of some of this really poor quality bone. Oops, let’s try that again. Again, I’ ... diabetic. Those thing contribute the over all tissue quality and turgor. I think she’ll have more ...

  8. Revision Knee Surgery

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    Full Text Available ... re going to put her through this aggressive physical therapy. She’s going to do more than she’s done ... them something to do to contribute to their rehabilitation and recovery. Well, Raj, I’d like to ...

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    Full Text Available ... 31, 2010 Welcome to this OR Live webcast presentation, brought to you by Zimmer from JFK Memorial ... Todd. Thanks for watching this OR Live webcast presentation brought to you by Zimmer from JFK Memorial ...

  10. Revision Knee Surgery

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    Full Text Available ... I cement the base plate in the metaphyseal region, I don’t mind if there’s a little ... stem. I’m going to cement the metaphyseal region. So you can see that engaged very nicely. ...

  11. Revision Knee Surgery

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    Full Text Available ... extension there. And my joint line is pretty far proximal, so I want to do some work ... either way. If my femoral component was too far translated laterally, for example, then I could have ...

  12. Revision Knee Surgery

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    Full Text Available ... in flexion and extension, you know the traditional teaching is you change the tibia. So if we ... Again, you know, when I was in academic practice like you, I saw a lot more disaster- ...

  13. Revision Knee Surgery

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    Full Text Available ... in flexion and extension, you know the traditional teaching is you change the tibia. So if we ... two years. So it kind of sets the stage for their expectation to be tempered, I think. ...

  14. Revision Knee Surgery

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    Full Text Available ... or CCK later on. And again, that’s the beauty of this system. You basically select whatever level ... All at once. All about time. Well the beauty of Halicos [PH] too, is that you’ve ...

  15. Revision Knee Surgery

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    Full Text Available ... they’re actually able to get bacterial DNA -- RNA and DNA from the surface of the prosthesis. ... is important in terms of getting their muscle function back. Well I agree with you. If I’ ...

  16. Revision Knee Surgery

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    Full Text Available ... know, I think there’s a lot of low-grade staff epi or something going on in these ... wounds unless I’m trying to capture the blood for reinfusion purposes. I’m glad to hear ...

  17. Revision Knee Surgery

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    Full Text Available ... years ago, she started developing pain with weight bearing. X-rays taken at that time were initially ... get our patients up and moving, full weight bearing right away. And you want to comment on ...

  18. Revision Knee Surgery

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    Full Text Available ... you just want a base that you can build your joint off of. That’s right. And obviously ... I establish my tibial plateau and I then build everything from there, so flexion gap, extension gap, ...

  19. Revision Knee Surgery

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    Full Text Available ... and finally, to the segmental system. At this time, I would like to introduce Mr. Raj Sinha ... with weight bearing. X-rays taken at that time were initially interpreted as being well fixed and ...

  20. Revision Knee Surgery

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    Full Text Available ... line itself and what we’re trying to protect. Obviously if we have any type of augmentation, ... to that, then that obviously has to be protected also to promote either in-growth. And then ...

  1. Revision Knee Surgery

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    Full Text Available ... I think it’s very important to do your examination while the patient’s anesthetized to see what the ... her for that, you know, and our whole education program from here on out is going to ...

  2. Revision Knee Surgery

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    Full Text Available ... macromotion in fragmenting the cement is probably the cause of it. Which has led to the lysis. ... in these those regions that are going the cause premature failures. And you’re right, the registry ...

  3. Revision Knee Surgery

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    Full Text Available ... to collapsed into varus. There are some other issues besides the loosening of the tibia that if ... think we’re going to run into several issues here, in addition to the bone stock loss, ...

  4. Revision Knee Surgery

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    Full Text Available ... inert. It’s faster. And are you a big therapy guy? Yeah, I believe in therapy. I believe in therapy for a couple reasons. One is, you know, ... become more debilitated. And so I think the therapy is important in terms of getting their muscle ...

  5. Revision Knee Surgery

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    Full Text Available ... a zero-degree cut, primarily because think it preserves a lot more bone by taking away a ... than a what technique? Mongrel. Just kind of wild mix of everything. All right. So what do ...

  6. Revision Knee Surgery

    Science.gov (United States)

    ... I think, is when you’re reaming the femur, you’ll notice I’m putting my fingers around the shaft of the bone and shooting down the middle. Because the angle of the femoral component is fixed, you want ...

  7. Revision Knee Surgery

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    Full Text Available ... I think, is when you’re reaming the femur, you’ll notice I’m putting my fingers around the shaft of the bone and shooting down the middle. Because the angle of the femoral component is fixed, you want ...

  8. Revision Knee Surgery

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    Full Text Available ... diathesis. And then if I get into a large diameter stem like a 20 or a 22, ... what you said, Raj, these defects are so large it’s almost difficult to customize broaches to anticipate ...

  9. Revision Knee Surgery

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    Full Text Available ... take that. Raj, just while you’re getting exposure there, I’d like to promote the participants. ... about 25 minutes or so in terms of exposure, then I’ll just convert to a rectus ...

  10. Revision Knee Surgery

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    Full Text Available ... and across the table from me, Allen Tiarina [PH], Angie Weems [PH], and to my right, Roya Royo [PH]. Elise Bond Is our circulator. If we can ... that I do, is something that Chip Randalwatt [PH] taught me, was to pressurize the cement with ...

  11. Revision Knee Surgery

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    Full Text Available ... a lot of low-grade staff epi or something going on in these those regions that are ... that point, then I would have to do something on the tibial side. So, for example, if ...

  12. Revision Knee Surgery

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    Full Text Available ... run into issues with reestablishing the proper joint line to get the kinematics set, as well as ... need to augment to help with our joint lines. So I’d like to use intramedullary instrumentation, ...

  13. Revision Knee Surgery

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    Full Text Available ... California March 31, 2010 Welcome to this OR Live webcast presentation, brought to you by Zimmer from JFK Memorial Hospital Indio, California. Hi, I’m Dr. Todd Sekundiak from Creighton University Medical Center in Omaha, Nebraska, I’d like ...

  14. Revision Knee Surgery

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    Full Text Available ... re going to put her through this aggressive physical therapy. She’s going to do more than she’s ... her for that, you know, and our whole education program from here on out is going to ...

  15. Revision Knee Surgery

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    Full Text Available ... the issue of modulus mismatch, then I’ll downside to a cemented stem. Okay. Come on. Let’s ... to get this joint line lower. What’s the downside of having this joint line higher up than ...

  16. Revision Knee Surgery

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    Full Text Available ... keep our wounds closed and sealed for a total of 14 days, so no dressing changes up ... diabetic. Those thing contribute the over all tissue quality and turgor. I think she’ll have more ...

  17. Revision Knee Surgery

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    Full Text Available ... either in-growth. And then it’s the soft tissue sleeve. I think the worse my soft tissue envelope, the more stress I’m going to ... You know, there was a lot of fibrous tissue that we cleaned out in those holes. So ...

  18. Revision Knee Surgery

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    Full Text Available ... you’re not worrying about filling up that hole on the medial side, you just want a ... fibrous tissue that we cleaned out in those holes. So let me show what you what I’ ...

  19. Revision Knee Surgery

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    Full Text Available ... Zimmer from JFK Memorial Hospital Indio, California. Hi, I’m Dr. Todd Sekundiak from Creighton University Medical Center in Omaha, Nebraska, I’d like welcome you, the participants, to another ...

  20. Revision Knee Surgery

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    Full Text Available ... It also allows us to incorporate the other technologies provided to us including trabecular metal cones and ... her for that, you know, and our whole education program from here on out is going to ...

  1. Revision Knee Surgery

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    Full Text Available ... lines. So I’d like to use intramedullary instrumentation, and we’ll ream up our tibia and ... a couple of reason, one I think the instrumentation really makes it very simple to get the ...

  2. Revision Knee Surgery

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    Full Text Available ... or wrong, is kind of a standard low molecular weight heparin, which we began within the 12 ... patient, I’ll put them on a low molecular weight Heparin. My preference is Arixtra. It seems ...

  3. Revision Knee Surgery

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    Full Text Available ... be a healed or maybe un-heeled periprosthetic fracture along the medial tibia. So with that, let’s ... As I mentioned before, she had that periprosthetic fracture off the medial side, so her MCL is ...

  4. Revision Knee Surgery

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    Full Text Available ... I shoot for the junction of the medial aspect in the middle third of the tubercle, sort ... you can see that in a posterior medial aspect. But my augment laterally is sitting on bone. ...

  5. Revision Knee Surgery

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    Full Text Available ... if I was running into a flexion extension gap balancing problem. She’s young. She’s only 64. You know, she probably has about 20 to 30 years of life ahead of her. If I can ...

  6. Revision Knee Surgery

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    Full Text Available ... not going to cement. Okay. I prefer the sharp fluted press-fit stem. I’m going to ... femoral component, tonsil, with a 20 by 75 sharp-fluted stem extension, ten millimeter distal augments and ...

  7. Revision Knee Surgery

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    Full Text Available ... the distal femur. You can also put the standard block underneath this plate here to sort of ... whether right or wrong, is kind of a standard low molecular weight heparin, which we began within ...

  8. Revision Knee Surgery

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    Full Text Available ... occasionally. Again, you know, when I was in academic practice like you, I saw a lot more ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  9. Revision Knee Surgery

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    Full Text Available ... it either way. That’s right. It’s the same concept either way. Okay. So let me get my ... nurses have gotten very tuned into the whole concept on the floor. So here we go again, ...

  10. Revision Knee Surgery

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    Full Text Available ... it anterior/posterior, depending on what you gap balance situation is going to be. Okay. Let’s see ... us what that. Yeah. This is a hot water bipolar sealer, and so the depth of penetration ...

  11. Revision Knee Surgery

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    Full Text Available ... manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The anesthesiologists do a great job with the spinals and a single shot of intrathecal narcotic that will really give patients almost 24 hours of pain-free status; that will allow us to get ...

  12. Revision Knee Surgery

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    Full Text Available ... she’s so young, is extremely important. I’ll leave that in there. Let me have a Rongeur. ... a bony defect here or there,” I can leave the trial component on and actually use the ...

  13. Revision Knee Surgery

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ... set up. And I’m all about OR time, so we eliminated that from our protocol. But ...

  14. Revision Knee Surgery

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    Full Text Available ... I don’t know what that vote of confidence does for you. Hey, Raj, we’ve got ... beauty of this system. You basically select whatever level of constraint you want. To be honest, I’ ...

  15. Revision Knee Surgery

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    Full Text Available ... I don’t know what that vote of confidence does for you. Hey, Raj, we’ve got ... Percocet every four hours. And you know the nurses have gotten very tuned into the whole concept ...

  16. Revision Knee Surgery

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    Full Text Available ... the worse my soft tissue envelope, the more stress I’m going to be putting on this ... extension, stable to varus and stable to valgus stress. So I think I like that pretty much. ...

  17. Revision Knee Surgery

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ... therapy. I believe in therapy for a couple reasons. One is, you know, where I live the ...

  18. Revision Knee Surgery

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    Full Text Available ... tend to shift things, flex them, and that leads to the inaccuracy and probably the inability to ... woman. All of those things are going to lead me to want to go ahead with more ...

  19. Revision Knee Surgery

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    Full Text Available ... tightening up the flexion gap, because all that increase in size is going to be added posteriorly. ... think that’s voodoo, or do you think it’s critical? Well I don’t think it’s voodoo. I ...

  20. Revision Knee Surgery

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    Full Text Available ... in other situations? And I was under the impression here that you’re using a cemented stem. ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  1. Revision Knee Surgery

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    Full Text Available ... in other situations? And I was under the impression here that you’re using a cemented stem. ... much bone loss medially -- It was hard to judge. -- it was completely unstable. Right. So go ahead ...

  2. Revision Knee Surgery

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    Full Text Available ... It’s basically an anterior cut that you can capture your champer cuts and your posterior cut. And ... anterior and posterior cuts. We brought this anterior capture guide. If you prefer to use that, it’s ...

  3. Revision Knee Surgery

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    Full Text Available ... penetration. Now the Zimmer system offers the traditional titanium augment and the tantalum, you know, block augments. ... re going to use? I primarily use the titanium augments. If it’s a younger patient, I’ll ...

  4. Revision Knee Surgery

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    Full Text Available ... Right. So the cementing technique is still critical. Well and to be honest, you almost did a little bit of ... with this lady, she hasn’t been functioning well for the last two years. There’s no way her endurance and strength can be to any significant degree. And don’t you ...

  5. Revision Knee Surgery

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ... her for that, you know, and our whole education program from here on out is going to ...

  6. Revision Knee Surgery

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    Full Text Available ... us what that. Yeah. This is a hot water bipolar sealer, and so the depth of penetration ... diabetic. Those thing contribute the over all tissue quality and turgor. I think she’ll have more ...

  7. Revision Knee Surgery

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    Full Text Available ... by altering femoral size and femoral place of employment. That’s right. Rongeur and I will ream. Now ... to put it in properly to eliminate that issue. And then the second issue of loosening, you ...

  8. Revision Knee Surgery

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    Full Text Available ... If we can take a look at the X-rays here, I’ll tell you about the case. ... ago, she started developing pain with weight bearing. X-rays taken at that time were initially interpreted as ...

  9. Revision Knee Surgery

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    Full Text Available ... occasionally. Again, you know, when I was in academic practice like you, I saw a lot more ... eliminated that from our protocol. But for the higher-risk patient, I’ll put them on a ...

  10. Revision Knee Surgery

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    Full Text Available ... decision, Todd? Well I think there’s a few factors that I’ll make, is first of all, ... that from our protocol. But for the higher-risk patient, I’ll put them on a low ...

  11. Revision Knee Surgery

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    Full Text Available ... try that. And again, there’s little bit of playing back and forth. We’ll start off with ... much valgus. I find the weight of these instruments too, and just with you reamer, I tend ...

  12. Revision Knee Surgery

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    Full Text Available ... much valgus. I find the weight of these instruments too, and just with you reamer, I tend ... adapter, and now we can go to the instrumentation to freshen up our distal cut a little ...

  13. Revision Knee Surgery

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    Full Text Available ... ll demonstrate that for you. Okay. What about antibiotics in these revisions? Yeah. I use the Palacos ... have to be careful. You could put more antibiotic in a cement. You could add some Vancomycin ...

  14. Revision Knee Surgery

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    Full Text Available ... t know if you noticed, one of the improvements is that we don’t have to change ... you’re going to continue to see slight improvements in flexion and muscle strength up to two ...

  15. Revision Knee Surgery

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    Full Text Available ... et cetera, that shows that the aseptic loosening rate is lower when you use the Gentamicin in ... really give patients almost 24 hours of pain-free status; that will allow us to get our ...

  16. Revision Knee Surgery

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    Full Text Available ... we have a little bit of rim that’s running into the IT band. There’s a little of ... go to a hinge prosthesis if I was running into a flexion extension gap balancing problem. She’s ...

  17. Revision Knee Surgery

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    Full Text Available ... going to reach a compromise. I’m already thinking I’m close to that point. Where I ... think that’s voodoo, or do you think it’s critical? Well I don’t think it’s voodoo. I ...

  18. Revision Knee Surgery

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    Full Text Available ... it, and they’re actually able to get bacterial DNA -- RNA and DNA from the surface of the prosthesis. So, clearly, not all aseptic loosening is not aseptic loosening. There’s a cohort of subclinical infections that we just can’t diagnose, but they ...

