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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....... RESULTS: The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small...... 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...

  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...

  3. Effect of nabumetone on hemostasis during arthroscopic knee surgery.

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    Schnitzer, T J; Donahue, J R; Toomey, E P; Holtby, R M; Scuderi, G R; Adams, P L; Poland, M P

    1998-01-01

    The known effects of commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) on hemostatic parameters have led to concern over their use in the perioperative period. Nabumetone, unlike other NSAIDs, has little effect on collagen-induced platelet aggregation. To evaluate the effect of nabumetone 2000 mg daily on other hemostatic parameters (e.g., bleeding time, prothrombin time, and partial thromboplastin time) in the clinical setting, this double-masked study was conducted in patients with osteoarthritis undergoing arthroscopic knee surgery. After a 1-week placebo washout period, 58 patients were randomized to receive nabumetone and 53 were randomized to receive placebo. They were assessed before surgery (after 1 to 2 weeks of treatment) and again after surgery (after an additional 3 weeks of treatment). The study was designed to have 90% power to show equivalence in bleeding time to within 1.5 minutes, a difference assumed to be of no clinical importance. No meaningful differences were observed between the groups in any of the measured hemostatic parameters. Before surgery, the bleeding time increased by only 0.3 minutes with nabumetone and decreased by 0.2 minutes with placebo. The mean (+/- SD) difference between the groups in change from baseline was 0.5 +/- 0.3 minutes. After surgery, the changes were 0.1 minutes and 0.0 minutes, respectively, and the difference between groups was 0.2 +/- 0.3 minutes. These differences were neither statistically nor clinically significant, and maximum individual increases were similar in each group. Furthermore, there were no reports of abnormal bleeding in the operative knees. The results of this study show that nabumetone had little or no effect on hemostasis and suggest that this drug can be used safely in the perioperative period.

  4. 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...

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

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

    2014-01-01

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

  6. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, L Stefan

    2017-01-01

    Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA......-77) years, 57% men) with full datasets available were included in the present study. Prior to surgery, patients completed questionnaires regarding onset of symptoms, duration of symptoms, and mechanical symptoms along with the knee injury and osteoarthritis outcome score (KOOS). At arthroscopy...

  7. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear.

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    Pihl, Kenneth; Englund, Martin; Lohmander, L Stefan; Jørgensen, Uffe; Nissen, Nis; Schjerning, Jeppe; Thorlund, Jonas B

    2017-02-01

    Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18-77) years, 57% men) with full datasets available were included in the present study. Prior to surgery, patients completed questionnaires regarding onset of symptoms, duration of symptoms, and mechanical symptoms along with the knee injury and osteoarthritis outcome score (KOOS). At arthroscopy, the operating surgeon recorded information about meniscal pathology and cartilage damage. Early or more established knee OA was defined as the combination of self-reported frequent knee pain, cartilage damage, and the presence of degenerative meniscal tissue. Results - 43% of patients (269 of 620) had early or more established knee OA. Of these, a large proportion had severe cartilage lesions with almost half having a severe cartilage lesion in at least 1 knee compartment. Interpretation - Based on a definition including frequent knee pain, cartilage damage, and degenerative meniscal tissue, early or more established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear.

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

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    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 patien...

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

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    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 .

  10. COMPARISON OF ANALGESIC EFFECT OF INTRA-ARTICULAR BUPRENORPHINE AND MORPHINE FOLLOWING ARTHROSCOPIC SURGERY OF KNEE

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    Shashidhar Gowdra Sugandarajappa

    2016-07-01

    Full Text Available BACKGROUND AND AIMS Pain after orthopaedic surgery depends on the site and extent of surgery and the preoperative use of analgesics by the patient. Arthroscopic procedures are routinely performed on outpatient basis and have spared patients large incisions and decreased morbidity compared with open incisions, but has not eliminated pain. At present several techniques are available to treat pain following arthroscopic surgeries; these include the use of opioids, local anaesthetics, NSAIDs, corticosteroids, clonidine and cryotherapy. Here, we compared the analgesic effect of intra-articular administration of morphine, buprenorphine and placebo following arthroscopic surgery of knee. METHODS A prospective, randomised, placebo-controlled double-blind comparative study conducted in 60 patients of either sex who underwent arthroscopic surgery of knee; between the age group of 18 and 65 years and of ASA class I and II physical status were included in the study. Patients were randomly assigned equally to one of the 3 groups of 20 each by a sealed envelope method. The groups were Group A - Patients receiving IA Buprenorphine 100 mcg in 20 mL normal saline. Group B - Patients receiving IA Morphine 3 mg in 20 mL normal saline. Group C - Patients receiving IA 20 mL normal saline as placebo. Parameters monitored were degree of analgesia along with haemodynamic parameters and side effects. Data were analysed using student’s t-test for continuous variables and Chi-Square test. RESULTS We found that 100 mcg buprenorphine when injected intra-articularly produced good and comparable postoperative pain control and reduced supplementary analgesic requirement when compared to other groups. CONCLUSION In summary, this study demonstrated that for eight hours postoperatively 100 mcg buprenorphine provided superior postoperative analgesia to that of 3 mg morphine

  11. Ear Acupuncture for Post-Operative Pain Associated with Ambulatory Arthroscopic Knee Surgery: A Randomized Controlled Trial

    Science.gov (United States)

    2014-01-14

    E7(/(3+21(180%(5 ,QFOXGHDUHDFRGH 14 Jan 2014 Final Report Ear acupuncture for post-operative pain associated with ambulatory arthroscopic...DISTRIBUTION A. Approved for public release: distribution unlimited. The purpose of this study is to compare ear acupuncture plus standard therapy versus...3298 Ear Acupuncture for Post-operative Pa111 Assoc1ated With Ambulatory Arthroscopic Knee Surgery A Randomized Controlled Trial ’• V ’’ ’-’ I

  12. Analgesic Effect of Dexamethasone after Arthroscopic Knee Surgery: A Randomized Controlled Trial

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    Jairo Moyano

    2016-01-01

    Full Text Available Background. Dexamethasone is sometimes used as a coanalgesic because of its anti-inflammatory properties. Objective. To evaluate opioid use, postoperative pain intensity, and side effects after a single dose of dexamethasone in patients undergoing arthroscopic knee surgery. Methods. In this randomized controlled study patients were randomized to receive either 10 mg of intravenous dexamethasone (DM group or 0.9% normal saline (NS group during the intraoperative period. Primary outcomes were pain intensity and total morphine and codeine use after surgery. Results. Seventy-eight patients were included in the study. The DM group showed statistically significant higher pain intensity at the fourth postoperative hour (DM: 3.96/10, standard deviation [SD] 0.54; NS: 2.46/10, SD 0.45; p=0.036. No statistically significant difference in total opioid use (morphine plus codeine was identified with 15.9 (SD 1.97 codeine tablets used in DM group and 20 (SD 2.14 in NS group (p=0.25. Discussion. Pain intensity tended to decrease in both groups suggesting morphine as the main source of analgesia. Conclusions. Intravenous dexamethasone during the intraoperative period has no clinical impact on postoperative pain intensity during the first 48 h after arthroscopic knee surgery. This trial is registered with R000020892.

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

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

    2016-01-01

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

  14. Spontaneous Recurrent Hemarthrosis of the Knee: A Report of Two Cases with a Source of Bleeding Detected during Arthroscopic Surgery of the Knee Joint

    OpenAIRE

    Eisuke Nomura; Hisatada Hiraoka; Hiroya Sakai

    2016-01-01

    We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more ...

  15. A COMPARATIVE CLINICAL STUDY OF INTRAARTICULAR CLONIDINE V/S DEXMEDETOMIDINE IN ARTHROSCOPIC KNEE SURGERIES (ACL REPAIR FOR POSTOPERATIVE ANALGESIA

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    Basavaraj Patil

    2016-07-01

    Full Text Available BACKGROUND Both clonidine and dexmedetomidine morphine (Both a2 agonists provide enhanced patient analgesia after arthroscopic knee surgeries when administered via intraarticular route. OBJECTIVES To compare the duration of post-operative analgesia of clonidine and dexmedetomidine when administered intraarticularly as well as haemodynamic stability after arthroscopic knee surgeries. METHODOLOGY This is a randomized trial study involving 40 pts. of ASA grade 1 and 2 of aged between 18 and 60 yrs. Patients were divided randomly into two groups as group C (n=20 and group D (n=20. After arthroscopic knee surgeries, postoperative pain was measured by VAS score at 0, 30 mins, 60 mins, 90 mins, 120 mins and then every 2 hrly up to 24 hrs. Side effects and vital signs were also noted. Duration of analgesia was noted in each case as when VAS score ≥3. RESULTS Mean duration of analgesia in postoperative period in group D was 18.4 hrs. ± 4.95 and in group C 15.1 hrs. ± 2.71. Differences in duration of analgesia was statistically significant (P<0.05 when compared by student ‘t’ test. VAS scores were also lower in group D compared to group at 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 hrs. postoperative period. No major side effects were noted in both groups in dosages used. CONCLUSION Dexmedetomidine produced more prolonged post-operative analgesia (mean 18.4 hrs. than clonidine (mean 15.1 hrs., which is statistically significant (P<0.05. No major side effects were noted in both groups in clinically used dosages.

  16. Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine.

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    Alagol, A; Calpur, O U; Usar, P Saral; Turan, N; Pamukcu, Z

    2005-11-01

    We conducted a randomized, placebo-controlled, double blinded study to compare the analgesic effects of intraarticular neostigmine, morphine, tenoxicam, clonidine and bupivacaine in 150 patients undergoing arthroscopic knee surgery. General anaesthesia protocol was same in all patients. At the end of the surgical procedure, patients were randomized into six intraarticular groups equally. Group N received 500 mug neostigmine, Group M received 2 mg morphine, Group T received 20 mg tenoxicam, Group C received 1 microg kg(-1) clonidine, Group B received 100 mg bupivacaine and Group S received saline 20 ml. Visual analog scale scores 0, 30 and 60 min and 2, 4, 6, 12, 24, 48 and 72 h, time to first analgesic need, analgesic consumption at 48 h and 72 h and side effects were noted. Demographic and operational parameters were similar in six groups. All study groups provided analgesia when compared with saline group (P<0.05). Duration of analgesia in Group N and C was longer than other groups (P<0.001). Analgesic consumptions of Group N, C and T were lower than other groups (P<0.01). Pain scores during 2 h postoperatively were lower in all study groups than the control group (P<0.001). In Group B, median pain scores were higher than Groups N and C at 0 min and 30 min postoperatively (P<0.001). Side effects were not significantly different among the six groups. We conclude that the most effective drugs that are administered intraarticularly are neostigmine and clonidine among the five drugs we studied. Tenoxicam provided longer analgesia when compared with morphine and bupivacaine, postoperatively.

  17. Spontaneous Recurrent Hemarthrosis of the Knee: A Report of Two Cases with a Source of Bleeding Detected during Arthroscopic Surgery of the Knee Joint

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    Eisuke Nomura

    2016-01-01

    Full Text Available We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery. It was highly probable that this soft tissue was the ruptured end of the lateral inferior genicular artery or its branch. This case report strongly supports the theory that the bleeding from the peripheral arteries of the posterior portion of the lateral meniscus is the cause of spontaneous recurrent hemarthrosis of the knee.

  18. Spontaneous Recurrent Hemarthrosis of the Knee: A Report of Two Cases with a Source of Bleeding Detected during Arthroscopic Surgery of the Knee Joint

    Science.gov (United States)

    Nomura, Eisuke; Hiraoka, Hisatada

    2016-01-01

    We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery. It was highly probable that this soft tissue was the ruptured end of the lateral inferior genicular artery or its branch. This case report strongly supports the theory that the bleeding from the peripheral arteries of the posterior portion of the lateral meniscus is the cause of spontaneous recurrent hemarthrosis of the knee. PMID:27703824

  19. Spontaneous Recurrent Hemarthrosis of the Knee: A Report of Two Cases with a Source of Bleeding Detected during Arthroscopic Surgery of the Knee Joint.

    Science.gov (United States)

    Nomura, Eisuke; Hiraoka, Hisatada; Sakai, Hiroya

    2016-01-01

    We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery. It was highly probable that this soft tissue was the ruptured end of the lateral inferior genicular artery or its branch. This case report strongly supports the theory that the bleeding from the peripheral arteries of the posterior portion of the lateral meniscus is the cause of spontaneous recurrent hemarthrosis of the knee.

  20. Comparison of efficacy of intraarticular application of tenoxicam, bupivacaine and tenoxicam: bupivacaine combination in arthroscopic knee surgery.

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    Talu, Gül K; Ozyalçin, Süleyman; Koltka, Kemallettin; Ertürk, Engin; Akinci, Ozkan; Aşik, Mehmet; Pembeci, Kamil

    2002-11-01

    Arthroscopic knee surgery is one of the most common surgeries done in outpatient settings; however, postoperative pain is believed to be the major barrier for discharge and early rehabilitation. In this study we evaluated and compared the efficacy of intraarticular application of long-lasting non-steroidal analgesic drug tenoxicam, a long-lasting local anaesthetic bupivacaine and combination of the two on postoperative pain after arthroscopic knee surgery. With the approval of the local ethics committee and signed informed consent of the patients, 75 American Society of Anesthesiologists I-II patients aged between 18 and 65 years going under elective arthroscopic meniscectomy were included in this randomized, blind, prospective study. The patients were divided into three groups: group-T (GT) patients ( n=25) had intraarticular 20 mg of tenoxicam in 20 ml normal saline; group-B (GB) patients ( n=25) had 50 mg bupivacaine in 20 ml normal saline (0.25%); group-BT (GBT) patients ( n=25) had intraarticular 20 mg of tenoxicam and 50 mg bupivacaine (0.25%) in 20 ml normal saline after completion of the surgery and before deflation of the tourniquet. Postoperative analgesia was maintained by intravenous tramadol hydrochloride 50 mg/s at the first 4 h and paracetamol 500 mg and codeine 7.5 mg preparation (Pacofen) as needed (maximum six per day) during the study period. The numeric rating scale (NRS) values were at rest and at active-passive motion at 4, 12, 24 and 48 h, total analgesic consumption, at 4 h for tramadol and at the end of 48 h for oral medication; and patient satisfaction at the end of 48 h was evaluated and recorded. The demographic features of the patients, and tourniquet times, were found to be similar between the groups. Group BT had significantly lower NRS values than GB at 12 h at rest. Group BT was found to have significantly lower NRS values at 4 h compared with GT, and significantly lower NRS values at 12 h compared with GB. Group BT was found to

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

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    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.

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

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    Artukoglu Feyzi

    2008-01-01

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

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

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

    2013-01-01

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

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

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    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

  5. Multimodal pain management after arthroscopic surgery

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    Rasmussen, Sten

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

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

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    Anjan Das

    2014-01-01

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

  7. 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.

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

    OpenAIRE

    Tsujii Akira; Tanaka Yoshinari; Yonetani Yasukazu; Shiozaki Yoshiki; Tomiyama Yoshiaki; Horibe Shuji

    2012-01-01

    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 sympt...

  9. 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.

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

    Science.gov (United States)

    Tsujii, Akira; Tanaka, Yoshinari; Yonetani, Yasukazu; Shiozaki, Yoshiki; Tomiyama, Yoshiaki; Horibe, Shuji

    2012-10-02

    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.

  11. 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

    contralateral to the surgical side. Ibuprofen and acetaminophen were given for 2 days before the first burn injury and again from the time of surgery. In the controls, the two burn injuries were separated by 7 days. Sensory variables included cumulated pain score during induction of the burn (visual analog...

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

    Directory of Open Access Journals (Sweden)

    Mohammed Babrak Manuar

    2014-01-01

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

  13. Pseudoaneurysm after arthroscopic procedure in the knee

    Directory of Open Access Journals (Sweden)

    Edmar Stieven Filho

    2015-04-01

    Full Text Available 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.

  14. 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.

  15. Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy of Nonopioid Analgesics on Pain following Arthroscopic Knee Surgery

    Directory of Open Access Journals (Sweden)

    Susanne Abdulla

    2012-01-01

    Full Text Available Purpose. In a randomized, double-blind trial, the efficacy of nonopioid analgesics on postoperative piritramide consumption was compared for pain relief during the first 24 h in patients recovering from arthroscopic knee surgery. Methods. 120 patients were treated with normal saline and/or one of the nonopioid analgesics (parecoxib, metamizole, paracetamol in addition to piritramide using the PCA pump. Beginning in the postanesthesia care unit (PACU, patients were asked to quantify their pain experience at rest while piritramide consumption was recorded. Results. Piritramide consumption upon arrival in the PACU was high in all groups. However, cumulative consumption in the parecoxib group was significantly lower than that in the placebo group at 6 and 12 h after surgery. At discharge from the PACU, VAS scores dropped in all groups and were significantly lower in the parecoxib group. In the PACU, satisfaction of the patients was moderate and improved with time after surgery. Conclusions. There was statistically significant opioid-saving effect by administering parecoxib with better VAS scores and satisfaction level compared to placebo. The high pain score in the PACU in all groups immediately after recovering from remifentanil-based anesthesia would be prevented if local anesthetics were administered intra-articularly as part of a multimodal analgesic approach.

  16. Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy of Nonopioid Analgesics on Pain following Arthroscopic Knee Surgery.

    Science.gov (United States)

    Abdulla, Susanne; Eckhardt, Regina; Netter, Ute; Abdulla, Walied

    2012-01-01

    Purpose. In a randomized, double-blind trial, the efficacy of nonopioid analgesics on postoperative piritramide consumption was compared for pain relief during the first 24 h in patients recovering from arthroscopic knee surgery. Methods. 120 patients were treated with normal saline and/or one of the nonopioid analgesics (parecoxib, metamizole, paracetamol) in addition to piritramide using the PCA pump. Beginning in the postanesthesia care unit (PACU), patients were asked to quantify their pain experience at rest while piritramide consumption was recorded. Results. Piritramide consumption upon arrival in the PACU was high in all groups. However, cumulative consumption in the parecoxib group was significantly lower than that in the placebo group at 6 and 12 h after surgery. At discharge from the PACU, VAS scores dropped in all groups and were significantly lower in the parecoxib group. In the PACU, satisfaction of the patients was moderate and improved with time after surgery. Conclusions. There was statistically significant opioid-saving effect by administering parecoxib with better VAS scores and satisfaction level compared to placebo. The high pain score in the PACU in all groups immediately after recovering from remifentanil-based anesthesia would be prevented if local anesthetics were administered intra-articularly as part of a multimodal analgesic approach.

  17. 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......) 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 initiation were...... group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18-33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements (P ≤ 0.002) in all other measured variables, with moderate to large effect sizes (0...

  18. Arthroscopic knee debridement can delay total knee replacement in painful moderate haemophilic arthropathy of the knee in adult patients.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; Gomez-Cardero, Primitivo

    2016-09-01

    The role of arthroscopic debridement of the knee in haemophilia is controversial in the literature. The purpose of this study is to describe the results of arthroscopic knee debridement (AKD), with the aim of determining whether it is possible to delay total knee replacement (TKR) for painful moderate haemophilic arthropathy of the knee in adult patients. In a 14-year period (1998-2011), AKD was performed for moderate haemophilic arthropathy of the knee in 27 patients with haemophilia A. Their average age at operation was 28.6 years (range 26-39 years). Indications for surgery were as follows: more than 90° of knee flexion, flexion deformity less than 30°, good axial alignment of the knee, good patellar alignment, and pain above >60 points in a visual analogue scale [0 (no pain) to 100 points]. Secondary haematological prophylaxis and rehabilitation (physiotherapy) was given for at least 3 months after surgery. Follow-up was for an average of 7.5 years (range 2-14 years). We assessed the clinical outcome before surgery and at the time of latest follow-up using the Knee Society pain and function scores, the range of motion, and the radiological score of the World Federation of Haemophilia. Knee Society pain scores improved from 39 preoperatively to 66 postoperatively, and function scores improved from 36 to 52. Range of motion improved on an average from -15° of extension and 90° of flexion before surgery, to -5° of extension and 110° of flexion at the last follow-up. A radiological deterioration of 2.8 points on average was found. There were two (7.4%) postoperative complications (haemarthroses resolved by joint aspiration). One patient (3.7%) required a TKR 12.5 years later. AKD should be considered in painful moderate haemophilic arthropathy of the knee in adult patients to delay TKR.

  19. 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 ...

  20. Osteonecrosis of the knee following arthroscopic meniscectomy; Osteoenecrosis de rodilla tras meniscectomia artrosocpica

    Energy Technology Data Exchange (ETDEWEB)

    Dobado, M. C.; Mota, J.; Roca, M. [Instituto Clinico Corachan. Barcelona (Spain)

    2000-07-01

    Primary osteonecrosis of the knee is characterized by acute onset of pain in elderly individuals who present no risk factors. Osteonecrosis following arthroscopic surgery for meniscal repair is a rare occurrence, the etiology of which remains to be determined. The authors present the magnetic resonance findings in a new case and a review of the related literature. (Author) 7 refs.

  1. Perioperative Nursing of 45 Patients with Knee Joint Surgery Via Arthroscope%45例膝关节镜手术的围手术期护理探讨

    Institute of Scientific and Technical Information of China (English)

    刘惠花

    2013-01-01

    Objective:To investigate perioperative nursing method for patients with knee joint surgery via arthroscope.Methods:A retrospective analysis of 45 cases underwent knee joint surgery via arthroscope.Results:45 patients were all successfully discharged.There was no serious complication occurred. Conclusion:Strengthen perioperative nursing can help to improve clinical outcomes,reduce patient pain,reduce complications,and promote the speedy recovery of patients.%  目的:探讨膝关节镜术患者的围手术期护理方法。方法:回顾性分析45例行膝关节镜术患者的临床资料及护理措施。结果:本组45例患者均顺利康复出院,无严重并发症发生。结论:加强围手术期护理有助于提高临床疗效,减轻患者痛苦,减少并发症,促进患者早日康复。

  2. Arthroscopic laser in intra-articular knee cartilage disorders

    Science.gov (United States)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

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

  3. 等速训练对膝半月板损伤关节镜手术后膝关节功能恢复及关节周围肌肉力量的影响%The Impact of Knee Function and Muscles Strength of Isokinetic for Patients with Knee Meniscus after Arthroscopic Surgery

    Institute of Scientific and Technical Information of China (English)

    邵正海; 张玉发; 吕宏; 毕霞; 高亮亮; 刘小垒; 黄鑫凝

    2014-01-01

    目的:回顾性分析等速训练康复方案对膝半月板损伤患者术后关节功能恢复及关节周围肌肉力量的影响。方法:对25例膝半月板损伤患者关节镜术后采取等速康复训练,与对照组行常规训练进行比较。结果:经治疗二个疗程后,观察组单次最大做功、力矩加速能、屈膝伸肌峰力矩测试和平均做功率各指标均优于对照组(P<0.05),差异有统计学意义。结论:等速康复训练对膝半月板损伤关节镜手术后患者具有较好的改善,能够明显改善患者的预后状况,值得临床推广应用。%Objective:Retrospective analysis impact of knee function and muscles strength of Isokinetic for patients with knee meniscus after arthroscopic surgery. Methods:25 cases of arthroscopic knee meniscus injury patients were taken isokinetic rehabilitation after surgery, and the efficacy of the control group were compared. Results:After two courses of treatment, the maximum single acting, torque acceleration energy, knee extensor peak torque test and the average power of the observation group were all better than the control group(P<0.05). Conclusion:The isokinetic method for knee meniscus injury patients’ rehabilitation after arthroscopic surgery was helpfui and could significantly improve the patient's prognosis, worthy of clinical application.

  4. Analysis of clinical effect of arthroscopic surgery in osteoarthrosis of knee%膝关节骨关节病应用关节镜手术疗效临床分析

    Institute of Scientific and Technical Information of China (English)

    吴健; 姚力; 王兵; 马克勇

    2015-01-01

    Objective To analyze the clinical effect of arthroscopic surgery in osteoarthrosis of knee. Methods 60 patients with osteoarthrosis of knee were selected in our hospital as the research object and were divided into two groups based on the different treatment nethods,with 30 cases in each group.To observe and to compare the clinical effect of patients in control group who were treated with conservative treatment,such as physical therapy,drug,and Chinese medicine and so on,and patients in observation group who were treated with arthroscopic surgery. Results Clinical results showed that,the total effective rate in observation group was better than which in control group, the change of postoperative score in observation group was better than which in control group,the differences were statically significant(P<0.05). Conclusion Arthroscopic surgery in the treatment of osteoarthrosis of knee has less trauma,faster rehabilitation,less complication,has significant clinical effect,is worthy of popularization and application.%目的:分析并研究膝关节骨关节病应用关节镜手术临床疗效。方法将我院膝关节骨关节病患者60例作为研究对象,按其治疗方法分成两组,每组30例。对照组患者实施保守治疗,比如:理疗、药物、中医中药等,观察组患者借助关节镜手术进行治疗,观察、比较两组患者临床治疗结果。结果临床结果显示,观察组患者治疗总有效率优于对照组,差异有统计学意义(P<0.05);且观察组术后评分变化情况优于对照组,差异有统计学意义(P<0.05)。结论对膝关节骨关节病患者借助关节镜手术进行治疗,创伤小、康复快、并发症少,临床效果显著,值得推广应用。

  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. 膝骨关节炎关节镜术后康复治疗的临床效果评价%Evaluation of the clinical effect of rehabilitation treatment after knee osteoarthritis arthroscopic surgery

    Institute of Scientific and Technical Information of China (English)

    谢卫娜; 谢川

    2016-01-01

    Objective:To evaluate the clinical effect of rehabilitation treatment after knee osteoarthritis arthroscopic surgery. Methods:98 patients with knee osteoarthritis were selected.They were divided into the control group and the observation group with 49 cases in each.The control group was given simple drug treatment.The observation group was given rehabilitation training and physiotherapy on the basis of the control group.Before treatment,2 months,4 months and 6 months after treatment,the knee joint functions and treatment effects of two groups were compared.Results:The knee joint function recovery of the observation group was significantly better than that of the control group.The total treatment rate of the observation group was significantly higher than that of the control group.Conclusion:The rehabilitation treatment after knee osteoarthritis arthroscopic surgery has a good clinical effect.%目的:评价膝骨关节炎关节镜术后康复治疗的临床效果。方法:收治膝骨关节炎患者98例,分成对照组和观察组各49例,对照组给予单纯药物治疗,观察组在对照组的基础上给予康复训练和物理治疗,对比两组患者在治疗前、治疗后的2个月、4个月、6个月膝关节的功能以及治疗效果。结果:观察组膝关节功能恢复情况明显优于对照组,观察组总治疗率明显高于对照组。结论:膝骨关节炎关节镜术后康复治疗具有较好的临床效果。

  7. Combined partial arthroscopic synovectomy and radiation therapy for diffuse pigmented villonodular synovitis of the knee.

    Science.gov (United States)

    Blanco, C E; Leon, H O; Guthrie, T B

    2001-05-01

    We present the results of combined partial arthroscopic synovectomy and low-dose external-beam radiation therapy (RT) in the treatment of diffuse pigmented villonodular synovitis (PVNS) of the knee. Mechanical synovectomy is an effective tool in treating PVNS of the knee, but when used alone it may be insufficient to eliminate all affected tissue. Intra-articular radiation or external-beam radiation may be added to mechanical synovectomy to treat recurrence but is not routinely done at the time of initial synovectomy. Combining intra-articular synovectomy with RT at the initial treatment for PVNS of the knee may reduce the recurrence rate. We present a prospective study of the treatment of 22 patients with clinical, ultrasonic, and histologically confirmed findings of diffuse PVNS of the knee. Characteristic clinical findings included pain, swelling, and erythema. These patients were treated by the Arthroscopic Surgery Group of the Orthopaedic Service at the Hospital "Hermanos Ameijeiras" in Havana, Cuba from 1990 to 1998. The protocol included anterior (patellofemoral, medial, and lateral) arthroscopic synovectomy and postoperative RT with a total dose of 2,600 cGy. This combination therapy was effective in reducing symptoms of pain and edema, and in improving overall function of patients. Nineteen patients (86%) had good or excellent results at an average follow-up of 33 months (range, 26 to 76 months). Three patients had residual stiffness and swelling, 2 of whom also had pain. Three had clinically and ultrasonically confirmed recurrence of disease and were treated with repeat arthroscopic synovectomy without harmful effects from RT. In all of the cases requiring repeat arthroscopic synovectomy, we observed fibrous bands secondary to reorganization of synovial inflamed tissue, meniscal retraction, and microscopic findings of fibrosis and cellular paucity. Partial arthroscopic synovectomy combined with low-dose RT in anti-inflammatory doses produced good results

  8. Stem cell procedures in arthroscopic surgery.

    Science.gov (United States)

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

    2016-07-13

    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 ways to improve the healing response. MSCs are particularly promising for this task given their regenerative potential. While methods of isolating those cells are no longer poses a challenge, the best way of application is not clear. Several experiments in the realm of basic science and animal models have recently been published, addressing this issue, yet the application in clinical practice has lagged. This review provides an overview addressing the current standing of MSCs in the field of arthroscopic surgery.

  9. 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.

  10. 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.