  19. Revision Knee Surgery

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    Full Text Available ... So I, again, you had a three-millimeter increase gap in extension with those gray blocks you ... tightening up the flexion gap, because all that increase in size is going to be added posteriorly. ...

  20. Revision Knee Surgery

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    Full Text Available ... turgor. I think she’ll have more extremity edema. And I prepped her for that, you know, ... out is going to be about elevation and edema reduction. We don’t like to use the ...

  1. Revision Knee Surgery

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    Full Text Available ... much contact proximally. How do you make that decision, Todd? Well I think there’s a few factors ... re going to use those? I make a decision to use an augment stem once I get ...

  2. Revision Knee Surgery

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ... that from our protocol. But for the higher-risk patient, I’ll put them on a low ...

  3. Revision Knee Surgery

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    Full Text Available ... continue to see slight improvements in flexion and muscle strength up to two years. So it kind ... therapy is important in terms of getting their muscle function back. Well I agree with you. If ...

  4. Revision Knee Surgery

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    Full Text Available ... practice like you, I saw a lot more disaster-type cases with huge bone loss. I don’ ... is going to be about elevation and edema reduction. We don’t like to use the Ted ...

  5. Revision Knee Surgery

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    Full Text Available ... to your primary setting? Not really. The pain management protocol that we have here is excellence. The ... diabetic. Those thing contribute the over all tissue quality and turgor. I think she’ll have more ...

  6. Revision Knee Surgery

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    Full Text Available ... bit with a Rongeur. Since I cement the base plate in the metaphyseal region, I don’t mind if there’s a little bit of slop there. In fact, like to get through this hard corticalized bone because it gives me better cement penetration. Now the Zimmer system ...

  7. Revision Knee Surgery

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    Full Text Available ... question from the viewers about when to use TM augments. And in these settings, I do use TM augments. At first I wasn’t sure of ... just the interdigitation of the cement with the TM augment and obviously onto the bone. And the ...

  8. Revision Knee Surgery

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    Full Text Available ... reciprocating saw and cut right through there and finish up the cut for the augments, not having ... that the tibial canal starts anterior proximally and finishes posterior distally. So I didn’t make a ...

  9. Revision Knee Surgery

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    Full Text Available ... manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The anesthesiologists do a great job with the spinals and a single shot of ...

  10. Revision Knee Surgery

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    Full Text Available ... interface stresses, even with the rotating hinges, are higher, and so I want fixation over a long ... What’s the downside of having this joint line higher up than where it should be? Well we ...

  11. Revision Knee Surgery

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    Full Text Available ... approximately ten years ago. Initially she did very well, although she was a little bit stiff and ... at that time were initially interpreted as being well fixed and normal; however she had progressive pain ...

  12. Revision Knee Surgery

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    Full Text Available ... the other technologies provided to us including trabecular metal cones and augments and allowing a smooth transition ... big enough to necessitate the use of trabecular metal cones. I think we should be able to ...

  13. Revision Knee Surgery

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    Full Text Available ... jig just to allow rotation or get a visual cue of your placement. And Rongeur. So I’ ... going to reach a compromise. I’m already thinking I’m close to that point. Where I ...

  14. Revision Knee Surgery

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    Full Text Available ... first, I assuming because that’s going to be affecting both your extension/flexion gaps. That’s right. I ... tibial side to bring it more proximal, thereby affecting flexion and extension simultaneously. And then if I ...

  15. Revision Knee Surgery

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    Full Text Available ... I’m going to do a hinge, my preference is to cement the whole stem, just because ... them on a low molecular weight Heparin. My preference is Arixtra. It seems to me that the ...

  16. Revision Knee Surgery

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    Full Text Available ... to that, then that obviously has to be protected also to promote either in-growth. And then ... and so I want fixation over a long area inside the diathesis. And then if I get ...

  17. Revision Knee Surgery

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    Full Text Available ... the concern, you know, and why I’m spending so much time in trying to get the ... think it’s voodoo. I think there’s enough registry data from Germany, et cetera, that shows that the ...

  18. Revision Knee Surgery

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    Full Text Available ... with some type of acrylic glue on the skin. We keep our wounds closed and sealed for ... the quill in the subcutaneous tissues and then skin staples. I don’t know that it makes ...

  19. Revision Knee Surgery

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    Full Text Available ... what that. Yeah. This is a hot water bipolar sealer, and so the depth of penetration is ... the tourniquet down more frequently, and with the bipolar sealer, that allows us to really get the ...

  20. Revision Knee Surgery

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    Full Text Available ... augment properly positioned, so I’m going to mark that with my actual implant and get a ... to overhang laterally, so I’m going to mark that as well. So I think we’re ...

  1. Revision Knee Surgery

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    Full Text Available ... with studies now quoting over 96-percent survivorship. It also allows us to incorporate the other technologies ... ll receive that and be able to address it for them. Okay. Great. Get some suction in ...

  2. Revision Knee Surgery

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    Full Text Available ... going to reach a compromise. I’m already thinking I’m close to that point. Where I ... her for that, you know, and our whole education program from here on out is going to ...

  3. Revision Knee Surgery

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    Full Text Available ... her for that, you know, and our whole education program from here on out is going to be about elevation and edema reduction. We don’t like to use the Ted stockings because patients hate putting them on and taking them off. ...

  4. Revision Knee Surgery

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    Full Text Available ... Again, you know, when I was in academic practice like you, I saw a lot more disaster- ... Todd. Thanks for watching this OR Live webcast presentation brought to you by Zimmer from JFK Memorial ...

  5. Revision Knee Surgery

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    Full Text Available ... is going to prevent from worrying about the real problem situation, which is getting a stable construct. ... correct? That’s correct. And when we put the real implants in I’ll show you the flutes. ...

  6. Revision Knee Surgery

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    Full Text Available ... by altering femoral size and femoral place of employment. That’s right. Rongeur and I will ream. Now ... things by moving my tibial component proximal to effect flexion and extension symmetrically, but then I would ...

  7. Arthroscopic management of the arthritic elbow: indications, technique, and results.

    Science.gov (United States)

    Savoie, F H; Nunley, P D; Field, L D

    1999-01-01

    Twenty-four patients with painful restricted motion of the elbow joint because of an arthritic process were treated with an arthroscopic modification of the open Outerbridge-Kashiwagi procedure. Average preoperative flexion was to 90 degrees (range 60 degrees to 140 degrees), and average extension loss was -40 degrees (range -5 degrees to -60 degrees). The average total arc of motion was 50 degrees. The procedure consisted of arthroscopic debridement, partial resection of the coronoid and olecranon processes, and fenestration of the olecranon fossa. The radial head was excised arthroscopically in 18 of the 24 patients. All patients were reexamined 24 to 60 months after operation (mean 32 months). All patients had a significant decrease in pain as described by a visual analog scale (preoperative 8.2; postoperative 2.2). Average flexion was to 139 degrees (range 95 degrees to 145 degrees), and average extension loss was -8 degrees (range 0 degree to 15 degrees). The average arc of motion was 131 degrees, an improvement of 81 degrees. Arthroscopic ulnohumeral arthroplasty provides satisfactory results in terms of pain control and improved motion. The complication rate is comparable to those reported in series of open ulnohumeral arthroplasties. This procedure seems to be a valuable adjunct in the management of the arthritic elbow, serving as an intermediate step between nonoperative management and elbow replacement surgery. PMID:10389075

  8. 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

  9. The Burden of Craft in Arthroscopic Rotator Cuff Repair: Where Have We Been and Where We Are Going.

    Science.gov (United States)

    Burkhart, Stephen S

    2015-08-01

    The rather turbulent history of arthroscopic rotator cuff repair went through stages of innovation, conflict, disruption, assimilation, and transformation that might be anticipated when a new and advanced technology (arthroscopic cuff repair) displaces an entrenched but outdated discipline (open cuff repair). The transition from open to arthroscopic rotator cuff repair has been a major paradigm shift that has greatly benefited patients. However, this technical evolution/revolution has also imposed a higher "burden of craft" on the practitioners of arthroscopic rotator cuff repair. Technological advancements in surgery demand that surgeons accept this burden of craft and master the advanced technology for the benefit of their patients. This article outlines the author's involvement in the development of arthroscopic rotator cuff repair, and it also explores the surgeon's obligation to accept the burden of craft that is imposed by this discipline. PMID:26251931

  10. Modified arthroscopic suture fixation of a displaced tibial eminence fracture.

    Science.gov (United States)

    Lehman, Ronald A; Murphy, Kevin P; Machen, M Shaun; Kuklo, Timothy R

    2003-02-01

    This study describes a new arthroscopic method using a whip-stitch technique for treating a displaced type III tibial eminence fracture. A 12-year-old girl who sustained a displaced type III tibial eminence fracture was treated with arthroscopic fixation using the Arthrosew disposable suture device (Surgical Dynamics, Norwalk, CT) to place a whip stitch into the anterior cruciate ligament (ACL). The Arthrex ACL guide (Arthrex, Naples, FL) was used to reduce the avulsed tibial spine fragment. Sutures were then passed through the tibial tunnel and secured over a bony bridge with the knee in 20 degrees of flexion. At 9 months, the patient has a full range of motion with normal Lachman and anterior drawer testing, and she has returned to competitive basketball. Radiographs show complete fracture healing. KT-1000 and isokinetic testing at 9-month follow-up show only minimal side-to-side differences. The Arthrosew device provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the ACL, thus obviating arthrotomy and hardware placement. This technique also restores the proper length and tension to the ACL, and provides a simplified, reproducible method of treatment for this injury. PMID:12579135

  11. Assessment of patients with diffuse pigmented Villonodular Synovitis of Knee before and after radio-synovectomy

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: the aim of this study was to evaluate subjective and objective findings of patients with diffuse pigmented villonodular synovitis (DPVNS) of knee before and after treatment with Yttrium-90 (Y-90) radio-synovectomy. Materials and methods: between years 2005 and 2013, 23 patients, 15 female and 8 male, who had adjuvant radio-synovectomy after arthroscopic surgery were included to our study. 5 mCi of Y-90 radiocolloid was administered under local anesthesia at least 6 weeks after arthroscopic surgery. The patients were reevaluated 6 months after radio-synovectomy. All the patients were assigned a Lysholm knee score prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy. Lysholm score was calculated according to patients' pain, swelling, instability, locking, limping, support, climbing the stairs, squatting and the highest evaluation score was 100. In addition modified Marshall scoring system was calculated according to objective and subjective findings of the patients prior to surgery and six months after radio-synovectomy. The highest evaluation score was 30 in modified Marshall scoring system where 19 points were provided by objective findings and 11 points were provided by subjective findings. Scores higher than 26 were defined as very good, between 21-25 was good, between 16-20 was medium, and values less than 16 points are considered to be poor. The obtained points using scoring systems were evaluated statistically. Results: the mean age was (31.7 ± 13.2) years. The average time period between the operation and radio-synovectomy was (12.8 ± 8.14) weeks. The calculated Lysholm scores prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy were (38.8 ± 4.1), (60.0 ± 4.4) and (82.9 ± 6.5), respectively (p <0.001). Modified Marshall scores prior to surgery, and 6 months after radio-synovectomy, was (12.4 ± 2.7) and (25.5 ± 3.1) respectively (p <0.001). Conclusion

  12. MR findings of chondromalacia Patella : correlation of the grade and associated lesions with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yon Su; Kwon, Soon Tae; Lee, Hwan Do; Kang, Yong Soo; Byun, Ki Yong; Rhee, Kwang Jin [Chungnam National Univ., Taejon (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To assess the MR findings of chondromalacia patella and correlate the grade and associated lesions with the arthroscopic findings. Twenty-five patients with pain in the anterior part of the knee underwent fat-suppressed axial and coronal T2-weighted and T2-weighted imaging, using a 10-cm field of view, and a 5-inch general purpose coil. We retrospectively assessed these findings, and the locations, grades and associated lesions, and correlated these with arthroscopic findings. We evaluated the exact location and grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopic findings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of an appropriate surgical method and plan. (author). 18 refs., 5 figs.

  13. 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

  14. Clinical results of arthroscopic treatment for localized pigmented villonodular synovitis of knee joint%膝关节镜下诊治局灶性色素沉着绒毛结节性滑膜炎的临床疗效

    Institute of Scientific and Technical Information of China (English)

    何耀华; 赵金忠; 蒋壶; 皇甫小桥; 王建华; 杨星光

    2008-01-01

    Objective To investigate the clinical results of the patients with localized pigmented villonodular synovitis of knee joint treated by arthroscopic technique.Methods From June 2004 to September 2007,there were twelve patients,five males and seven females,between the ages of 22 and 53 years (mean,36.3 years).All patients were treated by arthroscopic resection with partial synovectomy.The course of disease ranged from 1 month to 84 months,with the mean of 19.5 months.All patients were followed up and evaluated the clinical results with the Lysholm Knee Scoring Scale questionnaire.Results There were two cases with anterior horn of medial meniscus rupture,one with lateral meniscus rupture,four with medial plica hyperplasia (gradeⅢ),and three with patellofemoral arthritis (grade Ⅱ ),one of them also with medial and lateral condylar cartilage wear (grade Ⅲ).The masses involved sites were three at the anteremedial synovium near the anterior horn of the medial meniscus,three at the infrapattella fat pad,one near the anterior horn of the lateral meniscus,one at condylar notch,two at medial gutter,one at lateral gutter and one at the posteromedial compartment.The average size of the masses was 1.7 cm×1.4 cm×0.8 cm (0.5 cm×O.5 cm×0.5 cm-3cru×3 cm×2 cm),two without pedicle,and ten with pedicle.During follow-up for an average of 19.9 months (range,6-45 months),8 patients were rated as excellent,3 good and 1 fair according to the Lysholm Knee Scoring Scale questionnaire (mean 96.3).Conclusion Arthroscopy is effective in the diagnosis of localized pigmented villonodular synovitis and complete arthroscopic excision can be considered the effective treatment for localized pigmented villonodular synovitis.%目的 探讨采用关节镜技术诊治膝关节局灶性色素沉着绒毛结节性滑膜炎(localized pigmented villonodular synovitis,LPVNS)的临床疗效.方法 2004年6月至2007年9月,关节镜下辅助诊治12例LPVNS患者,男5例,女7例;年龄22~53

  15. 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

  16. [Arthroscopic resection of dorsal wrist ganglia].