  11. 低分子肝素应用于膝关节镜术后的临床观察%Clinical effects observation on the application of loW molecular Weight heparin after Knee arthroscopic surgery

    Institute of Scientific and Technical Information of China (English)

    刘金辉; 聂喜增; 李锋; 王华军

    2015-01-01

    Objective To discuss the clinical effects of low molecular weight heparin after arthroscopic surgery of the knee, Methods A analysis of 337 cases of arthroscopic surgery of the knee were done from January 2012 to January 2013, To_tally 337 patients were randomly divided into treatment group(n = 180 cases)and control group(n = 157 cases), The treat_ment group was given routine preventive application of low molecular heparin calcium;while the control group was not applied low molecule heparin and other anticoagulant and assisted thrombolytic drug, The occurrence of hemarthrosis,deep venous thrombosis( DVT)and pulmonary embolism were observed after surgery, Results Hemorrhage were founded 16 cases (8, 8% )in treatment group and 2 cases(1, 3% )in control group, DVT were founded 1 case in treatment group and 5 cases in control group by sonogram, Symptomatic DVT was not be founded in 2 groups, Symptomatic pulmonary embolism was founded 1 case in control group, Conclusion The antithrombotic drugs could cause the hemarthrosis after arthroscopic surgery of the knee,the application of which is not necessary for patients without risk factors, The functional rehabilitation exercises can pre_vent DVT and pulmonary embolism.%目的:探讨膝关节镜术后低分子肝素的应用价值。方法分析2012年1月_2013年1月337例膝关节镜手术,术后分为治疗组180例和对照组157例,治疗组予常规预防应用低分子肝素钙,对照组不应用低分子肝素及其它抗凝血药物和辅助溶血栓药物。观察术后关节积血、下肢深静脉血栓栓塞和肺栓塞的发生率。结果关节积血:治疗组16例(8,8%);对照组2例(1,3%)。术后30d 内经超声确诊发生患肢深静脉血栓栓塞:治疗组1例;对照组5例。2组均未发现具有临床症状的深静脉血栓栓塞,治疗组也未发现具有明显临床症状肺栓塞,但对照组发生1例。结论应用抗凝血药物是膝关节镜术后关节积

  12. 膝关节疾病合并下肢静脉血栓的关节镜治疗%The treatment of arthroscopic surgery on knee joint disease accompanied by thrombosis of lower limb

    Institute of Scientific and Technical Information of China (English)

    冯伟; 许建中; 辛若冰; 吴增浦

    2011-01-01

    [ Objective ] To explore the methods and therapeutic effect of arthroscope on knee joint disease accompanied by thrombosis of lower limb. [ Methods ] 30 patients with knee joint disease accompanied by thrombosis of lower limb, been cured from December 2007 to January 2010, all come from Department of Orthopaedics, First Affiliated Hospital, Zhengzhou University. Of which 11 patients are osteoarthritis, 19 cases are cruciate ligament injury. 20 cases are left keen, while 10 cases are right keen. Arthroscopic treatment was carried out on the clean-up, cruciate ligament reconstruction. Give early postoperative inflammatory, anticoagulant, expansion, while strengthening the limb muscle strength and functional exercise. [ Results ] All 30 patients successfully, no long-term complications of surgery, were followed up for 10-24 months, the efficacy rates were evaluated by Lysholm and Hss. The Lysholm scores ascended from (50±6.0) to (85.5±3.5) (t =30.267, P =0.000). The Hss scores ascended from (49.5± 5.5) to (87.0±2.5) (t=33.6O9, P =0.000). Using SPSS 16.0 software using matching t test analysis, P <0.05, with a statistical significance. [Conclusion] With lower limb thrombosis is not hamper combined surgery arthroscope, Arthroscopic surgery has a small, trauma and rapid recovery features.%目的 探讨膝关节疾病同时伴有下肢血栓的关节镜治疗方法及临床疗效.方法 对2007年12月~2010年1月郑州大学一附院骨科收治的30例膝关节疾病同时伴有下肢血栓患者临床资料进行分析,其中骨性关节炎患者11例,交叉韧带损伤者19例,左膝20例,右膝10例,在关节镜下分别对之进行关节清理、交叉韧带重建,术后早期给以抗炎、抗凝、扩容,同时加强患肢肌力和功能锻炼.结果 30例患者全部成功,随访6~25个月,术后均无出现下肢血栓,无手术远期并发症,疗效按Lysholm及Hss膝关节评分标准进行评定,Lysholm评分由术前(50.0±6.0)分提高到术后(85

  13. The Arthroscopic Treatment of Patients with Traumatic Synovitis of Knee joint Surgery Nursing Management%膝关节镜治疗创伤性膝关节滑膜炎手术患者的护理管理

    Institute of Scientific and Technical Information of China (English)

    宋友友

    2015-01-01

    目的:观察膝关节镜治疗创伤性膝关节滑膜炎手术患者的护理管理。方法将该院2014年2月—2015年9月收治的72例创伤性膝关节滑膜炎患者随机分为两组,对照组和观察组各36例,均采用膝关节镜手术治疗。对照组给予常规护理,观察组在常规护理的基础上给予综合护理。分别于护理前和护理后,检测患者的膝关节周径、膝关节屈伸度,评估疼痛程度,并检测患者膝关节液中炎症因子,分析两组的临床护理疗效。结果观察组的总有效率为97.22%,明显高于对照组的66.67%,差异无统计学意义(P﹤0.05);两组患者护理前的膝关节周径、膝关节屈伸度和VAS评分对比,差异无统计学意义(P﹥0.05);观察组患者护理后的膝关节周径、膝关节屈伸度和VAS评分分别为(33.08±2.25)cm、(88.69±17.64)o、(2.97±0.82)分,明显优于对照组的(37.38±3.41)cm、(77.66±16.95)°、(5.83±1.31)分,差异具有统计学意义(P﹤0.05);两组患者护理前的IL-1、IL-6和TNF-α对比,差异无统计学意义(P﹥0.05);观察组患者护理后的IL-1、IL-6和TNF-α分别为(18.47±6.82)pg/mL、(42.18±7.50)pg/mL、(8.29±2.54)pg/mL,明显优于对照组的(32.46±6.70)pg/mL、(53.28±7.83)pg/mL、(12.38±2.91)pg/mL,差异具有统计学意义(P﹤0.05)。结论给予膝关节镜治疗创伤性膝关节滑膜炎手术患者科学的综合护理,疗效确切,有利于患者膝关节功能恢复,值得推广应用。%Objective to observe the arthroscopic treatment of patients with traumatic synovitis of knee joint surgery nursing management. Methods from February 2014 to september 2015, 72 patients with traumatic synovitis of knee joint were ran-domly divided into two groups, control group and observation group 36 cases, adopt the arthroscopic surgery. Control group given conventional nursing, the observation group on the basis of conventional nursing care to comprehensive care. In nurs-ing before and after

  14. 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.)

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

    OpenAIRE

    Jayakrishnan; Gudi; Sujai; Fardeen; Siddalinga Swamy

    2015-01-01

    BACKGROUND: Many studies have reported symptomatic relief after arthroscopic debridement of knee for osteoarthrosis. The purpose of the study is to find out the outcome of arthroscopic debridement in osteoarthrosis of knee and to arrive at a consensus regarding the subsets of patients with osteoarthrosis who will benefit from the procedure. M...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2006-03-01

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

  19. 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.

  20. 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 i...

  1. 膝关节后纵隔解剖特点及其在关节镜手术中的应用%ANATOMIC FEATURES OF POSTERIOR SEPTUM OF KNEE JOINT AND ITS APPLICATION IN POSTERIOR TRANS-SEPTAL PORTAL FOR ARTHROSCOPIC SURGERY

    Institute of Scientific and Technical Information of China (English)

    孙金鹏; 熊依林; 雷光华

    2013-01-01

    目的 总结膝关节后纵隔解剖特点及其在关节镜手术中,尤其是跨后纵隔通路建立中的应用. 方法 查阅近年国内外有关膝关节后纵隔及膝关节镜的文献,并进行归纳分析. 结果 后纵隔上部血管、神经较丰富,在胫骨平台水平与腘动脉紧邻:将膝关节后室分为较小的外室和较大的内室.膝关节镜下建立跨后纵隔通道时应屈膝90°,方向由外向内,从后纵隔中间靠下部穿过较安全. 结论 跨后纵隔通道使膝关节镜应用范围大大扩展,但通道建立方法并不统一,只有综合考虑后纵隔解剖学特点,才能减少手术并发症.%Objective To summarize the anatomic features of the posterior septum of the knee joint and its application in posterior trans-septal portal for arthroscopic surgery. Methods The literature related to posterior septum of the knee joint and arthroscopic surgery was extensively reviewed and analyzed. Results The posterior septum of the knee joint has more mechanoreceptors and blood vessels in the upper part, which are close to arteria popliteal at the tibial plateau level; the posterior compartment is divided into wider posteromedial and narrower posterolateral compartments. A safe arthroscopic trans-septal portal is established, in the knee flexion of 90°, in a lateral-to-medial direction, and with an inserting location below the middle of posterior septum. Conclusion The establishment method of posterior trans-septal portal is not uniform and all the features of posterior septum should be considered to decrease the complications.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. 盐酸右美托咪定用于膝关节镜手术患者腰硬联合麻醉的临床分析%Clinical analysis of dexmedetomidine hydrochloride be used in spinal-epidural anesthesia for patients with knee ar-throscopic surgery

    Institute of Scientific and Technical Information of China (English)

    张军

    2016-01-01

    Objective:To investigate the effects of spinal-epidural anesthesia combined with dexmedetomidine hydrochloride in knee arthroscopic surgery process.Methods:88 patients who were treated by knee arthroscopy surgery were selected.They were grouped according to the sequence of operation treatment,the single number as the control group,the double number as the observation group.The control group patients combined with physiological saline intravenous drip before surgery.The patients in the observation group was combined with dexmedetomidine hydrochloride intravenous infusion anesthesia.Results:The scale score, VAS score,ramsay sedation score of the observation group were significantly better than those of the control group(P<0.05). Conclusion:Spinal-epidural anesthesia combined with dexmedetomidine hydrochloride in knee arthroscopic surgery can improve the emotion index and sedation index score significantly,and no additional adverse reactions.%目的:探讨腰硬联合麻醉结合盐酸右美托咪定在膝关节镜手术过程中的麻醉效果。方法:收治行膝关节镜手术治疗的患者88例,根据手术治疗先后顺序分组,单号为对照组,双号为观察组,对照组患者在手术前结合生理盐水进行静脉滴注,观察组患者则结合盐酸右美托咪定静脉滴注进行麻醉。结果:观察组患者 Scale 评分、VAS 评分、Ramsay镇静评分均显著优于对照组(P<0.05)。结论:在膝关节镜手术中的腰硬联合麻醉结合盐酸右美托咪定能够显著改善其相关情绪指标和镇静指标评分,同时无附加不良反应。

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

    Directory of Open Access Journals (Sweden)

    Jayakrishnan

    2015-08-01

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

  5. 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

  6. Arthroscopic Management of Osteoarthritis.

    Science.gov (United States)

    Pitta, Michael; Davis, William; Argintar, Evan H

    2016-02-01

    Arthroscopic surgery is commonly performed in the knee, shoulder, elbow, and hip. However, the role it plays in the management of osteoarthritis is controversial. Routine arthroscopic management of osteoarthritis was once common, but this practice has been recently scrutinized. Although some believe that there is no role for arthroscopic treatment in the management of osteoarthritis, it may be appropriate and beneficial in certain situations. The clinical success of such treatment may be rooted in appropriate patient selection and adherence to a specific surgical technique. Arthroscopy may serve as an effective and less invasive option than traditional methods of managing osteoarthritis.

  7. A clinical study on intra-articular injection of tramadol and ropivacaine for analgesia after arthroscopic knee surgery%曲马多联合罗哌卡因关节腔内注射用于膝关节镜术后镇痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    何崎; 秦燕; 刘丹凤

    2015-01-01

    Objective To observe the analgesic effects and side -effects of intra-articular injection of tramadol and ropivacaine for analgesia after arthroscopic knee surgery .Methods Ninety patients with ASAⅠ ~Ⅱ undergoing scheduled arthroscopic knee sur -gery with general anesthesia were randomly divided into three groups :ropivacaine group(group A),tramadol group(group B)and ropiv-acaine plus tramadol group(group C).At 10 minutes before end of surgery,the three groups received intra-articular injection of 0.45%ropivacaine,100 mg tramadol or tramadol 100 mg plus 0.45% ropivacaine in 20 ml,respectively.Visual Analog Scale(VAS)scores of pain at time points of 8,16,24 and 48 hours after the surgery,and the side effects such asdizziness ,nausea,vomiting and urine retention were recorded.Results Compared with the groups A and B,the VAS score in the group C was significantly decreased (P <0.05).No side effect was observed in all the three groups .Conclusion The intra-articular injection of tramadol and ropivacaine after arthroscopic knee surgery could reinforce the analgesia effect .%目的:观察膝关节镜术后关节腔内注射曲马多与罗哌卡因混合液的镇痛效果及不良反应。方法选择全麻下行膝关节镜手术患者90例,ASAⅠ~Ⅱ级,采用随机数字表法分为3组各30例,分别于手术结束时放止血带前10分钟向关节腔内注射罗哌卡因(A 组)、曲马多(B 组)及罗哌卡因与曲马多混合液(C 组),观察并比较三组术后的8、16、24、48 h 疼痛视觉模拟评分(VAS)及头晕、恶心、呕吐、尿潴留、局部感染等不良反应发生情况。结果C 组术后16、24、48 h 疼痛 VAS 评分明显低于 A、B 两组,差异有统计学意义(P <0.05);三组患者均未出现恶心、呕吐及尿潴留等不良反应。结论膝关节镜术后联合应用曲马多与罗哌卡因镇痛时间延长,不良反应并未增多。

  8. Intra-articular sodium hyaluronate injections after arthroscopic debridement forosteoarthritis of the knee: a prospective, randomized, controlled study

    OpenAIRE

    Heybeli, Nurettin; Doral, Mahmut; Atay, Özgür; Leblebicioğlu, Gürsel

    2017-01-01

    Objectives: The purpose of this study was to evaluate the effect of intra-articular hyaluronic acid (HA) injections after arthroscopic debridement on pain and functional parameters in patients with mild-to-moderate knee osteoarthritis.Methods: Sixty-seven patients (21 men, 46 women; mean age 56 years; range 40 to 65 years) who underwent standard arthroscopic debridement for primary knee osteoarthritis of Kellgren-Lawrence grade II-III were randomly assigned to HA injections (n=33) or to only ...

  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. Obesity May Not Compromise Knee Surgery Success

    Science.gov (United States)

    ... 164282.html Obesity May Not Compromise Knee Surgery Success Results similar after procedure to repair meniscus in ... the surgery and they would have the same success as someone who is not as heavy," he ...

  12. Correlation Between Magnetic Resonance Imaging and Arthroscopic Findings in the Knee Joint

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    Ahmad Khan

    2015-01-01

    Full Text Available Background The knee joint is the largest and the most complex joint of the human body. It is not covered by any thick muscular covering anteriorly. Objectives The purpose of this study was to explore the diagnostic capabilities of clinical examination, magnetic resonance imaging (MRI, and arthroscopy in traumatic disorders of the knee joint, to seek correlation between clinical findings, MRI findings and arthroscopic. Patients and Methods A total of 26 patients with a presentation suggestive of traumatic knee pathology were studied prospectively. A detailed history was taken and relevant clinical examination was done, which was followed by MRI of the knee. The patients were scheduled for arthroscopy under general/spinal anesthesia, whenever indicated. Results Keeping arthroscopic examination as standard, the correlation between clinical and arthroscopy showed a sensitivity of 80%, specificity of 86%, accuracy of 63.16%, negative predictive value of 93.48%; whereas MRI vs. arthroscopy showed a sensitivity of 74.42%, specificity of 93.10%, accuracy of 84.21%, and negative predictive value of 88.04%. Conclusions The clinical examination is an important and accurate diagnostic modality for evaluation of traumatic derangement of the knee joint. It is noninvasive, easy, available, and valuable diagnostic modality. The MRI is an accurate diagnostic modality. It can be used whenever there is an uncertain indication for arthroscopy. However, costs have to be kept in mind, especially in patients with low socio-economic status.

  13. Computer Graphics For CT-Assisted Knee Surgery

    Science.gov (United States)

    Rhodes, Michael L.; Jackson, Douglas W.; Azzawi, Yu-Ming; Glenn, William V.; Howland, Robert S.; Rothman, Stephen L.

    1984-08-01

    Computed tomography (CT) scanners provide images of internal anatomy with unsurpassed spatial resolution. Since these images are inherently digital, computer systems can be used to simulate, plan, and guide surgical procedures to submillimeter precision. The combination of CT images, specially designed instruments, and the software to coordinate them results in improved accuracy for stereotactic surgery. This paper introduces per cutaneous cruciate ligament replacement as a new application for computer-aided ster eotaxi s. The procedure is described here with the knee firmly attached to a custom device. Twenty-five to thirty CT scans are performed to view the knee in detail, with special care taken to visualize the cruciate ligaments and their attachment to the tibia and femur. At the display console, two trajectories are chosen, using images delivered by the scanner and alternative views generated by software. These trajectories position two attachment shafts through skeletal structure in the knee to secure a replacement cruciate ligament. Interaction is illustrated that allows both the selection of the trajectories and the simulated surgery along their path. Anatomy intersected by the proposed trajectories can be reviewed in detail prior to actual surgery. Once reviewed, frame sittings are delivered by the computer system to drill the ligament attachment shafts. A replacement cruciate ligament can be passed through these two drill holes. Only an arthroscopic procedure is needed for later fixation of the ligament. In this manner, 4-6 hour open surgery of the knee is avoided and patient rehabilitation should be reduced from several months to 4-5 weeks. The frame, software, procedure, and computational aspects of the interaction are described. Test and patient results are given.

  14. 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

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

    Science.gov (United States)

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

    2014-05-01

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

  16. Platelet Rich Plasma and Knee Surgery

    Directory of Open Access Journals (Sweden)

    Mikel Sánchez

    2014-01-01

    Full Text Available In orthopaedic surgery and sports medicine, the knee joint has traditionally been considered the workhorse. The reconstruction of every damaged element in this joint is crucial in achieving the surgeon’s goal to restore the knee function and prevent degeneration towards osteoarthritis. In the last fifteen years, the field of regenerative medicine is witnessing a boost of autologous blood-derived platelet rich plasma products (PRPs application to effectively mimic and accelerate the tissue healing process. The scientific rationale behind PRPs is the delivery of growth factors, cytokines, and adhesive proteins present in platelets and plasma, as well as other biologically active proteins conveyed by the plasma such as fibrinogen, prothrombin, and fibronectin; with this biological engineering approach, new perspectives in knee surgery were opened. This work describes the use of PRP to construct and repair every single anatomical structure involved in knee surgery, detailing the process conducted in ligament, meniscal, and chondral surgery.

  17. Arthroscopic decompressive medial release of the varus arthritic knee: Expanding the functional envelope.

    Science.gov (United States)

    Leon, H O; Blanco, C E; Guthrie, T B

    2001-05-01

    We present the rationale and technique for treating medial knee osteoarthritis by dynamically unloading the medial compartment of the knee. Recent advances in kinematic studies indicate a dynamic linkage between differing degrees of freedom in the knee joint. Both the adduction moment and the foot progression angle are important determinants of medial compartment loading. The medially osteoarthritic knee has progressive compromise of free motion in more than 1 plane. Arthroscopic decompressive medial release unloads the medial compartment by release of the medial capsule and medial collateral ligament in the presence of intact cruciate ligaments, which may allow a decreased adduction moment and decrease of the external rotation restraint in extension found in more severely osteoarthritic knees. A case series of 38 patients with medial gonarthrosis was treated by this technique at the Hermanos Ameijeiras Hospital in Havana, Cuba. All patients had good results without postoperative valgus instability or significant complications. We feel that this technique warrants further clinical and biomechanical study for its use in isolation or in combination with high tibial osteotomy or minimally invasive selective osteotomy for the treatment of medial gonarthrosis of the knee. A minimally invasive, selective approach to biomechanical factors in osteoarthritis may be combined with other modulating techniques in efforts to forestall or prevent the need for total joint replacement.

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

    Science.gov (United States)

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

    2013-05-01

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

  19. Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results

    OpenAIRE

    Yoo, Moon-Jib; Shin, Yong-Eun

    2016-01-01

    Purpose To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior t...

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

    Institute of Scientific and Technical Information of China (English)

    沙磊; 耿庆贺; 范卫民

    2009-01-01

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

  1. 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.

  2. 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

  3. 右美托咪定辅助腰丛联合坐骨神经阻滞在膝关节镜手术中的应用研究%Clinical study of dexmedetomidine as a supplementary to combined lumbar plexus-sciatic nerve block for arthroscopic knee surgery

    Institute of Scientific and Technical Information of China (English)

    田兵; 崔永康; 张选强; 史晓燕; 解铁科; 王静

    2013-01-01

    Objective To evaluate the effect of dexmedetomidine as a supplementary to combined lumbar plexus-sciatic nerve block for arthroscopic knee surgery.Methods Fifty patients who were scheduled for arthroscopic knee surgery and ASA class Ⅰ or Ⅱ grade,were divided into control group and dexmedetomidine group by random digits table method with 25 cases each.The patients of dexmedetomidine group were given loading dose dexmedetomidine 0.8 μ g/kg(injection time 10 min) by intravenous infusion,then were given maintenance dose 0.4 μμ g/(kg· h) to the end of operation.The patients of control group were given 0.9% sodium chloride,methods with the dexmedetomidine group.After 10 min,combined lumbar plexus-sciatic nerve block was performed by a nerve stimulator in both groups.Fentanyl 50 μμ g was infused intravenously to the patient whose effect of block was inadequately.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory frequency at preanesthesia (T0),beginning of dexmedetomidine infusion (T1),beginning of surgery (T2),10 minutes of surgery (T3) and the end of surgery (T4) were recorded,and intraoperative untoward reaction,using of fentanyl and doctor's satisfaction rate were recorded.Results There were no statistical differences in MAP and HR at T0 between the 2 groups (P> 0.05).MAP and HR at T2-4 were significantly higher than those at T0 in control group,furthermore MAP and HR at T2-4 in control group were significantly higher than those in dexmedetomidine group [MAP:(137 ± 18) mm Hg(1 mm Hg =0.133 kPa) vs.(107 ± 14) mm Hg,(132 ± 11) mm Hgvs.(107 ± 11) mm Hg,(131±13) mm Hg vs.(95 ± 12) mm Hg;HR:(99 ± 17) times/rmin vs.(88 ± 14) times/min,(99 ± 14) times/min vs.(81 ± 15) times/min,(97 ± 14) times/rmin vs.(76 ± 11) times/min],there were statistical differences (P < 0.05).There were no statistical differences in respiratory frequency and SpO2 between the 2 groups (P >0.05),but 2 cases in dexmedetomidine group

  4. A QUANTITATIVE ASSESSMENT OF PROPRIOCEPTIVE FUNCTION IMPROVEMENT AFTER ARTHROSCOPIC ACL RECONSTRUCTION SURGERY

    Directory of Open Access Journals (Sweden)

    Dobson

    2015-05-01

    Full Text Available OBJECTIVE: To quantify the deficit in proprioceptive function in Anterior Cruciate Ligament (ACL deficiency and to quantify the improvement after Arthroscopic ACL Reconstruction . Type of Study : Prospective cohort study . METHOD S : The study included 73 patients (49 men , 24 women ; mean age 26 . 8 years ; range 21 to 40 years who underwent Arthroscopic ACL reconstruction . Arthroscopic ACL reconstruction was performed using either a patellar tendon or a hamstring auto graft . All patients followed a standard rehabilitation program . Proprioceptive function in the form of (B . I Balance Index Score was tested using Kinesthetic Ability Trainer (SPORT KAT 1750 preoperatively and at the end of third and sixth months after su rgery . Their contralateral knees served as control . Results were statistically analyzed by Paired t - test using SPSS 16 . 0 . RESULTS: Mean B . I Score in ACL insufficient limb was 2203 . 19 and of normal contralateral limb was1573 . 01 at the time of presentation , with a mean deficit of 630 . 18 (p<0 . 001 . The injured limb showed significant improvement in proprioception from preoperative B . I Score of 2203 . 19 to B . I Score of 1221 . 95 at the end of 6 months after Arthroscopic ACL Reconstruction (p<0 . 001 . CONCLUSION: There is a significant deficit in proprioceptive function in the ACL insufficient limb compared to the normal contralateral limb . Proprioceptive function improves significantly after Arthroscopic ACL Reconstruction .

  5. Indications and techniques of arthroscopic treatment for knee osteoarthritis%膝骨关节炎关节镜治疗指征及手术方法探讨

    Institute of Scientific and Technical Information of China (English)

    黄迅悟; 常青; 孙继桐; 冯会成; 隰建成

    2011-01-01

    Objective To evaluate the indications and techniques of arthroscopic treatment for knee osteoarthritis. Methods A retrospective analysis was conducted on 305 patients (412 knees, aged over 45 years) with osteoarthritis treated in our hospital through arthroscopy from January 2004 to December 2006. We collected the data of gender, age, pathological changes under the arthroscope, and arthroscopic procedures. Hospital for Special Surgery (HSS) scoring system was applied to detect the function of the knee Preoperatively and two years postoperatively. Results 201 patients (289 knees) were followed up more than 2 years. Among them, 113 patients were of unilateral knee osteoarthritis, and 88 cases (176 knees) of bilateral knee osteoarthritis. The follow-up rate was 70%. Among the 289 knees followed up, 78 were excellent, 108 good, 64 fair, and 39 bad. The overall excellent and good rate was 64%. Conclusions Arthroscopic treatment for knee osteoarthritis should be individualized for each patient according to their different pathological changes. Satisfactory clinical outcome can be achieved through proper selection of indications, and accurate appropriate intraoperative arthroscopic procedures.%目的 探讨膝骨关节炎关节镜治疗指征及手术方法.方法 回顾性分析2004年1月至2006年12月应用关节镜治疗、年龄>45岁膝骨关节炎患者305例412膝,统计其性别、年龄、镜下病理变化、镜下手术方法,术前及术后2年膝关节功能HSS评分.结果 获得2年以上随访有289膝,其中单膝113膝,双膝88例176膝,随访率70%.在随访的289膝中,优:78膝,良:108膝,中:64膝,差:39膝,优良率64%.结论 关节镜治疗膝骨关节炎需要根据不同病理改变采取针对性治疗.选择合适的指征,手术中精确、合理的关节镜治疗,有希望获得理想的疗效.

  6. Reconstructive vascular surgery below the knee

    DEFF Research Database (Denmark)

    Rasmussen, L B; Jelnes, R; Sager, P

    1986-01-01

    In a series of 38 consecutive patients with advanced peripheral vascular disease (i.e. rest pain) reconstructive vascular surgery was performed with the distal anastomosis below the knee. Ankle/arm pressure index (AAI) was 0.28 (0.11-0.47) preoperatively; accumulated graft patency rate was 0.47 (SD...

  7. Surgery For The Arthritic Knee

    Science.gov (United States)

    Gross, Allan E.

    1985-01-01

    The optimal surgical procedure for the arthritic knee depends upon the type of arthritis and the patient. If the patient is ‘high demand’ (i.e., relatively active and young), and has incongruous arthritis (in either the medial or lateral compartments but not both), then realignment by osteotomy transfers the weight to the healthy compartment. If the osteotomy is successful, the patient may continue a physically demanding lifestyle. Knee replacement is indicated if the patient is ‘low demand’ (i.e., elderly or suffering from multiple joint disease) and has congruous arthritis, with destruction of both weight-bearing compartments. Knee replacement does not allow the same activity level as realignment but, fortunately, the low demand patient tends to have congruous disease (e.g., rheumatoid arthritis) and the high demand patient incongruous disease (e.g., osteoarthritis). ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Figs. 6A-BFigs. 6C-DFig. 7Fig. 8Fig. 9 PMID:21274227

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

    Directory of Open Access Journals (Sweden)

    Pylypenko O.V.

    2014-02-01

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

  9. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur

    Science.gov (United States)

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young

    2016-01-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained. PMID:27904732

  10. Getting your home ready - knee or hip surgery

    Science.gov (United States)

    Hip or knee surgery - getting your home ready; Osteoarthritis - knee ... Before you go to the hospital for surgery, set up your home to make your recovery and life easier when you come back. Do this well in advance of your surgery. ...

  11. 关节镜下病灶清除治疗膝关节结核性滑膜炎%Analysis on arthroscopic synovectomy in treatment of tuberculous synovitis of knee joint

    Institute of Scientific and Technical Information of China (English)

    高天君; 杨达宇

    2012-01-01

    Objective To evaluate the therapeutic effect of arthroscopic synovectomy in the treatment of tuberculous synovitis of the knee joint. Methods A total of 89 cases of tuberculous synovitis of the knee joint were treated by arthroscopic synovectomy. All patients were followed up for 12 ~36 months and the therapeutic effects were evaluated. Results In the 89 cases,the scores were ( 48. 2 ±3. 2 ) before the surgery and ( 92. 0 ± 3. 7 ) after the surgery according to the Lysholm criteria;the scores were ( 43. 4 ± 3. 6 ) before the surgery and ( 89. 3 ± 1.6) after the surgery according to the JOA criteria. Conclusion Arthroscopical synovectomy is an effective treatment for tuberculous synovitis of the knee.%目的 探讨关节镜下病灶清除治疗膝关节结核性滑膜炎的疗效.方法 89例膝关节结核性滑膜炎患者,采用关节镜活检和病变清除,通过12~36个月的随访,观察治疗效果.结果 89例随访患者,术前Lysholm膝关节功能评分为(48.2±3.2)分,术后随访Lysholm膝关节功能评分为(92.0±3.7)分,术前JOA膝关节功能评分为(43.4±3.6)分,术后随访JOA膝关节功能评分为(89.3±1.6)分.结论 关节镜下病灶清除术治疗膝关节结核性滑膜炎是一种有效的治疗方法.

  12. "Wet diapers--dry patients": an effective dressing for patients undergoing arthroscopic shoulder surgery.

    Science.gov (United States)

    Kapila, Atul; Bhargava, Amit; Funk, Len; Copeland, Stephen; Levy, Ofer

    2005-02-01

    Shoulder arthroscopy is very commonly associated with postoperative leakage of irrigation fluid. This causes apprehension to patients and their relatives and leads to frequent change of dressings. We describe a simple and effective diaper dressing for patients undergoing arthroscopic shoulder surgery. It is highly absorbent, cost-effective, and easy to apply. We have used this dressing successfully in more than 1,500 shoulder arthroscopies over the last 3 years with no adverse reaction.

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

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Holsgaard-Larsen, Anders; Creaby, M W;

    2016-01-01

    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...... 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......-lateral leg from before to 12 months after surgery (change difference: 0.38 Nm/BM*HT% 95% CI 0.01 to 0.76 (P = 0.049) and 0.20 Nm*s/BM*HT% 95% CI 0.10 to 0.30 (P

  14. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kawahara, Y. [Omura Municipal Establishment Hospital (Japan). Dept. of Radiology; Uetani, M.; Hayashi, K. [Dept. of Radiology, Nagasaki Univ. School of Medicine (Japan); Nakahara, N.; Futagawa, S.; Kinoshita, Y. [Isahaya Insurance General Hospital (Japan). Dept. of Radiology; Doiguchi, Y.; Nishiguchi, M. [Isahaya Insurance General Hospital (Japan). Dept. of Orthopedic Surgery

    1998-03-01

    Purpose: The objective was to assess the efficacy of fast spin-echo (FSE) imaging in the detection of articular cartilage abnormality in osteoarthrosis of the knee. Material and Methods: We studied 356 articular surfaces in 73 knees that had been examined by both MR imaging and arthroscopy. The MR images were obtained with FSE imaging (TR/TE 4200/100) on a 0.5 T unit. The surface abnormalities of the articular cartilage that were detected by MR imaging were compared with the arthroscopic findings. Results: The overall sensitivity and specificity of MR in detecting chondral abnormalities were 60.5% (158/261) and 93.7% (89/95) respectively. MR imaging was more sensitive to the higher grade lesions: 31.8% (34/107) in grade 1; 72.4% (71/98) in grade 2; 93.5% (43/46) in grade 3; and 100% (10/10) in grade 4. The MR and arthroscopic grades were the same in 46.9% (167/356), and differed by no more than 1 grade in 90.2% (321/356) and 2 grades in 99.2% (353/356). The correlation between arthroscopic and MR grading scores was highly significant with a correlation coefficient of 0.705 (p<0.0001). Conclusion: FSE sequence was less sensitive to mild cartilage abnormality but useful in detecting moderate to severe abnormality and in evaluating the degree of articular cartilage abnormality. (orig.).

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

    Science.gov (United States)

    Steinbrück, K; Wiehmann, J C

    1988-01-01

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

  16. Arthroscopic treatment of iliotibial band syndrome.

    Science.gov (United States)

    Cowden, Courtney H; Barber, F Alan

    2014-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Discussion Arthroscopic knee osteoarthritis treatment efficacy%膝关节镜在膝关节骨关节炎治疗中的疗效探讨

    Institute of Scientific and Technical Information of China (English)

    王庆祥

    2015-01-01

    Objective To investigate the treatment of knee osteoarthritis in knee arthroscope in effect. Methods A hospital in March 2009-November 2014 admitted 125 patients with knee osteoarthritis, its arthroscopic surgery.Woman patients were compared before and after the arthritis index, average OA severity index and VAS pain scores, and patient outcomes were recorded.Results Woman arthritis index before treatment 125 patients, with an average OA severity index and VAS pain scores were (53.75 ±7.36), (16.14 ± 1.76) and (16.14 ±1.76), respectively (31.75 ±after treatment 6.61), (6.08 ±1.17) and (1.47 ±0.49). Woman arthritis index before and after treatment, the severity of the discrepancy index and VAS pain scores were statistically significant average OA (P<0.05), in patients with post-treatment scores had significantly lower than before treatment.125 patients were treated and cured, 66 cases (52.8%), effective 54 cases (43.2%), ineffective in 5 cases (4.0%), the total number of 120 cases of effective (96.0%).Conclusions Arthroscopic in the adjutant treatment of osteoarthritis of the knee in a significant effect, safe, effective method of clinical treatment of knee osteoarthritis and should be introduced in the clinic.%目的:探讨膝关节镜在膝关节骨关节炎中治疗的效果。方法选取我院2009年3月至2014年11月收治的125例膝关节骨关节炎患者,对其进行膝关节镜下手术治疗。观察比较患者治疗前后Womac关节炎指数、平均OA严重程度指数及VAS疼痛评分,并对患者的治疗效果进行记录。结果治疗前125例患者的Womac关节炎指数、平均OA严重程度指数及VAS疼痛评分分别为(53.75±7.36)、(16.14±1.76)及(16.14±1.76),治疗后则分别为(31.75±6.61)、(6.08±1.17)及(1.47±0.49)。患者治疗前后Womac 关节炎指数、平均OA严重程度指数及VAS疼痛评分的差异均有统计学意义( P <0.05),患者治

  19. Testing Basic Competency in Knee Arthroscopy Using a Virtual Reality Simulator

    DEFF Research Database (Denmark)

    Jacobsen, Mads Emil; Andersen, Morten Jon; Hansen, Claus Ol;

    2015-01-01

    BACKGROUND: Diagnostic knee arthroscopy is a common procedure that orthopaedic residents are expected to learn early in their training. Arthroscopy requires a different skill set from traditional open surgery, and many orthopaedic residents feel less prepared for arthroscopic procedures. Virtual ...

  20. Arthroscopic treatment of symptomatic type D medial plica.

    Science.gov (United States)

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

    2008-12-01

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

  1. 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

    OBJECTIVE: People with meniscal tears are at high risk to develop or progress knee osteoarthritis. Knee extensor weakness is considered a risk factor for osteoarthritis and is often reported in these individuals. The purpose of this systematic review and meta-analysis was to investigate knee exte...

  2. 关节镜下松解膝关节粘连的疗效观察%Arthroscopic releasing of knee stiffness

    Institute of Scientific and Technical Information of China (English)

    王志强; 黄伟; 梁熙

    2011-01-01

    60.5° compared with preoperation;and the WOMAC score was 4.5 (0-17),which decreased by 9.5. Post-operatively,no obvious swelling or pain has been observed. Wound healing was uneventful. No complication has occurred. The average knee flexion angle was 98°(70°~125°). With respect to the efficacy,according to Judet's criteria,excellent was in 12 cases,good in 7 cases,fair in 2 cases and poor in 4 cases. However,patients with supracondylar femoral fracture,joint replacement surgery and joint dysfunction for more than 3 months were liable to have poor prognosis. Conclusion-. Arthroscopic releasing of knee stiffness can significantly improve the ROM of knee joint with intra-articular adhesions within 3 months. But other approaches may be necessary for the patients with supracondylar femoral fracture,joint replacement surgery and joint dysfunction for more than 3 months.

  3. 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.

  4. Level of evidence of knee surgery in national journal.

    Science.gov (United States)

    Rosário, Davi Araújo Veiga; Gracitelli, Guilherme Conforto; Luzo, Marcus Vinícius Malheiros; Filho, Mario Carneiro; Cohen, Moisés; Franciozi, Carlos Eduardo da Silveira

    2014-01-01

    Select the studies related to knee surgery in the orthopedic literature published by Acta Ortopédica Brasileira (AOB) and the Revista Brasileira de Ortopedia (RBO) and classify them according to the levels of evidence. We selected all studies published from 2000 to 2011 related to knee surgery in AOB and RBO. The following categorization was adopted: level 1: systematic review; level 2: clinical trial; level 3: cohort studies and case-control; level 4: number of cases; level 5: narrative review and others. We found in the national literature selected 255 studies related to knee surgery. In the Southeast were developed 212 articles (83.1%), 30 publications in the South (11.7%), Northeast 5 (2%), North and Central West 2 jobs each (0.8%). Four work performed in other country (1.6%). The most common issue was the anterior cruciate ligament in 58 studies (22.7%) and arthroplasty in 55 studies (21.5%). Most studies presented evidence level IV (27.8%) and V (50.2%). The national scientific production related to knee surgery presents itself expanding with predominant expression in the Southeast. Most studies related to knee surgery published in national journals have low level evidence and focuses on the approach of the anterior cruciate ligament and arthroplasty.

  5. 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.

  6. Arthroscopic quadriceps tendon repair: two case reports.

    Science.gov (United States)

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

    2015-01-01

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

  7. Observation of Arthroscopic Minimally Invasive Operation in the Treatment of Knee Gouty Arthritis%关节镜微创手术治疗膝关节痛风性关节炎的效果观察

    Institute of Scientific and Technical Information of China (English)

    张舸

    2015-01-01

    Objective By the experimental observation of arthroscopy of minimally invasive surgery in the treatment of gouty arthritis of knee joint effect. Methods 50 cases of patients with gouty arthritis of knee joint arthroscope under conventional surgery, postoperative medication, more patients of knee joint function changes before and after operation, observe the clinical effects of arthroscopic surgery. Results After 2 years of follow-up, all patients incision wereⅠhealing. Postoperatively, the Lysholm score and VAS scores were signiifcantly better than preoperative, P<0.05, the difference was statistically signiifcant. After surgery in patients with knee joint function were improved signiifcantly, P<0.05, the difference was statistically signiifcant. This group of 50 cases received surgical treatment for 3 weeks, 19 cases cured, 22 cases were markedly effective, 6 no effect, the total effective rate was 88%. Conclusion Arthroscopic surgery for the treatment of patients with gouty arthritis of knee joint clinical effect is good, obtained satisfactory curative effect, suggested that clinical widely used arthroscopy minimally invasive surgical treatment of patients with gouty arthritis of knee joint.%目的:通过试验观察关节镜微创手术治疗膝关节痛风性关节炎的临床效果。方法对50例膝关节痛风性关节炎的患者进行关节镜下常规手术治疗,术后坚持用药,比较患者手术前后的膝关节功能变化,观察关节镜手术的临床疗效。结果经过2年的随访,所有患者手术切口均为Ⅰ期愈合。术后患者的Lysholm评分和VAS评分均明显优于术前,P<0.05,差异有统计学意义。手术后患者的膝关节功能均明显改善,P<0.05,差异有统计学意义。本组50例患者接受手术治疗3周后,治愈19例,显效22例,无效6例,总有效率88%。结论关节镜手术对于治疗患者膝关节痛风性关节炎的临床效果良好,疗效较为满意,建议

  8. Target-controlled infusion (Propofol versus inhaled anaesthetic (Sevoflurane in patients undergoing shoulder arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2013-01-01

    Full Text Available Background: One of the challenges of anaesthesia for shoulder arthroscopic procedures is the need for controlled hypotension to lessen intra-articular haemorrhage and thereby provide adequate visualisation to the surgeon. Achievement of optimal conditions necessitates several interventions and manipulations by the anaesthesiologist and the surgeon, most of which directly or indirectly involve maintaining intra-operative blood pressure (BP control. Aim: This study aimed to compare the efficacy and convenience of target controlled infusion (TCI of propofol and inhalational agent sevoflurane in patients undergoing shoulder arthroscopic surgery after preliminary inter-scalene blockade. Methods: Of thirty four patients studied, seventeen received TCI propofol (target plasma concentration of 3 μg/ml and an equal number, sevoflurane (1.2-1.5 Minimum Alveolar Concentration. N 2 O was used in both groups. Systolic, diastolic, mean blood pressures and heart rate were recorded regularly throughout the procedure. All interventions to control BP by the anaesthesiologist and pump manipulation requested by the surgeon were recorded. The volume of saline irrigant used and the haemoglobin (Hb content of the return fluid were measured. Results: TCI propofol could achieve lower systolic, mean BP levels and the number of interventions required was also lower as compared to the sevoflurane group. The number of patients with measurable Hb was lower in the TCI propofol group and this translated into better visualisation of the joint space. A higher volume of saline irrigant was required in the sevoflurane group. No immediate peri-operative anaesthetic complications were noted in either category. Conclusion: TCI propofol appears to be superior to and more convenient than sevoflurane anaesthesia in inter-scalene blocked patients undergoing shoulder arthroscopy.

  9. Arthroscopic reconstruction of multiple ligaments injury of knees%膝关节多发韧带损伤的修复与重建

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 王锋; 朱越; 刘闻欣

    2011-01-01

    目的 探讨关节镜下重建膝关节前十字韧带(anterior cruciate ligament,ACL)、后十字韧带(posterior cruciate ligament,PCL)、后内侧韧带结构(posteromedial complex,PMC)或后外侧韧带结构(posterolateral complex,PLC)损伤的疗效.方法 2005年3月至2007年5月,43例膝关节多发韧带损伤患者采用异体肌腱于关节镜下重建ACL和PCL,同期重建增强PMC或PLC损伤.其中24例行ACL和PCL重建+PMC重建,19例行ACL和PCL重建+PLC重建.根据国际膝关节文献委员会(International Knee Documentation Committee,IKDC)评分和Lysholm膝关节功能评分表对患膝功能进行评估.结果 全部患者随访24~48个月,平均(33.10±9.65)个月.患者在0°和20°应力测试时稳定性均完全恢复.IKDC评分入院时均为显著异常(D级),术后随访时正常(A级)29例(67%,29/43)、接近正常(B级)11例(26%,11/43)、异常(C级)3例(7%,3/43).患者术前Lysholm膝关节功能评分为(46.7±4.2)分,末次随访时为(89.6±2.8)分,差异有统计学意义(t=8.563,P<0.01).结论 膝关节多发韧带损伤可于关节镜下行ACL和PCL联合重建,同期行关节外韧带结构修复增强,能有效恢复关节功能,治疗效果满意.%Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were

  10. 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

    -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...... with a population-based reference group and similar to patients prior to anterior cruciate ligament reconstruction. Quadriceps strength and lower-extremity performance were impaired for the injured leg compared with the non-injured leg (p10% differences between the injured and the non-injured leg....

  11. 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.

  12. 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

  13. Segmentation of multiple knee bones from CT for orthopedic knee surgery planning.

    Science.gov (United States)

    Wu, Dijia; Sofka, Michal; Birkbeck, Neil; Zhou, S Kevin

    2014-01-01

    Patient-specific orthopedic knee surgery planning requires precisely segmenting from 3D CT images multiple knee bones, namely femur, tibia, fibula, and patella, around the knee joint with severe pathologies. In this work, we propose a fully automated, highly precise, and computationally efficient segmentation approach for multiple bones. First, each bone is initially segmented using a model-based marginal space learning framework for pose estimation followed by non-rigid boundary deformation. To recover shape details, we then refine the bone segmentation using graph cut that incorporates the shape priors derived from the initial segmentation. Finally we remove overlap between neighboring bones using multi-layer graph partition. In experiments, we achieve simultaneous segmentation of femur, tibia, patella, and fibula with an overall accuracy of less than 1mm surface-to-surface error in less than 90s on hundreds of 3D CT scans with pathological knee joints.

  14. Lower limb biomechanics in individuals with knee osteoarthritis before and after total knee arthroplasty surgery.

    Science.gov (United States)

    Levinger, Pazit; Menz, Hylton B; Morrow, Adam D; Feller, Julian A; Bartlett, John R; Bergman, Neil R

    2013-06-01

    We investigated the biomechanical changes that occur in the lower limb following total knee arthroplasty (TKA). Lower limb joint kinematics and kinetics were evaluated in 32 patients before and 12 months following TKA and 28 age-matched controls. Analysis of variance with Bonferroni-adjusted post-hoc tests showed no significant changes in knee joint kinematics and kinetics following TKA despite significant improvements in pain and function. Significant increases in peak ankle plantarflexion and dorsiflexion moments and ankle power generation were observed which may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Differences in knee gait parameters may arise as a result of the presence of osteoarthritis and mechanical changes associated with TKA as well as retention of the pre-surgery gait pattern.

  15. Arthroscopic meniscal allograft transplantation without bone plugs.

    Science.gov (United States)

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

    2011-02-01

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

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

    DEFF Research Database (Denmark)

    Lunn, T H; Kehlet, H

    2013-01-01

    with local glucocorticoid. All studies were small-sized and none sufficiently powered to meaningfully evaluate uncommon adverse events. Most of the local administration studies had poor scientific quality (high risk of bias). Due to clinical heterogeneity and poor scientific quality, no meta-analysis......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...... 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 recommendations....

  17. Postoperative pain management for arthroscopic shoulder surgery: interscalene block versus patient-controlled infusion of 0.25% bupivicaine.

    Science.gov (United States)

    Chao, David; Young, Shaun; Cawley, Patrick

    2006-05-01

    We compared an interscalene block with a patient-controlled regional anesthesia device (Pain Care 2000; Breg, Inc, Vista, Calif) for pain management after outpatient arthroscopic shoulder surgery (subacromial decompression as principal procedure). The 41 patients in this prospective study were randomized to receive either the block or the device. During the postoperative period, all patients in both groups received standardized oral medications and continuous cold therapy and used continuous passive motion machines. Patients were given diaries and instruction in making entries upon waking and before retiring on postoperative days 1, 2, 3, 5, and 10. Data collected were number of pain medications used each day; number of nighttime awakenings; and subjective pain, activity, and quality-of-life levels rated on a visual analog scale. All data were statistically analyzed with the Mann-Whitney test. Compared with patients using the block, patients using the device awoke significantly fewer times the first night after surgery (P = .023), were significantly more active during postoperative days 1 and 2 (Ps = .018, .042), and took significantly fewer pain medications on postoperative day 2 (P = .034). On all other measures, results were equivalent or were better with the device, though these findings were not statistically significant. Patient-controlled subacromial infusion of bupivicaine is an effective alternative to interscalene block for outpatient pain management after arthroscopic shoulder surgery.

  18. The isokinetic study of different surgical procedures for the treatment of patients with arthroscopic knee meniscus%膝半月板损伤后关节镜手术不同术式的等速肌力测试分析

    Institute of Scientific and Technical Information of China (English)

    邵正海; 张玉发; 吕宏; 毕霞; 高亮亮; 刘小垒; 黄鑫凝

    2014-01-01

    目的:回顾性分析关节镜下行半月板缝合修整成型术和射频消融术的疗效差异,以向临床推广合适的术式。方法:对60例膝半月板损伤患者关节镜术后采取半月板缝合修整成型术和射频消融术,采用等速肌力测试比较两组治疗的差异。结果:观察组屈膝60°、120°时膝关节单次最大做功、力矩加速能、屈膝伸肌峰力矩测试和平均做功率均优于对照组,差异有统计学意义(P<0.05)。结论:半月板缝合修整成型术对膝半月板损伤关节镜手术后患者具有较好的改善,能够明显改善患者的预后状况。%Objective:Retrospective analysis of the isokinetic study of different surgical procedures for the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation for patients with arthroscop-ic knee meniscus ,in order to promote the appropriate surgery methods for clinical treatment .Methods :60 cases of patients with knee meniscus injury were treated by the treatment of arthroscopic meniscal suture repair angioplasty and radiofrequency ablation and the isokinetic treatment were used to compared the difference between the two groups .Results :The knee maximum single acting ,torque acceleration energy ,knee extensor peak torque testing and average power of the observation group were better than those in the control group and all P <0 .05 .Conclu-sion:The treatment of arthroscopic meniscal suture repair angioplasty for the patients can significantly improve the patient's prognosis ,and worthy of clinical application .

  19. 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.

  20. Development Trend of Modern Arthroscopic Surgery%现代关节镜外科的发展趋势

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的通过微创技术了解关节内病变。本文就关节镜外科的发展趋势予以综述。方法通过一根端部装有透镜的细管,将细管插入关节内部,关节内部的结构便会在监视器上显示出来。结果组织损伤小、术后恢复快,对关节疾病的诊断和治疗起到革命性的改变。结论关节镜手术开展的手术范围不断拓展,并为越来越多的临床骨科医师及广大患者所接受。%Objective Through minimally invasive techniques to understand the purpose of intra-articular lesions. In this paper, the development trend of arthroscopic surgery to be reviewed. Methods With the lens end portion of a thin tube, the thin tube is inserted inside the joint, the joint internal structure will be displayed on the monitor. Results Tissue damage, rapid postoperative recovery, for the diagnosis and treatment of joint disease play a revolutionary change. Conclusion The surgical arthroscopic surgery carried out continuously expand the scope, and a growing number of clinical orthopedic surgeons and accepted by the majority of patients.

  1. Femur chondrosarcoma misdiagnosed as acute knee arthritis and osteomyelitis--further developing a hitherto unreported complication of tumor embolic ischemic ileal perforation after arthroscopic lavage.

    Science.gov (United States)

    Chow, Louis Tsun Cheung

    2014-12-01

    The differentiation between osteomyelitis and bone tumor may be difficult due to their overlapping clinical and radiological features. A 25-year-old lady presented with left knee pain and joint effusion associated with redness and hotness. A sub-optimally taken plain radiograph showed mixed osteolytic and osteoblastic lesion in the left lower femur with surrounding soft tissue swelling. Since the clinical diagnosis was acute osteomyelitis and arthritis, arthroscopic lavage was performed as a diagnostic and therapeutic procedure. The removed loose bodies and fibrinous tissue showed pathological features suspicious of chondrosarcoma. Subsequent MRI revealed an infiltrative tumor eroding through the cortex and joint cartilage. En bloc excision of the left lower femur, upper tibia including the knee joint and patella was performed, and the final diagnosis was grade 2 chondrosarcoma. The patient developed bilateral pulmonary metastasis 33 months after operation. Five months later, she suffered from a hitherto undescribed complication of ischemic perforation of the terminal ileum secondary to tumor embolic arterial obstruction with no macroscopic intestinal or peritoneal tumor deposit. The patient developed multiple brain metastases and died 43 months after initial presentation. Our case illustrates that malignant bone tumor as a differential diagnosis of acute osteomyelitis and arthritis merits recognition and exclusion before arthroscopic lavage, which may enhance tumor dissemination and in our patient results in embolic ischemic ileal perforation.

  2. Arthroscopic Decompression for a Giant Meniscal Cyst.

    Science.gov (United States)

    Ohishi, Tsuyoshi; Suzuki, Daisuke; Matsuyama, Yukihiro

    2016-01-01

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

  3. Arthroscopic treatment for septic arthritis of the knee%膝关节感染性关节炎的关节镜治疗

    Institute of Scientific and Technical Information of China (English)

    杨波; 林进

    2014-01-01

    背景:膝关节感染性关节炎的治疗由于所需时间长、易复发和术后功能恢复差等特点,一直是关节外科临床上的棘手问题,相关的病例报道很多,但对手术技术细节的全面探讨并不多见。  目的:探讨关节镜下清理、冲洗、置管,术后持续大流量灌洗治疗膝关节感染性关节炎的疗效及技术细节。  方法:回顾性分析2004年1月至2014年8月,采用关节镜下清理及术后持续灌洗的方法治疗的膝关节感染性关节炎患者14例。男9例,女5例;年龄28~81岁,平均(48.07±14.56)岁。比较患者术前、术后1周及末次随访时膝关节的伸屈活动度、VAS评分及Lysholm评分。  结果:14例患者平均随访(24.18±12.60)个月(3~45个月)。膝关节术前、术后1周和末次随访时的平均伸直度分别为5.71°±5.29°、3.57°±3.49°和1.14°±1.50°;平均屈曲度分别为85.77°±33.32°、95.01°±25.12°和116.79°±11.43°;VAS评分分别为(8.64±0.97)分、(5.43±1.80)分和(1.14±1.19)分。术前和末次随访时的Lysholm评分分别为(51.93±10.86)分和(89.07±4.99)分。至末次随访时,无1例复发。t检验结果:术后1周和末次随访时的VAS评分均较术前有明显下降(P0.05),但末次随访时的伸屈度数与术前比较,均有显著统计学差异(P  结论:关节镜下清理、冲洗、置管,术后持续灌洗治疗膝关节感染性关节炎可以显著改善患膝的症状及功能,是一种创伤小、恢复快的有效方法。%Background:Treatment of septic arthritis of the knee has been a troublesome problem in joint surgery due to its prolonged time needed for treatment, recurrent characteristics and poor functional recovery. Though there are many reports about it, few comprehensive discussion on the technical details of the operation is seen. Objective:To investigate the role of arthroscopic debridement

  4. Pustulotic arthro-osteitis report of a case successfully treated with laser-assisted arthroscopic synovectomy.

    Science.gov (United States)

    Yamada, K; Imaizumi, T; Uemura, M

    1999-02-01

    A 61-year-old man with palmoplantar pustulosis had pain and swelling persisting in his left knee for more than 3 years. The rheumatoid factor and HLA B 27 antigen were absent. Plain radiographs of the knee revealed no abnormalities despite the persistent synovitis. The bone scintigraphy showed increased uptake in the manubriosternal joint as well as in the knee. Eventually, the patient underwent arthroscopic synovectomy assisted with a holmium: YAG laser. No postoperative complications such as hemarthrosis were noted. The patient was pain free with full range of motion of the knee 22 months after surgery. Peripheral arthritis associated with palmoplantar pustulosis is usually transient. This unique case suggests that laser-assisted arthroscopic synovectomy would be a useful therapeutic option for persistent severe synovitis resistant to conservative treatment in pustulotic arthro-osteitis.

  5. 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

  6. The Clinical Study on Arthroscope Combined with limited Open Treating Knee Multiple Ligament Injury%关节镜结合有限切开治疗膝关节多韧带损伤

    Institute of Scientific and Technical Information of China (English)

    彭永海; 张青松; 李烨; 胡勇; 汤洁

    2012-01-01

    目的:探讨应用关节镜结合有限切开治疗膝关节多韧带损伤的方法和近期疗效.方法:膝关节多韧带损伤患者25例,采用关节镜下异体胫前肌腱重建前后交叉韧带,同时有限切开修复关节周围韧带,处理合并的半月板软骨损伤.术前按照国际膝关节文献委员会(IKDC)综合评价患膝功能均为D级,Lysholm评分平均为(35.0±1.4)分.结果:25例患者术后获24~30个月(平均27.4个月)随访,患膝功能均明显改善.末次随访时IKDC综合评价结果:A级10个(40%),B级12个(48%),C级3个(12%),Lysholm评分平均为(92±1.8)分,与术前相比差异有统计学意义(P<0.01).结论:关节镜下同种异体胫前肌腱重建前后交叉韧带结合有限切开修复关节周围韧带,可以明显改善膝关节功能,临床疗效较好.%Objective:To discuss the treatment methods and short term effect of arthroscope combined with limited open treating knee joint multiple ligament injury. Method:25 cases of ACL and PCL injury were reconstructed with anterior tibial tendon allograft under arthroscope, while repaired the ligaments around the knee and meniscus cartilage through mini - open approach. According to the International Knee Documentation Committee (IKDC) standard, the knee function was class D and Lysholm average score was (35 ± 1.4) before operation. Results:After surgery the 25 patients were followed - up about 24 - 30 months (average 27. 4 months), The knee function of all patients were improved significantly. At termination of follow-up, IKDC score was graded as A in ten cases (40%) , B in twelve cases (48%) , and C in threee cases (12%). Lysholm average score was (92±1. 8). Compared with preoperation, the IKDC and Lysholm score showed significant changes (P<0. 01). Conclusion:Reconstruction of ACL and PCL with anterior tibial tendon allograft under Arthros-copy through mini-open approach can significantly improve the knee function The clinical efficacy is better.

  7. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    Science.gov (United States)

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  8. Arthroscopic airbrush assisted cell implantation for cartilage repair in the knee: a controlled laboratory and human cadaveric study

    NARCIS (Netherlands)

    Windt, de T.S.; Vonk, L.A.; Buskermolen, J.K.; Visser, J.; Karperien, H.B.J.; Bleys, R.L.A.W.; Dhert, W.J.A.; Saris, D.B.F.

    2015-01-01

    Summary Objective The objective of this study was to investigate the feasibility of arthroscopic airbrush assisted cartilage repair. Methods An airbrush device (Baxter) was used to spray both human expanded osteoarthritic chondrocytes and choncrocytes with their pericellular matrix (chondrons) at 1

  9. Arthroscopic airbrush assisted cell implantation for cartilage repair in the knee : a controlled laboratory and human cadaveric study

    NARCIS (Netherlands)

    de Windt, T S; Vonk, L A; Buskermolen, J K; Visser, J.; Karperien, M; Bleys, R L A W; Dhert, W J A; Saris, D B F

    2015-01-01

    OBJECTIVE: The objective of this study was to investigate the feasibility of arthroscopic airbrush assisted cartilage repair. METHODS: An airbrush device (Baxter) was used to spray both human expanded osteoarthritic chondrocytes and choncrocytes with their pericellular matrix (chondrons) at 1 × 10(6

  10. Arthroscopic airbrush assisted cell implantation for cartilage repair in the knee : A controlled laboratory and human cadaveric study

    NARCIS (Netherlands)

    de Windt, T. S.; Vonk, L. A.; Buskermolen, J. K.; Visser, J.; Karperien, M.; Bleys, R. L A W; Dhert, W. J A; Saris, D. B F

    2015-01-01

    Objective: The objective of this study was to investigate the feasibility of arthroscopic airbrush assisted cartilage repair. Methods: An airbrush device (Baxter) was used to spray both human expanded osteoarthritic chondrocytes and choncrocytes with their pericellular matrix (chondrons) at 1×106cel

  11. Clinical Application and Curative Effect of Plasma Blade Combined Arthroscopic Surgery on Meniscus Lesions of 38 Cases%等离子刀联合关节镜治疗膝半月板损伤38例临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    张勇; 朱昊; 蒋定华; 黄立新; 孙树金; 董天华

    2015-01-01

    ObjectiveTo investigate the clinical application and curative effect of plasma blade combined arthroscopic surgery on meniscus lesions.Methods The data of surgical treatment in 38 patients with meniscal injury in 41 knees were retrospectively analyzed. The proper surgical procedures were selected respectively according to the injury position and the type of lesions. Lysholm score system was applied and the scores of pre- and post-operation were compared, all patients were followed up over 2 years.ResultsThese 38 patients with meniscal injury in 41 knees were conifrmed by arthroscopic surgery. All the surgeries were successful with no serious complications. All the patients were followed up for over 24 months. Their symptoms completely disappeared in 26 knees, improved in 13 knees in comparison with preoperative status. The effect in 2 knees was not satisfying. The excellent and good rate of the post-operative function was 95.12%.ConclusionThe meniscus injury cured under the combination of plasma blade and arthroscopic surgery is of the advantages of intuitive and accurate checking, simple procedures, less trauma, faster recovery, and the effect is more ideal.%目的:探讨应用等离子刀联合关节镜微创手术治疗半月板损伤的临床疗效。方法回顾性收集分析38例41膝半月板损伤患者的临床资料,根据半月板损伤部位及损伤类型,选择相应的关节镜手术方式予以治疗。术后2年以上随访观察,以Lysholm膝关节评分系统评价治疗效果。结果患者38例41膝半月板损伤术中均得到确诊。手术均获成功,未见严重并发症。术后2年随访,无失访病例。症状完全消失26膝,比术前好转13膝,效果一般2膝。优良率为95.12%。结论应用等离子刀联合关节镜治疗半月板损伤具有操作简便、创伤小、疗效确切、术后恢复快的特点。

  12. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis

    OpenAIRE

    Song, Mingzhi; Sun, Xiaohong; Tian, Xiliang; Zhang, Xianbin; Shi, Tieying; SUN, RAN; Dai, Wei

    2016-01-01

    Aim This study aims to conduct a meta-analysis to identify and compare the effectiveness of compressive cryotherapy and cryotherapy alone for patients undergoing knee surgery. Background Postoperative management is an important guarantee for the success of surgery. Cryotherapy and compression are two common nursing techniques after knee surgery, and are considered to be effective for postoperative clinical symptoms such as local pain and swelling. However, no previous meta-analyses have compa...

  13. Timing of surgery in anterior cruciate ligament-injured knees.

    Science.gov (United States)

    Shelbourne, K D; Patel, D V

    1995-01-01

    Despite recent advances in the surgical techniques of anterior cruciate ligament (ACL) reconstruction in the past two decades, there is no consensus of opinion as to the ideal timing for ACL surgery. Based on the evolution of management of patients with ACL injuries over the period 1982-1994, we have found that various factors need to be considered in order to provide the best possible long-term result to the patient with minimal or no complications. In this review, we discuss the perioperative factors that one must consider to determine optimum timing for ACL surgery. Factors such as mental preparation of the patient; school, work, family, and social schedules; preoperative condition of the knee [i.e., minimal or no swelling, good strength, good leg control, and full range of motion (ROM) including full hyperextension]; and associated ligamentous and/or meniscal injuries must be considered before undertaking ACL surgery. With careful consideration of the above-mentioned factors and with our preoperative and postoperative rehabilitation program, we have been able to obtain predictable, successful, long-term results following ACL reconstruction in our athletic population. We emphasize that every patient should be treated on his or her own merit, and treatment decisions must be individualized.

  14. Effect of isokinetic training on the function recovery of knee meniscus injuries following arthroscope%关节镜术后等速训练对膝半月板损伤恢复的影响

    Institute of Scientific and Technical Information of China (English)

    李兴海; 任延波; 席国平

    2006-01-01

    training on the functional recovery of knee flexors and extensors and the muscle force around the joint after knee meniscus injuries receiving arthroscopy.DESIGN: Case-control observation SETTING: Department of Police Training, Liaoning Advanced Police Officer School PARTICIPANTS: A total of 20 patients with acute meniscus injury of lateral knee joint were selected from the Department of Surgery, Affiliated Hospital of Dalian Medical University between September 2004 and January 2005. They were randomly divided into experimental group and control group,including 11 cases respectively. METHODS: All the patients were treated with arthroscope operation, additionally the control patients received routine blocking, physiotherapy and massage, etc. To recover the function. From the 2nd to 4th days postoperative, the patients of experimental group began to carry out the functional rehabilitation, and received isokinetic exercise in both knees flexors and extensors with the Cybex-6000 isokinetic dynamometer 3 weeks later.MAIN OUTCOME MEASURES: Peak torque values, total work, torque accelerating energy and average power in both knee flexors and extensors at different angular velocities [60, 120 and 180(°)/s].RESULTS: A total of 22 patients were involved in the result analysis.①After arthroscope operation and isokinetic training, the range of joint movement were extended, and the maximum flexion angle changed from (132±25)° to (158±21)°. There were significant differences before and after training by t test (P < 0.01).②The experimental group had statistical significance compare with control group in the test index at 60, 120 and 180(°)/s(P < 0.05).CONCLUSION: The arthroscope combining with isokinetic training can speed up the rehabilitation after knee meniscus injury, enhance the muscle force around knee joint and maintain the stability of knee joint and motor ability.

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

    Directory of Open Access Journals (Sweden)

    Kostov Rostislav V

    2015-07-01

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

  16. Arthroscopic observation was useful to detect loosening of the femoral component of unicompartmental knee arthroplasty in a recurrent hemoarthrosis

    OpenAIRE

    Yamakado Kotaro; Arakawa Hitoshi; Hayashi Seigaku

    2012-01-01

    Abstract A case of recurrent hemarthrosis of the knee after a mobile-bearing unicompartmental knee arthroplasty (UKA; Oxford UKA) is described. A 58-year-old man met with a road traffic accident 10 months after UKA. He developed anteromedial pain and hemarthrosis of the knee joint 1 month after the accident, which required multiple aspirations. Physical examination showed no instability. Plain radiograph revealed no signs of loosening. All laboratory data, including bleeding and coagulation t...