    Science.gov (United States)

    Borisch, N

    2014-10-01

    In arthroscopic wrist surgery, the resection of dorsal wrist ganglia has become a well accepted practice. As advantages for the minimally invasive procedure the low complication rate and low postoperative morbidity, less postoperative pain and faster recovery over open techniques are discussed. The possibility to assess accompanying joint pathology is considered as another advantage. The importance of identifying a so-called ganglion cyst stalk seems to have been overstated. Regarding the technique, the main discussion points are the size and localisation of the capsular window and the necessity of additional midcarpal arthroscopy. The possibility and results of treatment of recurrent ganglion cysts are still controversial. Our own experience and that of some authors are positive. Hardly mentioned in the literature is the treatment of occult dorsal wrist ganglia and its results, which is considered as very successful by the authors. PMID:25290273

  17. Large lateral meniscal ganglion cyst extending into the intercondylar fossa of the knee.

    Science.gov (United States)

    Jäger, Alwin; Eberhardt, Christian; Hailer, Nils P

    2004-07-01

    We report the case of a 31-year-old, otherwise healthy man with a large intra-articular meniscal ganglion cyst (27.7 x 13.5 mm) originating from the dorsal horn of the lateral meniscus. Clinically, the patient presented with knee pain in a squatting position. Magnetic resonance imaging revealed a large intra-articular cyst in the posterior compartment. At arthroscopic surgery, the ganglion cyst was found in the intercondylar space posteriorly to the posterior cruciate ligament. After removal of the ganglion cyst, a horizontal tear in the dorsal horn of the lateral meniscus was revealed and treated by partial meniscectomy. To our knowledge, a meniscal ganglion cyst originating from the lateral meniscus and extending into the joint is an extremely rare event, with only two previous reported cases. We review the current literature on the pathogenesis, distribution, and treatment of meniscal ganglion cysts. PMID:15243414

  18. 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

  19. Bicompartmental knee arthroplasty

    Science.gov (United States)

    Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect of knee biomechanics, lower complications rates, shorter hospital stay, faster rehabilitation. Moreover, in case of failure of the first implant the conversion to TKA is undemanding and can be compared to a standard prosthesis. Our experience suggest that BKA is a reliable technique in selected cases and especially younger people with higher functional requests can favourably profit from it. Although those results are encouraging, we still need further prospective, randomized, long-term studies to finally assess BKA indications and outcomes. PMID:26855941

  20. Bicompartmental knee arthroplasty.

    Science.gov (United States)

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect of knee biomechanics, lower complications rates, shorter hospital stay, faster rehabilitation. Moreover, in case of failure of the first implant the conversion to TKA is undemanding and can be compared to a standard prosthesis. Our experience suggest that BKA is a reliable technique in selected cases and especially younger people with higher functional requests can favourably profit from it. Although those results are encouraging, we still need further prospective, randomized, long-term studies to finally assess BKA indications and outcomes. PMID:26855941

  1. Intra-Articular Hyaluronic Acid Injection after Arthroscopic Debridement for Knee Osteoarthritis: A Systematic Review%关节镜下清理术联合关节内透明质酸注射治疗膝关节骨关节炎有效性的系统评价

    Institute of Scientific and Technical Information of China (English)

    蒋勰; 占美; 李棋; 刘东; 李箭

    2012-01-01

    Objective To systematically evaluate the effectiveness of intra-articular hyaluronic acid injection after arthroscopic debridement for knee osteoarthritis (KOA). Methods Databases including The Cochrane Library, SCI, MEDLINE, EMbase, CBM and WanFang Data were searched from inception to 2012, so as to collect randomized controlled trials (RCTs) on intra-articular hyaluronic acid injection after arthroscopic debridement (combined therapy) vs. monotherapy in treating KOA. Two reviewers independently screened literature according to inclusion and exclusion criteria, evaluated quality, and extracted data. Then the meta-analysis was conducted using RevMan5.0 software. Results A total of 7 RCTs involving 526 patients were included. The results of meta-analyses showed that: there was no significant difference in the excellent-good rate between the combined therapy group and the monotherapy groups including either the intra-articular hyaluronic acid injection group (RR=1.40, 95%CI 0.99 to 1.98, P=0.06) or the arthroscopic debridement group (RR=1.09, 95%CI 0.93 to 1.26, P=0.29). But the intra-articular hyaluronic acid injection group was inferior to the combined therapy group in improving Lysholm score, with a significant difference (MD=-14.81, 95%CI -17.55 to -12.08, P<0.000 01). Conclusion Arthroscopic debridement combined with intra-articular hyaluronic acid injection for KOA shows no significant difference in the excellent-good rate compared with the monotherapy, but it is superior to the monotherapy of hyaluronic acid injection in improving Lysholm score, so it is believed the combined therapy group is superior to the control groups in therapeutic effects. Due to the limited quantity and quality of the included studies, this conclusion needs to be proved by performing more high quality RCTs.%目的 系统评价关节镜下清理术联合关节内透明质酸注射治疗膝关节骨关节炎的有效性.方法 计算机检索The Cochrane Library

  2. Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone.

    Science.gov (United States)

    Cerlier, Alexandre; Gay, André-Mathieu; Levadoux, Michel

    2015-10-01

    Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications. PMID:26697314

  3. Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study

    DEFF Research Database (Denmark)

    W-Dahl, Annette; Toksvig-Larsen, Sören; Roos, Ewa

    2009-01-01

    radiographs including the hip and ankle joints. Knee pain was measured by the subscale pain (0 - 100, worst to best scale) of the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at one year follow-up. To estimate the association between knee alignment and knee pain multivariate......BACKGROUND: The association between knee alignment and knee pain in knee osteoarthritis (OA) is unclear. High tibial osteotomy, a treatment option in knee OA, alters load from the affected to the unaffected compartment of the knee by correcting malalignment. This surgical procedure thus offers the...... possibility to study the cross-sectional and longitudinal association of alignment to pain. The aims were to study 1) the preoperative association of knee alignment to preoperative knee pain and 2) the association of change in knee alignment with surgery to change in knee pain over time in patients operated...

  4. Diagnostic performance of 3D TSE MRI versus 2D TSE MRI of the knee at 1.5 T, with prompt arthroscopic correlation, in the detection of meniscal and cruciate ligament tears*

    Science.gov (United States)

    Chagas-Neto, Francisco Abaeté; Nogueira-Barbosa, Marcello Henrique; Lorenzato, Mário Müller; Salim, Rodrigo; Kfuri-Junior, Maurício; Crema, Michel Daoud

    2016-01-01

    Objective To compare the diagnostic performance of the three-dimensional turbo spin-echo (3D TSE) magnetic resonance imaging (MRI) technique with the performance of the standard two-dimensional turbo spin-echo (2D TSE) protocol at 1.5 T, in the detection of meniscal and ligament tears. Materials and Methods Thirty-eight patients were imaged twice, first with a standard multiplanar 2D TSE MR technique, and then with a 3D TSE technique, both in the same 1.5 T MRI scanner. The patients underwent knee arthroscopy within the first three days after the MRI. Using arthroscopy as the reference standard, we determined the diagnostic performance and agreement. Results For detecting anterior cruciate ligament tears, the 3D TSE and routine 2D TSE techniques showed similar values for sensitivity (93% and 93%, respectively) and specificity (80% and 85%, respectively). For detecting medial meniscal tears, the two techniques also had similar sensitivity (85% and 83%, respectively) and specificity (68% and 71%, respectively). In addition, for detecting lateral meniscal tears, the two techniques had similar sensitivity (58% and 54%, respectively) and specificity (82% and 92%, respectively). There was a substantial to almost perfect intraobserver and interobserver agreement when comparing the readings for both techniques. Conclusion The 3D TSE technique has a diagnostic performance similar to that of the routine 2D TSE protocol for detecting meniscal and anterior cruciate ligament tears at 1.5 T, with the advantage of faster acquisition. PMID:27141127

  5. 膝关节周围骨折术后早期推拿临床观察%Clinical effects of early massage on rehabilitation after fractures around the knee surgery

    Institute of Scientific and Technical Information of China (English)

    朱荣光

    2015-01-01

    Objective: To investigate recovery of knee function for rehabilitation after fractures around the knee surgery by early massage. Methods: 52 cases of fractures around the knee surgery in our hospital from March 2011 to October 2013 were randomly divided into two groups: the observation group and the control group, 26 cases for each group. After the fractures around the knee surgery, the control group received conventional rehabilitation. The observation group received massage. Results: After the rehabilitation, 92.3% of patients in the observation group had good knee function. 65.4% of patients in the control group had good knee function. There was significant difference between groups (P<0.05). Conclusion: Early massage was effective on the recovery of limb joint function.%目的:研究膝关节周围骨折术后采取早期推拿对膝关节功能恢复的影响。方法:选取我院在2011年3月-2013年10月期间收治的膝关节周围骨折术后患者52例,随机分成观察组和对照组,各26例。对照组在术后采取常规的康复训练,观察组在术后采取推拿治疗。结果:经过康复训练,观察组膝关节活动功能优良率为92.3%,对照组为65.4%,差异显著(P<0.05)。结论:早期推拿能够有效的促进患肢关节功能恢复。

  6. 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...

  7. 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.

  8. Total Knee Replacement Arthroplasty with Buechel and Pappas Knee: Minimum 2-Year Follow-up

    OpenAIRE

    Moon, Kyoung Ho; Hong, Seung Hyun; Hong, Taek Ho

    2015-01-01

    Background Clinical and radiologic evaluation and analyses of the surgeries using Buechel and Pappas (B-P) knee implants. Methods The study was conducted on 60 patients who underwent 94 total knee replacement arthroplasty with B-P knee implants from May 2009 to December 2010. The results were compared to the results of 41 patients who underwent 60 knee joint surgeries using NexGen-LPS implants from January 2008 to August 2009. Results The American Knee Society score of the B-P knee group incr...

  9. Arthroscopic treatment of pigmented villonodular synovitis of the proximal tibiofibular joint.

    Science.gov (United States)

    Lui, Tun Hing

    2015-08-01

    Disorders of the proximal tibiofibular joint should be kept in mind in the evaluation of lateral knee pain. They include osteoarthrosis, rheumatic disease, traumatic subluxation or dislocation, ganglion or synovial cysts, synostosis, synovial chondromatosis, pigmented villonodular synovitis and hypomobility of the joint. Peroneal nerve can be at risk with pathologies of the joint either by compressive effect or formation of intra-neural ganglion. A case of pigmented villonodular synovitis of the proximal tibiofibular joint was reported which presented with lateral knee pain. It was successfully treated by arthroscopic synovectomy. Level of evidence V. PMID:24788187

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial

    OpenAIRE

    Paphon Sa-ngasoongsong; Thanaphot Channoom; Viroj Kawinwonggowit; Patarawan Woratanarat; Pongsthorn Chanplakorn; Bussanee Wibulpolprasert; Siwadol Wongsak; Umaporn Udomsubpayakul; Supaporn Wechmongkolgorn; Nantaporn Lekpittaya

    2011-01-01

    A high-dose local tranexamic acid has been introduced in total knee arthroplasty for bleeding control. We are not sure about the systemic absorption and side effects. The aim of this study was to evaluate the effect of low dosage of intra-articular tranexamic acid injection combined with 2-hour clamp drain in minimally bleeding computer-assisted surgery total knee replacement (CAS-TKR). A prospective randomized controlled trial was conducted in a total of 48 patients underwent CAS-TKR. The pa...

  12. Knee pain

    Science.gov (United States)

    ... the bones of the knee Infection in the knee joint Injuries and overuse Bursitis . Inflammation from repeated pressure ... felt on the inside or outside of the knee joint. Strain or sprain . Minor injuries to the ligaments ...

  13. Large Intra-Articular Anterior Cruciate Ligament Ganglion Cyst, Presenting with Inability to Flex the Knee

    OpenAIRE

    Philip Pastides; Davinder Paul Singh Baghla; Sreeram Penna; Vivek Gulati; Jake Sloane

    2010-01-01

    A 41-year-old female presented with a 3-month history of gradually worsening anterior knee pain, swelling and inability to flex the knee. Magnetic resonance imaging (MRI) revealed a large intra-articular cystic swelling anterior to the anterior cruciate ligament (ACL), extending into the Hoffa's infrapatellar fat pad. Following manipulation under anaesthesia and arthroscopic debridement of the cyst, the patient's symptoms were relieved with restoration of normal knee motion. ACL ganglion cyst...

  14. 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

  15. Treating Osteoarthritis of the Knee

    Science.gov (United States)

    ... with an artificial joint made from metals and plastic. All or part of the knee joint may be replaced in this procedure. Although recovery may take a long time depending on the extent of your surgery, the results of arthroplasty are often successful. Knee ...

  16. Arthritic Pain Relief through Partial Knee Replacement

    Medline Plus

    Full Text Available ... younger patients this can be caused by either fractures or just natural wear and tear and excessive ... prior surgery on the knee, any sort of fracture surgery or any sort of osteotomy, which is ...

  17. Fiber-optics couple arthroscope to TV

    Science.gov (United States)

    Franke, J. M.; Rhodes, D. B.

    1981-01-01

    Convenient, hand-held coupler images output of arthroscope onto coherent fiber bundle. Arthroscope allows surgeons to examine internal organs through any small opening in body. Coupler is also used for engine inspection, instrument repair, and around-corner visual inspection. Image from arthroscope travels along flexible bundle and appears at other cable end where it is recollimated by lens. Image is read from lens or projected on color TV camera.

  18. The Effect of Risk Factors on the Levels of Chemical Elements in the Tibial Plateau of Patients with Osteoarthritis following Knee Surgery

    Directory of Open Access Journals (Sweden)

    Natalia Lanocha-Arendarczyk

    2015-01-01

    Full Text Available The aim of this study was to evaluate the aforementioned chemical elements in tibial plateau samples obtained during knee arthroplasty. The gender-specific analysis of chemical element levels in the bone samples revealed that there were statistically significant differences in the concentration of Pb and Se/Pb ratio. The contents of elements in the tibial plateau in the patients with osteoarthritis (OA can be arranged in the following descending order: F− > K > Zn > Fe > Sr > Pb > Mn > Se > Cd > THg. We observed statistical significant effects of environmental factors including smoking, seafood diet, and geographical distribution on the levels of the elements in tibial bone. Significant positive correlation coefficients were found for the relationships K-Cd, Zn-Sr, Zn-F−, THg-Pb, Pb-Cd, Se-Se/Pb, Se-Se/Cd, Se/Pb-Se/Cd, Pb-Cd/Ca, Cd-Cd/Ca, and F−-F−/Ca·1000. Significant negative correlations were found for the relationships THg-Se/Pb, Pb-Se/Pb, Cd-Se/Pb, K-Se/Cd, Pb-Se/Cd, Cd-Se/Cd, THg-Se/THg, Pb-Se/THg, Se-Pb/Cd, Zn-Cd/Ca, and Se/Cd-Cd/Ca. The results reported here may provide a basis for establishing reference values for the tibial plateau in patients with OA who had undergone knee replacement surgery. The concentrations of elements in the bone with OA were determined by age, presence of implants, smoking, fish and seafood diet, and sport activity.

  19. Arthroscopically assisted treatment of intraosseous ganglions of the lunate.

    Science.gov (United States)

    Bain, Gregory I; Turner, Perry C; Ashwood, Neil

    2008-12-01

    Intraosseous ganglia (IOGs) of the lunate are a relatively rare, but by no means insignificant, condition because treatment by traditional open curettage and bone grafting can lead to ongoing pain and stiffness of the wrist.An arthroscopically assisted minimally invasive technique of debridement and grafting of the lunate IOG is discussed, as well as the history of the condition, indications and contraindications, surgical technique with postoperative rehabilitation, and potential complications.The outcomes of 8 patients with persistent symptoms and typical radiographic and bone scan findings were assessed independently preoperatively and postoperatively by using a modified Green and O'Brien wrist score. The intraosseous cyst was drilled under arthroscopic and fluoroscopic guidance via either a volar or dorsal portal, depending on the position identified on the computed tomography scan. Average follow-up time was 3.8 years (range, 1-5.6 yrs). All patients returned to employment within 4 months. Wrist scores improved 34 points, from 51 to 85 points, by 1 year after surgery, with trabeculation being noted within the grafting lunate. The greatest improvements were seen in visual and analog pain scores, reducing from 68.3 to 11.2, and flexion-extension arcs, which increased from 98 to 114 degrees.The technique of arthroscopically assisted debridement of IOGs of the lunate is safe, with minimal morbidity and recurrence of symptoms during the follow-up period. PMID:19060679

  20. 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...