  17. 关节镜下常规清理联合去神经化治疗中晚期膝关节骨性关节炎中的临床效果%The effect of routine arthroscopic cleanup combined with denervation therapy on patients with advanced knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    戴涟生; 叶俊星; 杨晓斐

    2016-01-01

    Objective To study the effect and safety of routine arthroscopic cleanup combined with denervation therapy on advanced knee osteoarthritis. Methods From March 2013 and March 2016,80 patients with advanced knee osteoarthritis in our hospital were randomly divided into control group and observation group. And cleanup routine arthroscopic treatment was used in control group,denervation therapy combined with cleanup routine arthroscopic were used in observation group. The pain vulgar,postoperative wound healing time,and knee function of two groups were compared. Results 1 month after surgery,VAS scores in observation group was significantly lower than that in the control group,the differ-ence was significant( P < 0. 05). 1 and 3 months after surgery Lysholm score in the observation group was significantly higher than that in the control group,the difference was significant( P < 0. 05). 3 months after surgery,excellent rate of HSS score in the observation group and control group were 95. 03% and 80. 0% ,respectively. The excellent rate of the observation group was significantly higher than that of control group,the difference was significant( P < 0. 05). Conclusion Routine arthroscopic cleanup combined with denervation therapy can effectively relieve the pain level,and promote the recovery of knee function,improve the efficacy of treatment for patients with advanced knee osteoarthritis.%目的观察关节镜下常规清理联合去神经化治疗中晚期膝关节骨性关节炎中的临床效果以及安全性。方法将2013年3月至2016年3月期间80例中晚期膝关节 OA 病人随机分成对照组与观察组。对照组进行关节镜下常规清理治疗,观察组进行关节镜下常规清理联合去神经化治疗。比较两组的疼痛程度、术后切口愈合时间以及膝关节功能等。结果手术1个月后观察组的视觉模拟评分(VAS 评分)明显的低于对照组,差异具有显著性( P <0.05);手术后1个月、3

  18. Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation

    Science.gov (United States)

    Wright, Rick W.; Ross, James R.; Haas, Amanda K.; Huston, Laura J.; Garofoli, Elizabeth A.; Harris, David; Patel, Kushal; Pearson, David; Schutzman, Jake; Tarabichi, Majd; Ying, David; Albright, John P.; Allen, Christina R.; Amendola, Annunziato; Anderson, Allen F.; Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler V, J. Brad; Campbell, John D.; Carpenter, James E.; Cole, Brian J.; Cooper, Daniel E.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; DeBerardino, Thomas M.; Dunn, Warren R.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Lantz, Brett A.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Mann, Barton; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O’Neill, Daniel F.; Owens, LTC Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Spindler, Kurt P.; Stuart, Michael J.; Svoboda, LTC Steven J.; Taft, Timothy N.; Tenuta, COL Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.; Carey, James L.

    2014-01-01

    Background: Osteoarthritis of the knee is commonly diagnosed and monitored with radiography. However, the reliability of radiographic classification systems for osteoarthritis and the correlation of these classifications with the actual degree of confirmed degeneration of the articular cartilage of the tibiofemoral joint have not been adequately studied. Methods: As the Multicenter ACL (anterior cruciate ligament) Revision Study (MARS) Group, we conducted a multicenter, prospective longitudinal cohort study of patients undergoing revision surgery after anterior cruciate ligament reconstruction. We followed 632 patients who underwent radiographic evaluation of the knee (an anteroposterior weight-bearing radiograph, a posteroanterior weight-bearing radiograph made with the knee in 45° of flexion [Rosenberg radiograph], or both) and arthroscopic evaluation of the articular surfaces. Three blinded examiners independently graded radiographic findings according to six commonly used systems—the Kellgren-Lawrence, International Knee Documentation Committee, Fairbank, Brandt et al., Ahlbäck, and Jäger-Wirth classifications. Interobserver reliability was assessed with use of the intraclass correlation coefficient. The association between radiographic classification and arthroscopic findings of tibiofemoral chondral disease was assessed with use of the Spearman correlation coefficient. Results: Overall, 45° posteroanterior flexion weight-bearing radiographs had higher interobserver reliability (intraclass correlation coefficient = 0.63; 95% confidence interval, 0.61 to 0.65) compared with anteroposterior radiographs (intraclass correlation coefficient = 0.55; 95% confidence interval, 0.53 to 0.56). Similarly, the 45° posteroanterior flexion weight-bearing radiographs had higher correlation with arthroscopic findings of chondral disease (Spearman rho = 0.36; 95% confidence interval, 0.32 to 0.39) compared with anteroposterior radiographs (Spearman rho = 0.29; 95

  19. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

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

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

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

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

    Science.gov (United States)

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

    2009-03-01

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

  2. 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......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...

  3. Arthroscopic observation was useful to detect loosening of the femoral component of unicompartmental knee arthroplasty in a recurrent hemoarthrosis

    Directory of Open Access Journals (Sweden)

    Yamakado Kotaro

    2012-02-01

    Full Text Available Abstract A case of recurrent hemarthrosis of the knee after a mobile-bearing unicompartmental knee arthroplasty (UKA; Oxford UKA is described. A 58-year-old man met with a road traffic accident 10 months after UKA. He developed anteromedial pain and hemarthrosis of the knee joint 1 month after the accident, which required multiple aspirations. Physical examination showed no instability. Plain radiograph revealed no signs of loosening. All laboratory data, including bleeding and coagulation times, were within normal limits. Diagnostic arthroscopy demonstrated loosening of the femoral component. Any intraarticular pathology other than nonspecific synovitis was ruled out. The loose femoral component and polyethylene meniscal bearing were revised. Since then, hemarthrosis has not recurred.

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

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

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

  5. Mechanical and physiological factors in knee joint contact mechanics

    DEFF Research Database (Denmark)

    Mølgaard, Carsten

    Numerous biomechanical studies have provided evidence that laterally wedged insoles reduce the knee adduction moment during walking in healthy controls as well as patients with knee osteoarthritis potentially reducing the contact stress of medial tibial and femoral condyles. The knee adduction...... moment has been recognized as a suitable biomechanical marker for progression of knee osteoarthritis. However, recent clinical trials have not been able to confirm this potentially favourable effect. With the increasing prevalence of knee osteoarthritis and knee replacement surgery the demand for early...... healthy subjects, and 3) to identify the acute effect of laterally wedged insoles on biomechanical markers in patients after an medial arthroscopic partial meniscectomy. The results showed that shoe design and lateral wedges are equally important factors for changing the knee adduction moment...

  6. Comparison on the efficacy of proximal fibular osteotomy and arthroscopic debridement in treatment of varus knee osteoarthritis%腓骨近端截骨与关节镜清理治疗内翻型膝关节骨关节炎的疗效比较

    Institute of Scientific and Technical Information of China (English)

    侯永新; 程伟强; 张民; 魏垒

    2016-01-01

    proximal fibula osteotomy group (n=27) and arthroscopic group (n=27). Visual analogue scale (VAS), the hospital for special surgery (HSS) knee score and knee society score (KSS) were recorded and compared before and after operation. Results Fifty-four patients were followed up from 6 to 7 months, with an average of (6.5±0.3) months. The operation time of the two groups were compared, the difference was not statistically significant (t=8.487, P>0.05). And in preoperative VAS, HSS knee score, KSS (clinical), KSS (function), there were not statistically significant (P>0.05), but at 1 week, 1 month, 3 months, 6 months after operation, the KSS (clinical), KSS (function) in the proximal fibula osteotomy group were higher than that in the arthroscopic debridement group, the VAS was lower than that in the arthroscopic debridenent group. Compared with the preoperative values the VAS, HSS, KSS (clinical) and KSS (function) in the two groups were all significantly improved (P<0.05), the differences were statistically significant (P<0.05). In the proximal fibula osteotomy group, 1 case suffered from femoral vein thrombosis, 2 cases suffered from venous thrombosis in the lower leg, 3 cases suffered from foot back numbness (1 case was not improved), 2 cases of mild hematoma; In the simple arthroscopic group, 3 cases suffered from lower leg intramuscular venous thrombosis, 4 cases suffered from joint fluid accumulation. Conclusions The effect of proximal fibula osteotomy in treatment of patients with knee osteoarthritis is better than that of arthroscopic debridement, which can effectively improve the knee joint function, reduce knee pain, and less postoperative complications, and it is an effective treatment method for varus knee osteoarthritis.

  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. 陇中牌中药洗剂配合膝关节镜治疗膝骨性关节炎的临床对照研究%Clinical Observation of Traditional Chinese Lotion of Longzhong Brand Integrated with Arthroscopic for Treating Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    赵振文; 李盛华; 柴喜平

    2012-01-01

    Objective: To detect the clinical effect of herbal lotion of Longzhong brand with arthroscopic for treating knee osteoarthritis. Methods; Ail 60 cases were randomly divided into control group and treatment group from March 2010 to March 2011, 30 patients in each group. The VAS score and lysholm score were observed in the two groups 1, 3, 6, and 12 months before and after operation, Results.The VAS score and lysholm score was not difference between the two groups before surgery (P>0. 05), but there was significant difference between the two groups 1, 3, 6, and 12 months after operation (P<0. 05). Conclusion:The herbal lotion combined with arthroscopic is effective for relieving pain of knee osteoarthritis.%目的:探讨陇中牌中药洗剂配合膝关节镜治疗骨性关节炎的治疗效果,方法:自2010年3月-2011年3月,将60例随机分为2组,治疗组30例,对照组30例,2组分别在治疗前和术后1、3、6、12月进行VAS评分、lysholm评分.结果:治疗组和对照组在治疗前VAS评分、lysholm评分比较差异无统计学意义(P>0.05),治疗组和对照组在治疗后1、3、6、12月VAS评分、lysholm评分比较差异有统计学意义(P<0.05).结论:中药洗剂配合膝关节镜治疗膝骨性关节炎是缓解膝骨性关节炎疼痛的一种有效的治疗方法.

  9. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.].

  11. 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

  12. [Arthroscopic styloidectomy].

    Science.gov (United States)

    Levadoux, M; Cognet, J M

    2006-11-01

    The radial styloidectomy is a symptomatic treatment of the radio scaphoidal impingement. Famous many years ago for the treatment of post-traumatic arthritis of the wrist (SLAC, SNAC wrist) this procedure has been progressively abandoned. The miniaturization of the wrist's arthroscopical tools allows stiloidectomy under arthroscopy. This treatment allows the disappearance of the impingement and protects the surrounding soft tissue. After a short historical, anatomical and biomechanical study, the authors expose the technique of the styloidectomy under an arthroscopic procedure.

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

    Science.gov (United States)

    Wee, James; Lee, Keng Thiam

    2014-04-01

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

  14. Fast-track surgery for bilateral total knee replacement

    DEFF Research Database (Denmark)

    Husted, H; Troelsen, A; Otte, K S;

    2011-01-01

    Bilateral simultaneous total knee replacement (TKR) has been considered by some to be associated with increased morbidity and mortality. Our study analysed the outcome of 150 consecutive, but selected, bilateral simultaneous TKRs and compared them with that of 271 unilateral TKRs in a standardised...

  15. 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

  16. 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.

  17. FAST TRACK SURGERY IN TOTAL KNEE ARTHROPLASTY - A REVIEW.

    OpenAIRE

    2015-01-01

    The number of orthopedic surgeons who are convinced in the need for significant changes in planned total knee arthroplasty (TKA) is increasing slowly and steadily. A new approach to pain control has been developed over the past 10-15 years, and the introduction of techniques to reduce perioperative stress, and the use of minimally invasive surgical techniques can help limit postoperative complications and shorten recovery time. This type of optimization is regarded as Fast-track Care program,...

  18. FAST TRACK SURGERY IN TOTAL KNEE ARTHROPLASTY - A REVIEW.

    Directory of Open Access Journals (Sweden)

    Pencho Kosev

    2015-08-01

    Full Text Available The number of orthopedic surgeons who are convinced in the need for significant changes in planned total knee arthroplasty (TKA is increasing slowly and steadily. A new approach to pain control has been developed over the past 10-15 years, and the introduction of techniques to reduce perioperative stress, and the use of minimally invasive surgical techniques can help limit postoperative complications and shorten recovery time. This type of optimization is regarded as Fast-track Care program, where improved healing process is particularly useful to comorbid patients.

  19. Prometheus payment model: application to hip and knee replacement surgery.

    Science.gov (United States)

    Rastogi, Amita; Mohr, Beth A; Williams, Jeffery O; Soobader, Mah-Jabeen; de Brantes, Francois

    2009-10-01

    The Prometheus Payment Model offers a potential solution to the failings of the current fee-for-service system and various forms of capitation. At the core of the Prometheus model are evidence-informed case rates (ECRs), which include a bundle of typical services that are informed by evidence and/or expert opinion as well as empirical data analysis, payment based on the severity of patients, and allowances for potentially avoidable complications (PACs) and other provider-specific variations in payer costs. We outline the methods and findings of the hip and knee arthroplasty ECRs with an emphasis on PACs. Of the 2076 commercially insured patients undergoing hip arthroplasty in our study, PAC costs totaled $7.8 million (14% of total costs; n = 699 index PAC stays). Similarly, PAC costs were $12.7 million (14% of total costs; n = 897 index PAC stays) for 3403 patients undergoing knee arthroplasty. By holding the providers clinically and financially responsible for PACs, and by segmenting and quantifying the type of PACs generated during and after the procedure, the Prometheus model creates an opportunity for providers to focus on the reduction of PACs, including readmissions, making the data actionable and turn the waste related to PAC costs into potential savings.

  20. Histoplasmosis diagnosed after arthroscopy of the knee: case report.

    Science.gov (United States)

    Falster, Lorenzo; Marin, Maurício B; Gomes, João Luiz Ellera

    2015-01-01

    Fungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure. The joint was debrided in this second intervention and the patient received itraconazole initially and fluconazole latter on. The arthritis subsided after 10 months of treatment.

  1. Histoplasmosis diagnosed after arthroscopy of the knee: case report

    Directory of Open Access Journals (Sweden)

    Lorenzo Falster

    2015-10-01

    Full Text Available ABSTRACTFungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure. The joint was debrided in this second intervention and the patient received itraconazole initially and fluconazole latter on. The arthritis subsided after 10 months of treatment.

  2. Bariatric Surgery Prior to Total Knee Arthroplasty is Associated With Fewer Postoperative Complications.

    Science.gov (United States)

    Werner, Brian C; Kurkis, Gregory M; Gwathmey, F Winston; Browne, James A

    2015-09-01

    This study used a national database to compare 90-day postoperative complication rates between three groups of patients who underwent total knee arthroplasty (TKA): (1) non-obese patients (n=66,523), (2) morbidly obese patients who did not have bariatric surgery (n=11,294) and (3) morbidly obese patients who underwent bariatric surgery prior to TKA (n=219). Morbidly obese patients who underwent bariatric surgery prior to TKA had reduced rates of major (OR 0.45, P=0.001) and minor (OR 0.61, P=0.01) complications compared to morbidly obese patients who did not have bariatric surgery. Bariatric surgery prior to TKA appears to be associated with less risk of postoperative complications, although not to the same level as non-obese patients.

  3. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Structural pathology is not related to patient-reported pain and function in patients undergoing meniscal surgery

    DEFF Research Database (Denmark)

    Tornbjerg, Simon Maretti; Nissen, Nis; Englund, Martin;

    2016-01-01

    BACKGROUND: The relationship between meniscal tears and other joint pathologies with patient-reported symptoms is not clear. We investigated associations between structural knee pathologies identified at surgery with preoperative knee pain and function in patients undergoing arthroscopic meniscal...... the Knee Injury and Osteoarthritis Outcome Score (KOOS), were obtained by online questionnaires prior to surgery. Knee pathology was assessed by the operating surgeons using a modified version of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification...... of meniscal tears questionnaire, supplemented with information extracted from surgery reports. Following hypothesis-driven preselection of candidate variables, backward elimination regressions were performed to investigate associations between patient-reported outcomes and structural knee pathologies. RESULTS...

  6. 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.

  7. Lower limb salvage surgery using Ilizarov circular external frame for a landmine injury about the knee.

    Science.gov (United States)

    Demiralp, Bahtiyar; Yıldırım, Cengiz; Yurttaş, Yüksel; Çiçek, Engin Ilker; Başbozkurt, Mustafa

    2013-01-01

    Limb salvage for severe trauma has been replaced amputation as the primary treatment in many trauma centers. However, the long-term outcomes after limb reconstruction or amputation have not been fully evaluated. In this report, we present the treatment results of limb salvage surgery using Ilizarov external circular frame in a male case who had a-22-cm bone loss on the left distal femur and left proximal tibia and large soft tissue defect around the knee due to stepping on a landmine with his knee. The decision to amputate a severely injured limb, being irreversible, is challenging and significantly affects the body image and the patient. Extremity salvage surgery should be considered initially when evaluating patients with high-energy injured limbs at high risk for amputation.

  8. Editorial Commentary: Role of Synovial Biomarkers in Patient Outcomes After Knee Arthroscopy.

    Science.gov (United States)

    Brand, Jefferson C

    2016-03-01

    Humans are notably poor at predicting event outcomes. In "Correlation of Synovial Fluid Biomarkers With Cartilage Pathology and Associated Outcomes in Knee Arthroscopy," Cuellar, Cuellar, Kirsch, and Strauss show that some synovial fluid biomarkers (20 were sampled for the investigation) may predict operative findings at the time of arthroscopy and patient-reported outcome measures at follow-up. Further research will clarify the role of synovial biomarkers in knee pathology and, hopefully, narrow the choices to one or two pertinent markers that can be used to improve our ability to predict outcomes from arthroscopic knee surgery.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......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...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    clinics in Norway. PARTICIPANTS: 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. INTERVENTIONS: 12 week supervised exercise therapy alone or arthroscopic partial......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...... 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...

  11. Arthroscopic psoas tenotomy.

    Science.gov (United States)

    Wettstein, Michael; Jung, Jochen; Dienst, Michael

    2006-08-01

    Tenotomy may be indicated for psoas tendinitis or painful snapping if conservative treatment remains unsuccessful. Because of significant complications with open techniques, endoscopic operations have been developed. We present a new arthroscopic technique to access and release the psoas tendon from the hip joint. This procedure can be performed in addition to other arthroscopic procedures of the hip joint or alone. To exclude additional hip disease, a diagnostic round of the joint should be completed. After hip arthroscopy of the central compartment has been performed, traction is released and the 30 degrees arthroscope is placed via the proximal anterolateral portal lying on the anterior femoral neck. The medial synovial fold can be identified. This fold lies slightly medially underneath the anteromedial capsule at the level of the psoas tendon. The arthroscope is turned toward the anterior capsule. Sometimes, the tendon shines through a thin articular capsule, or it may even be accessed directly via a hole connecting the hip joint and the iliopectineal bursa at the level of the anterior head-neck junction. If this cannot be done, an electrothermic probe is introduced via the anterior portal to make a 2-cm transverse capsular incision. The tendon is released with the back side of the electrothermic device turned to the iliacus muscle that lies anterior to the psoas tendon. A complete release is achieved when the tendon stumps can be seen gapping at a distance and the fibers of the iliacus muscle are visible. The first 9 patients who underwent surgery performed according to this technique developed no complications, and their hip flexion strength was restored to normal within 3 months.

  12. 关节镜下止点重建治疗膝关节外侧半月板后根部撕裂%Arthroscopic ending reconstruction of posterior root tears of the lateral meniscus in the knee

    Institute of Scientific and Technical Information of China (English)

    刘玉强; 刘宁; 梁振雷; 王续鹏; 胡滨

    2015-01-01

    Objective To evaluate clinical outcomes of arthroscopic ending reconstruction of posterior root tear of the lateral meniscus in the knee.Methods From March 2010 to March 2014, 18 cases of posterior root tear of the lateral meniscus in the knee underwent arthroscopic ending reconstruction. Seven cases were of simple tear of the root, 11 were of combined radial tear of the posterior lateral complex. Fifteen cases combined with anterior cruciate ligament ( ACL ) injury and 3 cases with multiple ligaments injury underwent one-stage reconstruction. Lysholm score, IKDC score and visual analog scale ( VAS ) were applied to evaluate knee functions preoperatively and postoperatively. MRI and arthroscopic exploration of patients with follow-up were used to evaluate the healing of the lateral meniscus tear.Results The mean follow-up period was 20.2 months ( range: 6-41 months ). Postoperatively, the Lysholm knee score was 90.0±4.5, IKDC knee score was 84.6±3.2, VAS knee score was 0.7±0.9. Differences were statistically significant (P<0.001 ). Eighteen cases received MRI examination 1 year postoperatively: 17 cases ( healing rate: 94.4% ) showed completely healing of the meniscus and 18 cases ( healing rate: 100% ) with cruciate ligaments injury were conifrmed completely healing of the lateral meniscus by arthroscopic exploration.Conclusions Arthroscopic ending reconstruction is a good option in the treatment of posterior root tears of the lateral meniscus in the knee with the advantage of complete internal suture and reconstruction. It can receive satisfactory knee functions.%目的:探讨关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的临床效果。方法2010年3月至2014年3月,18例膝关节外侧半月板后根部损伤患者接受关节镜手术治疗。其中单纯后根部损伤7例,后根联合体部放射状撕裂11例,18例中15例合并前交叉韧带( anterior cruciate ligament,ACL )损伤、3例合并多发韧带损伤者

  13. 关节镜下膝关节多发韧带损伤重建术后的康复护理%Rehabilitation nursing after arthroscopic reconstruction for multiple ligament injuries of knee

    Institute of Scientific and Technical Information of China (English)

    钱雪梅; 董伟强; 刘素霞; 杨春英

    2013-01-01

    Objective To investigate the rehabilitation nursing procedure and its effects after arthroscopic reconstruction for multiple ligament injuries of the knee. Methods From March 2010 to September 2012, 11 cases of multiple ligament injuries of knee received anterior/posterior cruciate ligaments reconstruction by arthroscopy. According to the reconstruction materials, different surgical techniques and individual differences of patients, various rehabilitation training plans for perioperation period were specificly guided and managed. Patients were followed up to evaluate the clinical effects of training. Results All the patients were regularly followed up for one week to 29 months, with an average time of ( 14. 29 ±9. 13) months. All the patients felt no more unstability of the knee. Their gaits were normal. The anterior drawing test and lateral stress test were both negative in all cases. Posterior drawing test was positive in nine cases and negative in two cases. The difference between preoperative and postoperative knee functions was statistically significant (P 95°,无关节不稳定症状.11例膝关节前抽屉试验及外侧侧方应力试验均为(-);后抽屉试验:(+)9例,(-)2例,手术前后比较差异均有统计学意义(Z=3.035,Z=3.066,P均小于0.01).结论 根据患者多发韧带损伤特点,制定个体化、系统的围手术期康复训练计划,加强出院后持续康复训练管理,对促进关节镜下重建多发韧带损伤术后关节功能的全面康复至关重要.

  14. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty.

    Science.gov (United States)

    Lee, Minyoung; Suh, Dongwon; Son, Jaebum; Kim, Jungjin; Eun, Seon-Deok; Yoon, BumChul

    2016-01-01

    This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

  15. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty

    Directory of Open Access Journals (Sweden)

    Minyoung Lee, PT, BSc

    2016-03-01

    Full Text Available This article explored the perspectives of 25 patients regarding virtual reality (VR-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/– 0.3 out of 5.0 and a high rate of expectation of therapeutic effect (96% and intention of exercise adherence (96%. Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time, leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

  16. Analysis of the outcome of Anterior Cruciate Ligament reconstruction surgery on knee in athletes from Sari, 2007-2008

    Directory of Open Access Journals (Sweden)

    Seyed Esmaeel Shafiei

    2009-01-01

    Full Text Available (Received 3 November, 2009 ; Accepted 11 May, 2010AbstractBackground and purpose: The anterior cruciate ligament (ACL is one of the four major ligaments of the knee and also the most important knee stabilizer. Since the incidence of ACL tearing is especially high in young athletes, and reconstruction surgery and a prolonged rehabilitation may be rtequired, understanding the outcome of the ACL reconstruction surgery and preventive measures such as physiotherapy and muscle supporting exercises, could improve the outcome of the ACL reconstruction surgery. The aim of this study was to evaluate and recognize the outcome of ACL reconstruction surgery in athletes from Sari in 2007-2008.Materials and methods: In this descriptive study, 57 male athletes (mean age: 26.56 ± 6.17 years referred to several hospitals in sari during 2007-2008 were assessed after ACL reconstruction surgery. The assessment for the outcome of the ACL reconstruction surgery was done by physical examination, such as range of motion (ROM and performing stability tests (lachman test, anterior drawer test. Data were analyzed using statistical tests; ANOVA, χ2 and t -test.Results: Mean age of the patients was 26.56 ± 6.17 years (17-51. Mean duration after surgery was 18.4 ± 10.57(5-35. The most common cause of tearing was playing soccer (63.2%. The right knee was affected in 35 players (61.4% compared with the left knee in 22 (38.6%. Thirty three (57.9% right knees were dominant in comparison with 24(42.1% left knees. Type of trauma in 17 subjects (29.8% was contact and 40 (70.2% was non-contact. There were three (5.3% patients with movement limitation (10-30˚ and five (8.8% with knee instability. There was no significant relationship between mean duration after surgery and limitations in movements (P=0.412, knee stability (P=0.999, and patients satisfaction (P=0.412. There was a significant relation between dominant knee and stability (P=0.046.Conclusion: According to the results

  17. Vascular Complications in Arthroscopic Repair Of Posterior Cruciate Ligament

    Science.gov (United States)

    Agotegaray, Juan Ignacio; Comba, Ignacio; Bisiach, Luciana; Grignaffini, María Emilia

    2017-01-01

    Introduction: Posterior cruciate ligament is the primary stabilizer of the knee. Among the potential complications in arthroscopic repair of this ligament, there are vascular lesions, due to laceration, thrombosis and injury of the intima of the popliteal artery. We used one case to show the vascular complications that may arise in arthroscopic repair of the posterior cruciate ligament, how to handle it and the results. Methods: One patient, 33 years old, with a history of traffic accident. In a physical exam the patient shows pain and swelling of the knee, positive posterior drawer test and positive Godfrey test. X-rays on the knee show posterior tibial translation and MRI a complete fibers rupture at the middle third of the posterior cruciate ligament. An arthroscopic repair surgery was scheduled three weeks after trauma, with PCL reconstruction using simple band technique.After surgical intervention, hemostatic cuff was released, no peripheral pulse, paleness and coldness of the member was confirmed. An arteriography was carried out, which confirmed absences of distal vascular filling in the popliteal artery. An urgent referral was carried out with Vascular Surgery Services, who had been informed of the surgery previously (a notification that is part of our routine for this kind of interventions). Arteriorrhaphy and venorrhaphy of the popliteal arteries was fulfilled 12 hours later, with a leg fasciotomy. Daily monitoring was performed, and after 72 hours, muscle necrosis is seen with wound drainage, analysis shows presence of gram-negative bacilli, Proteus Mirabilis-Pseudomonas spp and the lab results showed leukocytes: 8.700/ml, ESR: 58, CRP: 48. A new surgery is performed with complete resection of the anterior external compartment of the leg, and a system of continuous cleansing is applied with physiological saline solution and boric acid for 14 days until drainage is eliminated. Vancomycin and ceftazidime EV was indicated for 14 days and, after a good

  18. 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.

  19. EFFICACY OF TREATING TENNIS ELBOW BY BLOCK AND ARTHROSCOPIC SURGERY%封闭与关节镜手术治疗网球肘的疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘大为; 刘国民; 白浩天; 孙玉朝; 陈雷

    2014-01-01

    目的:探讨局部封闭及关节镜手术治疗网球肘的临床疗效,为网球肘的微创治疗奠定基础。方法:将2010-06~2012-06收治网球肘病人共60例,平均分为2组,一组行封闭治疗,另一组行关节镜手术治疗,术前及术后行疼痛VAS评分及Mayo肘功能评分,进行对比分析。结果:封闭治疗组与关节镜手术组疼痛VAS评分及Mayo肘功能评分治疗后较治疗前均显著减小(P<0.05);关节镜手术组Mayo肘功能评分显著低于封闭治疗组(P<0.05);关节镜手术组临床痊愈率及总有效率显著高于封闭治疗组(P<0.05)。封闭组无效率高于关节镜手术组(P<0.05)。结论:封闭及关节镜手术均是网球肘治疗的有效手段,但关节镜手术的治疗效果优于封闭治疗。%Objective:To investigate the clinical efficacy of the patients with tennis elbow who received the partial block and arthroscopic surgical treatment. Methods:a total of 60 patients ( June 2010~June 2012 ) admitted to tennis elbow were randomly divided into two groups. A set of rows received block treatment,and the other group was underwent arthroscopic surgery. Before surgery and after surgery the pain VAS score and Mayo elbow function score were analyzed. Results:The Mayo elbow pain and VAS score function score of block treatment group and arthroscopic surgery group after treatment were significantly reduced than before treatment,with statistical significance(P<0. 05). Mayo elbow function scores of arthroscopy group was significantly lower than block treatment group ( P<0 . 05 ) . The clinical cure rate and the total effective rate Arthroscopic surgery were significantly higher than the block treatment group(P<0. 05). The inefficiency of block group was higher than arthroscopic surgery group,with statistical significance(P<0. 05). Conclusion:The block and arthroscopic surgery treatment are an effective means of treating tennis elbow, but the therapeutic effect of

  20. Polymerized-Type I Collagen Downregulates Inflammation and Improves Clinical Outcomes in Patients with Symptomatic Knee Osteoarthritis Following Arthroscopic Lavage: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Janette Furuzawa-Carballeda

    2012-01-01

    Full Text Available Objectives. Polymerized-type I collagen (polymerized collagen is a downmodulator of inflammation and cartilage regenerator biodrug. Aim. To evaluate the effect of intraarticular injections of polymerized collagen after arthroscopic lavage on inflammation and clinical improvement in patients with knee osteoarthritis (OA. Methods. Patients (n=19 were treated with 6 intraarticular injections of 2 mL of polymerized collagen (n=10 or 2 mL of placebo (n=9 during 3 months. Followup was 3 months. The primary endpoints included Lequesne index, pain on a visual analogue scale (VAS, WOMAC, analgesic usage, the number of Tregs and proinflammatory/anti-inflammatory cytokine-expressing peripheral cells. Secondary outcomes were Likert score and drug evaluation. Clinical and immunological improvement was determined if the decrease in pain exceeds 20 mm on a VAS, 20% of clinical outcomes, and inflammatory parameters from baseline. Urinary levels of C-terminal crosslinking telopeptide of collagen type II (CTXII and erythrocyte sedimentation rate (ESR were determined. Results. Polymerized collagen was safe and well tolerated. Patients had a statistically significant improvement (P<0.05 from baseline versus polymerized collagen and versus placebo at 6 months on Lequesne index, VAS, ESR, Tregs IL-1β, and IL-10 peripheral-expressing cells. Urinary levels of CTXII were decreased 44% in polymerized collagen versus placebo. No differences were found on incidence of adverse events between groups. Conclusion. Polymerized collagen is safe and effective on downregulation of inflammation in patients with knee OA.