  1. Does arthroscopic subacromial decompression improve quality of life

    Science.gov (United States)

    Whiteman, A; Wilson, J; Paul, E; Roy, B

    2015-01-01

    Introduction There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner. Methods Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost–utility analysis was performed. Results Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4–27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11–15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16–0.30), translating to a minimum cost per QALY of £5,683. Conclusions Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients. PMID:26263808

  2. Complications in knee arthroscopy.

    Science.gov (United States)

    Reigstad, Ole; Grimsgaard, Christian

    2006-05-01

    All simple arthroscopic procedures during 1999 through 2001 performed at Baerum community hospital were retrospectively examined. Procedures were excluded when being part of more complex procedures. A total of 876 procedures performed on 785 patients were left for examination. Complications were registered from the patient record and all received a written questionnaire or phone call. The answer was obtained from 97.6%. The overall complications rate was low, giving total of 5.00%. A total of 0.68% of the complications had therapeutic consequences. There were two superficial infections, one thromboembolic event/pulmonary embolus and one reoperation due to scar tissue. Other complications were considered minor, and had none or little consequence for the patient comprising preoperative bradycardial episodes, asthmatic events, subcutaneous infusion of total intravenous anaesthetics (TIVA), instrument breakage and conversion to arthrotomi. Postoperatively registered complications included swelling, haemarthros, portal bleeding and fistulation, temporary sensory loss and longstanding pain. Duration of surgery was the only predicting factor for postoperative complications. Simple arthroscopic surgery is safe and has few serious complications. The use of TIVA or tourniquet does not increase the morbidity or complication rate, and prophylaxis against thromboembolism was not necessary. PMID:16208459

  3. Extravasation of joint fluid into the mediastinum and the deep neck during atthoscopic shoulder surgery

    International Nuclear Information System (INIS)

    Extravasation of shoulder joint fluid into the surrounding muscles during shoulder arthroscopic surgery is common and inevitable. Here, we report a case of massive extravasation of shoulder joint fluid leading to mediastinal and retrotracheal effusion after arthroscopic shoulder surgery. We will discuss the anatomical basis of fluid leakage from the shoulder to the mediastinum and to the deep neck on CT.

  4. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Jörg Tomeczkowski

    Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  5. Hip or knee replacement - after - what to ask your doctor

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000232.htm Hip or knee replacement - after - what to ask your doctor To ... had surgery to get a new hip or knee joint while you were in the hospital. Below ...

  6. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    Science.gov (United States)

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities.

  7. Effect of compression therapy on knee swelling and pain after total knee arthroplasty

    DEFF Research Database (Denmark)

    Munk, Stig; Jensen, Niels J F; Andersen, Ida;

    2013-01-01

    PURPOSE: Knee swelling after total knee arthroplasty may impair postoperative mobilisation and training, and as medical elastic compression stockings are well tolerated and effective to prevent oedema, haematoma and postoperative pain after venous surgery, we wanted to study whether this effect...... could be transferred to total knee arthroplasty surgery reducing postoperative swelling and pain and thereby facilitating mobilisation and improving patient-reported knee function. METHODS: In a randomised controlled study, 88 patients were randomised to use either a medical elastic compression stocking...... or no stocking from the first postoperative day and the following 4 weeks after total knee arthroplasty. Outcome measures were knee, calf and ankle swelling, knee flexion, pain and patient-reported knee function. RESULTS: Seventy per cent of the swelling had occurred before application of the...

  8. Retrospective Cohort Study of 207 Cases of Osteochondritis Dissecans of the Knee

    Science.gov (United States)

    Green, Daniel W.; Arbucci, John; Silberman, Jason; Luderowski, Eva; Uppstrom, Tyler J.; Nguyen, Joseph; Tuca, Maria

    2016-01-01

    with 1.6 mm bioabsorbable nails (54.2%), using an average of 4 nails (1-9). Only 2 cases were fixed using metallic headless screws. Other surgical treatments were drilling (13.9%), microfracture (13.9%), microfracture + fixation (6.9%), removal of loose body/chondroplasty (6.9%), and allograft transplantation (4.2%). Fixation was achieved all-arthroscopic in 43.1% of the cases, and 61.3% of the lesions that were fixed underwent curettage of the subchondral bone. Revision surgery was required in 14 knees (19.4%). The most common revision procedures were microfracture, removal of hardware, chondroplasty and allograft implantation, where some revisions had combined procedures. Most surgical patients had postoperative MRIs (55 knees), with an average radiological follow-up of 14.5 months (range 2.1-55.4). Conclusion: JOCD occurs more frequently in young adolescent athlete boys, affecting the middle third of the medial femoral condyle. In our cohort, 1/3 of the patients had surgery, where bigger lesions and higher BMI were risk factors for operative treatment. At short-term follow up, the success rate following surgery was above 80%.

  9. Functional outcomes after arthroscopic treatment of lateral epicondylitis

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate surgical outcomes of arthroscopic debridement for lateral epicondylitis using a validated, patient-assessed scoring system as well as conventional outcome measures. We also wanted to identify potential predictive factors that may be associated with the outcomes. A total of 20 elbows in 18 patients with chronic lateral epicondylitis who underwent arthroscopic surgery were included. There were nine men and nine women with a mean age of 54 years (range 42-71 years). Operative treatment consisted of debridement of the extensor carpi radialis brevis (ECRB) origin and resection of the radiocapitellar synovial plica interposed in the joint. Outcomes were assessed using a patient rating, visual analogue scale (VAS) pain score, the Japanese Orthopaedic Association (JOA) elbow score, and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. The average length of follow-up was 28 months (range 24-40 months). After surgery, according to the patients' reports, 14 of 20 elbows were much better, and 6 elbows were better. A mean preoperative VAS pain score at rest of 3.9 points improved to 0.3 points (P<0.0001), and that during activity improved from 7.8 points to 0.9 points (P<0.0001). The mean preoperative JOA elbow score of 29 points was improved to 90 points (P<0.0001). The mean postoperative DASH score was 10.6 (range 0-50). Absent of T2-weighted high signal focus of the ECRB origin on preoperative magnetic resonance imaging (MRI) (P=0.02) and receiving public assistance (P=0.01) were significantly associated with worse DASH scores. Arthroscopic release was a satisfactory procedure for chronic lateral epicondylitis. Preoperative MRI of the ECRB origin and socioeconomic factors were significantly associated with postoperative residual symptoms evaluated with the DASH score. (author)

  10. Opinions among Danish knee surgeons about indications to perform total knee replacement showed considerable variation

    DEFF Research Database (Denmark)

    Troelsen, Anders; Schrøder, Henrik; Husted, Henrik

    2012-01-01

    During the past decade, the incidence of primary total knee replacement (TKA) surgery in Denmark has approximately doubled. This increase could be due to weakened indications to perform TKA surgery. We aimed to investigate variation in opinions about indications to perform TKA among Danish knee...

  11. Knee Injuries

    Science.gov (United States)

    ... of the knee. Sometimes fluid collects around the knee (this is called effusion ). Fractures and Dislocations A fracture is a cracked, broken, or shattered bone and is usually diagnosed by an X-ray. You may have trouble ... off to the side of the knee joint by twisting or some kind of impact. ...

  12. Knee Problems

    Science.gov (United States)

    ... in Chinese 繁體中文 ) What Are Knee Problems? (in Korean 한국어 ) What Are Knee Problems? (in Vietnamese bằng ... the knee. Ultrasound. A technique that uses sound waves to produce images of the soft tissue structures ...

  13. 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

  14. 运动所致膝关节损伤的防治与康复%Prevention and rehabilitation of knee joint injury in sports

    Institute of Scientific and Technical Information of China (English)

    章莹; 尹庆水; 黄华扬; 张惠民

    2003-01-01

    @@ BACKGROUND: The main manifestation of knee joint injury is the injury of menisous and relative ligament. The microtraumatic technique of arthroscope could be applied to most of the knee joint injury patients, however, the rehabilitation measure is also necessary for functional recovery.

  15. 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

  16. 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

  17. CPM Exercise Combined With Rehabilitation Nursing in Improving the Application of Knee Joint Function After Surgery for Fractures of the Knee%CPM锻炼结合护理康复在改善膝部骨折术后膝关节功能中的应用探讨

    Institute of Scientific and Technical Information of China (English)

    关淼

    2016-01-01

    Objective To analysis the CPM exercise combined with rehabilitation nursing of knee fractures of the knee joint function after surgery for application effect.Methods95 patients were divided into two groups, control group and CPM exercise routine, observation group of 54 CPM exercise combined with routine nursing rehabilitation.Results The observation group was 85.2% higher than that of control group 63.4%, two groups of nursing after the HSS score, compared to the knee joint mobility, P<0.05.Conclusion The combination of CPM exercise rehabilitation nursing can improve the postoperative patients with knee joint function.%目的:分析CPM锻炼结合护理康复对膝部骨折术后膝关节功能的应用效果。方法将95例患者分为两组,对照组41例行CPM锻炼,观察组54例行CPM锻炼结合护理康复。结果观察组优良率85.2%高于对照组63.4%,两组护理后HSS评分、膝关节活动度对比,P<0.05。结论 CPM锻炼结合护理康复可提高患者术后膝关节功能。

  18. A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints

    International Nuclear Information System (INIS)

    We have previously described a technology based on diffuse reflectance of broadband light for measuring joint articular cartilage thickness, utilizing that optical absorption is different in cartilage and subchondral bone. This study is the first evaluation of the technology in human material. We also investigated the prospects of cartilage lesion imaging, with the specific aim of arthroscopic integration. Cartilage thickness was studied ex vivo in a number of sites (n = 87) on human knee joint condyles, removed from nine patients during total knee replacement surgery. A reflectance spectrum was taken at each site and the cartilage thickness was estimated using the blue, green, red and near-infrared regions of the spectrum, respectively. Estimated values were compared with reference cartilage thickness values (taken after sample slicing) using an exponential model. Two-dimensional Monte Carlo simulations were performed in a theoretical analysis of the experimental results. The reference cartilage thickness of the investigated sites was 1.60 ± 1.30 mm (mean ± SD) in the range 0-4.2 mm. Highest correlation coefficients were seen for the calculations based on the near-infrared region after normalization to the red region (r = 0.86) and for the green region (r = 0.80).

  19. Popliteal lesion due to traction during unicompartmental knee revision surgery☆

    OpenAIRE

    Kerens, Bart; Boonen, Bert; Schotanus, Martijn G.M.; Kort, Nanne P.

    2013-01-01

    Popliteal artery injury is a rare but known complication in knee surgery. Only one article in current literature reports that the risk increases during revision knee surgery. A new case is described in which an injury to the popliteal artery occurred during lateral unicompartmental to total knee arthroplasty revision surgery. This vascular injury occurred 5–10 cm below the tibial resection level in a healthy patient with a history of cruris fracture with plate osteosynthesis and lateral unico...

  20. 膝前方撞击的关节镜下病因分析%Etiological analysis of anterior knee impingement under athroscopy

    Institute of Scientific and Technical Information of China (English)

    王英明; 徐斌; 徐洪港; 周亮; 钱三祥

    2011-01-01

    Aim To investigate the etiology of anterior knee impingement. Methods We reviewed 137 cases of arthroscopic surgery patients who suffered from either or both of knee extension limitation and anterior knee pain before operation from May 2007 to May 2008 ,121 cases ( accounting for 88. 3% of the total) of which were found of anterior knee impingement,including 68 male and 53 female and the mean age was 36. 5 years old ( rangine from 8 to 72 years old) . The reasons of anterior knee impingement were identified by arthroscopic examination. Results Arthroscopic findings were osteophytes formation in the femoral intercondylar notch or patella inferior pole or in the anterior marginal part of the tibial intercondylar eminence ,meniscus injury , anterior cruciate ligament( ACL) injury ,joint loose bodies , patellar tilt or subluxation . avulsion fracture in the tibial intercondylar eminence , plica syndrome , completed anterior cruciate ligament reconstruction ,intra-articular tumor, ACL ' s cyst. Conclusion Anterior knee impingement is a very important factor of knee extension limitation and anterior knee pain. The very common causes of anterior knee impingement are meniscus injury , anterior cruciate ligament injury or osteophytes formation.%目的 探讨膝关节前方撞击的病因机制.方法 2007年5月~2008年5月对137例该院收治伸膝受限、膝前痛患者行关节镜手术,其中121例患者关节(占88.3%)存在撞击,对此进行回顾性分析.结果 撞击病因有:膝关节退变性骨赘形成41例(包括髌骨下极骨赘、胫骨髁间嵴骨赘、髁间窝骨赘,ACL胫骨止点前缘骨赘等),半月板损伤 30 例,前交叉韧带(ACL)断裂26例,关节游离体22例,髌骨外侧倾斜12例、髌骨半脱位2例,胫骨髁间嵴撕脱性骨折9例,滑膜皱襞综合征6例,ACL重建术后5例,关节内肿瘤4例,ACL囊肿3例.结论 膝前方撞击是导致膝前痛及伸直受限的重要因素之一.造成撞击的较常见原因为半月

  1. Thompson's quadricepsplasty for stiff knee

    OpenAIRE

    Kundu, ZS; Sangwan, SS; Guliani, G; Siwach, RC; Kamboj, P; Singh, Raj

    2007-01-01

    Background: Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods: Twenty-two male patients (age range 20-45 years) with posttraumatic knee stiffness following...

  2. Knee extension and flexion: MR delineation of normal and torn anterior cruciate ligaments

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Ikeda, Kotaroh; Fukubayashi, Tohru; Anno, Izumi; Itai, Yuji [Univ. of Tsukuba, Ibaraki (Japan)

    1996-03-01

    Our goal was to assess the effect of joint position of semiflexed and extended knees in MR delineation of the anterior cruciate ligament (ACL). With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semiflexed position (average 45{degrees} of flexion) within the magnet bore. Sets of oblique sagittal MR images were obtained for both extended and flexed knee positions. Thirty-two knees with intact ACLs and 43 knees with arthroscopically proven ACL tears were evaluated. Two observers compared paired MR images of both extended and flexed positions and rated them by a relative three point scale. Anatomic correlation in MR images was obtained by a cadaveric knee with incremental flexion. The MR images of flexed knees were more useful than of extended knees in 53% of the case reviews of femoral attachments and 36% of reviews of midportions of normal ACLs. Compared with knee extensions, the MR images for knee flexion provided better clarity in 48% of reviews of disrupted sites and 52% of residual bundles of torn ACLs. Normal ACL appeared taut in the knee extension and lax in semiflexion. Compared with MR images of knees in extension, MR images of knees in flexion more clearly delineate the femoral side of the ligament with wider space under the intercondylar roof and with decreased volume-averaging artifacts, providing superior visualization of normal and torn ACLs. 13 refs., 7 figs., 1 tab.