  1. 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

  2. 关节镜微创技术治疗膝关节骨创伤的效果分析%Treatment of Knee Trauma Effect Arthroscopic Technical Analysis

    Institute of Scientific and Technical Information of China (English)

    乔冠儒

    2016-01-01

    Objective To explore the trauma of knee arthroscopy minimally invasive treatment to take effect. Methods Group selection hospital in March 2013 to October 2015 admissions of 74 patients with traumatic knee osteoarthritis were studied, according to the law they randomly divided into two groups of 37 patients in the control group to implement con-ventional therapy, the study group to implement arthroscopic minimally invasive treatment, comparison of two clinical effect in patients. Results The total effective rate was 94.59%, compared with 78.38% in the control group, the study group was significantly higher,the difference was statistically significant. (P<0.05). Conclusion The application of minimally invasive techniques in arthroscopic knee bone trauma patients can significantly improve clinical results, and promote early recovery of patients, it is worth learning from.%目的:探讨膝关节骨创伤采取关节镜微创技术治疗的效果。方法整群选择该院2013年3月—2015年10月接诊的膝关节骨创伤患者74例进行研究,按照随机数字法将他们分为2组,每组37例,对照组实施常规治疗,研究组实施关节镜微创技术治疗,比较两组患者临床效果。结果研究组总有效率为94.59%,对照组则为78.38%,研究组显著高于对照组,差异有统计学意义(P<0.05)。结论关节镜微创技术应用在膝关节骨创伤患者中可明显改善临床效果,促进患者早日康复,值得借鉴。

  3. 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

    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...

  4. 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.

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

    Science.gov (United States)

    Trochimczuk, R.; Kuźmierowski, T.

    2014-11-01

    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.

  6. MR imaging of the knee following cruciate ligament reconstruction and meniscal surgery; MRT des Kniegelenks nach Kreuzband- und Meniskusoperationen

    Energy Technology Data Exchange (ETDEWEB)

    Woertler, K. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Inst. fuer Roentgendiagnostik

    2009-03-15

    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.)

  7. Rituximab therapy for flare-up of rheumatoid arthritis after total knee replacement surgery.

    Science.gov (United States)

    Mirza, Rabeea; Ishaq, Saliha; Khan, Muhammad Owais; Memon, Adil

    2012-10-01

    A variety of drug types are used alone or in combination to manage Rheumatoid Arthritis along with physiotherapy. We report herein the case of a 51 year old female patient with a history of Rheumatoid Arthritis whose disease remained active despite being on routinely used multiple disease modifying antirheumatic drugs. The patient underwent bilateral total knee arthroplasty with subtotal synovectomy due to the severe pain caused by her concomitant age related osteoarthritis which was only aggravated by her active rheumatoid arthritis disease. Three months following surgery, the patient's knee pain with typical rheumatoid flare and swelling reappeared for which a B cell monoclonal antibody, rituximab, was given. Her number of tender and swollen joints reduced to less than three and her C-reactive protein levels and erythrocyte sedimentation rate reduced significantly along with considerable improvement in her Global Assessment score. Her severity of pain also decreased to 3 from an initial score of 8 on the Visual Analog Scale. Thus, Rituximab helped improve our patient's symptoms from recurrence of synovitis after total knee replacement.

  8. Cold bupivacaine versus magnesium sulfate added to room temperature bupivacaine in sonar-guided femoral and sciatic nerve block in arthroscopic anterior cruciate ligament reconstruction surgery

    Science.gov (United States)

    Alzeftawy, Ashraf Elsayed; El-Daba, Ahmad Ali

    2016-01-01

    Background: Cooling of local anesthetic potentiates its action and increases its duration. Magnesium sulfate (MgSo4) added to local anesthetic prolongs the duration of anesthesia and postoperative analgesia with minimal side effects. Aim: The aim of this prospective, randomized, double-blind study was to compare the effect of cold to 4°C bupivacaine 0.5% and Mg added to normal temperature (20–25°C) bupivacaine 0.5% during sonar-guided combined femoral and sciatic nerve blocks on the onset of sensory and motor block, intraoperative anesthesia, duration of sensory and motor block, and postoperative analgesia in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. Patients and Methods: A total of 90 American Society of Anesthesiologists classes I and II patients who were scheduled to undergo elective ACL reconstruction were enrolled in the study. The patients were randomly allocated to 3 equal groups to receive sonar-guided femoral and sciatic nerve blocks. In Group I, 17 ml of room temperature (20–25°C) 0.5% bupivacaine and 3 ml of room temperature saline were injected for each nerve block whereas in Group II, 17 ml of cold (4°C) 0.5% bupivacaine and 3 ml of cold saline were injected for each nerve block. In Group III, 17 ml of room temperature 0.5% bupivacaine and 3 ml of MgSo4 5% were injected for each nerve block. The onset of sensory and motor block was evaluated every 3 min for 30 min. Surgery was started after complete sensory and motor block were achieved. Intraoperatively, the patients were evaluated for heart rate and mean arterial pressure, rescue analgesic and sedative requirements plus patient and surgeon satisfaction. Postoperatively, hemodynamics, duration of analgesia, resolution of motor block, time to first analgesic, total analgesic consumption, and the incidence of side effects were recorded. Results: There was no statistically significant difference in demographic data, mean arterial pressure, heart rate, and duration of

  9. Racial disparities in receiving total hip/knee replacement surgery: the effect of hospital admission sources.

    Science.gov (United States)

    Chen, Jie; Rizzo, John A; Parasuraman, Shreekant; Gunnarsson, Candace

    2013-02-01

    Using a nationally-representative inpatient care dataset (the HCUP National Inpatient Sample from 2002 to 2007) we examined racial disparities in receiving total hip replacement (THR) and total knee replacement (TKR) surgeries. Multivariable logistic regression models revealed that racial minorities were significantly less likely to receive THR or TKR than Whites, controlling for patients' hospital admission source and hospital characteristics. Employing Blinder-Oaxaca decomposition techniques, we found that observed difference in population characteristics explained 55%-67% and 78% of the racial disparities in THR and TKR, respectively. Differences in patients' hospital admission source emerged as the major individual factor associated with these disparities, explaining 57%-77% of racial disparities in THR and 26%-50% of racial disparities in TKR. This study suggests that substantive racial and ethnic disparities exist in utilization of THR and TKR surgery. Observed population characteristics accounted for most of these differences, with hospital admission source being the key factor.

  10. Bariatric surgery does not improve outcomes in patients undergoing primary total knee arthroplasty.

    Science.gov (United States)

    Martin, J R; Watts, C D; Taunton, M J

    2015-11-01

    Bariatric surgery has been advocated as a means of reducing body mass index (BMI) and the risks associated with total knee arthroplasty (TKA). However, this has not been proved clinically. In order to determine the impact of bariatric surgery on the outcome of TKA, we identified a cohort of 91 TKAs that were performed in patients who had undergone bariatric surgery (bariatric cohort). These were matched with two separate cohorts of patients who had not undergone bariatric surgery. One was matched 1:1 with those with a higher pre-bariatric BMI (high BMI group), and the other was matched 1:2 based on those with a lower pre-TKA BMI (low BMI group). In the bariatric group, the mean BMI before bariatric surgery was 51.1 kg/m(2) (37 to 72), which improved to 37.3 kg/m(2) (24 to 59) at the time of TKA. Patients in the bariatric group had a higher risk of, and worse survival free of, re-operation (hazard ratio (HR) 2.6; 95% confidence interval (CI) 1.2 to 6.2; p = 0.02) compared with the high BMI group. Furthermore, the bariatric group had a higher risk of, and worse survival free of re-operation (HR 2.4; 95% CI 1.2 to 3.3; p = 0.2) and revision (HR 2.2; 95% CI 1.1 to 6.5; p = 0.04) compared with the low BMI group. While bariatric surgery reduced the BMI in our patients, more analysis is needed before recommending bariatric surgery before TKA in obese patients.

  11. A preliminary evaluation of limb salvage surgery for osteosarcoma around knee joint.

    Directory of Open Access Journals (Sweden)

    Xing Wu

    Full Text Available OBJECTIVE: To evaluate the effectiveness and drawbacks of diversified procedures of limb salvage surgery (LSS, providing a reference of rational surgical criterion of LSS. METHODS: Fifty eight patients with stage IIB extremity osteosarcoma around knee joint area between 1992 and 2002 were studied retrospectively. Among them, 43 patients were treated by LSS followed by reconstruction. Reconstruction approaches included re-implantation of irradiation-devitalized tumor bone (n = 12, autoclaving-devitalized tumor bone (n = 8, prosthetic replacement (n = 11, allograft transplantation (n = 8 and vascularized fibula autograft implantation (n = 4. Amputations were performed in 15 patients. Patients were followed up for 6-16 years. RESULTS: There were no significant difference between LSS and amputation groups regarding disease free survival and local recurrence rates. The actuarial 5-year continuous disease free survival and local recurrence rate were 30.0% and 25.0% in patients of devitalized LSS group, whereas those were 56.5% and 8.7% in patients of non-devitalized reconstruction group. The complication rate was significantly higher in LSS group compared to amputation group (P = 0.003. CONCLUSION: LSS with non-devitalized procedures is the optimal treatment for osteosarcoma around knee joint area. Prosthesis implantation is the preferred option for bone reconstruction following LSS. Prevention and treatment of post-operative complications should be paid more attention to get good long-term outcomes of surgery.

  12. Application of arthroscope in diagnosis and treatment of knee synovitis%关节镜在不同膝关节滑膜病变中的诊疗分析

    Institute of Scientific and Technical Information of China (English)

    王玉冰; 庞子轩; 张亮; 康发军

    2014-01-01

    目的:观察关节镜在不同膝关节滑膜病变中的诊断、治疗作用,分析不同病变的临床疗效。方法选取50例关节镜下诊断、治疗的膝关节滑膜病变患者为研究对象,术前拟诊为类风湿性关节炎10例,色素沉着绒毛结节性滑膜炎11例,膝关节慢性感染5例,慢性非特异性滑膜炎12例,膝关节滑膜结核5例,半月板损伤4例,不明原因3例,记录关节镜对膝关节滑膜病变的诊治效果。结果关节镜结合病理检查结果,术后10例患者更正临床诊断,所有伤口均一期愈合,无严重并发症发生。出院后所有患者均获得随访,6例色素沉着绒毛结节性滑膜炎,2例类风湿性关节炎,1例滑膜结核,1例慢性非特异性滑膜炎术后复发,其余患者术后膝关节功能均获得显著改善,总有效率80.0%。结论关节镜检查有利于明确诊断,而且微创可彻底切除病变的滑膜组织,耐受性好。%Objective To investigate the value of arthroscope in the diagnosis and treatment of knee synovitis. Methods 50 cases of knee synovitis diagnosed by arthroscopy and treated by endoscopic synovectomy were studied. There were 10 cases with rheumatoid arthritis, 11 cases with pigmented villonodular synovitis,5 cases with chronic infection of knee joint,12 cases with chronic non-specific synovitis,5 ca-ses with tuberculous synovitis of the knee,4 cases with meniscus injury,3 cases with unknown cause. The efficacy of the treatment was recor-ded. Results All these cases were clearly diagnosed by microscopic examination combined with synovial pathological examination,and 10 cases were corrected with clinical diagnosis post-operation. All cases received primary healing without serious complications. All cases were followed up,and 6 cases of pigmented villonodular synovitis,2 cases of rheumatoid arthritis,1 case of chronic non-specific synovitis and 1 case of tuberculous synovitis of the knee had recurred. The total effective rate was 80. 0

  13. A STUDY OF ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-09-01

    Full Text Available BACKGROUND : Meniscal injuries are common as a result of sports related injuries and motor vehicle accidents. Current arthroscopic partial menisectomy / repairs indicated for management of meniscal tears because of early rehabilitation and return to work and minimal complications . MATERIALS AND METHODS: Present study is a hospital based prospective study of 20 adult cases admitted for a period of 14 months, age group involved was between 10 - 40 years with 17 patients were male and 3 patients were female. RESULTS : Meniscal injuries on Right K nee were 11 cases and Left Knee were 9 cases. Type of meniscal tear were longitudinal 10 cases, oblique 5 cases, horizontal 3 cases, radial 1 case and complex (with discoid meniscus tear 1 case. Meniscal injuries associated with partial/complete ACL tear were 6 cases. There was one case of discoid meniscus. Surgery was performed at an average 1 month after Meniscal tear, duration of hospital stay was 3 . 6 days ranging from 3 - 6 days, mean time for earliest return to work was 14.35 days with range 10 - 16 days. Excellent to good results were seen in 95 %.of cases. CONCLUSION : Arthroscopic menisectomy is minimally invasive technique. Advantage of which includes early return to work, minimal complications, early post - operative rehabilitation, Short duration of hos pital stay.

  14. [Vascular injury as a complication of knee arthroscopic surgery. Report of two cases and review of the literature].

    Science.gov (United States)

    Enríquez-Vega, María Elizabeth; Cruz-Castillo, Juan Ernesto; Pacheco-Pittaluga, Ernesto; Solorio-Rosette, Hugo; Linarte-Márquez, Lizbeth; Iturburu-Enríquez, Alessandra

    2013-01-01

    Antecedentes: la artroscopia de rodilla es uno de los procedimientos más seguros, con tasas de complicaciones que van de 0.56 a 8.2%. Las complicaciones vasculares son aún más raras (0.0032%) y generalmente se relacionan con lesiones en la arteria poplítea. Casos clínicos: reportamos los casos de dos pacientes con complicaciones no sospechadas de lesiones vasculares post artroscopia. Ambos casos tenían lesión vascular posterior a cirugía electiva de artroscopia de rodilla. El primer caso es el de un paciente con pseudoaneurisma trombosado de la arteria poplítea y sección completa de la vena poplítea, desafortunadamente el diagnóstico se estableció 72 horas después de la artroscopia de rodilla y requirió amputación. El segundo caso tenía una fistula arteriovenosa a nivel poplíteo y se trató exitosamente con desmantelamiento de la fístula y reparación directa de la arteria y la vena. Conclusiones: aunque es extremadamente infrecuente, la lesión vascular postartroscopia de rodilla debe tenerse en mente como una posible complicación postquirúrgica porque su bajo índice de sospecha puede causar una desafortunada e inoportuna demora en el diagnóstico y tratamiento, con un riesgo potencial de amputación de la extremidad y muerte.

  15. Knee Replacement: What you can Expect

    Science.gov (United States)

    ... improves function lessen with each additional surgery. Artificial knees can wear out Another risk of knee replacement ... replacement surgery to last about two hours. After knee replacement surgery After surgery, you're wheeled to ...

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  17. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery: preliminary results

    DEFF Research Database (Denmark)

    Lund, J; Jenstrup, M T; Jæger, P;

    2011-01-01

    Because both the saphenous nerve and in part the obturator nerve are traversing the adductor canal of the thigh, we hypothesised that repeated administration of a local anaesthetic (LA) into this aponeurotic space could be a useful option for post-operative analgesia after knee replacement surgery....... A systematic search of the literature pertinent to the blockade of the saphenous and/or obturator nerves for pain relief after knee surgery was conducted. Further, pain and opioid requirements were evaluated in eight patients receiving a continuous blockade of the saphenous and obturator nerve (adductor-canal......-blockade) after total knee arthroplasty (TKA). Finally, we performed cross-sectional MR scans of the adductor canal after injection of ropivacaine 30ml in one patient. The systematic literature search revealed only one controlled study, where selective blockade of the saphenous nerve was investigated...

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  19. 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.

  20. 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

  1. Tissue structure damage in late-stage knee osteoarthritis: medication, markers, and disease modification before replacement surgery

    NARCIS (Netherlands)

    de Boer, T.N.

    2012-01-01

    The aim of this thesis is to gain more insight in the characteristics of end-stage osteoarthritic patients who are about to undergo total knee replacement surgery. Their use of medication, potential markers of actual characteristics of joint damage and inflammation, and effects of potential disease

  2. 关节镜微创手术配合复方丹红注射液及维生素 B12局部穴位注射治疗膝骨关节炎疗效观察%Clinical observation on the curative effect of knee osteoarthritis with mnimally invasive arthroscopic operation and local injection

    Institute of Scientific and Technical Information of China (English)

    付博

    2015-01-01

    Objective To observe the curative effect of knee osteoarthritis with mnimally invasive arthroscopic operation and local injection.Methods Choose 90 patients with knee osteoarthritis diagnosed as hospitalized patients from March 2012 to February 2013.They were randomly divided into Dan-wei treatment group, Qu-li treatment group, and the con-trol group.There were 30 cases in each group.Patients were informed consent and signed informed consent.All patients do Arthroscopic inflammation of the synovial membrane.Dan-wei treatment groups was with local pain points for injection of compound Dan red injection (2 mL) and vitamin B12 injection (0.5 mg).Qu-li treatment group was with Umcy Ann Ned injection (2 mL) with lidocaine hydrochloride injection (1 mL).1 time a week, 3 times were a course of treatment. The control group was only with arthroscopic minimally invasive surgery.Follow up for 6 months after treatment.The clini-cal effect of Lysholm was evaluated by Lequsne efficacy and knee function score.Results Two scoring results are displayed. Compared with control group, The clinical therapetic effect of Dan-wei treatment group and Qu-li treatment group were obvious(P0.05).Conclusion There is good clinical therapetic effect of minimally invasive surgery combined with compound Dan red injection and vitamin B12 local acupoint injection for osteoarthritis of knee joint, and avoided the complications caused by the Qu-li treatment group.%目的:观察关节镜微创手术配合复方丹红注射液及维生素B12局部穴位注射治疗膝骨关节炎疗效。方法选取2012年2月—2013年3月诊断为膝关节骨关节炎90例患者的临床资料,根据治疗方法分为丹维治疗组、曲利治疗组、对照组。每组各30例。所有患者行关节镜下炎症滑膜清理术,丹维治疗组患者配合局部痛点注射复方丹红注射液(2 mL)及维生素B12注射液(0.5 mg);曲利治疗组患者配合局部痛点注射

  3. Biological Knee Reconstruction With Concomitant Autologous Chondrocyte Implantation and Meniscal Allograft Transplantation

    Science.gov (United States)

    Ogura, Takahiro; Bryant, Tim; Minas, Tom

    2016-01-01

    mean 5.9 years after surgery. Seven of the 12 knees (58%) required subsequent surgical procedures (5 arthroscopic alone, 2 both arthroscopic and open). Conclusion: Combined ACI with MAT provided significant improvement in 65% of the operated knees over a mid- to long-term follow-up. This procedure can allow patients to retain their biological knees, delay or prevent rapid degeneration to osteoarthritis, and could be recognized as a bridge procedure before artificial knee replacement. However, careful discussion between the patient and surgeon is necessary before surgery to ensure realistic expectations.

  4. Physical and rehabilitation medicine (PRM) care pathways: "patients after knee ligament surgery".

    Science.gov (United States)

    Calmels, P; Ribinik, P; Barrois, B; Le Moine, F; Yelnik, A-P

    2011-11-01

    This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (Sofmer) and the French Federation of PRM (Fedmer). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. Patients after knee ligament surgery are classified into four care sequences and two clinical categories, taking into account personal and environmental factors that could influence patients' needs, in accordance with the International Classification of Functioning (WHO).

  5. 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.

  6. Arthroscopic surgery for treatment of sinus tarsi syndrome%跗骨窦综合征的关节镜下手术治疗

    Institute of Scientific and Technical Information of China (English)

    桂鉴超; 王黎明; 蒋逸秋; 徐晨阳; 张理; 顾湘杰; 马昕; 王旭

    2010-01-01

    目的 探讨跗骨窦综合征的关节镜下手术治疗效果.方法 2006年7月-2008年5月,共治疗跗骨窦综合征患者15例,男6例,女9例;年龄26~63岁,平均46.3岁.均为单侧患者,左侧10足,右侧5足.所有患者均在侧卧位、止血带下手术.术中采用外侧、前外侧和后外侧入路,必要时增加内侧入路.随访采用视觉模拟疼痛评分(VAS)和美国足踝外科协会(America Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分.结果 所有患者在关节镜下均有2个以上阳性表现,包括跗骨窦内瘢痕组织增生、炎症,距下关节内软组织撞击,距下关节滑膜炎,距下关节囊部分损伤,距跟骨间韧带部分损伤,颈韧带部分损伤,软骨面损伤,距下关节退行性变.所有患者均获得19~35个月(平均26.1个月)随访,VAS评分由术前7.6分(6~9分)减少到末次随访时的2.5分(1~4分)(P<0.01),AOFAS评分由术前41.9分(20~67分)提高到末次随访时的83.1分(70~100分)(P<0.01).末次随访时AOFAS踝-后足功能评分优良率达到73%.结论 对保守治疗无效的跗骨窦综合征患者应积极进行关节镜下手术治疗,能够获得较好的临床效果.%Objective To investigate the result of arthroscopic surgery in the treatment of sinus tarsi syndrome. Methods The study involved 15 patients (6 males and 9 females) with sinus tarsi syndrome admitted to First Hospital of Nanjing from July 2006 to May 2008. The age of the patients ranged from 23 to 63 years ( average 46.3 years). All the patients had one side involvement, including 10 patients with left side involvement and five with right side involvement. All the operations were performed under the tourniquet control and the patients were placed at the lateral decubitus position. The lateral, anterolateral and posterolateral portals were applied intraoperatively and the medial portal was applied when necessary. Visual analogue scale (VAS) and American orthopedic foot and ankle

  7. 膝关节多发韧带损伤关节镜下修复与重建术后的康复护理%Rehabilitation nursing after arthroscopic reconstruction for multiple ligaments injury of knees

    Institute of Scientific and Technical Information of China (English)

    陈瑛

    2014-01-01

    目的:探讨膝关节多发韧带损伤关节镜下修复与重建术后的康复护理。方法对10例膝关节多发韧带损伤的患者,施行关节镜下膝关节前、后交叉等多韧带重建术,根据手术方式和患者的个体差异制定了有针对性的围术期康复计划,同时加强出院后持续康复训练指导,分阶段对康复训练效果进行随访。结果随访1周~24个月,平均随访(12.30±6.65)个月,全部患者入院时 Lysholm 膝关节功能评分为(26.90±5.07)分,末次随访时评分为(89.50±3.81)分,差异有统计学意义(P <0.01)。结论根据患者多发韧带损伤特点,制定个性化、有针对性的围术期康复训练计划,加强出院后持续康复训练指导,对促进多发韧带损伤修复重建术后关节功能的全面康复尤为重要。%Objective To investigate the rehabilitation nursing procedure and its effects af-ter arthroscopic reconstruction for multiple ligaments injury of knees.Methods 10 patients with multiple ligaments injuries of knee received anterior posterior cruciate ligaments reconstruction by arthroscopy.According to different surgical techniques and individual differences of patients,tar-geted rehabilitation training plans in perioperative period were specifically guided and managed.Pa-tients were followed up to evaluate the clinical effects of training in stages.Results All the patients were regularly followed up foroneweek to2 4 months ,with an average timeof (1 2 .3 0 ± 6.65)months.The difference was statistically significant since the average Lysholm score of the all cases were (26.90±5.07)and (89.50±3.81)before operation and at final follow-up respective-ly(P <0.01).Conclusion Planned and targeted rehabilitation nursing based on the different sur-gical techniques and individual differences can benefit functional recovery of knee joint.It is impor-tant for patients who have arthroscopic reconstruction of

  8. In Vitro Antimicrobial Susceptibility of Mycobacterium massiliense Recovered from Wound Samples of Patients Submitted to Arthroscopic and Laparoscopic Surgeries

    Directory of Open Access Journals (Sweden)

    Alessandra Marques Cardoso

    2011-01-01

    Full Text Available Testing of rapidly growing species of mycobacteria (RGM against antibacterial agents has been shown to have some clinical utility. This work establishes the MICs of seven antimicrobial agents following the guidelines set forth by the Clinical and Laboratory Standards Institute (CLSI against eighteen isolates of Mycobacterium massiliense recovered from wound samples of patients submitted to minimally invasive surgery such as arthroscopy and laparoscopy. The isolates showed susceptibility to amikacin (MIC90=4 μg/mL and clarithromycin (MIC9016 μg/mL, doxycycline (MIC90>32 μg/mL, sulfamethoxazole (MIC90>128 μg/mL, and tobramycin (MIC90=32 μg/mL, and intermediate profile to cefoxitin (MIC90=64 μg/mL. Therefore, we suggest that the antimicrobial susceptibilities of any clinically significant RGM isolate should be performed.

  9. 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.

  10. The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review.

    Science.gov (United States)

    Barlow, Timothy; Downham, Christopher; Barlow, David

    2013-10-01

    Ambulatory knee surgery is a common procedure with over 100,000 knee arthroscopies performed in the U.K. in 2010-2011. Pain after surgery can decrease patient satisfaction, delay discharge, and decrease cost effectiveness. Multi-modal therapies, including complementary therapies, to improve pain control after surgery have been recommended. However, a comprehensive review of the literature regarding the use of complementary therapies to enhance pain control after ambulatory knee surgery is lacking, and this article aims to address this deficit. CINHAL, EMBASE, MEDLINE, AMED and CENTRAL databases were searched. Only Randomised Controlled Trials were included. All eligible papers were quality assessed using the Jadad system, and data was extracted using piloted forms. Two independent reviewers performed each stage of the review. Full details of the study methodology can be found on Prospero, a systematic review register. Five studies satisfied our eligibility criteria: three reporting on acupuncture, one on homeopathy, and one on acupoints. Acupoint pressure was the only study that demonstrated reduced pain compared with placebo. This study was the least methodologically robust. Arnica, although demonstrating a significant reduction in swelling, did not affect post-operative pain. Acupuncture did not affect post-operative pain; however, a reduction in ibuprofen use was demonstrated in two studies. Before recommending complementary therapy for routine use in ambulatory knee surgery, further work is required. Two areas of future research likely to bear fruit are demonstrating robust evidence for the effect of acupoint pressure on post-operative pain, and quantifying the positive effect of homeopathic arnica on post-operative swelling.

  11. Delay in surgery predisposes to meniscal and chondral injuries in anterior cruciate ligament deficient knees

    Science.gov (United States)

    Gupta, Ravi; Masih, Gladson David; Chander, Gaurav; Bachhal, Vikas

    2016-01-01

    Background: Despite improvements in instability after anterior cruciate ligament (ACL) reconstruction, associated intraarticular injuries remain a major cause of concern and important prognostic factor for long term results as it may lead to osteoarthritis. Delay in ACL reconstruction has been in variably linked to increase in these injuries but there is lack of consensus regarding optimal timing of reconstruction. The goal of this study was to investigate delay in surgery and other factors, associated with intraarticular injuries in ACL deficient knees. Materials and Methods: A total of 438 patients (42 females; 396 males) enrolled for this prospective observational study. The average age of patients was 26.43 (range 17–51 years) years with a mean surgical delay of 78.91 (range 1 week - 18 years) weeks after injury. We analyzed the factors of age, sex, surgical delay, instability, and level of activity for possible association with intraarticular injuries. Results: Medial meniscus injuries had a significant association with surgical delay (P = 0.000) after a delay of 6 months. Lateral meniscus injuries had a significant association with degree of instability (P = 0.001). Medial-sided articular injuries were significantly affected by age (0.005) with an odds ratio (OR) of 1.048 (95% confidence interval [CI] of 1.014–1.082) reflecting 4.8% rise in incidence with each year. Lateral-sided injuries were associated with female sex (P = 0.018) with OR of 2.846 (95% CI of 1.200–6.752). The level of activity failed to reveal any significant associations. Conclusion: Surgical delay predicts an increase in medial meniscal and lateral articular injuries justifying early rather than delayed reconstruction in ACL deficient knees. Increasing age is positively related to intraarticular injuries while females are more susceptible to lateral articular injuries. PMID:27746491

  12. 关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效%Arthroscopic surgery for treatment of acute patellofemoral joint impingent

    Institute of Scientific and Technical Information of China (English)

    李烨; 汤洁; 胡勇; 赵胜豪; 黎清波; 彭永海

    2012-01-01

    Objective To evaluate the clinical effects of arthroscopic technique in managing acute patellofemoral joint impingent syndrome.Methods Retrospective analysis was made on clinical data of 19 cases of patients with acute patellofemoral joint impact syndrome in orthopedic in our hospital from August 2006 to December 2009.Results 3 knees were done debridement in this group; 13 knees were done debridement + patella medial band suture;5 knees were done debridement + patella medial band suture + lateral with lysis.12 cases were torn out of 17 the intra-articular fracture of block.All patients did not occur to blood vessels,nerve damage and infection or other complications.All patients with follow-up period did not recur in the dislocation of the patella,without dislocation of the fear of weight-bearing exercises,12 months after operation were followed up for joint activity can resume normal,18 patients were followed up for 12 months after recovery to pre-injury exercise level,only 1 case after double knee injury exercise levels were affected,but did not affect their daily lives.Lysholm clinical scoring system to assess knee function excellent were 17 knees,good were 3 knees,excellent rate of 95.2%.Conclusion The method is simple and effective of arthroscopic treatment of acute patellofemoral joint impingement syndrome,should be used in clinical practice.%目的 探索膝关节镜治疗急性滑脱性髌股关节撞击综合征的临床疗效.方法 回顾性分析2006年8月至2009年12月该院骨科采用膝关节镜治疗急性滑脱性髌股关节撞击综合征19例患者的临床资料.结果 本组3膝行清理术;13膝行清理术加髌骨内侧支持带缝合术;5膝行清理术加髌骨内侧支持带缝合术加外侧支持带松解术.全部患者均未发生血管、神经损伤和感染等并发症,无术后关节内出血而再次手术者.全部患者随访期内未再发生髌骨脱位,负重练习后无脱位恐惧感,术后12个月复诊时关

  13. 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

  14. 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).

  15. Arthroscopic treatment of symptomatic type D medial plica

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

    2007-01-01

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

  16. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA.

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

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    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.

  18. A prospective and comparative study of either physiotherapy along or accompanied arthroscopic surgery for degenerative meniscal tears%退行性半月板撕裂患者理疗与关节镜下手术疗效的前瞻性比较研究

    Institute of Scientific and Technical Information of China (English)

    付东; 单连成; 蔡郑东; 李国东

    2014-01-01

    to physical therapy accompanied by arthroscopic surgery in the treatment of degenerative meniscal tears.Methods A total of 40 patients of more than 50 years old were diagnosed as meniscal tears based on Magnetic Resonance Imaging ( MRI ), and then were divided into 2 treatment groups. The patients in the physical therapy accompanied by arthroscopic surgery group (n=20 ) received arthroscopic surgery and then postoperative physical therapy, and the patients in the physical therapy group (n=20 ) received physical therapy alone. The differences in the Knee Injury and Osteoarthritis Outcome Score ( KOOS ) were compared between the 2 groups at 6, 12 and 24 months after the treatment.Results At 6 months after the treatment, the pain, sports and entertainment, daily activities and KOOS scores both in the physical therapy accompanied by arthroscopic surgery group and in the physical therapy group were obviously improved when compared with the preoperative scores, and the differences between them were statistically signiifcant. In the physical therapy group, the pain scores was improved from 46.35 points to 40.10 points (P0.05 ).Conclusions During the 2-year follow-up, no statistically signiifcant differences are found in the functional improvement or pain relief between the 2 groups. Physical therapy should be considered as the preferred treatment choice for degenerative meniscal tears.

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

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    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.