  3. Role of Arthroscopy in Disorder of Knee Joints:Analysis of 30 Cases.

    Directory of Open Access Journals (Sweden)

    R.K.Gupta , Ravi Mittal

    2001-07-01

    Full Text Available Thirty cases of various disorders of knee joint were subjected to an arthroscopic examination inorder to confirm/alter the diagnosis and simultaneously correctthe pathology detected. Torn menisciand ACL tear constitured the large percentage ofcases. Partial menisectomy was the most commonlyperformed procedure accounting for 47% of cases. The superiority of arthroscopy in diagnosingand treating various disorders of knee joint was proved beyond doubt.

  4. An Unusual Case of Acl Cyst with Multiple Melon Seed Bodies of the Knee

    OpenAIRE

    Vaish, Abhishek; Sancheti, Parag; Vaishya, Raju

    2016-01-01

    Introduction: The cyst of anterior cruciate ligament (ACL) is a known clinical entity, but its association with knee synovitis and melon or rice bodies is not documented. Case Report: We report a rare case of ganglionic cyst of of the knee in association with diffuse synovitis and multiple melon or rice bodies in a 36 year old male. The case was treated arthroscopically with removal ofthe cyst of ACL and multiple melon seed bodies. Conclusion: Information regarding incidence, treatment, and o...

  5. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark

    DEFF Research Database (Denmark)

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-01-01

    arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES: Yearly incidence of meniscal procedures per 100 000 inhabitants was calculated with...

  6. Rehabilitation training combined with clinical nursing in the application research of knee joint function after surgery for fractures of the knee%康复训练结合临床护理在膝部骨折术后膝关节功能中的应用研究

    Institute of Scientific and Technical Information of China (English)

    王玉馨

    2016-01-01

    目的:探讨康复训练结合临床护理在膝部骨折术后膝关节功能中的应用。方法:选取该院收治的87例膝部骨折患者随机分为2组,对照组42例膝部骨折患者仅采用康复训练,观察组45例采用康复训练结合临床护理,对比2组患者治疗后膝关节功能恢复情况。结果:观察组患者术后6 w、3个月、6个月、1年的 HSS 评分明显高于对照组(P <0.05)。结论:膝部骨折患者治疗时采用康复训练结合临床护理,有利于膝关节功能的早日恢复,应用前景广阔。%Objective:to study the rehabilitation training combined with clinical nursing in the application of knee joint function after surgery for fractures of the knee.Methods:choose 87 cases of our hospital knee fracture patients were randomly divided into 2 groups,control group of 42 patients with fracture of the knee with rehabilitation training,only observation group 45 cases with clinical nursing,rehabilitation training combined with comparing two groups after treatment in patients with knee joint function recovery.Results:the observation group of patients after 6 weeks,3 months,6 months,1 year of HSS score significantly higher than the control group(P <0.05).Conclusions:in patients with fracture of knee treated by the combined clinical nursing,rehabilitation training is helpful to early recovery of knee joint function and application prospect.

  7. Repair of articular cartilage defects in minipigs by microfracture surgery and BMSCs transplantation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of minipigs was taken out and the bone marrow derived mesenchymal stem cells (BMSCs) were isolated and cultured to passage 3. Then 6 minipigs were randomly divided into 2 groups with 6 knees in each group. After the articular cartilage defect was induced in each knee. the left defect received microfracture surgery and was injected with 2. 5 ml BMSCs cells at a concentration of 3×107 cells/ml into the articular cavity; while right knee got single microfracture or served as blank control group. The animals were killed at 8 or 16 weeks, and the repair tissue was histologically and immunohistochemically examined for the presence of type Ⅱ collagen and glycosaminoglycans (GAGs) at 8 and 16 weeks. Results:Eight weeks after the surgery, the overlying articular surface of the cartilage defect showed normal color and integrated to adjacent cartilage. And 16 weeks after surgery, hyaline cartilage was observed at the repairing tissues and immunostaining indicated the diffuse presence of this type Ⅱ collagen and GAGs throughout the repair cartilage in the treated defects. Single microfracture group had the repairing of fibro-cartilage, while during the treatment, the defects of blank group were covered with fewer fiber tissues, and no blood capillary growth or any immunological rejection was observed. Conclusion:Microfracture technique and BMSCs transplantation to repair cartilage defect is characterized with minimal invasion and easy operation, and it will greatly promote the regeneration repair of articular cartilage defect.

  8. 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.

  9. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    OpenAIRE

    Diab, Mohammed A.; Fernandez, G N; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reductio...

  10. 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...

  11. 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

  12. Evaluation of microfracture of traumatic chondral injuries to the knee in professional football and rugby players

    Directory of Open Access Journals (Sweden)

    Rolf Christer

    2009-05-01

    Full Text Available Abstract Background Traumatic chondral lesions of the knee are common in football and rugby players. The diagnosis is often confirmed by arthroscopy which can be therapeutic by performing microfracture. Prospective information about the clinical results after microfracture is still limited. Aim To evaluate the short-term outcome of microfractured lesions in professional football ad rugby players in terms of healing and ability to return to play. Methods Twenty-four consecutive professional male players with isolated full-thickness articular cartilage defects on weight-bearing surface of femoral condyles were treated with microfracture. Clinical assessment of healing was done at three, six, 12 and at 18 months by using modified Cincinnati subjective and objective functional scoring. All 24 subjects were periodically scanned by 3-Tesla MRI on the day of the clinical evaluations and scored by the Henderson MRI classification for cartilage healing. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing by using ICRS scoring system. This was done due to presence of discrepancy between a "normal" MRI and persistent clinical symptoms. Results This study showed that 83.3% of players' resume full training between five to seven months (mean: 6.2 after microfracture of full-thickness chondral lesions of weight-bearing surface of the knee. Function and MRI knee scores of the 24 subjects gradually improved over 18 months, and showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r2 = 0.993, 0.986 and 0.993, respectively however, the second look arthroscopy score proved to have stronger strength of association with function score than MRI score. Conclusion We confirmed that microfracture is a safe and effective procedure in treating isolated traumatic chondral lesions of the load-bearing areas of the knee. Healing as defined by subjective symptoms and evaluated

  13. Local Anaesthetic Infusion with Elastomeric Pump After Arthroscopic Subacromial Decompression

    Science.gov (United States)

    Little, Kevin; Pillai, Anand; Fazzi, Umberto; Storey, Neil

    2007-01-01

    INTRODUCTION The use of extended local anaesthesia for postoperative pain has previously been reported, and has several advantages over other methods, including ease of placement, safety, reliability, lower cost and effective analgesia. We present our experience with a portable elastomeric infusion device in patients undergoing arthroscopic subacromial decompression, and make a case for its potential to allow same-day discharge. PATIENTS AND METHODS Forty patients undergoing arthroscopic subacromial decompression were followed-up. At the end of the procedure, an epidural catheter connected to a portable elastomeric local anaesthetic infusion system was inserted into the subacromial space. All patients were electively admitted for overnight stay postoperatively and assessed using a visual analogue scale (VAS) to evaluate their level of pain. RESULTS No patient reported severe pain at any stage. None of the patients required any parenteral opiate analgesia with the pump in situ. CONCLUSIONS These findings suggest that the use of this elastomeric infusion device following shoulder surgery allows safe and early discharge of patients with decreased need for parenteral opiate analgesia. PMID:17535622

  14. 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

  15. Secondary knee instability caused by fracture of the stabilizing insert in a dual-articular total knee

    DEFF Research Database (Denmark)

    Boesen, Morten P; Jensen, Tim Toftgaard; Husted, Henrik

    2004-01-01

    A case of a fractured polyethylene stabilizing insert causing secondary knee instability in a Dual-articular total knee arthroplasty (TKA) is presented. A 65-year-old woman who underwent surgery with a Dual-articular TKA 4 years earlier had a well-functioning prosthesis until a fall, after which......-articular knee....

  16. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... 000 of these operations a year, and they project that we’ll be doing approximately 3 to ... done in knee surgery, which is the pain management. In spite of this patient having a spinal ...

  17. Arthritic Pain Relief through Partial Knee Replacement

    Medline Plus

    Full Text Available ... knee. The damaged joint was caused by bones grinding against each other, leading to pain, stiffness and ... smaller hospitals with lower volume. It's fairly demanding technology surgery that you were just doing there. Don' ...

  18. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... it today. Now having said that, the whole concept of minimally invasive knee surgery for replacement is ... their experience, both in the prevention, in the management, and the care they’re after of the ...

  19. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... have done in knee surgery, which is the pain management. In spite of this patient having a spinal ... Can you talk a little bit about the pain management. Absolutely. Behind the curtain here we have Dr. ...

  20. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... 50 years, so we have quite a good track record. The other very common question that patients ... in knee surgery today have just an outstanding track record. One of the things that people ask ...

  1. Knee Pain and the Weekend Warriors

    Medline Plus

    Full Text Available ... little redness here as it comes in and feeds the meniscus to about right here. The rest ... orthopedics for approximately 35, 40 years. So these materials that we’re using in knee surgery today ...

  2. Radial tunnel syndrome caused by ganglion cyst: treatment by arthroscopic cyst decompression.

    Science.gov (United States)

    Mileti, Joseph; Largacha, Mauricio; O'Driscoll, Shawn W

    2004-05-01

    Compressive neuropathies of the radial nerve at the elbow can lead to one of 2 clinical entities. Posterior interosseous syndrome is primarily a motor deficiency of the posterior interosseous nerve, and radial tunnel syndrome presents as pain along the radial tunnel and extensor muscle mass. The radial nerve can be compressed at a number of sites around the elbow. In addition, numerous mass lesions reported in the literature can cause compressive neuropathy of the radial nerve at the elbow. Standard surgical management for persistent radial tunnel syndrome that is refractory to nonsurgical treatment is open decompression of the radial nerve. Cysts occurring in other joints are commonly treated arthroscopically. Supraglenoid cysts of the shoulder, meniscal cysts in the knee, and dorsal wrist ganglia are routinely treated with arthroscopic decompression or excision with management of the underlying etiology of the cyst. We present a case of radial tunnel syndrome caused by a ganglion cyst of the proximal radioulnar joint that was treated using arthroscopic excision of the cyst and decompression of the radial nerve. PMID:15122155

  3. Arthroscopic subacromial decompression: one- to seven-year results

    OpenAIRE

    Atalar, Ata Can; Demirhan, Mehmet; Kocabey, Yavuz; Akalin, Yilmaz

    2004-01-01

    Objectives: Impingement syndrome is one of the most important causes of pain in the shoulder region. Advances in arthroscopic techniques allowed acromioplasty to be performed arthroscopically. In this study, we evaluated the results of arthroscopic subacromial decompression in patients with impingement syndrome. Methods: Seventy patients who were treated with arthroscopic subacromial decompression and who had a follow-up period of at least a year were retrospectively evaluated. There were ...

  4. Synovial folds in the knee joint. The plica parapatellaris medialis

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, H.

    1987-12-01

    Stimulated by arthroscopic insight into central abnormalities of the knee joint and by the large number of unexplained case of 'anterior knee pain', we have studied the synovia in more than 2000 contrast examinations of the joint. Surprisingly, and contrary to the views expressed in the literature, the clinically significant plica parapatellaris medialis was seen as frequently during pneumo-arthrography as during more complex procedures. Abnormalities in the synovial fold emerged as a discreet disease identified as the 'medial shelf syndrome' and should be included in the differential diagnosis of causes of pain round the lower end of the femur and patella.

  5. Extra-Articular Ganglion Cysts around the Knee Joint

    OpenAIRE

    Park, Sang-Eun; Panchal, Karnav; Jeong, Jae-Jung; Kim, Young-Yul; Ji, Jong-Hun; Park, Sung-Ryeoll; Park, Min-Kyu

    2015-01-01

    Purpose The purpose of this study was to report clinical results of open excision of extra-articular ganglion cysts around the knee joint combined with arthroscopic management of intra-articular pathologies if present. Materials and Methods Of the total 107 cases of cystic lesions around the knee, 23 cases of extra-articular ganglion cysts were reviewed between January 2006 and July 2011. There were 13 males and 10 females with a mean age of 48 years (range, 30 to 73 years). The mean follow-u...

  6. Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Paphon Sa-ngasoongsong

    2011-10-01

    Full Text Available A high-dose local tranexamic acid has been introduced in total knee arthroplasty for bleeding control. We are not sure about the systemic absorption and side effects. The aim of this study was to evaluate the effect of low dosage of intra-articular tranexamic acid injection combined with 2-hour clamp drain in minimally bleeding computer-assisted surgery total knee replacement (CAS-TKR. A prospective randomized controlled trial was conducted in a total of 48 patients underwent CAS-TKR. The patients were randomly assigned to receive either of a mixed intra-articular solution of tranexamic acid 250 mg with physiologic saline (TXA group, or physiologic saline (control group and then followed by clamp drain for 2 hours. Postoperative blood loss was measured by three different methods as drainage volume, total hemoglobin loss and calculated total blood loss. Transfusion requirement and postoperative complications were recorded. All patients were screened for deep vein thrombosis and the functional outcomes were evaluated at 6 months after surgery. The mean postoperative drainage volume, total hemoglobin loss and calculated total blood loss in TXA group were 308.8 mL, 2.1 g/dL and 206.3 mL compared to 529.0 mL, 3.0 g/dL and 385.1 mL in the control group (P=0.0003, 0.0005 and <0.0001 respectively. Allogenic blood transfusion was needed for one patient (4.2% in TXA group and for eight patients (33.3% in the control group. Postoperative knee scores were not significantly different between groups. No deep vein thrombosis, infection or wound complication was detected in both groups. In this study, low dose intra-articular tranexamic acid injection combined with 2-hour clamping drain was effective for reducing postoperative blood loss and transfusion requirement in CAS-TKR without significant difference in postoperative complications or functional outcomes.

  7. Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial

    Science.gov (United States)

    Sa-ngasoongsong, Paphon; Channoom, Thanaphot; Kawinwonggowit, Viroj; Woratanarat, Patarawan; Chanplakorn, Pongsthorn; Wibulpolprasert, Bussanee; Wongsak, Siwadol; Udomsubpayakul, Umaporn; Wechmongkolgorn, Supaporn; Lekpittaya, Nantaporn

    2011-01-01

    A high-dose local tranexamic acid has been introduced in total knee arthroplasty for bleeding control. We are not sure about the systemic absorption and side effects. The aim of this study was to evaluate the effect of low dosage of intra-articular tranexamic acid injection combined with 2-hour clamp drain in minimally bleeding computer-assisted surgery total knee replacement (CAS-TKR). A prospective randomized controlled trial was conducted in a total of 48 patients underwent CAS-TKR. The patients were randomly assigned to receive either of a mixed intra-articular solution of tranexamic acid 250 mg with physiologic saline (TXA group), or physiologic saline (control group) and then followed by clamp drain for 2 hours. Postoperative blood loss was measured by three different methods as drainage volume, total hemoglobin loss and calculated total blood loss. Transfusion requirement and postoperative complications were recorded. All patients were screened for deep vein thrombosis and the functional outcomes were evaluated at 6 months after surgery. The mean postoperative drainage volume, total hemoglobin loss and calculated total blood loss in TXA group were 308.8 mL, 2.1 g/dL and 206.3 mL compared to 529.0 mL, 3.0 g/dL and 385.1 mL in the control group (P=0.0003, 0.0005 and <0.0001 respectively). Allogenic blood transfusion was needed for one patient (4.2%) in TXA group and for eight patients (33.3%) in the control group. Postoperative knee scores were not significantly different between groups. No deep vein thrombosis, infection or wound complication was detected in both groups. In this study, low dose intra-articular tranexamic acid injection combined with 2-hour clamping drain was effective for reducing postoperative blood loss and transfusion requirement in CAS-TKR without significant difference in postoperative complications or functional outcomes. PMID:22053253

  8. Severe Heterotopic Ossification following Total Knee Replacement

    OpenAIRE

    Dodds, Alexander L.; Keene, Gregory C. R.

    2014-01-01

    Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO) is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-...

  9. Knee pain

    Science.gov (United States)

    ... time, overuse, or injury. Dislocation of the kneecap Fracture of the kneecap or other bones Iliotibial band syndrome . Injury to the thick band that runs from your hip to the outside of your knee. Pain in the front of your knee around ...

  10. Arthroscopic subacromial decompression results in normal shoulder function after two years in less than 50% of patients

    DEFF Research Database (Denmark)

    Konradsen, Lars Aage Glud; Jensen, Claus Hjorth

    2015-01-01

    INTRODUCTION: The aim of this study was to evaluate the outcome two years after arthroscopic subacromial decompression using the Western Ontario Rotator-Cuff (WORC) index and a diagram-based questionnaire to self-assess active shoulder range of motion (ROM). METHODS: Outcomes in 80 patients with...... impingement of the shoulder undergoing arthroscopic subacromial decompression were prospectively assessed preoperatively, at three months and at two years post-operatively using the WORC index. All patients had received non-operative treatment for at least six months before undergoing surgery. Active range of...... only 45% reported near normal or normal WORC scores, and 56% presented with a reduced active ROM at two years. CONCLUSION: Arthroscopic subacromial decompression -appears effective in alleviating symptoms in patients with subacromial impingement who are resistant to conservative treatment, but can only...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 军事训练致膝关节损伤的关节镜下诊断和治疗%Arthroscopy in diagnosis and therapy of knee joint injuries due to military training

    Institute of Scientific and Technical Information of China (English)

    邹庆; 赵新华

    2012-01-01

    Objective To investigate the arthroscopy in early diagnosis of knee joint injuries due to military training and its and treatment effect. Methods The clinical data of the 171 patients of knee joint injuries from military training which performed with early arthroscopic examination and therapy in our hospital from January 2002 to October 2009 were retrospectively analyzed. The characteristics of knee joint injuries due to military training were summarized. All patients underwent knee MRI examination, and arthroscopic surgery or clearing. Compare the accuracy of MUI findings. Lysholm scores evaluation and the patients' subjective e-valuation of pre-operation and post-operation were performed. Results All patients were followed up for 10 to 22 months. The pre-operative Lysholm scores were (42. 1 ?.7) points and postoperative were (84. 3 ?.3) points. No surgery-related vascular and nerve injury and infection and other complications were observed. Conclusion MRI has high diagnostic value of knee joint injuries in military training and that also is a treat method. Arthroscopic examination in knee joint injuries from military training can evaluate the extent of knee joint injury completely and minimally invasive treat the knee joint injury. It has the obvious superiority compared with the other treatment.%目的 探讨关节镜对军事训练所致膝关节损伤的诊断及其治疗效果.方法 回顾性分析我院2002年1月-2009年10月收治的171例军事训练所致膝关节损伤官兵临床资料,总结军事训练所致膝关节损伤的特点.所有病例均行膝关节MRI检查,并在关节镜下行手术治疗或关节探查清理.对比MRI检查结果的准确率.术前、术后均对所有病例行膝关节Lysholm评分及主观评价.结果 本组病例随访时间10~ 22月,Lysholm评分术前(42.1±3.7)分,术后为(84.3±2.3)分.无因手术而症状加重及发生血管神经损伤及感染等并发症.结论 关节镜既有诊断价值又是治疗

  13. Diagnostic Efficacy in Knee MRI Comparing Conventional Technique and Multiplanar Reconstruction with One-Millimeter FSE PDW Images

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Y.C.; Kim, S.S.; Chung, H.W.; Choe, B.K.; Ahn, J.H. [Dept. of Radiolog y, Kangwon National Univ. School of Medicine, Kangwon-do (Korea)

    2007-10-15

    Background: Magnetic resonance (MR) imaging has proved to be an excellent tool in diagnosing injuries of the cruciate ligaments and menisci. However, multiple planes and sometimes optimal oblique or double-oblique scan planes are needed due to the variability in the positioning of important structures, which means there is a lower throughput and longer scanning time. Purpose: To compare the performance of a 1-mm-thickness fast spin-echo (FSE) proton-density-weighted (PDW) MR imaging technique with multiplanar reconstruction (MPR) in diagnosing tears of the menisci and cruciate ligaments with that of conventional MR imaging. Material and Methods: Twenty-five consecutive patients underwent preoperative conventional and 1-mm-thickness FSE PDW MR imaging with subsequent knee arthroscopic surgery. Two musculoskeletal radiologists evaluated the status of the cruciate ligaments and menisci using two sets of MR images (method A: conventional images including seven sequences, taking 26 min; method B: 1-mm-thickness FSE PDW images with MPR, taking 7 min 20 s). The diagnostic efficacies of both methods for tears of the cruciate ligament and menisci were calculated and compared. Results: Arthroscopic surgery revealed 10 anterior cruciate ligament (ACL) tears, one posterior cruciate ligament (PCL) tear, and 26 meniscal tears. The diagnostic values of both methods were 100% for a cruciate ligament tear. The diagnostic values (sensitivity, specificity, accuracy, positive predictive value, and negative predictive value) for meniscal tears were 90%, 100%, 96%, 100%, and 94% for method A, and 95%, 100%, 98%, 100%, and 97% for method B, respectively. There were no significant differences in the diagnostic values between methods A and B. Conclusion: 1-mm-slice-thickness FSE PDW imaging with MPR showed comparable performance in diagnosing tears of the cruciate ligaments and menisci to conventional sequences but the scan time was much shorter. Therefore, this technique (method B) might

  14. Comparing analgesic and hemodynamic effects of unilateral spinal levobupivacaine, levobupivacaine-fentanyl and levobupivacaine-morphine combinations for arthroscopic procedures

    Directory of Open Access Journals (Sweden)

    Özlem Özorak

    2010-09-01

    Full Text Available Objectives: Aim of the study was to compare the analgesic and hemodynamic effects of levobupivacaine, levobupivacaine-fentanyl, levobupivacaine-morphine for arthroscopic knee surgery under unilateral spinal anesthesia.Methods: A total of 44 ASA I/II patients scheduled for arthroscopy were included in the study. After prehydration patients kept in a lateral position on the nondependent side. Spinal puncture was performed at L3–4/L4–5 intervertebral space. Patients divided into three subgroups: Group L (n=14 received 0.5% levobupivacaine 1 ml+1 ml distilled water; Group LF (n=15, 25 mcg fentanyl (0.5 ml+0.5 ml distilled water; and Group LM (n=15, 0.01 mg morphine (0.5 ml+0.5 ml distilled water. Patients remained in that position for 15 minutes. Blood pressure and heart rate were recorded before and 1st, 3rd, 5th, 10th, 15th, 20th and 30th minutes after the block and every 15 minutes during the operation. Motor blockade and sensorial level, side effects, motor block regression time (MBRT, first urination time and first analgesic need (FAN were recorded.Results: Group LM had the longest MBRT, but difference with other groups did not reach to a significant level (p>0.05. Group LM had significantly longer FAN time compare with other groups (p<0.05. The first urination time was latest in Group LM (p<0.05. Motor blockade was least in Group L (p<0.05 and almost 50% patients had not motor block.Conclusion: All three groups had successful anesthesia. Morphine group added group had significantly longer analgesia without significant urinary retention and motor blockade regression time. We concluded that additional low doses of morphine will be a better choice.

  15. 数字化快速成型技术在全膝关节置换术中应用%Clinical application of digital rapid prototyping technology on total knee replacement surgery

    Institute of Scientific and Technical Information of China (English)

    张鹰; 杨宇; 刘大鹏; 杨晶; 倪鹏辉

    2016-01-01

    Objective To explore the feasibility and clinical efficacy of digital rapid prototyping technology in total knee replacement ( TKA) surgery. Methods One case of patient with knee osteoarthritis was selected in this study. DICOM data of the affected knee was obtained via 3D reconstruction,then the data and image were processed via Mimics 15. 0 and Unigraphics NX 9. 0,to establish the nav-igation template of digital model of knee. After that,rapid prototyping technology was performed to produce the navigation template,and osteotomy was carried out when the affected knee was affixed with the template as designed. Results The TKA surgery was success-ful,in which operation time was 115 minutes and intraoperative bleeding was 450 ml. Postoperative X-ray image showed that knee pros-thesis was in position with wider joint space,and eversion of the knee was inversed. HSS score was 89. 6 at 2 weeks postoperative-ly. Conclusion Navigation template is a feasible approach for arthroplasty assisted with rapid prototyping technology,with such ad-vantages as less operation time,individual treatment,high precision and minimally invasive. It has definite clinical effect.%目的:探究数字化快速成型技术在全膝关节置换术( TKA)中应用的可行性及临床疗效。方法选择1例需行TKA的骨性关节炎患者,通过三维重建得到患者膝关节的DICOM格式数据;借助于医学影像控制系统Mimics 15.0和三维工程设计软件Unigraphics NX 9.0进行计算分析、图像处理等操作,建立与患者股骨髁和胫骨平台三维互补的膝关节截骨导向板的数字模型;然后,依靠快速成型技术打印制作的截骨导向板实物模型,通过截骨导航模板与膝关节紧密贴合,按照预先设计的截骨通道进行膝关节截骨。结果患者截骨操作顺利,TKA手术时间115 min,术中出血约450 ml;术后X线影像显示,膝关节假体在位正常,关节间隙变宽,膝关节外翻畸形完全矫正;术后2

  16. Unusual Cause of Knee Locking

    Directory of Open Access Journals (Sweden)

    Gazi Huri

    2013-01-01

    Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  17. A RANDOMIZED TRIAL OF ISOKINETIC VERSUS ISOTONIC REHABILITATION PROGRAM AFTER ARTHROSCOPIC MENISCECTOMY

    Science.gov (United States)

    Koutras, Georgios; Letsi, Magdalini; Papadopoulos, Pericles; Gigis, Ioannis

    2012-01-01

    Background: Although both isotonic and isokinetic exercises are commonly used in the rehabilitation of patients after arthroscopic meniscectomy no studies have compared their effect on strength recovery and functional outcomes. Purpose: The purpose of this study was to investigate the effects of two rehabilitation programs (isotonic and isokinetic) on muscle strength and functional performance after partial knee meniscectomy. A secondary purpose was to assess the correlation between isokinetic strength deficits and hop test performance deficits. Methods: Twenty male patients who underwent arthroscopic partial meniscectomy volunteered for the study. Both isotonic and isokinetic training were performed with the same equipment thereby blinding subjects to the mode of exercise. Main outcome measures were collected on the 14th and 33rd postoperative days and included isokinetic strength of the knee extensors and flexors, functional performance (single, triple, and vertical hopping) and the Lysholm questionnaire. Multivariate and univariate analyses of variance were used to assess the effects of the independent variables on the isokinetic variables, functional tests, and Lysholm score. Pearson's correlation was used to assess the relationship between isokinetic strength deficits and functional performance deficits. Results: Isokinetic measures, functional tests, and the Lysholm score all increased between initial and final assessment (p≤0.003). However, there were no group or group*time effects on any of the outcome variables (p≥0.33). Functional tests were better predictors of isokinetic deficits in the 14th compared to the 33rd postoperative day. Conclusion: No differences were found in the outcomes of patients treated using an isokinetic and an isotonic protocol for rehabilitation after arthroscopic meniscectomy. More than half of patients did not meet the 90% criterion in the hop tests for safe return to sports five weeks after meniscectomy. There were

  18. Metalworking defects in surgery screws as a possible cause of post-surgical infections

    Science.gov (United States)

    Spector, Mario; Peretti, Leandro E.; Romero, Gustavo

    2016-04-01

    In the first phase of this work, surface defects (metalworking) in stainless steel implantable prostheses and their possible relation to infections that can be generated after surgery was studied. In a second phase, the results obtained in the aforementioned stage were applied to knee cruciate ligaments surgery screws, considering the fact that a substantial number of Mucormycetes infections have been reported after arthroscopic surgery in Argentina since the year 2005. Two types of screws, transverse and interference screws, were analyzed. The Allen heads presented defects such as burrs and metalworking bending as a result of the machining process. These defects allow the accumulation of machining oil, which could be contaminated with fungal spores. When this is the case, the gaseous sterilization by ethylene oxide may be jeopardized. Cortical screws were also analyzed and were found to present serious metalworking defects inside their heads. To reduce the risk of infection in surgery, the use of screws with metalworking defects on the outer surface, analyzed with stereomicroscope and considering the inside part of the Allen as an outer surface, should be avoided altogether.

  19. Painful locking of the knee due to bucket handle tear of mediopatellar plica

    Institute of Scientific and Technical Information of China (English)

    HE Rui; YANG Liu; GUO Lin

    2011-01-01

    A case of swelling and anterior painful knee due to tear of mediopatellar plica is reported. The patient also felt clunk of the patellofemoral joint and knee locking. Under arthroscopic examination, a thick and fibrous plica was found medial to patellar, and a bucket tear along the plica fi.om medial patellar retinaculum to infrapatellar fat pad. Polarized microscopic examination showed collagen fiber fragment and loss of light reflecting property. Neuroimmunohistology suggested up-regulation of synovial plica innervation in the area around the crack. This may be related to the pain. The bucket tear of mediopatellar plicacaused pain and lock of knee are more common than previously reported.

  20. Multiple Ligament Knee Injury: Complications

    OpenAIRE

    Manske, Robert C.; Hosseinzadeh, Pooya; Giangarra, Charles E.

    2008-01-01

    Non-operative and operative complications are common following multiple ligament knee injuries. This article will describe common complications seen by the surgeon and physical therapist following this complex injury. Complications include fractures, infections, vascular and neurologic complications following injury and surgery, compartment syndrome, complex regional pain syndrome, deep venous thrombosis, loss of motion and persistent laxity issues. A brief description of these complications ...

  1. Time and cost savings in arthroscopic subacromial decompression: the use of bipolar versus monopolar radiofrequency

    Science.gov (United States)

    Fernandez, G. N.; Elsorafy, Kareem

    2008-01-01

    There is currently an increased interest in the use of electro surgery in arthroscopy. Since the introduction of the bipolar arthroscopic radiofrequency (RF) wand, it has started to replace the classic Bovie monopolar probe on the assumption that the new technology provides multifunctional devices, combining both tissue removal and haemostasis into one instrument. The more efficient tissue ablation and precise haemostasis achieved with these instruments should result in a significant reduction in the operative time and cost. We ran a prospective comparative randomised study to test this hypothesis. Forty patients underwent arthroscopic subacromial decompression, randomised into two groups. The group treated with bipolar RF was associated with an average operative time saving of 8 min (P < 0.0001) and an average cost saving of £83 (€111) per case (P < 0.003), compared to monopolar RF. Bipolar RF is the instrument of choice in arthroscopic shoulder surgery, as it saves time and money. PMID:18414860

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

    OpenAIRE

    Matthias Aurich; Hofmann, Gunther O; Bernd Rolauffs; Florian Gras

    2014-01-01

    Osteoarthritis (OA) is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically) and the cartilage lesions (arthroscopically) of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients) was performed, who were treated due ...