  20. 关节镜辅助下一期修复重建膝关节三联损伤疗效观察%Clinical effect of one-stage arthroscopically assisted repair and reconstruction on Triplicate injuries of knee joint

    Institute of Scientific and Technical Information of China (English)

    何建华; 谢水华; 王小鹏; 丁浩

    2015-01-01

    目的:探讨关节镜下一期修复重建膝关节三联损伤(前交叉韧带,内侧副韧带和内侧半月板损伤)的方法及效果。方法2009年10月-2014年6月,对21例膝关节三联损伤患者采用一期关节镜下手术,取腘绳肌腱(或同种异体肌腱)重建前交叉韧带,止点重建或缝合修复治疗内侧副韧带损伤,一期缝合或修整损伤的内侧半月板。结果术后均获随访6-30个月,平均16个月,术前Lysholm膝关节功能评分为(40.4±15.8)术后末次随访为(84.5±12.8),有显著改善。患者在0°和20°应力测试时稳定性均完全恢复。结论膝关节三联损伤可以一期在关节镜下完成重建及修复,早期有效恢复膝关节稳定性。%Objective To investigate one-stage arthroscopic repair and reconstruction of the triplicate Injuries of knee joint (anterior cruciate ligament,medial collateral ligament and medial meniscus). Methods From October 2009- June 2014,21 cases of knee joint injury were treated as taking arthroscopic operation with one stage ,The ACL was reconstructed using the hamstring tendon autograft (or tendon allograft),medial collateral ligament was repaired and reconstruction of the interdictory point,One-stage suture or trimmed medial meniscus injury. Results All cases were followed up for 6-30 months,average 16 months,Accord-ing to the Lysholm scale of knee function,preoperative was (40.4+15.8),the last follow-up was (84.5+12.8) after operation,has im-proved significantly. Patients with stress test stability were recovered in 0 degree and 20 degree. Conclusion The triplicate In-juries of knee joint can be reconstructed and repaired for one stage under the arthroscope ,early and effective recovery of knee joint stability.

  1. Role of physiotherapy in peri-operative management in total knee and hip surgery.

    Science.gov (United States)

    Lenssen, A F; de Bie, R A

    2006-12-01

    Knee osteoarthritis (OA) is often associated with pain, functional impairment and various degrees of disability. Physiotherapy in combination with both aerobic and strength training exercises have shown positive effects in both the pre-operative and post-operative period. At the initial stages of osteoarthritis, physical therapy and education can improve the functional outcome and the participation of patients in daily activities. In the case of OA progression and when an operation is the only effective treatment, physiotherapy is very useful in enhancing self-esteem and minimising depression and anxiety for the forthcoming surgery. Post-operative intense physical therapy and Continuous Passive Motion (CPM) application offer remarkable benefits in terms of faster recovery, shorter hospital stay and increase of range of motion. Furthermore, home-based excercises following discharge from the hospital should be encouraged in order to optimise the final result. Although the entire mechanism remains unclear, physical exercise protocols may be beneficial for patients and the health system alike.

  2. 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

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

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    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

  4. [The effect of postoperative cold therapy in joint surgery using a new cooling device].

    Science.gov (United States)

    Münst, P; Bonnaire, F; Kuner, E H

    1988-08-01

    The effect of continuous cold therapy with a new cooling device in post-operative treatment after knee surgery has been proved. Ten patients with different operations of the knee joint participated in this study. Eight out of ten patients reported no or poor pain, whereas in the control group especially after arthrotomy considerable or violent pain was reported. After arthroscopic operations we found more an decrease of swelling and effusion, after arthrotomy more pain reduction. The subjective feeling of all patients was very good and they were generally very receptive to it.

  5. 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…

  6. Prophylactic GSV surgery in elderly candidates for hip or knee arthroplasty

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    Quarto Gennaro

    2016-01-01

    Full Text Available Aging is one of the major risk factors for varicose veins. The same is for Knee and Hip Osteoarthritis. Most of the patients undergoing to Hip (THA or Knee (TKA arthroplasty are over sixteen. Varicose veins, excluding thrombophilia, are the most significant risk factors for VTE after THA and TKA.

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

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    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.

  8. Taking care of your new knee joint

    Science.gov (United States)

    Knee arthroplasty - precautions; Knee replacement - precautions ... After you have knee replacement surgery , you will need to be careful about how you move your knee, especially for the first few ...

  9. Reconstruction of the anterior cruciate ligament of the knee

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    Nikolić Dragan

    2006-01-01

    Full Text Available Background/Aim. Numerous papers on reconstruction of the anterior cruciate ligament of the knee (ACL contribute to the significance of this method. The aim of this study was to analyze the outcome of the use of this surgical treatment method regardless the type of surgical intervention, graft, and the choice of the material for fixing. Methods. The study included 324 patients treated within the period from April 1997 to April 2004. Arthroscopically assisted ACL reconstruction was typically performed using the central one-third of the patellar ligament, as a graft, with bone blocks. Fixing was performed using screws (spongy or interferential, Mitek type. In the cases who required revision of the surgery, we used a graft m. semitendinosus and m. gracilise (STG or a graft of the patellar ligament (B-Pt-B. Fixation in these cases was performed using absorptive wedges according to the Rigidfix technique or metallic implants. Results. The analysis included the results of the reconstruction of the anterior cruciate ligament of the knee (B-Pt-B or STG graft in 139 of the knees. Chronic injuries were revealed in 132 (94.9% of the knees. According to the anamnesis and clinical findings, the feeling of instability prevailed in 132 (94.9% of the knees, pain in 72 (51.7%, effluents in 24 (17.2%, and blockages in 13 (9.3%. Early and late postoperative complications were noticeable in 3.5% each. Hypotrophy of the upper knee musculature up to 2 cm was present in 53.9% of the operated knees, while minor contractions in 13.6% of them. The final result of the reconstruction graded begusing the Lysholm Scale was 85.2, simultaneous reconstructions of other ligaments 75.3, and revision surgery 68.0. First-grade degenerative postoperative changes according to the K/L Scale were found in 55.0% of the surgically treated knees, while the worst, four-grade one in 2.5%. Conclusion. On the basis of these findings, we can conclude that this method is the method of choice in

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

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    S R Sundararajan

    2011-01-01

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

  11. Malassezia species infection of the synovium after total knee arthroplasty surgery

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    Leylabadlo, Hamed Ebrahimzadeh

    2016-09-01

    Full Text Available Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a species. This is a case report of infection after left knee total arthroplasty caused by species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors’ knowledge, the present case is the first report of species in a patient after total knee arthroplasty.

  12. Malassezia species infection of the synovium after total knee arthroplasty surgery

    Science.gov (United States)

    Leylabadlo, Hamed Ebrahimzadeh; Zeinalzadeh, Elham; Akbari, Najibeh Asl Rahnemaii; Kafil, Hossein Samadi

    2016-01-01

    Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a Candida species. This is a case report of infection after left knee total arthroplasty caused by Malassezia species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors’ knowledge, the present case is the first report of Malassezia species in a patient after total knee arthroplasty. PMID:27730027

  13. An unusual meniscal ganglion cyst that triggered recurrent hemarthrosis of the knee.

    Science.gov (United States)

    Ogawa, Hiroyasu; Itokazu, Mansho; Ito, Yoshiki; Fukuta, Masashi; Simizu, Katsuji

    2006-04-01

    A 58-year-old woman suffered spontaneous recurrent hemarthrosis of the knee. In the clinical course, pigmented villonodular synovitis was mostly suspected, but in arthroscopic surgery the lateral meniscus appeared to be upturned and stuck into the lateral pouch with the meniscal ganglion cyst. It was suggested that meniscal tear with meniscal ganglion cyst was related with recurrent hemarthrosis. Generally, both the meniscal ganglion cysts and spontaneous recurrent hemarthrosis are highly rare conditions. In this case, we speculated that a negligible power could induce the meniscal tear with recurrent hemarthrosis in the particular situation in which the meniscal ganglion cyst existed. In other words, the meniscal ganglion cyst might basically and physically relate with hemorrhagic condition. Arthroscopically, the meniscal ganglion cyst was removed together with the anterior segment of the lateral meniscus. Recurrent hemarthrosis was treated successfully by resection of the meniscus.

  14. Analysis of Short -term Outcome of Arthroscopic Synovectomy for Difused Pigmented Villonodular Synovitis of Knee Joint%关节镜治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的短期临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    罗毅; 丁晓川; 刘煊文; 张强; 侯伟光

    2014-01-01

    目的:探讨关节镜治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的短期临床疗效。方法自2007年1月~2011年1月对7例弥漫型色素沉着绒毛结节性滑膜炎患者进行了全滑膜切除术,并进行了2~5年的临床随访。结果7例患者均完全获得随访,平均随访时间32月。6例患者术后症状、功能得以明显改善,1例患者术后2月出现复发,再次进行关节镜下全滑膜切除术,术后联合局部放疗,截止末次随访为止,未见复发。 Ly-sholm关节功能评分由术前(41.21±12.32)分提高到(83.25±5.10)分(P<0.05),较术前关节功能评分具有显著性差异。结论关节镜治疗弥漫型色素沉着绒毛结节性滑膜炎损伤少、恢复快,复发率低,短期临床疗效满意。%Objective To evaluate the short-term outcome of arthroscopic synovectomy for difused pigmented vil-lonodular synovitis of knee joint.Methods 7 cases suffered difused difused pigmented villonodular synovitis of knee joint were performed arthroscopic total synovectomy from January 2007 to from January 2011, The patients were followed up for 2 to 5 years.Results All cases were followed up for an average time of 38 months.6 cases get satisfactory clincal outcome, Only 1 case relapsed at 3 months postoperatively and was cured by reoperation of arthroscopic synovectomy combined with local chemoradiotherapy postoperatively.At the last followed-up,the IKDC Subjective Knee Score im-proved from 41.21 ±12.32 to 83.25 ±5.10, There was significant statistical difference after knee arthroscope operation in Lysholm scale ( P<0.05).Conclusions Arthroseopic total synovectomy is an effective method for PVNS with lower recurrence rate in short-term,and the procedure is mini-invasive and easy to restore the knee function.

  15. 关节镜清理配合腔内注射玻璃酸钠治疗膝关节骨性关节炎疗效观察%Observation of therapeutic effect of arthroscopic debridement combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    孙克宁

    2015-01-01

    目的:探讨关节镜下清理术联合关节腔内注射玻璃酸钠治疗膝骨关节炎的临床疗效和安全性。方法选取2014年1月至2015年3月于我院就诊的膝骨性关节炎患者70例,随机分为观察组、对照组,各35例。对照组患者单纯行关节镜清理术,观察组患者在关节镜清理术基础上,配合玻璃酸钠注射治疗。以5周为一个疗程。患者出院后进行3~6个月的随访,记录患者术后恢复情况,根据 Lysholm 膝关节评分判断患者的治疗效果,比较两组评分及疗效。结果通过随访获得结果可见,所有患者关节镜术切口均甲级愈合,且无感染等并发症发生。观察组患者评分明显高于对照组,且优27例,良6例,可2例,优良率为94.3%,明显优于对照组(P<0.05)。结论采用关节镜下清理术联合关节腔内注射玻璃酸钠治疗膝骨关节炎,能改善膝关节疼痛症状,有利于膝关节功能的恢复,并发症少,值得临床推广应用。%Objective To investigate the clinical efficacy and safety of arthroscopic debridement combined with intra‐articular injection of sodium hyaluronate in the treatment of knee osteoarthritis .Methods From January 2014 to March 2015 ,70 patients with knee osteoarthritis were randomly divided into observation group and control group ,35 cases in each group .The control group was treated with arthroscopic debridement ,and the observation group was treated with sodium hyaluronate injection on the basis of arthroscopic debridement .It took 5 weeks as a course of treatment .The patients were followed up for 3‐6 months after the operation ,and the recovery of the pa‐tients was recorded ,and the treatment effect was compared between the two groups .Results The results showed that all the patients had grade a healing and no infection and other complications occurred .In the observation group ,27 cases were excellent ,6 cases good ,2 cases ,the

  16. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte; Jacobsen, Steffen

    2008-01-01

    after total hip and knee replacement surgery. PATIENTS AND METHODS: Between September 2003 and December 2005, 712 consecutive, unselected patients (440 women) with a mean age of 69 (31-91) years were admitted for hip and knee replacement surgery at our specialized fast-track joint replacement unit......BACKGROUND AND PURPOSE: Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction...... characteristics that influence postoperative outcome, LOS, and patient satisfaction in our series of consecutive fast-track joint replacement patients, enabling further attention to be paid to certain aspects of surgery and rehabilitation....

  17. 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.

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

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    Tomasz Piontek

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

  19. An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

    OpenAIRE

    Katoh, Munenori; Kaneko, Yoshihiro

    2014-01-01

    [Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and use...

  20. Treatment of knee flexion contracture in patients with chronic juvenile arthritis: A case report

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    Matijević Radmila

    2006-01-01

    Full Text Available Introduction. Knee flexion contractures are common after-effects of juvenile arthritis. Treatment is usually conservative and may include physical therapy and kinesitherapy. Surgical treatment, particularly of the soft parts, indicated for contractures resistant to conservative treatment, helps to correct the deformity, maintain movements, and relieves pain. Intensive postoperative physiotherapy is of special importance. Case report. A 23-year-old female patient with chronic juvenile arthritis since the age of one was admitted for treatment of flexion con­tractures in both knees, muscle hypotrophy, loss of strength and gait disability. The patient underwent arthroscopic synovectomy. The operation was first performed on the right and after 3 mouths on the left knee. The pre operative range of motion in the rigth knee was 30°-70° and in the left 40°-80°. The patient underwent intensive physical therapy to reduce postoperative swelling of knees and firstly passive and then active kinesitherapy. Nine months after the first surgery and six months after the second, the range of motion in the right knee was 0°-100° and in the left 0°-105°. The strength of tested muscles was increased and gait was improved. Conclusion. Management and rehabilitation of patients with chronic juvenile arthritis include maintenance or improvement in position and function of joints that is achieved with synovectomy. The results depend on combined interdisciplinary rehabilitation, well-experienced staff, and pre- and post-operative physiotherapy as well as kinesitherapy. Arthroscopic synovectomy has many advantages and we believe that it was a better solution than open capsulosynovectomy in this patient with chronic juvenile arthritis of the knee. .

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

    Energy Technology Data Exchange (ETDEWEB)

    Schild, H.; Ahlers, J.

    1987-08-01

    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.

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

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    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

  3. Analysis of 50 cases of arthroscopic minimal invasion combined with LISS steel plate in treatment of knee joint injuries%关节镜下微创加LISS钢板治疗膝关节损伤50例分析

    Institute of Scientific and Technical Information of China (English)

    石玉刚; 沙广钊; 朱献忠; 沙磊

    2015-01-01

    目的:探讨关节镜下微创加LISS钢板治疗膝关节损伤的疗效。方法2010年1月~2014年7月我科收治膝关节损伤患者100例。分观察组和对照组各50例,观察组采用关节镜下微创加LISS钢板治疗;对照组采用开放复位钢板螺丝钉固定骨折,直视下修复交叉韧带和侧副韧带,修复或切除半月板。结果膝关节功能按Lysholm评估,观察组优良率为92.00%,对照组为74.00%,两组膝关节功能优良率比较有统计学意义(x2=5.4767,P<0.05)。两组并发症比较:观察组发生各种并发症7例,对照组发生各种并发症10例,两组并发症比较无统计学意义(x2=1.7718,P>0.05)。结论对于膝关节损伤患者,使用关节镜微创加LISS钢板固定,膝关节功能恢复优于开放治疗好,功能恢复满意。%ObjectiveTo explore curative effect of arthroscopic minimal invasion combined with LISS steel plate in treatment of knee joint injuries.Methods 100 patients with knee joint injuries who were admitted to our department in our hospital from April 2010 to July 2014 were selected and allocated to the observation group and the control group. The observation group was treated with arthroscopic minimal invasion combined with LISS steel plate while the control group was treated with open reduction steel plate screw fixed fracture, repairing cruciate ligament and collateral ligament under direct vision and repairing or resecting meniscus.ResultsExcellent and good rate of knee joint function in the observation group was 92.00% while that in the control group was 74.00% which was evaluated by Lysholm. Excellent and good rate of knee joint function of two groups had statistical significance (x2=5.4767,P0.05).Conclusion Arthroscopic minimal invasion combined with LISS steel plate fixation in treatment with patients with knee joint injuries has a better and satisfying knee joint function recovery than open treatment.

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

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    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.

  5. 关节镜下膝关节清理术联合体外冲击波治疗膝关节骨性关节炎的疗效分析%Efficacy of Arthroscopic Debridement Combined with Extracorporeal Shock Wave Treatment of Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    何子微; 赵维彪

    2016-01-01

    Objective:To analyze the curative effect of arthroscopic debridement combined with extracorporeal shock wave therapy in the treatment of knee osteoarthritis. Methods:All cases were divided into 2 groups:the control group were treated with arthroscopic debridement,the treatment group were treated with arthroscopic debridement combined with extracorporeal shock wave therapy. The Lysholm score and VAS score was used to determine the changes in patients. Results:After 1 months and 3 months, Lysholm score in the two groups of patients was higher than that before operation (P0.05) . Conclusion:Arthroscopic debridement combined with extracorporeal shock wave therapy in early stage can achieve the functional recovery and pain-relief effect, can better improve the patient's joint function and quality of life.%目的:关节镜下膝关节清理术联合体外冲击波治疗膝关节骨性关节炎的疗效分析。方法:将纳入病例分为2组:对照组患者单纯行关节镜下膝关节清理术;治疗组患者行关节镜下膝关节清理术联合冲击波疗法。对2组患者分别进行膝关节功能Lysholm评分和视觉模拟(VAS)评分,判断患者自觉膝关节功能和疼痛症状的变化。结果:治疗后1个月和3个月两个时间点2组患者的Lysholm评分较治疗前均升高(P<0.05),治疗组Lysholm评分大于对照组;VAS疼痛评分小于对照组(P<0.05)。治疗后6个月,2组患者的Lysholm评分及VAS评分差异无统计学意义(P>0.05)。结论:关节镜下膝关节清理术联合体外冲击波治疗在早期即能达到恢复功能及缓解疼痛的效果,能够更好地改善患者的关节功能和生活质量。

  6. Arthroscopy of the knee without pathological findings.

    Science.gov (United States)

    Schlepckow, P; Weber, M; Hempel, K

    1994-01-01

    From 1983 to 1990, 82 knee arthroscopies (8.2%) carried out in our patients found nothing pathological. Sixty-four percent of these patients were active in sports, but trauma was noted in 32% of the cases only. Football and other ball games, skiing, and track and field athletics were the main causes. Twenty-six percent of the patients had undergone previous surgery in the affected knee. At a mean of 4.6 years postoperatively, clinical and radiological re-assessment was conducted so as to compare our pre- and intraoperative findings with the further course of events. We found that 48.2% of the patients were symptom-free after the diagnostic arthroscopy, 37.5% had persistent discomfort and 14.3% had a recurrence of discomfort after 6 months to 2 years. The objective measurement score (Zarins Rowe score), at 47.5 out of 50 points, was better than the subjective score, at 40 out of 50 points. Our diagnoses had to be changed retrospectively: meniscal lesions were diagnosed too frequently, while chondropathia patellae and instability were often missed. Additionally, complaints could be related to abnormal axis, limited range of motion of the hip or knee, leg length inequality and hypermobility. Being unable to verify a presumed intra-articular lesion arthroscopically is frustrating for both doctor and patient. Our data suggest that meniscal signs should be looked at more critically and emphasise the need for a complete evaluation of the whole locomotor system.

  7. Variation in age and physical status prior to total knee and hip replacement surgery

    DEFF Research Database (Denmark)

    Ackerman, Ilana N; Dieppe, Paul A; March, Lyn M

    2009-01-01

    OBJECTIVE: To investigate whether variation exists in the preoperative age, pain, stiffness, and physical function of people undergoing total knee replacement (TKR) and total hip replacement (THR) at several centers in Australia and Europe. METHODS: Individual Western Ontario and McMaster Univers...

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

    Science.gov (United States)

    Rowton, Joseph

    2013-01-01

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

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

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    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.

  10. [Jumper's knee--a review].

    Science.gov (United States)

    Tibesku, C O; Pässler, H H

    2005-06-01

    Jumper's knee has been defined as painful chronic overuse injury of the extensor mechanism of the knee joint. The disease has a high incidence in jumping sports and depends on training frequency and level of performance. Its natural course is protracted, repetitive, and often bilaterally occurring. Its etiology is a chronic overload of the knee extensor mechanism which is triggered by jumping sports (volleyball, basketball etc.) as well as different intrinsic (ligamentous laxity, Q-angle, patella height, tenderness, pattern of force development) and extrinsic dispositions (frequency of training, level of performance, hardness of underground). The place of pathology most often is the osteo-tendinous transition zone of the proximal patellar tendon. Histologic evaluation of the tendon showed that the disease is rather degenerative than inflammatory. The diagnosis is primarily based on the typical sports history, physical examination, and ultrasound. MRI is helpful in operation planning. Plain radiography, CT, and bone scans are used to rule out differential diagnoses. Therapy should be chosen according to the stage of the disease and usually starts with a non-surgical approach. This includes rest from sports activities, immobilisation, non-steroid antiphlogistics, para-tendinous cortisone injections, massage, electric therapy, ultrasound and extracorporal shock waves. Afterwards an increase of activities is begun (moderate training, adequate warm-up, ice cooling after activity, muscle stretching, eccentric strengthening of the quadriceps). Patella straps and soft insoles are used as prevention. Up to 42 % of patients need surgical therapy after failure of long-lasting non-surgical measures, carried out either open or arthroscopically. Surgical principles include excision of the para-tendon, excision of the degenerative tissue, resection of the lower patella pole, and longitudinal incisions into the tendon. Most patients are pain-free after surgery but return to sports

  11. Improvement of articular pain by arthroscopic douche in osteoarthritis of knee joint%关节镜下冲洗改善膝关节骨关节炎患者的关节疼痛

    Institute of Scientific and Technical Information of China (English)

    王天胜; 刘永灿; 谢爱国; 丁海蛟; 滕寿发

    2002-01-01

    @@ Many methods are adopted in treatment of osteoarthritis and NSAID drugs and hormones are often used in clinic,but these methods can only alleviate symptoms in a short time and can't prevent progressing of disease.Many researches have been done these years directing to the key that degeneration of cartilage and destroy of surface lead to osteoarthritis. Systematic clearance and douche under arthroscope have a good effect in alleviating pain and improving symptoms to osteoarthritis.

  12. A 3-portal approach for arthroscopic subtalar arthrodesis

    NARCIS (Netherlands)

    Beimers, L.; de Leeuw, P.A.J.; van Dijk, C.N.

    2009-01-01

    We present a 3-portal approach for arthroscopic subtalar arthrodesis with the patient in the prone position. The prone position allows the use of the two standard posterior portals and it allows for accurate control of hindfoot alignment during surgery. Furthermore, the introduction of talocalcaneal

  13. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  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)

    Kise, Nina Jullum; 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 supervised

  15. Arthroscopic tennis elbow release.

    Science.gov (United States)

    Savoie, Felix H; O'Brien, Michael J

    2015-01-01

    Lateral epicondylitis, originally referred to as tennis elbow, affects between 1% and 3% of the population and is usually found in patients aged 35 to 50 years. Although it was initially thought that lateral epicondylitis was caused by an inflammatory process, most microscopic studies of excised tissue demonstrate a failure of reparative response in the extensor carpi radialis brevis tendon and in any of the associated structures. Most cases of lateral epicondylitis respond to appropriate nonsurgical treatment protocols, which include medication, bracing, physical therapy, corticosteroid injections, shock wave therapy, platelet-rich plasma, and low-dose thermal or ultrasound ablation devices. However, when these protocols are unsuccessful, surgical measures may be appropriate and have a high rate of success. The results of arthroscopic surgical procedures have documented satisfactory results, with improvement rates reported between 91% and 97.7%. Recent advances in arthroscopic repair and plication of these lesions, along with recognizing the presence and repair of coexisting lesions, have allowed arthroscopic techniques to provide excellent results.

  16. 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.

    Science.gov (United States)

    Ageberg, Eva; Roos, Harald P; Silbernagel, Karin Grävare; Thomeé, Roland; Roos, Ewa M

    2009-02-01

    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 surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at 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 limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that

  17. 关节镜下清理与保守疗法治疗不伴关节交锁的中期膝关节骨关节炎的疗效对比%Prospective and Comparative Study of Arthroscopic Debridement and Conservative Treatment for Middle-Stage Knee Osteoarthritis without Locked Joint

    Institute of Scientific and Technical Information of China (English)

    钟志宏; 张平; 潘永谦; 李健; 余灏涛

    2016-01-01

    Objective To compare the therapeutic effect of arthroscopic debridement and conservative treatment for middle-stage knee osteoarthritis without locked joint .Methods A retrospective study was carried out from June of 2008 to March of 2014, and there were 68 middle-stage knee osteoarthritises without locked joint .Cases were operated by arthro-scopic debridement (30 cases) or conservative method (38 cases).Results of all cases had been followed up from 1 year to 4 years 6 months, mean average 2.5 years.A clinical outcome was quantified by the Lysholm scores , VAS scores and nar-rowed joint space .Results The total successful rate of the arthroscopic debridement group and conservative treatment group were 83.33%and 81.58%, which were not significantly different (P>0.05).The mean hospital stay of arthroscopic de-bridement group was significantly shorter than that of conservative treatment group (7.3 days and 13.8 days respectively ( P0.05).Conclusion The successful rate of arthroscopic debridement group is similar to that of the conservate treatment group.As a new minimally invasive technique , arthroscopic debridement is an safe , rapid effective treatment for middle -stage knee osteoarthritis without locked joint .%目的:对比关节镜辅助膝关节清理术与保守治疗不伴关节交锁的中期膝关节骨关节炎的临床疗效。方法自2008年6月~2014年3月治疗不伴关节交锁的中期膝关节骨关节炎68例,分两组,30例采用关节镜下清理术,38例行保守治疗。随访1年~4年6个月,平均2.5年,采用VAS、Lysholm评分、关节间隙缩窄评价疗效。结果关节镜组和保守治疗组出院时总体治疗优良率分别为83.33%和81.58%,无显著性差异( P>0.05);两组平均住院时间分别为7.3±1.7d和13.8±1.9d,有显著性差异(P<0.05);复发率分别为16.67%和31.58%,有显著性差异( P<0.05)。关节镜组有1例患者术后1周出现

  18. Arthroscopic Treatments of Knee Osteoarthritis with Injection of Sodium Hyaluronate%关节镜清理配合腔内注射玻璃酸钠治疗膝关节骨性关节炎临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    金成辉

    2014-01-01

    Objective:To explore the arthroscopic treatments of knee osteoarthritis with injection of so-dium hyaluronate .Method: 117 cases ( 158 knees ) of knee osteoarthritis underwent synovial hyperplasia cleaning , shaped meniscus , removal of free articular cartilage and radiofrequency ablation of losing bone , then injected sodium hyaluronate 2.5mL, once a week for 3-5 weeks.Patients were guided by quadriceps ex-ercises and ankle pumps practice .Drainage were taken out after 48 hours and stitched one week later .Re-sult:Patients were evaluated by Lysholm knee score ,excellent rate was 89.8%(86.9±11.2) at discharge, excellent rate was 80.5%(78.2±12.8) at 1-year follow-up.Conclusion:Arthroscopy with injection of sodi-um hyaluronate is a reliable method for the treatment of osteoarthritis of the knee .%目的:探讨关节镜清理配合腔内注射玻璃酸钠治疗膝关节骨性关节炎的临床疗效。方法:关节镜下对117例(158膝)膝关节骨性关节炎患者行滑膜增生刨削,半月板修整或成形,剥离关节软骨及游离体取出术,骨缺损的关节面射频消融等。关节腔内注入玻璃酸钠2.5mL,加压包扎。以后每周注射1次,连续3-5周,术后行股四头肌锻炼及踝泵练习,48h拔出引流后行抬腿练习,1周拆线。结果:术后按Lysholm膝关节评分标准评定,出院时(86.9±11.2)优良率为89.8%,1年随访(78.2±12.8)优良率为80.5%。结论:关节镜清理配合腔内注射玻璃酸钠是治疗膝关节骨性关节炎的可靠方法。

  19. [A man with a painful knee with restricted flexion

    NARCIS (Netherlands)

    Valkering, L.J.; Zengerink, M.; Kampen, A. van

    2015-01-01

    A 39-year-old man presented with knee pain and limited knee flexion. MRI showed a mucoid degeneration of the anterior cruciate ligament (celery stalk sign). This rare condition can be treated with arthroscopic debridement with volume reduction of the anterior cruciate ligament. In severe cases, ante

  20. [Arthroscopic treatment for calcaneal spur syndrome].

    Science.gov (United States)

    Stropek, S; Dvorák, M

    2008-10-01

    PURPOSE OF THE STUDY Arthroscopic treatment of calcaneal spur syndrome is a tissue-sparing and effective approach when conservative therapy has failed. This method, its results and our experience with the treatment of this syndrome are presented here. MATERIAL Between January 2003 and November 2007, 26 patients underwent an arthroscopic procedure for calcaneal spur syndrome; of these, 20 were women with an average age of 49 years, and six were men with an average age of 45 years. Four, three women and one man, were lost to follow-up, therefore 22 patients with 24 heels were eventually evaluated. All had conservative therapy for 3 to 6 monts. METHODS The arthroscopic method used was developed by the arthroscopic group of the Orthopaedic Service of Hospital Hermanos Ameijeiras in Havana, Cuba. The surgical technique insolves treatment of the spur and plantar fasciitis commonly found in calcaneal spur syndrome, but it also addresses adjacent calcaneal periostitis. RESULTS The results were evaluated on the scale that is part of the foot function index developed by Budiman-Mak for measuring rheumatoid arthritis pain. The patients were asked mine questions on pain intensity during various activities before and after surgery. Pain was evaluated on a scale with grades from 0 to 9. The average value was 5.9 before surgery and 1.4 after surgery. A 0-1 pain range was reported by 25 %, 1-2 by 26 % and 2-4 by 22 % of the patients. All patients reported improvement. DISCUSSION The orthopaedic group in Havana led by Carlos achieved 85 % excellent outcomes (pain range, 0-2) at one-year followup; this was 79 % in our study, in which no problems with foot arches or wound infection were recorded. CONCLUSIONS The heel spur syndrome is a result of an inflamed ligament (plantar fascia) due to repeated microtrauma. It is not a traction osteophyte,but a reaction of the tissue where it attaches to the calcaneus. Adjacent calcaneal periostitis is usually present as well. Therefore, this

  1. 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 < 0.0001). The mean cost of a revision for infection was more than three times that of an aseptic revision (£30 011 (sd 4514) vs £9655 (sd 599.7), p < 0.0001). Current NHS 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.

  2. 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.

  3. 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.

  4. 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

    , mobility, and expectations. Methods One reviewer searched the PubMed database in autumn 2012 and identified qualified studies. Three reviewers assessed the studies regarding inclusion criteria [lidt uforståeligt, umiddelbart]. Randomized studies of preoperative education (written, verbal and/or audio...... visual) given by health professionals to patients were included. Results Seven studies involving 677 participants met the inclusion criteria. Two studies involved patients undergoing THA replacement, while five studies involved patients undergoing both THA and TKA replacement surgery. Mean number...