  4. Knee arthroscopy

    Science.gov (United States)

    ... remove it. Torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) Torn or damaged ... in the knee Blood clot in the leg Injury to a blood vessel or nerve Infection in ...

  5. Knee Injuries and Disorders

    Science.gov (United States)

    Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

  6. Knee Replacement Patients May Be Able to Hit the Shower Sooner

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159055.html Knee Replacement Patients May Be Able to Hit the ... 26, 2016 THURSDAY, May 26, 2016 (HealthDay News) -- Knee surgery patients are usually instructed to wait two ...

  7. Comparison of parecoxib and patient controlled intravenous analgesia as a postoperative analgesic following the arthroscopic shoulder-elbow surgery:a case control study%帕瑞昔布与静脉镇痛泵对肩关节镜外科术后早期镇痛疗效的研究

    Institute of Scientific and Technical Information of China (English)

    江小成; 鲁谊; 姜春岩

    2013-01-01

    Objective Postoperative rehabilitation is closely related to the treatment effect of the arthroscopic shoulder operation.Articular contracture or adhesion in shoulder and elbow may result in limited mobility of these large joints.However,early postoperative functional exercise can effectively avoid the limitation of joint motion,and further satisfactory surgical outcomes may be achieved.Such early functional exercise should be based on less postoperative pain or painlessness.Therefore,it is very important to alleviate their early postoperative pain for these patients with the shoulder surgery. At present,a patient-controlled intravenous analgesia(PCIA)pump with opioids is commonly used for the postoperative analgesia in orthopaedics.In recent years,increasing studies have shown that opioids are not the ideal postoperative orthopaedic analgesic for its poorer curative effect of the pain derived from movement,which is not good for patients′early postoperative functional exercise.Postoperative opioid analgesia can also cause nausea,vomiting,dizziness,respiratory depression,urinary retention, addiction and other adverse reactions.Therefore,selective cox-2 inhibitors-parecoxib has been widely used in surgery.The purpose of this study was to compare the early postoperative analgesia effect of parecoxib with PCIA using opioid for postoperative analgesia of the arthroscopic shoulder-elbow surgery.Methods This study selected patients with rotator cuff inj ury or shoulder instability treated by shoulder arthroscopy from August 2011 to May 2012 in our department.The exclusion criteria include:history of shoulder or elbow surgery, long-term use of analgesics, liver and kidney disfunction,active peptic ulcer patients and other inappropriate patients for the study.A total of 178 cases,including 104 male and 74 female,aged 12 to 78 years old (average 44.45 years),were performed under general anesthesia.According to the patients′choice,they were divided into the parecoxib

  8. 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.

  9. Gender differences in knee injury epidemiology among competitive alpine ski racers.

    OpenAIRE

    Stevenson, H; Webster, J.; Johnson, R.; Beynnon, B

    1998-01-01

    A questionnaire was sent in 1995 to all members of the Vermont Alpine Racing Association and several New England NCAA Division I ski racing programs. A total of 1010 surveys were sent and 404 responses were received. The survey included questions regarding the racer's age, gender, number of years spent ski racing, injury to knee(s), surgery to knee(s), and reinjury to a surgically reconstructed anterior cruciate ligament (ACL) requiring subsequent surgery. Only injuries that occurred during a...

  10. Atypical pyoderma gangrenosum following total knee replacement surgery: first report in dermatologic literature Pioderma gangrenoso atípico após artroplastia total do joelho: primeiro relato na literatura dermatológica

    Directory of Open Access Journals (Sweden)

    Shyam B. Verma

    2009-12-01

    Full Text Available An atypical pyoderma gangrenosum mimicking a post surgical cutaneous and subcutaneous infection is being reported for the first time in international literature after knee replacement surgery with the operation site being the starting point of pyoderma gangrenosum. Orthopedic surgeons and general surgeons should be aware of the existence of this disease and its association with surgical trauma.Um pioderma gangrenoso atípico, similar a uma infecção cutânea e subcutânea pós-operatório, está sendo relatado pela primeira vez na literatura mundial, depois de realização de artroplastia do joelho, tendo como foco inicial o local da cirurgia. Cirurgiões ortopédicos e gerais devem estar cientes da existência dessa doença e de sua associação ao trauma cirúrgico.

  11. 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

  12. Arthritic Pain Relief through Partial Knee Replacement

    Medline Plus

    Full Text Available ... than 10 or 15 percent of the knee surgery candidates that come into my office are real good patients who are good candidates for this particular ... essentially the fixation of these implants are as good on the first day of the surgery as they'll ever be, right? So you ...

  13. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery...

  14. 微创膝关节单髁置换术治疗70岁以上老年膝关节内侧间室骨性关节炎%Minimally invasive surgery unicompartmental knee arthroplasty for medial compartment knee osteoarthritis of patients older than 70 years

    Institute of Scientific and Technical Information of China (English)

    刘晓东; 蔡珉巍; 马童; 涂意辉; 张长青

    2012-01-01

    目的 探讨微创膝关节单髁置换术(MIS-UKA)治疗70岁以上老年膝关节内侧间室骨性关节炎的可行性及初步疗效.方法 采用MIS-UKA治疗70岁以上老年膝关节内侧间室骨性关节炎21例(24膝).评估切口大小、手术时间、出血量、引流量和并发症.比较术前、术后膝关节HSS评分、膝关节活动度及下肢力线(髋膝踝角).结果 术后平均随访18个月(12~24个月).末次随访患者膝关节内侧间室疼痛明显减轻,HSS评分明显增加,下肢力线内翻畸形明显减少,但膝关节活动度无明显改善,无感染、脂肪栓塞或下肢深静脉血栓形成,假体位置不良、脱位,假体松动等并发症.结论 MISUKA可治疗70岁以上老年膝关节内侧间室骨性关节炎,但远期疗效尚需进一步随访.%Objective To explore the feasibility and preliminary effect of minimally invasive surgery unicompartmental knee arthroplasty (MIS-UKA) for medial compartment knee osteoarthritis of patients older than 70 years. Methods All of 21 consecutive patients older than 70 years(24 knees)with medial compartment knee osteoarthritis were treated with MIS-UKA. Incision, surgical time, blood loss, drainage and complications were measured. The pre- and post- operative function of the knees were evaluated by HSS score system. The pre- and post- operative range of motion (ROM) and alignment of the lower limbs (hip-knee-ankle angle) were measured and compared. Results All cases were followed up for average 18 months (12-24 months). At the last follow up, all cases achieved significant relief of pain, improvement of HSS score and correction of varus deformity. But ROM was not significantly improved, and none had complications of infection, fat embolism, deep vein thrombosis, malposition of prosthesis, dislocation and loosing. Conclusion MIS-UKA is an effective alternative for the treatment of medial compartment knee osteoarthritis of patients older than 70 years, however, further

  15. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players

    OpenAIRE

    Lee, Myungchun; SUNG, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, SoJung; Kim, Seungho; Kim, Jooyoung

    2016-01-01

    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG...

  16. Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

    Science.gov (United States)

    Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

    2016-01-01

    Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

  17. 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

  18. Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study

    Directory of Open Access Journals (Sweden)

    Roos Ewa M

    2009-12-01

    Full Text Available Abstract Background The association between knee alignment and knee pain in knee osteoarthritis (OA is unclear. High tibial osteotomy, a treatment option in knee OA, alters load from the affected to the unaffected compartment of the knee by correcting malalignment. This surgical procedure thus offers the possibility to study the cross-sectional and longitudinal association of alignment to pain. The aims were to study 1 the preoperative association of knee alignment to preoperative knee pain and 2 the association of change in knee alignment with surgery to change in knee pain over time in patients operated on for knee OA by high tibial osteotomy. Methods 182 patients (68% men mean age 53 years (34 - 69 with varus alignment having tibial osteotomy by the hemicallotasis technique for medial knee OA were consecutively included. Knee alignment was assessed by the Hip-Knee-Ankle (HKA angle from radiographs including the hip and ankle joints. Knee pain was measured by the subscale pain (0 - 100, worst to best scale of the Knee injury and Osteoarthritis Outcome Score (KOOS preoperatively and at one year follow-up. To estimate the association between knee alignment and knee pain multivariate regression analyses were used. Results Mean preoperative varus alignment was 170 degrees (153 - 178 and mean preoperative KOOS pain was 42 points (3 - 86. There was no association between preoperative varus alignment and preoperative KOOS pain, crude analysis 0.02 points (95% CI -0.6 - 0.7 change in pain with every degree of HKA angle, adjusted analysis 0.3 points (95% CI -1.3 - 0.6. The mean postoperative knee alignment was 184 degrees (171 - 185. The mean change in knee alignment was 13 degrees (0 - 30. The mean change in KOOS pain was 32 (-16 - 83. There was neither any association between change in knee alignment and change in KOOS pain over time, crude analysis 0.3 point (95% CI -0.6 - 1.2, adjusted analysis 0.4 points (95% CI 0.6 - 1.4. Conclusion We found no

  19. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard; Roos, Ewa; Gooberman-Hill, Rachael

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...... traumas; and many described their lack of trust in their knee. Patients believed that surgery would provide joint stability. Despite the ostensible satisfaction with surgery, more detailed exploration showed mixed views. CONCLUSIONS: Participants in a trial of treatments for acute ACL injury express a......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...

  20. 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...

  1. 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

  2. State-of-the-Art Hip Surgeries for Active Adults

    Medline Plus

    Full Text Available ... Thomas Jefferson University Hospital specializing in hip and knee joint replacement. And today with me I have ... University Hospital who also specializes in hip and knee replacement surgery. For our viewers, I would like ...

  3. 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

  4. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up.

    Science.gov (United States)

    Jiménez-Martín, Antonio; Pérez-Hidalgo, Santiago

    2011-04-01

    Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg), fracture of left clavicle (type I, Craig), and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws) with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws). Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression. PMID:21897586

  5. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

    Directory of Open Access Journals (Sweden)

    Antonio Jiménez-Martín

    2011-01-01

    Full Text Available Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg, fracture of left clavicle (type I, Craig, and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws. Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Total knee arthroplasty for severe valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    Zhou Xinhua; Wang Min; Liu Chao; Zhang Liang; Zhou Yixin

    2014-01-01

    Background Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging,and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release.The purpose of this study was to review 8 to 11 years (mean,10 years) follow-up results of primary TKA for varient-Ⅲ valgus knee deformity with use of different type implants.Methods Between January 2002 and January 2005,20 women and 12 men,aged 47 to 63 (mean,57.19±6.08) years old,with varient-Ⅲ valgus knees underwent primary TKA.Of the 32 patients,37 knees had varient-Ⅲ deformities.Pie crusting was carefully performed with small,multiple inside-out incisions,bone resection balanced the knee in lieu of soft tissue releases that were not used in the series.Cruciate-retaining knees (Gemini MKⅡ,Link Company,Germany) were used in 13 knees,Genesis Ⅱ (Simth & Nephew Company,USA) in 14 knees,and hinged knee (Endo-Model Company,Germany) in 10 knees.In five patients with bilateral variant-Ⅲll TKAs,three patients underwent 1-stage bilateral procedures,and two underwent 2-stage procedures.All implants were cemented and the patella was not resurfaced.The Hospital for Special Surgery (HSS) knee score was assessed.Patients were followed up from 8 to 11 years.Results The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001).The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001).The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001).No patients underwent revision.One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years.Three patients developed transient peroneal nerve palsies,which resolved within nine months.Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban

  9. [Imaging strategies for knee injuries].

    Science.gov (United States)

    Hegenscheid, K; Puls, R; Rosenberg, C

    2012-11-01

    Injuries of the knees are common. The Ottawa knee rule provides decisional support to determine whether radiographs are indicated or not. With the use of ultrasound it is possible to detect defects of the extensor ligaments and the anterior cruciate ligament. Furthermore, it is possible to detect indirect signs of an intra-articular fracture, e.g. lipohemarthrosis. In complex fractures, e.g. tibial plateau fractures, further diagnostic procedures with multislice computed tomography (CT) are needed for accurate classification and preoperative planning. Multislice CT with CT angiography enables three-dimensional reconstruction of the knee and non-invasive vascular imaging for detection of vascular injury. Magnetic resonance imaging (MRI) is the gold standard for detection of occult fractures and injuries of the ligaments and menisci. Higher field strengths can be used to improve the diagnostics of cartilage lesions. Virtual MR arthrography is superior to conventional MRI for detection of cartilage lesions especially after meniscus surgery. PMID:23154845

  10. Imaging strategies for knee injuries

    International Nuclear Information System (INIS)

    Injuries of the knees are common. The Ottawa knee rule provides decisional support to determine whether radiographs are indicated or not. With the use of ultrasound it is possible to detect defects of the extensor ligaments and the anterior cruciate ligament. Furthermore, it is possible to detect indirect signs of an intra-articular fracture, e.g. lipohemarthrosis. In complex fractures, e.g. tibial plateau fractures, further diagnostic procedures with multislice computed tomography (CT) are needed for accurate classification and preoperative planning. Multislice CT with CT angiography enables three-dimensional reconstruction of the knee and non-invasive vascular imaging for detection of vascular injury. Magnetic resonance imaging (MRI) is the gold standard for detection of occult fractures and injuries of the ligaments and menisci. Higher field strengths can be used to improve the diagnostics of cartilage lesions. Virtual MR arthrography is superior to conventional MRI for detection of cartilage lesions especially after meniscus surgery. (orig.)

  11. Arthroscopic anatomy of the subdeltoid space

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. Postoperative Autologous Reinfusion in Total Knee Replacement

    OpenAIRE

    A. Crescibene; Martire, F.; Gigliotti, P.; Rende, A.; Candela, M

    2015-01-01

    Surgeries for total knee replacement (TKR) are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two g...

  14. Patients’ decision making in total knee arthroplasty

    OpenAIRE

    Barlow, T.; Griffin, D.; Barlow, D; Realpe, A.

    2015-01-01

    Objectives A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review’s objective is to systematically examine the qualitative literature surrounding patients’ decision making in knee arthroplasty. Methods A systematic literature review using Medline and Embase was conducted to ...

  15. Thompson′s quadricepsplasty for stiff knee

    OpenAIRE

    Kundu Z; Sangwan S; Guliani G; Siwach R; Kamboj P; Singh Raj

    2007-01-01

    Background : Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods : 22 male patients (age range 20-45 years) with posttraumatic knee stiffness following dist...

  16. Polyethylene in knee arthroplasty: A review

    OpenAIRE

    Chakrabarty, Gautam; Vashishtha, Mayank; Leeder, Daniel

    2015-01-01

    Polyethylene (PE) has been used extensively in knee arthroplasty since the mid 20th century. Progress in material manufacturing and processing has led to newer polyethylenes over last few decades with different material properties. It has been established that PE wear in knee arthroplasty causes particle induced osteolysis which is the main reason for late failure and requires revision surgery. Although there are various causes of wear, the properties of PE have long been a matter of investig...

  17. Arthroscopic decompression for subacromial impingement syndrome.

    OpenAIRE

    S. J. Kim; Lee, J. W.; Kim, B. S.

    1997-01-01

    Arthroscopic decompression and cuff debridement was performed on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome: 19 with no actual tear of the cuff (stage II); 13 with a partial thickness tear (stage IIIa); 10 with complete tear less than 3 cm long (stage IIIb); and 5 with complete tear longer than 3 cm (stage IIIc). Patients were classified into impingement syndrome without tear (Group I), impingement syndrome with partial thickness tear (Group II)...

  18. Arthroscopic management of distal radius fractures.

    Science.gov (United States)

    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

  19. Arthroscopic management of painful first metatarsophalangeal joint

    Directory of Open Access Journals (Sweden)

    Debnath U

    2005-01-01

    Full Text Available Background: Arthroscopy of the great toe MTP joint has been practiced with favourable outcomes. A range of indications have been described ranging from synovitis to osteochondral defects. The purpose of the present study was to describe our technique and to assess the functional outcome following arthroscopic management of Hallux MTP disorders using AOFAS scoring system. Methods: We describe the technique of Hallux MTP joint arthroscopy in twenty patients. Indications included hallux rigidus with osteophytes, chondromalacia, OCDs, loose bodies, arthrofibrosis, synovitis, tophaceous gout arthritis and intra-articular fractures of MTP joint. All patients had been evaluated clinically and radiologically with record of their AOFAS scores pre-operatively. At a minimum follow-up of two years the clinical assessment was carried out with AOFAS scores. Results: The mean pre-operative and post-operative AOFAS score were 47 (range 10-78 and 97 (87 -100 respectively. The patient with intra-articular fracture had an excellent outcome following arthroscopic reduction of the fracture. Conclusion: Arthroscopic management of painful hallucial MTP joint is a specialized technique, which if performed for the right indications, gives a favourable outcome with minimal complications.

  20. In vivo morphometry of menisci of the knee in South Indians: A preliminary study

    Directory of Open Access Journals (Sweden)

    K.V.N. Dhananjaya

    2014-02-01

    Full Text Available Background: Since the in vivo morphometric data on the menisci of the knee joint of Indian subjects are scarce, we hereby studied the width and thickness of the menisci using Magnetic Resonance Imaging (MRI to establish standard dimensions of the normal medial and lateral meniscus as an aid to orthopaedic surgery. Methods: Eighty menisci from 40 knee joints were analysed in each of three regions, the anterior horn, the mid body and the posterior horn. The thickness and width of the menisci were measured in sagittal and coronal T1-weighted and T2-weighted MRI images and analysed statistically. Results: The mean thickness of medial meniscus at the anterior horn, mid body, and posterior horn were 6.3 ± 1.1 mm, 5.2 ± 1.3 mm, and 6.9 ± 1.1 mm, respectively. The respective values for the lateral meniscus were 4.8 ± 0.7 mm, 6.4 ± 1.1 mm, and 7.0 ± 0.9 mm. The mean width of medial meniscus at the anterior horn, mid body, and posterior horn were 10.5 ± 1.2 mm, 7.8 ± 1 mm and 13.9 ± 0.9 mm, respectively. The widths of lateral meniscus at the same regions were 11.8 ± 1.4 mm, 8.6 ± 1.2 mm, and 12.0 ± 0.9 mm, respectively. The lateral meniscus was significantly wider than medial at the anterior horn and mid body (p = 0.00. In contrast, the posterior horn of medial meniscus was significantly wider than lateral meniscus. Both menisci were significantly wider at their posterior horn, followed by the anterior horn and were significantly narrower at their mid body. Conclusion: The present study provides new information on the meniscal thickness and width in South Indians that can be used in planning of orthopaedic and arthroscopic surgeries of the knee joint. However, the study needs to be analyzed with a large sample size for the better interpretation.

  1. Developing a placebo-controlled trial in surgery: Issues of design, acceptability and feasibility

    Directory of Open Access Journals (Sweden)

    McDonald AM

    2011-02-01

    Full Text Available Abstract Background Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK. Methods Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons; plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists; three focus groups with anaesthetists (one national, two regional; 58 anaesthetists; two focus groups with members of the patient organisation Arthritis Care (7 participants; telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants; interviews with Chairs of UK ethics committees (6 individuals; postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists; two centre pilot (49 patients assessed. Results There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions proved easier than the method of anaesthesia (general anaesthesia. General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully. Conclusions Our study illustrated the opposing and often strongly held opinions about

  2. Severe Heterotopic Ossification following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Alexander L. Dodds

    2014-01-01

    Full Text Available Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays. Treatment consisted of nonoperative measures only, including physiotherapy with hydrotherapy and anti-inflammatories. She eventually regained her range of motion when seen at 8 months after operation. This case illustrates that nonoperative treatment without the use of radiotherapy or surgery can be used to safely resolve stiffness caused by HO after total knee replacement.

  3. Influencing factors of functional recovery of knee joint after surgery in patients with femoral intercondylar fracture%股骨髁间骨折术后膝关节功能恢复的影响因素

    Institute of Scientific and Technical Information of China (English)

    张立军; 杨占辉

    2014-01-01

    Background: Knee joint function limitation often occurs after internal fixation for femoral intercondylar fracture, but the mechanism of functional limitation and factors affecting the recovery of knee joint function are unclear. Objective:To explore the influencing factors of functional recovery of knee joint after femoral intercondylar fracture. Methods:A total of 118 patients with intercondylar fracture of femur were treated by open reduction and internal fixation be-tween February 2009 and February 2014 in our hospital. Their age, gender, fracture reason, classification of fracture, opera-tion time, ISS score, fixed mode, reduction, capsular repair, bone healing, CPM exercise were recorded during follow up. Results:Single factor analysis showed that patients with C2 and C3 types of fracture, high ISS score (>16), no anatomic re-duction, no capsular repair, delayed healing and disunion and no CPM exercise had worse functional recovery of knee joint after surgery (P16), no ana-tomic reduction, no capsular repair, delayed healing and disunion, no CPM exercise were risk factors of functional recovery of knee joint after surgery (P<0.05). Conclusions: The more severe crushing injury and the heavier of combined injury, the prognosis is poorer. It is advanta-geous to functional recovery of knee joint after femoral intercondylar fracture if patients have rigid fixation of knee joint, good anatomic reduction and capsular repair, and doing functional exercise passively or actively early after operation.%背景:股骨髁间骨折内固定术后常出现膝关节功能受限,但对其功能受限的发生机制及影响因素尚无定论。目的:探究股骨髁间骨折术后膝关节功能恢复的影响因素。方法:选取2009年2月至2014年2月我院收治的股骨髁间骨折患者118例,均行切开复位内固定治疗,术后进行随访。记录并分析患者的年龄、性别、骨折原因、骨折类型、手术时机、ISS评分、固定

  4. Anterior cruciate ligament of the knee - MRI protocol

    International Nuclear Information System (INIS)

    Full text: MRI examination of the knee lesions is golden standard in nowadays diagnostic. It gives valuable information for conventional, physiatrics and/or arthroscopic microinvasive treatment. Three planar MRI examinations and 3D reconstructions are highly precise in the analysis of the intra and periarticular structures, with exceptions of anterior cruciatre ligament (ACL). Direct contact with the roof of the intercondilar fossa (in the full extension during the examination) and its specific orientation makes visualisation of ACL diagnostically problematic. In a period from 2004 to presence, precise protocol for MRI visualisation of ACL was established, tested and applied as 'Angled biplanar reconstruction in the parasagital and paratransversal planes (patient-related and arbitrary selected in full extension)', on T2, 2 mm slice and 0,2 mm gap. Five hundred patients are examined in Clinical Center of Montenegro during mentioned period of time. Angled biplanar reconstruction gives visualisation of ACL superiority to examination in flexion, and it is adapted to the concrete morphology of the patients ACL. It was not depend of the volume of knee and, finally, takes less time to perform. Beside the ligament is shown at three to six slices, which is more than with the standard techniques. Precise visualisation of ACL is contribution to effectiveness of MRI of the knee injuries that helps in staging of conventional physiatric treatment. Beside it decrees number of diagnostic arthroscopies and arthroscopic interventions to bee microinvasive and effective in therapeutic treatment

  5. Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period

    OpenAIRE

    Harato, Kengo; YOSHIDA, Hiroki

    2015-01-01

    Background Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. However, unfortunately, very little has been reported on this phenomenon in the literature. The purpose of the current study was to investigate the relationship between symptomatic knee effusion and postoperative knee pain and to clarify the reason of the effusion accompanied by hip fracture. Methods A total of 100 pa...

  6. 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.

  7. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  8. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  9. An Unusual Case of Acl Cyst with Multiple Melon Seed Bodies of the Knee

    Science.gov (United States)

    Vaish, Abhishek; Sancheti, Parag; Vaishya, Raju

    2016-01-01

    Introduction: The cyst of anterior cruciate ligament (ACL) is a known clinical entity, but its association with knee synovitis and melon or rice bodies is not documented. Case Report: We report a rare case of ganglionic cyst of of the knee in association with diffuse synovitis and multiple melon or rice bodies in a 36 year old male. The case was treated arthroscopically with removal ofthe cyst of ACL and multiple melon seed bodies. Conclusion: Information regarding incidence, treatment, and outcomes for patients with synovial cysts and melon seed bodies is lacking. Arthroscopic examination of joint gives the opportunity to diagnose such rare entity of the joint and also provide minimally invasive effective treatment of such pathology. PMID:27299116

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Aquaflo pump vs FMS 4 pump for shoulder arthroscopic surgery.

    OpenAIRE

    Ampat, G.; Bruguera, J.; Copeland, S A

    1997-01-01

    A prospective controlled trial was carried out to compare two different fluid delivery systems used for shoulder arthroscopy. One an advanced pump system that controls both pressure and flow of fluid delivered, the other an air-driven diaphragm pump that only controls fluid pressure. Blood loss, presence of bleeding vessels and visual clarity were parameters used to assess the pump systems. There was no difference between the pumps in straightforward shoulder procedures. However, complicated ...

  12. MR diagnosis of meniscal tears of the knee

    International Nuclear Information System (INIS)

    Many reports have been published about the utilization of MR imaging for the diagnosis of the meniscal injury of the knee. The grading system frequently used in these reports was proposed by Mink, although, this grading does not measure menisci with structural abnormality such as discoid deformity and bucket handle tear. Accordingly, there is ample room for further improvement in this evaluating system. To pursuit the accuracy of our newly designed grading system, we performed retrospective study on 128 patients who underwent MRI examination prior to arthroscopic examination. Furthermore, follow up study of the menisci, which showed high-intensity signal, was done to ascertain whether such abnormalities progress to meniscal tears. Based upon the newly developed grading system, the accuracy in identifying meniscal tears of lateral meniscus was 91.4% and median meniscus was 88.3% respectively. These accuracy compare favorably with the results of previously reported grading systems. Follow up MRIs and confirmation with arthroscopic examination were carried out in 13 cases which showed high-intensity signal in the meniscus. The mean interval between the initial and follow up imaging was 29 months (range, 15-50 months). In 7 cases of stable knee, increment of intra-meniscal intensity and zone were observed, although, there was no progression of grade and no tear was revealed by arthroscopic examination. On the other hand, in 6 cases with cruciate ligament injury, progression of the grade was observed. The results suggest that intra-meniscal derangement does not progress if the knee is stable and patient's activity is within recreation sports activity. (author)

  13. 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

  14. 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.

  15. Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

    OpenAIRE

    Degnan, Andrew J.; Catherine Maldjian; Richard J. Adam; Harner, Christopher D.

    2014-01-01

    The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. ...

  16. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Woodmass JM

    2015-04-01

    Full Text Available Jarret M Woodmass,1 John G Esposito,1 Yohei Ono,1,2 Atiba A Nelson,1 Richard S Boorman,1 Gail M Thornton,1,3 Ian KY Lo1 1Department of Surgery, Section of Orthopaedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 2Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 3Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada Purpose: Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods: Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH” OR “acromioclavicular* (text” OR “coracoclavicular* (text” AND “Arthroscopy (MeSH” OR “Arthroscop* (text” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence: IV Results: A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26

  17. Symptomatic venous thromboembolism following fractures distal to the knee

    DEFF Research Database (Denmark)

    Wahlsten, L. R.; Eckardt, H.; Lyngbæk, S.;

    2015-01-01

    the knee. METHODS: Using individual linkage of nationwide registries, we included all Danish patients who had undergone surgery for a fracture distal to the knee between 1999 and 2011. Patients were followed for 180 days from discharge. Event rates of DVT/PE were calculated, and significant risk...... of DVT/PE was low following surgery for fractures distal to the knee; however, the risk was increased in the presence of a number of risk factors. This study suggests that specific groups of patients undergoing surgery for a fracture distal to the knee might benefit from postdischarge antithrombotic......BACKGROUND: Our aims were to determine the incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) that required inpatient or outpatient treatment, and to identify specific risk factors associated with DVT/PE in patients who had undergone surgery for a fracture distal to...

  18. Neglected case of osteoarticular Brucella infection of the knee.

    Science.gov (United States)

    Yorgancigil, Huseyin; Yayli, Guler; Oyar, Orhan

    2003-12-01

    A 49-year-old farmer had a history of recurrent knee effusion for 20 years. He did not report undergoing any diagnostic or therapeutic procedures apart from repeated aspirations of the joint fluid. After the isolation of Brucella melitensis from the joint fluid, computed tomography-guided bone biopsy was performed and histopathologic examination of the biopsy sample confirmed the diagnosis of chronic Brucella osteomyelitis. Arthroscopic synovectomy combined with antimicrobial therapy with doxycyclin, rifampicin, and ciprofloxacin for six months resulted in clinical recovery. This case indicates that brucellosis should be suspected in patients with non-specific and chronic osteoarticular symptoms, especially in endemic regions. PMID:14652892

  19. Immediate effect of valgus bracing on knee joint moments in meniscectomised patients

    DEFF Research Database (Denmark)

    Thorning, Maria; Thorlund, Jonas Bloch; Roos, Ewa M;

    2016-01-01

    OBJECTIVES: Patients undergoing medial arthroscopic partial meniscectomy are at increased risk of developing and/or progressing knee osteoarthritis, with increased medial compartment load being a potential contributor. The aim of this study was to evaluate the immediate effect of a valgus unloader...... forward lunge (mean difference [95% CI]) 0.54 [0.27-0.82] (Nm/(BW×HT)%), p<0.001 and one-leg rise (mean difference 0.45 [95% CI 0.08-0.82] (Nm/(BW×HT)%), p=0.022). No other significant differences were found between conditions in any of the included tasks. CONCLUSIONS: A significant effect of the knee...

  20. Role of integrated approach of yoga therapy in a failed post-total knee replacement of bilateral knees

    Directory of Open Access Journals (Sweden)

    John Ebnezar

    2014-01-01

    Full Text Available OA Knee is the most common arthritis. Knee replacement Surgeries are being done increasingly in the present times. This has led to the violation of the standard indications and when knees are replaced ignoring other co - musculoskeletal conditions it results in the surgery failing early. This is about a patient who encountered a failed TKR due to improper selection as patient had bilateral OA Hip that was ignored in the initial stages. To overcome the problem she was advised bilateral hip replacement which would leave her with four replacements in the lower limb. She refused surgery and was told there are no alternative treatment options. This patient underwent a 3 week integrated course of IAYT at our center and she made a remarkable recovery. IAYT is a good non-surgical treatment that can be affective both before and after knee replacement and it should be considered as the first choice of treatment before surgery.