  5. Comparison of Curative Effect of Arthroscopic Surgery and Acupotomy Treatment of Patellofemoral Lateral Pressure Syndrome%关节镜手术与小针刀治疗髌股外侧高压综合征的疗效对比

    Institute of Scientific and Technical Information of China (English)

    傅团结; 李光友

    2016-01-01

    目的:探讨关节镜手术与小针刀治疗髌股外侧高压综合征的临床疗效。方法选取2012年3月至2014年3月在本院治疗的符合要求的100例髌股外侧高压综合征患者,随机分为2组(A组和B组),每组50例。A组采用关节镜下外侧支持带松解,B组采用小针刀松解髌股外侧支持带。采用改良Lysholm评分标准、视觉模拟评分法及髌股关节Kujala评分进行疗效评定。结果两组治疗方法相比,结果具有统计学差异(P<0.05),关节镜手术治疗临床效果明显优于小针刀治疗。结论关节镜手术是治疗髌股外侧高压综合征的首选方法。%Objective To explore the clinical effect of arthroscopic surgery and acupotomy treatment of patellofemoral lateral pressure syndrome. Methods One hundred cases in our hospital for treatment of patellofemoral lateral pressure syndrome patients from March 2012 to March 2014. Randomly divided into two groups. A group using arthroscopic lateral support with loose solution, Group B with needle knife loose of the lateral retinaculum solution. The modified Lysholm standard for evaluation, visual analogue score and Kujala score of patellofemoral joint were used to evaluate the efficacy. Rwsults Compared with the two groups, the difference was statistically significant (P<0.05), Arthroscopic surgery for treatment of clinical effect is obviously better than the therapy of small needle knife. Conclusions Arthroscopic surgery is the first choice for the treatment of patellofemoral lateral pressure syndrome.

  6. Effect of Mirrored Views on Endoscopic and Arthroscopic Skill Performance

    Science.gov (United States)

    Benninger, Emanuel; Meier, Christoph; Wirth, Stefan; Koch, Peter Philipp; Meyer, Dominik

    2017-01-01

    Background: Arthroscopic procedures may be technically challenging because of impaired vision, limited space, and the 2-dimensional vision of a 3-dimensional structure. Spatial orientation may get more complicated when the camera is pointing toward the surgeon. Hypothesis: Spatial orientation and arthroscopic performance may be improved by simply mirroring the image on the monitor in different configurations regarding the position and orientation of camera and instrument. Study Design: Descriptive laboratory study. Methods: Thirty volunteers from an orthopaedic department were divided into 3 equal groups according to their arthroscopic experience (beginners, intermediates, seniors). All subjects were asked to perform a standardized task in a closed box mimicking an endoscopic space. The same task had to be performed in 4 different configurations regarding camera and instrument position and orientation (pointing toward or away from the subject) with either the original or mirrored image on the monitor. Efficiency (time per stick; TPS), precision (successful completion of the task), and difficulty rating using a visual analog scale (VAS) were analyzed. Results: Mirroring the image demonstrated no advantage over the original images in any configuration regarding TPS. Successful completion of the task was significantly better when the image was mirrored in the configuration with the camera pointing toward and the instrument away from the surgeon. There was a positive correlation between TPS and subjective VAS difficulty rating (r = 0.762, P = .000) and a negative correlation between the successful completion of the task and VAS (r = −0.515, P = .000). Conclusion: Mirroring the image may have a positive effect on arthroscopic performance of surgeons in certain configurations. A significantly improved performance was seen when the arthroscope was pointing toward and the grasping instrument pointing away from the subject. Mirroring the image may facilitate surgery in

  7. Efficacy comparison of arthroscopic and incision in treatment of rheuma-toid arthritis%关节镜与切开术治疗类风湿性关节炎的效果比较

    Institute of Scientific and Technical Information of China (English)

    余海龙

    2014-01-01

    Objective To investigate the clinical effect of arthroscopic and incision in the treatment of rheumatoid arthritis. Methods 86 cases of patients with rheumatoid arthritis of the knee in our hospital from October 2009 to Oc-tober 2011 were divided into incision group (43 cases) treated by open surgical synovectomy and the arthroscopic group (43 cases) treated by arthroscopic synovectomy.The hospitalization time,blood loss,postoperative functional exercise time were analysed.All patients were followed up for 6-24 months and the recovery of knee function were compared by using the HSS score. Results The exercise recovery time,the average length of stay in arthroscopic group was shorter than that of the incision group,and the mean blood loss was less than that of the incision group,the difference was significant (P0.05). Conclusion Arthroscopic and incision surgery can effectively recover joint function,is an effective method for the treatment of rheumatoid arthritis.Compared with incision surgery,the arthroscopic surgery has advantage of less trauma,less bleeding, shorter hospitalization time and patients should be preferred arthroscopy if they adapt to arthroscopic surgery.%目的:比较关节镜与切开术治疗类风湿性关节炎的效果。方法选择2009年10月~2011年10月于本院就诊的膝关节类风湿性关节炎患者86例,根据患者意愿分为切开术组和关节镜组,切开术组43例患者采用切开直视滑膜切除术,关节镜组43例患者采用关节镜下滑膜切除术,比较两组的住院时间、术中出血量、术后功能锻炼时间。所有患者均随访6~24个月,采用膝关节HSS评分,对膝关节功能恢复情况进行比较。结果关节镜组恢复功能锻炼时间、平均住院时间均短于切开术组,术中平均出血量少于切开术组,两组差异有统计学意义(P0.05)。结论关节镜与切开术均可有效恢复患者的关节功能,是治疗类风湿性关节炎的有效方

  8. Glanzmann’s Thrombasthenia Diagnosed following Knee Arthroscopy

    Directory of Open Access Journals (Sweden)

    John E. Zvijac

    2015-01-01

    Full Text Available A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann’s thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults.

  9. 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.

  10. 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

  11. 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.

  12. 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 consisted...... of 50 patients who had an acute, traumatic extension deficit of the knee. All patients were submitted to MRI prior to arthroscopy. Following MRI and surgery, standardized forms were filled out, attempting to objectify the findings. The orthopaedic surgeon was not aware of the MRI result prior to surgery......, the following results were calculated for the overall appearance of a lesion able to cause locking: Positive predictive value = 0.85, negative predictive value = 0.77, sensitivity = 0.95, specificity = 0.53. Two knees were erroneously evaluated with no mechanical locking at MRI (one bucket-handle lesion and one...

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

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  14. Hip or knee replacement - before - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  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. Arthroscopic double-bundle posterior cruciate ligament reconstruction surgical technique.

    Science.gov (United States)

    Fanelli, Gregory C; Beck, John D; Edson, Craig J

    2010-06-01

    The keys to successful posterior cruciate ligament (PCL) reconstruction are to identify and treat all pathology, use strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, use a mechanical graft tensioning device, use primary and back-up graft fixation, and use the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single-bundle and double-bundle arthroscopic transtibial tunnel PCL reconstruction based on stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements.

  17. Arthroscopic and open management of posterolateral rotatory instability of the elbow.

    Science.gov (United States)

    O'Brien, Michael J; Savoie, Felix H

    2014-09-01

    Posterolateral rotatory instability (PLRI) is the most common cause of residual instability following a simple elbow dislocation. PLRI may result from trauma or iatrogenic injury to the radial ulnohumeral ligament during treatment for other conditions, such as lateral epicondylitis. PLRI can be identified through a combination of history and physical examination, and confirmed with magnetic resonance imaging arthrography. Once diagnosed, surgery is necessary to correct persistent instability. Instability can be confirmed arthroscopically through several findings, including subluxation of the radial head on the capitellum and the arthroscopic "drive through sign of the elbow." Acute repairs, both open and arthroscopic, heal with excellent patient outcomes. In the chronic setting, graft reconstruction may be required. This report describes arthroscopic repair of the radial ulnohumeral ligament and open reconstruction with associated outcomes. A high index of suspicion is necessary to correctly diagnosis this condition in patients with lateral elbow pain and feelings of instability.

  18. Arthroscopic Gluteal Muscle Contracture Release With Radiofrequency Energy

    OpenAIRE

    LIU Yu-jie; Wang, Yan; Xue, Jing; Lui, Pauline Po-Yee; Chan, Kai-Ming

    2008-01-01

    Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals...

  19. SLAP repair with arthroscopic decompression of spinoglenoid cyst

    Directory of Open Access Journals (Sweden)

    Hashiguchi Hiroshi

    2016-01-01

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

  20. Imaging of knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

    2005-05-01

    Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

  1. The perioperative dialogue--a model of caring for the patient undergoing a hip or a knee replacement surgery under spinal anaesthesia.

    Science.gov (United States)

    Pulkkinen, Maria; Junttila, Kristiina; Lindwall, Lillemor

    2016-03-01

    The aim of the study was to describe how patients undergoing either a hip or a knee replacement surgery under spinal anaesthesia experienced to be a part of the perioperative dialogue as an ideal model of caring. A qualitative approach was chosen as a method. Nineteen patients undergoing either a hip or a knee replacement surgery under spinal anaesthesia participated. These patients and their nurse anaesthetists had three perioperative dialogues in the pre-, intra- and postoperative phase of care. Data were collected by means of conversational interviews by four voluntary nurse anaesthetists who wrote the dialogues from each perioperative phase. The text from the collected data was analysed by qualitative, latent content analysis. The findings of the analysis show three identified themes: Suffering while waiting for surgery (preoperative dialogue), Continuity creates togetherness (intraoperative dialogue) and Uniqueness - the patient has been seen (postoperative dialogue). The findings show evidence that the perioperative dialogue is an ideal model of caring and serves the patients' desires of individual and dignified care. The patients have a deep appreciation when there is time to develop a caring encounter with his or her own nurse. When a caring encounter has been established, the patient is involved in his or her own care. This model of caring offers the perioperative nurses a new way of caring and arouses reflections about their main task caring for the suffering patient. The continuity created by the perioperative dialogue probably has an influence on both patient satisfaction and patient safety.

  2. Arthroscopic approach and anatomy of the hip

    Science.gov (United States)

    Aprato, Alessandro; Giachino, Matteo; Masse, Alessandro

    2016-01-01

    Summary Background Hip arthroscopy has gained popularity among the orthopedic community and a precise assessment of indications, techniques and results is constantly brought on. Methods In this chapter the principal standard entry portals for central and peripheral compartment are discussed. The description starts from the superficial landmarks for portals placement and continues with the deep layers. For each entry point an illustration of the main structures encountered is provided and the principal structures at risk for different portals are accurately examined. Articular anatomical description is carried out from the arthroscope point of view and sub-divided into central and peripheral compartment. The two compartments are systematically analyzed and the accessible articular areas for each portal explained. Moreover, some anatomical variations that can be found in the normal hip are reported. Conclusion The anatomical knowledge of the hip joint along with a precise notion of the structures encountered with the arthroscope is an essential requirement for a secure and successful surgery. Level of evidence: V. PMID:28066735

  3. Comparison of Intraarticular Bupivacaine and Levobupivacaine with Morphine and Epinephrine for Knee Arthroscopy

    Science.gov (United States)

    Ozdemir, Nurdan; Kaya, Fatma Nur; Gurbet, Alp; Yilmazlar, Aysun; Demirag, Burak; Mandiraci, Bilgen Onbasi

    2013-01-01

    Objective: To compare the efficacy of intraarticularly injected bupivacaine with levobupivacaine when administered in combination with morphine and adrenaline for post-operative analgesia and functional recovery after knee surgery. Materials and Methods: Sixty American Society of Anesthesiologists physical status I–II patients were randomized into three groups: Group B was administered 30 mL isobaric 0.5% bupivacaine, 2 mg morphine and 100 μg adrenaline, Group L was administered 30 mL 0.5% levobupivacaine, 2 mg morphine and 100 μg adrenaline, and Group C was administered 30 mL 0.9% NaCl solution into the knee joint by the surgeon at the end of surgery. The morphine usage and visual analog pain scores were recorded regularly afterwards. We also recorded the time that elapsed before each patients’ first mobilization, positive response to straight leg raising, tolerance to 30–50° knee flexion, recovery of quadriceps reflexes and discharge from the hospital. We also recorded patient and surgeon satisfaction. Results: The pain scale values were lower in Groups B and L than in Group C at 2, 4, 6, 8, 12 and 24 hours post-operatively (all p<0.001). In Groups B and L, the time for first analgesic request was longer (p<0.01), the morphine consumption was lower (p<0.001), and the duration of morphine usage was shorter (p<0.001). The times to positive response to straight leg raising, tolerance to 30–50° knee flexion and the first mobilization were shorter in Groups B and L (p<0.001 for all). Conclusion: After arthroscopic knee surgery, intraarticular levobupivacaine combined with morphine and adrenaline decreases analgesic requirements, shortens the postoperative duration of analgesic use and hastens mobilization as effectively as bupivacaine. PMID:25610257

  4. Rehabilitation Nursing Effect Analysis of Arthroscopic Treatment of Knee Ligament Joint Damage%膝关节韧带联合损伤关节镜治疗后的康复护理效果

    Institute of Scientific and Technical Information of China (English)

    李淑琴

    2013-01-01

    Objective:To evaluate the nursing effect after treatment of knee ligament joint injury via arthroscopy. Method:Selected 12 patients from January 2011 to January 2012 who were treated with systematic rehabilitation nursing after knee ligament joint injury via arthroscopy,retrospective analysis the nursing efficacy. Result:3 of the patients’knee-joint were able to curve 90°-120°,while 9 of them were able to curve over 120°. Conclusion:Systematic rehabilitation nursing after knee ligament joint injury via arthroscopy has remarkable advantage for patients,it is much more valuable for patients’recovery of function.%目的:探讨膝关节韧带联合损伤关节镜治疗后的康复护理效果。方法:选择2010年1月-2012年1月本院收治的膝关节韧带联合损伤关节镜治疗患者12例,所有患者均接受系统的康复护理,回顾分析患者的临床护理效果。结果:3例患者膝关节屈曲90°~120°,9例超过120°,患者关节均稳定恢复。结论:由本次临床研究结果可知,膝关节韧带联合损伤患者接受关节镜治疗,且术后接受系统的康复护理,有助于患者关节功能的恢复。

  5. 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.

  6. Partial knee replacement

    Science.gov (United States)

    ... al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad ... Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  7. 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.)

  8. Severe Osteoarthritis of the Knee as an Early Symptom of Alkaptonuria: A Case Report

    Directory of Open Access Journals (Sweden)

    Alois Franz

    2016-02-01

    Full Text Available Introduction: Alkaptonuria (AKU is a very rare disease and occurs due to the deficiency of the enzyme homogentisate1, 2-dioxygenase (HGD which results in ochronosis, a term used to describe the dark pigmentation of the tissues. Alkaptonuria affects mostly the knee joint followed by the hip as major weight bearing joints, where the life quality of such patients is severely affected. Case Presentation: We present a case of Caucasian male who was suffering from severe osteoarthritis of the knee. Initially he underwent an arthroscopic partial meniscectomy in a nearby hospital. Fourteen months later we performed a total knee replacement using the Journey II CR prosthesis. We found a dark pigmentation of the inside of the knee (synovial tissue and cartilage. A positive urine test and a pathological specimen examination revealed the diagnosis of AKU. The patient had no complications after the surgery and underwent a standard rehabilitation program. Conclusions: Osteoarthritis could be the first manifestation of patients with AKU and the onset of the joint disease could be late and rapid.

  9. 关节镜下微创手术治疗运动性肩袖损伤50例康复护理%Rehabilitation nursing care in the treatment of 50 cases of sport rotator cuff injury with minimally invasive arthroscopic surgery

    Institute of Scientific and Technical Information of China (English)

    宋学良; 于红英; 钭晓帆

    2011-01-01

    目的:探讨关节镜下微创手术治疗运动性肩袖损伤患者的康复护理方法.方法:对50例运动性肩袖损伤患者行关节镜下微创手术治疗,并给予个性化心理护理、疼痛护理及有计划的阶段性康复训练.结果:50例患者均未出现肩关节僵硬强直、创伤性骨性关节炎及神经损伤等并发症.随访3个月~1.5 年,根据美国UCLA肩关节评分标准评分优35例、良10例、可5例,优良率90%.患者自我满意度高.结论:关节镜下微创手术后早期阶段性康复训练能促进肩关节功能恢复,提高手术治疗的效果.%Objective: To explore the rehabilitation nursing methods in the treatment of sport rotator cuff injury with minimally invasive arthroscopic surgery. Methods: 50 patients with sport rotator cuff injury were treated with minimally invasive arthroscopic surgery and given individualized psychological care, pain care and planned staged rehabilitation training. Results: There was no occurrence of stiffness and rigidity of shoulder joint, traumatic osteoarthritis and nerve damage in these 50 patients. The patients were followed up for 3 months to 1.5 years, the scoring showed 35 cases were excellent, 10 cases good and 5 cases fair according to U.S. UCLA shoulder grading standard. The excellent and good rate was 90%. The patient's self - satisfaction was high. Conclusions: The early staged rehabilitation training can promote the functional recovery of shoulder joint and improve surgical outcome after minimally invasive arthroscopic surgery.

  10. 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.

  11. 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.

  12. Reconstruction of anterior cruciate ligament of knee joint with single bundle allograft under arthroscopic%关节镜下应用单束同种异体肌腱重建膝关节前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    罗绍伟; 张平; 李文胜; 郑创义; 邱开封

    2016-01-01

    目的 探讨关节镜下采用同种异体肌腱解剖单束重建膝关节前交叉韧带(ACL)损伤的治疗效果.方法 对62例ACL断裂患者在关节镜下进行重建,采用同种异体肌腱作为移植物,在胫骨近端及股骨远端建立骨隧道,利用挤压钉对移植物进行固定.术后应用支具固定膝关节12周,按照Lysholm和Larson膝关节评分标准进行主观评估;对患者行Lachman试验进行客观评估,了解重建韧带的稳定性和膝关节的功能恢复情况.结果 Lysholm术前评分平均(43.1±2.1)分,术后韧带重建后随访时评分平均(91.0±2.3)分,术前与术后对比,差异有统计学意义(t=3.460,P=0.001).Larson术前评分平均(41.0±2.9)分,韧带重建后最终评分平均(90.1±3.5)分,术前与术后对比,差异有统计学意义(t=3.232,P=0.001).62例患者在最后复查时Lachman试验结果均为阴性.所有患者术后无膝关节感染、深静脉血栓及僵硬.在术后1年均能完全伸直,屈膝达到120度.随访期间未发生韧带再断裂.结论 关节镜下采用同种异体单束解剖重建前交叉韧带可以获得满意的临床疗效.%Objective To introduce the treatment efficacy of using allograft muscle ligament anatomical to rebuild anterior cruciate ligament (ACL) of knee joint under the arthroscopy.Methods Sixty-two cases patients with ACL rupture in anterior cruciate ligament reconstruction under arthroscopy.Allograft ligaments were used as graft,a bone tunnel was established in the proximal tibia and distal femur,and the graft was fixed by the extrusion screw.After the operation,the knee joint was fixed for 12 weeks,and the subjective evaluation was carried out according to the Lysholm and Larson knee score standards;in order to assess the stability of the ligament and the functional recovery of the knee joint,objective evaluation was carried out according to Lachman test in patients.Results The preoperative average Lysholm scale was (43.1±2.1) points,the final

  13. Ergonomic handle for an arthroscopic cutter.

    Science.gov (United States)

    Tuijthof; van Engelen; Herder; Goossens; Snijders; van Dijk

    2003-03-01

    From an analysis of the routinely performed meniscectomy procedures, it was concluded that a punch with a side-ways steerable tip would improve the reachability of meniscal tissue. This potentially leads to a safer and more efficient meniscectomy. Furthermore, the current scissors handles of arthroscopic punches are ergonomically not sufficient. An ergonomic handle is designed with one lever that enables opening and closing of the instrument tip, and side-ways steering of the instrument tip. The design of the handle complies with ergonomic guidelines that were found in the literature. A model of the instrument tip was added to the new handle for comparison with conventional handles. Experiments were performed with a knee joint model, using objective and subjective criteria. The results show that the concept of a side-ways steerable punch is promising, since faster task times are achieved without increasing the risk of damaging healthy tissue. The current design of the ergonomic handle incorporates two degrees of freedom in an intuitive way, the handle is more comfortable to hold, and easy to control. The external memory capabilities of the new handle could be improved. Further development of this handle and the addition of a sufficient instrument tip and force transmission are recommended.

  14. 关节镜下清理配合术后灌洗治疗膝痛风性关节炎的临床研究%Clinical study of arthroscopic debridement combined with lavage for treating gouty arthritisof the knee

    Institute of Scientific and Technical Information of China (English)

    崔操; 郭一行; 李厚成; 李彬彬

    2014-01-01

    Objective To study the therapeutic effects of the debridement combined with continuous drainage after surgery in the treatment of joint gouty arthritis under arthroscopy and also to explore the value of arthroscopy in the treatment of recurrent gouty ar -thritis of the knee .Methods There were 17 patients with joint gouty arthritis who received joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage .After surgery, the patients were given routine drug therapy and early func-tional exercise .Lysholm scores of the knee were compared before surgery and 6 months after surgery .Results Gouty arthritis under ar-throscopy displayed specific white ball -like crystal deposited on the surfaces of synovium , cartilage and other joint structure .All the patients had medical follow -ups for a duration of 6 to 24 months, averaging 16.3 months.Last follow-up revealed that there was not a significant recurrent case after surgery .In accordance with the Lysholm knee scores , the patient function scores before surgery were (50.0 ±3.1), and the function scores 6 months after surgery were (90.0 ±4.8) on the average.Significant statistical differences could be noted in Lysholm scores, when comparisons were made before surgery and 6 months after surgery (P<0.01).Conclusion Arthroscopy displayed a high diagnostic rate of gouty arthritis , at the same time , joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage were a good treatment method with quick response , minimal invasion and positive efficacy for the treatment of joint gouty arthritis .%目的:探讨关节镜在治疗反复发作性痛风性膝关节炎中的应用价值,并探讨和观察运用关节镜下清理术联合术后置管持续引流治疗痛风性关节炎的方法和疗效。方法17例膝关节痛风性关节炎患者,行关节镜下清理及滑膜切除术,术后灌洗并常规服用降血尿酸药物、早期功能锻炼

  15. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature.

    Science.gov (United States)

    Springer, Bryan D; Carter, Jonathan T; McLawhorn, Alexander S; Scharf, Keith; Roslin, Mitchell; Kallies, Kara J; Morton, John M; Kothari, Shanu N

    2017-01-01

    Obesity accelerates the development of osteoarthritis of the knee and hip by exerting deleterious effects on joints through both biomechanical and also systemic inflammatory changes. The objective of this review was to evaluate the impact of obesity on lower limb biomechanics and total joint arthroplasty outcomes, as well as weight changes after joint arthroplasty and the role of bariatric surgery among patients requiring joint arthroplasty. The currently published data indicate that weight loss increases swing time, stride length, gait speed, and lower extremity range of motion. Total joint arthroplasty improves pain and joint function, but does not induce significant weight loss in the majority of patients. Bariatric surgery improves gait biomechanics, and in the severely obese patient with osteoarthritis improves pain and joint function. The evidence for supporting bariatric surgery before total joint arthroplasty is limited to retrospective reports with conflicting results. Fundamental clinical questions remain regarding the optimal management of morbid obesity and lower extremity arthritis, which should be the focus of future collaborations across disciplines providing care to patients with both conditions.

  16. 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

  17. 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

    Directory of Open Access Journals (Sweden)

    Francisco Abaeté Chagas-Neto

    2016-04-01

    Full Text Available Abstract 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.

  18. Post-Operative Pain after Knee Arthroscopy and Related Factors

    OpenAIRE

    Bharat Sutariya; Amit Patel; Ankit Desai; Sadik Shaikh

    2014-01-01

    Objectives: The aim of this study was to explore the intensity of post-arthroscopy knee pain during the first 24 hours, and to study the influence of pre-operative pain, tourniquet time and amount of surgical trauma on post-arthroscopy pain. Methods: In 78 male patients that underwent elective arthroscopic menisectomy or diagnostic arthroscopy of the knee, preoperative and post-operative pain was registered using the Visual Analogue Scale. Variance for repeated measures and for independen...

  19. Post-Operative Pain After Knee Arthroscopy and Related Factors

    OpenAIRE

    Drosos, G. I.; Stavropoulos, N.I; Katsis, A; Kesidis, K; Kazakos, K.; Verettas, D.-A

    2008-01-01

    The aim of this study was to explore the intensity of post-arthroscopy knee pain during the first 24 hours, and to study the influence of pre-operative pain, tourniquet time and amount of surgical trauma on post-arthroscopy pain. In 78 male patients that underwent elective arthroscopic menisectomy or diagnostic arthroscopy of the knee, preoperative and post-operative pain were registered using the Visual Analogue Scale. Variance for repeated measures and for independent observations was analy...

  20. Recovery of lower extremity muscle strength and functional performance in middle-aged patients undergoing arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Ganderup, Tina; Jensen, Carsten; Holsgaard-Larsen, Anders

    2017-01-01

    -surgery, and that this deficiency would be normalized at 12 months following surgery. METHODS: Twenty-three patients (46 ± 6.5 years) meniscectomized in 2012 and 2013 were examined for knee extension, knee flexion, and hip abduction maximal isometric muscle strength (iMVC), rate of force development (RFD200), and knee function...... (single-leg hop for distance and single-leg knee bends in 30 s.) before surgery, 3 and 12 months after surgery. RESULTS: Functional performance, knee extension iMVC and RFD200 were impaired in the affected leg compared to the contralateral leg (p

  1. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte; Jacobsen, Steffen

    2008-01-01

    BACKGROUND AND PURPOSE: Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction....... Epidemiological, physical, and perioperative parameters were registered and correlated to LOS and patient satisfaction. RESULTS: 92% of the patients were discharged directly to their homes within 5 days, and 41% were discharged within 3 days. Age, sex, marital status, co-morbidity, preoperative use of walking...... aids, pre- and postoperative hemoglobin levels, the need for blood transfusion, ASA score, and time between surgery and mobilization, were all found to influence postoperative outcome in general, and LOS and patient satisfaction in particular. INTERPRETATION: We identified several patient...

  2. Efficacy of an Intra-Operative Imaging Software System for Anatomic Anterior Cruciate Ligament Reconstruction Surgery

    Directory of Open Access Journals (Sweden)

    Xudong Zhang

    2012-01-01

    Full Text Available An imaging software system was studied for improving the performance of anatomic anterior cruciate ligament (ACL reconstruction which requires identifying ACL insertion sites for bone tunnel placement. This software predicts and displays the insertion sites based on the literature data and patient-specific bony landmarks. Twenty orthopaedic surgeons performed simulated arthroscopic ACL surgeries on 20 knee specimens, first without and then with the visual guidance by fluoroscopic imaging, and their tunnel entry positions were recorded. The native ACL insertion morphologies of individual specimens were quantified in relation to CT-based bone models and then used to evaluate the software-generated insertion locations. Results suggested that the system was effective in leading surgeons to predetermined locations while the application of averaged insertion morphological information in individual surgeries can be susceptible to inaccuracy and uncertainty. Implications on challenges associated with developing engineering solutions to aid in re-creating or recognizing anatomy in surgical care delivery are discussed.

  3. Arthroscopic debridement of osteoarthritic elbow in professional athletes

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  4. Arthroscopic Treatment of Calcific Tendonitis

    OpenAIRE

    2014-01-01

    Calcific tendonitis, or calcifying tendonitis, is a common disorder characterized by the multifocal accumulation of basic calcium phosphate crystals within the rotator cuff tendons. In most cases, the multifocal calcifications are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. The initial treatment should be nonoperative including oral anti-inflammatory medication and physical therapy. If this is unsuccessful, arthroscopic debridement of the deposi...

  5. Arthroscopic Management of Shoulder Osteoarthritis

    OpenAIRE

    George, Michael S

    2008-01-01

    Osteoarthritis (OA) can cause severe pain and dysfunction of the shoulder. When conservative treatment fails and operative treatments such as shoulder arthroplasty and open glenohumeral resurfacing are not advisable, shoulder arthroscopy may be used to treat shoulder OA. Arthroscopic treatment of concomitant pathology in the shoulder including subacromial decompression, labral repair, capsular release, microfracture, and distal clavicle excision have been shown to yield good results when comb...

  6. Arthroscopic treatment of calcific tendonitis.

    Science.gov (United States)

    Barber, F Alan; Cowden, Courtney H

    2014-04-01

    Calcific tendonitis, or calcifying tendonitis, is a common disorder characterized by the multifocal accumulation of basic calcium phosphate crystals within the rotator cuff tendons. In most cases, the multifocal calcifications are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. The initial treatment should be nonoperative including oral anti-inflammatory medication and physical therapy. If this is unsuccessful, arthroscopic debridement of the deposit is effective. The technique used is an arthroscopic localization and debridement without associated subacromial decompression. The rotator cuff should be evaluated for partial- and full-thickness tears before and after the debridement of calcifications. If a partial- or full-thickness rotator cuff tendon tear is identified, it should be treated in a fashion consistent with those without associated calcium deposits. In our hands, tears 5 mm or greater in depth are repaired using a tendon-to-tendon or tendon-to-bone technique. Tears with less depth are debrided and then left alone. Arthroscopic debridement of calcific tendonitis can yield excellent functional results and high patient satisfaction.

  7. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    Science.gov (United States)

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability.

  8. Multidetector computed tomography arthrography of the knee: Diagnostic accuracy and indications

    Energy Technology Data Exchange (ETDEWEB)

    De Filippo, Massimo [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy)], E-mail: massimo.defilippo@unipr.it; Bertellini, Annalisa [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Pogliacomi, Francesco [Department of Surgery, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Sverzellati, Nicola [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Corradi, Domenico [Department of Anatomy, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Garlaschi, Giacomo [Department of Radiology, University of Genoa, Genoa Hospital, Via Balbi, 5-16126 Genova (Italy); Zompatori, Maurizio [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy)

    2009-05-15

    Purpose: To evaluate the diagnostic accuracy and indications of arthrography with multidetector computed tomography (arthro-MDCT) of the knee, in patients with absolute or relative contraindications to MRI and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Materials and methods: After intra-articular injection of iodixanol and volumetric acquisition, 68 knees in patients of both sexes (30 females, 38 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. The patients had arthralgia but no radiologically detected fractures. They could not be studied by MRI either because of absolute contraindications (subcutaneous electronic implants), surgical metal implants or claustrophobia. In 37 of 68 patients who had had previous knee surgery, the arthro-CT examination was preceded by an MRI on the same day. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results: In non-operated patients the comparison between arthro-MDCT and arthroscopy showed sensitivity and specificity ranging between 86% and 100%. In the 37 operated knees, arthro-MDCT had an accuracy of 95% compared with 53% of the MRI. Inter-observer agreement was almost perfect (K = 0.97) in the evaluation of all types lesions, both on MDCT and MRI. When arthro-MDCT was compared with MRI in post-operative patients by a McNemar test, a significant difference (p < 0.05) was found between these two techniques. Conclusions: Arthro-MDCT of the knee is a safe technique that provides accurate diagnosis in identifying chondral, fibrocartilaginous and intra-articular ligamentous lesions, in patients that cannot be evaluated by MRI, and in patients after surgical.

  9. 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

    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...

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

    Institute of Scientific and Technical Information of China (English)

    唐葆青; 林舟丹; 黄育强

    2011-01-01

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

  11. Comparison of the Effects of Intrathecal Fentanyl and Intrathecal Morphine on Pain in Elective Total Knee Replacement Surgery

    Directory of Open Access Journals (Sweden)

    Refika Kılıçkaya

    2016-01-01

    Full Text Available Objective. Total knee replacement is one of the most painful orthopedic surgical procedures. In this study, our goal was to compare the intraoperative and postoperative hemodynamic effects, the side effects, the effect on the duration of pain start, the 24-hour VAS, and the amount of additional analgesia used, of the fentanyl and morphine we added to the local anesthetic in the spinal anesthesia we administered in cases of elective knee replacement. Materials and Methods. After obtaining the approval of the Erciyes University Medical Faculty Clinical Drug Trials Ethics Committee, as well as the verbal and written consent of the patients, we included 50 patients in our prospective, randomized study. Results. In our study, the morphine group (Group M had lower pain scores in the 2nd, 6th, 12th, and 24th hours compared to the fentanyl group (Group F. When additional analgesic requirements were compared, it was found that in the 2nd, 6th, and 24th hours fewer Group M patients needed more analgesics than did Group F patients. Conclusion. The fentanyl group also had lower first analgesic requirement times than did the morphine group. In terms of nausea and vomiting, there was no statistically significant difference between the two groups.

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

    Science.gov (United States)

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

    2012-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  14. Knee Problems

    Science.gov (United States)

    ... BMI Calculator myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Knee ProblemsPain, swelling, stiffness and "water" on the knee are common symptoms. Follow this chart for more ...

  15. Surgery

    Science.gov (United States)

    ... the hospital, sometimes in an intensive care unit (ICU). Direct discharge home A person being sent home ... from surgery should occur gradually. Some people need rehabilitation , which involves special exercises and activities, to improve ...

  16. 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

    significantly higher area of 7.7 (0.5-17) (p=0.023). Average BMI was 21.6 versus 20.2 for surgical and non-surgical patients, respectively, significantly higher for those who underwent surgery (p=0.002). Most common procedure was fixation 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%.

  17. Quality of life in young patients after bone tumor surgery around the knee joint and comparison with healthy controls.

    NARCIS (Netherlands)

    Bekkering, W.P.; Vliet Vlieland, T.P.M.; Koopman, H.M.; Schaap, G.R.; Schreuder, H.W.B.; Beishuizen, A.; Tissing, W.J.; Hoogerbrugge, P.M.; Anninga, J.K.; Taminiau, A.H.M.

    2010-01-01

    BACKGROUND: This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. PROCEDURE: Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received t

  18. Quality of Life in Young Patients After Bone Tumor Surgery Around the Knee Joint and Comparison With Healthy Controls

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vlieland, Theodora P. M. Vliet; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Tissing, Wim J. E.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Taminiau, Antonie H. M.

    2010-01-01

    Background. This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. Procedure. Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received t

  19. Reduction and fixation of coronoid fractures by arthroscopic surgery%全关节镜下交换棒技术治疗尺骨冠状突骨折

    Institute of Scientific and Technical Information of China (English)

    欧阳侃; 王大平; 陆伟; 熊建义; 张洪; 彭亮权

    2010-01-01

    目的 探讨关节镜下交换棒技术治疗尺骨冠状突骨折的可行性及疗效.方法 2008年1月至2009年12月,分别取肘关节标准近侧前内侧入路、前外侧入路、肘关节前正中入路,采用交换棒技术,于前正中入路直接将加压螺钉固定于骨折处治疗尺骨冠状突骨折6例.其中男4例,女2例;年龄19~34岁,平均26.6岁;左侧2例,右侧4例;6例患者均为同侧肘关节半脱位伴冠状突骨折而无桡骨头骨折;按照Regan-Morrey骨折分型:Ⅰ型2例,Ⅱ型4例;根据O'Driscoll分型:Ⅰ型2例,Ⅱ型4例.结果 关节镜下及术后X线片均示骨折复位良好,固定螺钉位置与骨折线垂直.本组1例失访,5例患者随访7~24个月,平均11个月.骨折愈合良好,5例患者的肘关节平均伸直为-2°(-10°~0),屈曲为140°(135°~145°);旋前旋后正常,无肘关节不稳定;无发生血管、神经等并发症.Mayo肘关节功能评分均为优.结论 关节镜下正确运用交换棒技术能提供优良的视野,解剖修复无需大的手术切口,能保护骨折周围的软组织,骨块固定稳固,且利于早期康复锻炼.%Objective To investigate the feasibility and methods of arthroscopic reduction and fixation of coronoid fractures. Methods During 2008 and 2009, 6 patients (4 male and 2 female) with coronoid fractures of Regan and Morrey Types Ⅰ and Ⅱ underwent arthroscopic treatment in our department. Their ages ranged from 19 to 34 years, averaging 26. 6 years. Two fractures involved the left side and 4 the right side. By Regan-Morrey classification, 2 were of type Ⅰ and 4 of type Ⅱ. Standard elbow approaches and the exchange rod technique were applied. Compression screws were used to directly fixate the fracture via the anterior median approach. Results One patient was lost to the follow-up. A mean follow-up of 11 months (7 to 24 months) showed that the other 5 patients achieved a functional range of motion with an average flexion/extension of -2

  20. Septic arthritis of the knee associated with calf abscess.

    Science.gov (United States)

    Izumi, Masashi; Ikeuchi, Masahiko; Tani, Toshikazu

    2012-08-01

    Septic arthritis associated with extra-articular abscess is rare. We report on 2 non-rheumatic patients with septic arthritis of the knee associated with calf abscess. Magnetic resonance imaging showed a distinct leakage pathway from the knee joint in each patient. One was a ruptured popliteal cyst (posteromedial). Another was a pathologic popliteus hiatus (posterolateral). These patients underwent open drainage of the calf abscess via a small incision, followed by arthroscopic debridement of the knee. Careful palpation of the lower leg, followed by magnetic resonance imaging and needle aspiration, is important to exclude a possible extra-articular abscess regardless of the presence of a popliteal cyst.

  1. Arthroscopic trans-portal deep medial collateral ligament pie-crusting release.

    Science.gov (United States)

    Atoun, Ehud; Debbi, Ronen; Lubovsky, Omri; Weiler, Andreas; Debbi, Eytan; Rath, Ehud

    2013-02-01

    Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space.

  2. Arthroscopic gluteal muscle contracture release with radiofrequency energy.

    Science.gov (United States)

    Liu, Yu-Jie; Wang, Yan; Xue, Jing; Lui, Pauline Po-Yee; Chan, Kai-Ming

    2009-03-01

    Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior portals. With the patient lying laterally, we developed and enlarged a potential space between the gluteal muscle group and the subcutaneous fat using blunt dissection. Under arthroscopic guidance through the inferior portal, we débrided and removed fatty tissue overlying the contractile band of the gluteal muscle group using a motorized shaver introduced through the superior portal. Radiofrequency then was introduced through the superior portal to gradually excise the contracted bands from superior to inferior. Finally, hemostasis was ensured using radiofrequency. Patients were followed a minimum of 7 months (mean, 17.4 months; range, 7-42 months). At last followup, the adduction and flexion ranges of the hip were 45.3 degrees +/- 8.7 degrees and 110.2 degrees +/- 11.9 degrees, compared with 10.4 degrees +/- 7.2 degrees and 44.8 degrees +/- 14.1 degrees before surgery. No hip abductor contracture recurred and no patient had residual hip pain or gluteal muscle wasting. We found gluteal muscle contracture could be released effectively with radiofrequency energy.

  3. Knee Bursitis

    Science.gov (United States)

    ... make a diagnosis of knee bursitis during a physical exam. Your doctor will inspect your knee by: Comparing the condition of both knees, particularly if only one is painful Gently pressing on different areas of your knee to detect warmth, swelling and the source of pain Carefully moving ...

  4. Comparison of a continuous temperature-controlled cryotherapy device to a simple icing regimen following outpatient knee arthroscopy.

    Science.gov (United States)

    Woolf, Shane K; Barfield, William R; Merrill, Keith D; McBryde, Angus M

    2008-01-01

    This prospective, randomized study compared postoperative pain control with use of a continuous temperature-controlled cryotherapy system versus a traditional ice therapy regimen following outpatient knee arthroscopy. Patients with unilateral knee pathology scheduled for outpatient arthroscopic surgery were included. Patients with major ligament reconstructions were excluded. A specific cold therapy regimen was begun postoperatively and continued for 2 weeks as adjunctive management of postoperative pain. Preoperative and postoperative pain intensity, pain type, functionality, and sleep quality were assessed. Patients were randomly assigned to either an ice or a continuous cryotherapy group. Follow-up questionnaires were completed on 5 postoperative days. Data were analyzed using a chi-square test with a level of significance at P Pain intensity was similar between groups throughout the course of the study. Among patients who reported experiencing night pain, 36% of those in the continuous cryotherapy group were able to sleep soundly with minimal awakening through postoperative day 2 versus 5.9% among the ice therapy group (P = 0.04). No significant differences existed between groups regarding functional ability, and no differences were noted on other follow-up days. These findings support use of continuous temperature-controlled cold therapy devices for nighttime pain control and improved quality of life in the early period following routine knee arthroscopy.

  5. 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.

  6. 膝关节镜下交叉韧带重建术后下肢深静脉血栓的临床研究%The research of deep venous thrombosis after arthroscopic surgery of the cruciate ligament in the normal population

    Institute of Scientific and Technical Information of China (English)

    刘晓峰; 董江涛; 陈百成; 赵宝辉; 王飞; 陈涛平

    2012-01-01

    [Objective]The purpose of this study is to analyze the incidence of deep venous thrombosis with different arthroscopic surgical type of cruciate ligament and expose the reason. [Method]From September 2009 to May 2009,282 patients with cruciate ligament injuries received arthroscopic ligament reconstruction. All patients received Color Doppler ultrasound pre-operatively, 3 days and 7 days after operation respectively. We recorded the incidence of DVT with different surgical type and different time of using tourniquet. [ Result] The incidence of DVT in 282 patients was 12. 06% . The incidence of DVT in isolated ACL reconstructed patients was 7. 24% , in ACL combined with posteromedial (posterolateral) reconstruction was 12. 77% , in isolated PCL reconstruction was 17.39% ,in PCL combined with posteromedial (posterolateral) was 23.53% ,in simultaneously ACL-MCL reconstruction was 25. 00% . The comparison between five groups was significant( P < 0. 05). The incidence in patients used tourniquet less than 90 minutes was 5. 56% ,in patients used tourniquet from 90 minutes to 120 minutes was 12. 77% and in patients with more than 120 minutes tourniquet time was 17. 35%. The comparison between different tourniquet u-sing time was also significant(P <0. 05). [ Conclusion] The incidence of DVT in patients with arthroscopic cruciate ligament surgery cant be ignored by arthroscopic surgeon. There is a high incidence in patients with PCL and its related surgery and in patients with more than 2 hours tourniquet using time, so we should pay more attention to these surgery and take some necessary prophylaxis.%[目的]分析膝关节镜下交叉韧带重建术后不同术式下肢深静脉血栓的发生率,并探讨其原因.[方法]对2009年9月~20011年5月河北医科大学第三医院关节外科收治的282例膝关节交叉韧带损伤并接受韧带重建手术的患者进行统计研究,以彩色超声多普勒检查为诊断依据,分别于入院24h内,术后第3d

  7. Clinicoanatomic study of optimal arthroscopic approaches to the elbow

    Directory of Open Access Journals (Sweden)

    I. A. Kuznetsov

    2015-01-01

    Full Text Available The purpose: development and topographic substantiation of optimal arthroscopic approaches to the elbow, taking into account the location of the neurovascular structures in different functional positions. Material and methods: Anatomical relationships of elbow nerves and bony structures were studied by dissection of non-fixed anatomical material (6 elbow joints. To investigate the variant anatomy of the brachial artery, MRI in 23 patients were performed. In 10 patients the authors used ultrasound to study the topographic relationships of elbow nerve structures at different functional positions of the upper extremity Variability of the brachial artery deviation, depending on the angle of elbow flexion, was studied in six angiograms of non-fixed anatomical material. Statistical analysis was performed using Instant + and Past 306 software. Results: It was found that elbow flexion of 180°-90° moves the brachial artery away from the bones with a maximum distance from the humerus of 5 cm above the joint space. Distance increases from 23.5±3.1 mm to 23.9±3.1 mm. In 90° elbow flexion radial and median nerves are at the maximum distance from bony structures - 16.01±0.43 and 20.48±0.28 mm, respectively. Conclusion: These findings allowed justification of the conclusion that the lateral arthroscopic approaches to the elbow are the safest. It is possible to perform two lateral arthroscopic approaches: optical and instrumental, without conflict with major neurovascular structures. The optimal position for the surgery is 90° elbow flexion.

  8. 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.

  9. Use of amplified Mycobacterium tuberculosis direct test (Gen-probe Inc., San Diego, CA, USA in the diagnosis of tubercular synovitis and early arthritis of knee joint

    Directory of Open Access Journals (Sweden)

    Vinay Kumar Aggarwal

    2012-01-01

    Conclusion: AMTDT or Genprobe is a rapid diagnostic test for early diagnosis of tubercular arthritis, but has low sensitivity in knee joint tuberculosis. Nuclear amplification tests are still far from being a single promising alternative to conventional tests in cases of joint tuberculosis. Routine use of arthroscopic biopsies in all suspected cases is helpful in the early diagnosis of knee joint tuberculosis.

  10. 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 Bøgh;

    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 stocking the day...

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

    Science.gov (United States)

    Johansson, A.; Sundqvist, T.; Kuiper, J.-H.; Öberg, P. Å.

    2011-03-01

    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).

  12. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. The Impact of Arthroscopic Capsular Release in Patients with Primary Frozen Shoulder on Shoulder Muscular Strength

    Directory of Open Access Journals (Sweden)

    Michał Waszczykowski

    2014-01-01

    Full Text Available The aim of this study was to evaluate the impact of arthroscopic capsular release in patients with primary frozen shoulder on muscular strength of nonaffected and treated shoulder after at least two-year follow-up after the surgery. The assessment included twenty-seven patients, who underwent arthroscopic capsular release due to persistent limitation of range of passive and active motion, shoulder pain, and limited function of upper limb despite 6-month conservative treatment. All the patients underwent arthroscopic superior, anteroinferior, and posterior capsular release. After at least two-year follow-up, measurement of muscular strength of abductors, flexors, and external and internal rotators of the operated and nonaffected shoulder, as well as determination of range of motion (ROM and function (ASES in the operated and nonaffected shoulder, was performed. Measurement of muscular strength in the patient group did not reveal statistically significant differences between operated and nonaffected shoulder. The arthroscopic capsular release does not have significant impact on the decrease in the muscular strength of the operated shoulder.

  15. Arthroscopically Assisted Acromioclavicular and Coracoclavicular Ligament Reconstruction for Chronic Acromioclavicular Joint Instability.

    Science.gov (United States)

    Martetschläger, Frank; Tauber, Mark; Habermeyer, Peter; Hawi, Nael

    2016-12-01

    Acromioclavicular (AC) joint injuries are common injuries, especially in the young and active, male population. AC joint injuries account for 12% of all injuries of the shoulder girdle in the overall population. Although conservative treatment is recommended for Rockwood type I and type II injuries, there is controversial debate about optimal treatment for type III injuries. High-grade injuries are typically treated operatively to avoid painful sequelae. A vast number of different surgical methods have been described over the past few decades. Recent advances in arthroscopic surgery have enabled the shoulder surgeon to treat acute and chronic AC lesions arthroscopically assisted. Clinical studies have already shown good and reliable results. Although surgeons agree that a biological augmentation is required to minimize the risk of recurrent instability in chronic cases, a gold standard still needs to be defined. We present an arthroscopically assisted biological augmentation technique to reconstruct the AC and coracoclavicular ligaments, protected by a button-suture tape construct for chronic AC joint instability. The presented arthroscopic biological augmentation technique uses less and/or smaller drill holes in the clavicle and coracoid than previously described, thus reducing weakening of the bony structures. At the same time it enhances both horizontal and vertical stability.

  16. 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

  17. 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...

  18. Knee Injuries

    Science.gov (United States)

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

  19. 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。

  20. Arthroscopic rotator cuff repair in elite rugby players

    Directory of Open Access Journals (Sweden)

    Tambe Amol

    2009-01-01

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

  1. Direct treatment comparison of DAbigatran and RIvaroxaban versus NAdroparin in the prevention of venous thromboembolism after total knee arthroplasty surgery : design of a randomised pilot study (DARINA)

    NARCIS (Netherlands)

    van der Veen, L.; van Raay, J.J.A.M.; Gerritsma-Bleeker, C.L.E.; Veeger, N.J.G.M.; van Hulst, M.

    2013-01-01

    Introduction: Two novel agents, dabigatran and rivaroxaban, recently gained market authorisation for prevention of venous thromboembolism (VTE) after hip and knee arthroplasty. However, safety data of the new oral anticoagulants with a long-term use of 42 days are not available for total knee arthro

  2. "Owl" Technique for All-Arthroscopic Augmentation of a Massive or Large Rotator Cuff Tear With Extracellular Matrix Graft.

    Science.gov (United States)

    Narvani, A Ali; Consigliere, Paolo; Polyzois, Ioannis; Sarkhel, Tanaya; Gupta, Rohit; Levy, Ofer

    2016-08-01

    Despite the vast improvement in techniques and technology for arthroscopic rotator cuff surgery, repairs of massive and large tears remain challenging because they are associated with significantly high failure rates. In recent years, patch augmentation has gained popularity as a technique to decrease these high failure rates. Arthroscopic patch augmentation of rotator cuff repair, however, is technically difficult. The purpose of this report is to describe a simple and reproducible technique for all-arthroscopic extracellular matrix graft augmentation. With this technique, which we refer to as the "owl" technique because the prepared extracellular augment resembles an owl, there are relatively few suture ends involved; therefore, augment introduction is straightforward with a reduced risk of suture ends becoming tangled. In addition, the way in which our augmentation is prepared helps to prevent it from becoming bunched up when being secured.

  3. Synovial hemangioma of the knee with recurrent effusion and pain: a case report.

    Directory of Open Access Journals (Sweden)

    Mohammad Naghi Tahmasbi

    2014-08-01

    Full Text Available Synovial hemangioma is a rare benign malformation of the synovium. It presents frequently in the knee with pain, tenderness, intermittent swelling and recurrent hemarthrosis. MRI can be helpful in diagnosis of synovial hemangioma. In this paper, we present a 45-year-old lady with chronic symptoms and obscure clinical symptoms for 35 years which finally diagnosed and managed arthroscopically as synovial hemangioma of the knee. The patient`s complaints resolved efficiently with no recurrence after one year.

  4. 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.

  5. 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.

  6. A novel arthroscopic procedure for fixation of avulsion fracture of tibial attachment of anterior cruciate ligament guided by meniscal stitching needle

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; FAN Hong-bin; MENG Cheng-fei; CHEN Hui; CAO Shi-lei

    2008-01-01

    Objective: To introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the clinical results.Methods : From 1999 to 2005, fifteen cases of tibial eminence avulsion were treated with this new technique. Lysholm scoring scale system was used to assess knee function before and after surgery. Regular plain anteroposterior and lateral X-ray films were undertaken to detect the bony healing of avulsed fragment.Results: The operating time could be controlled within 30 minutes. No complications such as intraarticular infection, iatrogenic injury, fibroarthritis or nonunion of fracture occurred in this group. X-ray film revealed that bony healing in all 15 cases was achieved from 6 weeks to 12 weeks postoperatively. Lysholm score was improved from 19.1±15.2 (ranging from 10 to 56) preoperatively to 97.5 ±3.7 (ranging from 91 to 100) postoperatively on average in 12-54 months follow up ( mean 23 months). The statistically significant difference was shown in Student's t test (t = 18. 483, P = 3. 100 × 10 -11 , P < 0. 01). Wire breakage was found in two patients whose wires were removed 8 months and 14 months after initial operation, respectively.Conclusion : This technique has many advantages, such as simplicity, wide indications from type Ⅱ to type Ⅳ fractures, minimal invasion, short operating time and predictable satisfactory results.

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

    Directory of Open Access Journals (Sweden)

    Fabio Alexandre Martynetz

    2013-12-01

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

  8. Arthroscopic reconstruction of anterior and posterior cruciate ligaments with LARS artificial ligaments%关节镜下使用LARS人工韧带重建膝前、后交叉韧带

    Institute of Scientific and Technical Information of China (English)

    叶俊星; 沈光思; 周海斌; 谢宗刚; 徐炜; 董启榕; 徐又佳

    2013-01-01

    Objective To investigate the initial effect of LARS artificial ligaments arthroscopically in reconstruction of ipsilateral anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).Methods A total of 21 patients (13 males and 8 females,at average age of 31.5 years) received ACL and PCL restoration using LARS artificial ligaments since June 2006.Preoperative MRI exactly confirmed them as ACL and PCL ruptures.Lysholm score on knee joint was (47.6 ±6.7) points.Surgery had reconstruction of PCL prior to ACL under arthroscope.Results All patients were followed up for average 42 months (range,36-49 months),which showed no infection,ligament rupture,ligament loosening,or other postoperative complications.At postoperative 3 years,Lysholm score was (90.8 ± 3.7) points and International Knee Documentation Committee (IKDC) score was normal in 14 patients,near normal in six,and abnormal in one,with excellent-good rate of 95%.Conclusions LARS artificial ligaments can attain anatomical reconstruction and stability of the knee joint in treatment of ACL and PCL ruptures.Meanwhile,arthroscopic surgery shows superiorities of micro-wound,rapid recovery and satisfactory curative effect.%目的 探讨膝关节镜下使用LARS人工韧带重建同侧膝关节前交叉韧带(anterior cruciate ligament,ACL)和后交叉韧带(posterior cruciate ligament,PCL)的初步临床效果. 方法 从2006年6月开始,在关节镜下运用LARS人工韧带对21例ACL、PCL断裂患者进行重建,其中男13例,女8例,平均年龄31.5岁.所有患者术前MRI明确诊断为ACL、PCL断裂,Lysholm评分(47.6±6.7)分,手术在关节镜下进行,先重建PCL,再重建ACL. 结果 对21例患者均进行36~49个月(平均42个月)的随访,未发生感染、韧带断裂、松动等术后并发症.术后3年,Lysholm评分(90.8±3.7)分;国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分,正常14例,接近正常6例,不正常1例,优良率达95%.

  9. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... or a mobile bearing CR TKA. METHODS: We identified all patients receiving a new generation CR TKA or mobile bearing TKA at our institution between 2010 and 2012. These were matched to a population of patients receiving a standard CR TKA regarding age, gender, year of surgery, Kellgren-Lawrence (KL) grade...

  10. A three-dimensional anatomy of the posterolateral compartment of the knee: the use of a new technology in the study of musculoskeletal anatomy

    Directory of Open Access Journals (Sweden)

    Astur DC

    2012-01-01

    Full Text Available Diego Costa Astur1, Gustavo Gonçalves Arliani1, Camila Cohen Kaleka2, Wahy Jalikjian3, Pau Golano4,5, Moises Cohen11Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (UNIFESP, São Paulo, 2Department of Orthopedics and Traumatology, Faculdade de Medicina da Santa Casa de Misericórdia de São Paulo, São Paulo, 3Department of Orthopedics and Traumatology, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil; 4Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit, University of Barcelona, Barcelona, Spain; 5Orthopedic Surgery Department, Pittburgh University, Pittsburgh, PA, USABackground: Recently, an interest has developed in understanding the anatomy of the posterior and posterolateral knee. The posterolateral compartment of the knee corresponds to a complex arrangement of ligaments and myotendinous structures. Undiagnosed lesions in this compartment are the main reason for failure of the anterior and posterior cruciate ligament reconstructions. Understanding the anatomy of these structures is essential to assist in the diagnosis and treatment of these lesions. The aim of this study was to better understand the relationship between these structures of the knee using three-dimensional technology.Methods: Ten knees were included from cadaver lower limbs of adult patients. The skin and subcutaneous tissue were removed leaving only the muscle groups and ligaments. The neurovascular bundles and their ramifications were preserved. Images were acquired from the dissections using a Nikon D40 camera with AF-S Nikkor 18–55 mm (1:3.5 5.6 GII ED and Micro Nikkor 105 mm (1:2.8 lenses. The pair of images were processed using Callipyan 3D and AnaBuilder software, which transforms the two images into one anaglyphic image.Results: During the dissection of the knees, twelve pictures were acquired and transformed into anaglyphic

  11. 关节镜辅助治疗婴幼儿难复性发育性髋关节脱位短期观察%Short-term effects on arthroscopic-assisted surgery for irreducible or unstable developmental dislocation of the hip in infants

    Institute of Scientific and Technical Information of China (English)

    丁仰坤; 李祁伟; 张立军; 李连永; 刘振江; 史立伟; 王恩波; 吉士俊; 赵群

    2016-01-01

    目的 探讨关节镜辅助治疗婴幼儿难复性发育性髋关节脱位(developmental dysplasia or dislocation of the hip,DDH)优缺点和短期临床效果.方法 2009年4月至2010年9月,应用关节镜辅助治疗难复性婴幼儿DDH患儿15例16髋,记录手术时间、出血量及术中阻碍髋关节复位的因素.采用改良McKay评分标准进行髋关节功能评估.应用髋臼指数(acetabular index,AI),臼头指数(acetabular head index,AHI),股骨头缺血性坏死(avascular necrosis,AVN),Severin方法分级等指标进行影像学评估.结果 手术时间平均123 min,出血平均4.8ml.妨碍髋关节复位的因素有:髋臼窝内增生的软组织、粗大的圆韧带,髋臼横韧带和内翻关节盂唇.所有患儿均获得成功复位.术后患儿均无切口感染、神经损伤等手术并发症.平均随访时间32个月(6~59个月).近期随访的6例患儿临床功能结果,优3髋,良1髋,可1髋,差1髋.近4岁以上的8髋,其中4髋(50%)为Severin分级为优良.16髋中有7髋(43.8%)出现AVN迹象,Kalamchi-MacEwenⅠ型6髋,Ⅱ型1髋.结论 关节镜辅助下治疗难复性婴幼儿DDH,手术安全创伤小,出血少,能够成功获得髋关节复位.但术后AVN可能与改良蛙式膏固定有关,关节液压力可能对股骨头血运产生影响,术后残余髋臼发育不良可能与未进行髋臼截骨有关.%Objective To explore the short-term effects on arthroscopic-assisted surgery for irreducible or unstable developmental dislocation of the hip (DDH) in infants.Methods From April 2009 to September 2010, 15 children (16 hip) with irreducible or unstable DDH undergoing arthroscopic-assisted surgery were followed up.The operative duration, blood loss and obstructions for hip reduction were recorded.Modified McKay grading was used for evaluating the hip joint functions.Acetabular index (AI), acetabular head index (AHI), avascular necrosis (AVN) and Severin's classification were used for evaluating the

  12. Morphological classification of acromial spur: correlation between Rockwood tilt view and arthroscopic finding

    Directory of Open Access Journals (Sweden)

    Kongmalai Pinkawas

    2017-01-01

    Full Text Available Purpose and hypothesis: Acromion spur is the extrinsic factor for impingement syndrome and rotator cuff tear. The Rockwood tilt view can be used to evaluate prominence of the anterior acromion, however no study has shown the correlation of findings between the Rockwood tilt view and the arthroscopic finding. Methods: We developed the arthroscopic classification of acromion spur as type 1 flat spur, type 2 bump spur, type 3 heel spur, type 4 keel spur, and type 5 irregular spur. Patients with rotator cuff syndrome who underwent arthroscopic surgery were recruited. Two observers were asked to classify the type of spur from arthroscopic findings and Rockwood tilt views separately in random pattern. The prevalence of supraspinatus tendon tear was also recorded as no tear, partial-thickness tear, and full-thickness tear. Results: The keel spur (33.9% was the most common finding followed by the heel spur (27.8%. The correlation was high especially for the heel, the keel, and the irregular spur (75.47%, 74.03%, and 72.73%, respectively. These three types of spurs have a high prevalence of full thickness of supraspinatus tendon tear. Conclusion: The Rockwood tilt view can be used to evaluate the morphology of an acromion spur, especially the at-risk spur that correlates highly with the full-thickness supraspinatus tendon tear. The arthroscopic classification will also be a useful tool to improve communication between the surgeon and the guide for appropriate treatment in a rotator cuff tear patient when encountering the heel, keel, and irregular spur.

  13. Influence of different cold therapy on postoperative rehabilitation of osteoarthritis patients undergoing arthroscopic knee surgery%不同冷疗法对骨性关节炎病人行膝关节镜术后康复的影响

    Institute of Scientific and Technical Information of China (English)

    黄文春; 罗宝凤; 邹国耀; 宋恩鸿; 徐红英

    2013-01-01

    [目的]评价不同冷疗法对骨性关节炎病人膝关节镜术后康复的影响.[方法]将2011年2月-2012年8月桂林医学院附属医院脊柱骨病外科收治的膝关节骨性关节炎病人54例随机分成3组,每组18例,其中冲洗组在膝关节镜术后用4℃~8℃生理盐水3 000 mL持续冲洗关节腔6h;冰敷组使用冰袋持续冰敷6h,空白对照组在膝关节镜术后不做任何处理.分别于术前及术后第1天、第7天记录3组病人患膝关节疼痛度、肿胀值、自主活动度.[结果]术后第1天、第7天冲洗组和冰敷组疼痛评分、肿胀值、活动度比较差异无统计学意义,与空白对照组相比差异有统计学意义(P<0.05).[结论]关节镜术后应用4℃~8℃生理盐水持续冲洗和冰袋冰敷均能有效改善病人的主观疼痛感,减轻关节肿胀度,促进膝关节功能的早期恢复.

  14. Validity of arthroscopic measurement of glenoid bone loss using the bare spot

    Directory of Open Access Journals (Sweden)

    Miyatake K

    2014-03-01

    Full Text Available Katsutoshi Miyatake, Yoshitsugu Takeda, Koji Fujii, Tomoya Takasago, Toshiyuki Iwame Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Komatsushima, Tokushima, Japan Purpose: Our aim was to test the validity of using the bare spot method to quantify glenoid bone loss arthroscopically in patients with shoulder instability. Methods: Twenty-seven patients with no evidence of instability (18 males, nine females; mean age 59.1 years were evaluated arthroscopically to assess whether the bare spot is consistently located at the center of the inferior glenoid. Another 40 patients with glenohumeral anterior instability who underwent shoulder arthroscopy (30 males, ten females; mean age 25.9 years were evaluated for glenoid bone loss with preoperative three-dimensional computed tomography (3D-CT and arthroscopic examination. In patients without instability, the distances from the bare spot of the inferior glenoid to the anterior (Da and posterior (Dp glenoid rim were measured arthroscopically. In patients with instability, we compared the percentage glenoid bone loss calculated using CT versus arthroscopic measurements. Results: Among patients without instability, the bare spot could not be identified in three of 27 patients. Da (9.5±1.2 mm was smaller than Dp (10.1±1.5 mm, but it was not significantly different. However, only 55% of glenoids showed less than 1 mm of difference between Da and Dp, and 18% showed more than 2 mm difference in length. The bare spot could not be identified in five of 40 patients with instability. Pearson's correlation coefficient showed significant (P<0.001 and strong (R2=0.63 correlation in percentage glenoid bone loss between the 3D-CT and arthroscopy method measurements. However, in ten shoulders (29%, the difference in percentage glenoid bone loss between 3D-CT and arthroscopic measurements was greater than 5%. Conclusion: The bare spot was not consistently located at the center of the inferior glenoid

  15. 腘窝囊肿的关节镜下治疗%Arthroscopic treatment of popliteal cyst

    Institute of Scientific and Technical Information of China (English)

    王敏; 周浩; 叶湛; 孙晓海

    2013-01-01

    Objective To evaluate the clinical effect of arthroscopic treatment of popliteal cyst.Methods Data of 42 patients,who had undergone arthroscopic treatment for popliteal cyst from November 2005 to January 2010,were retrospectively analyzed.There were 13 males and 29 females,including 6 children,aged from 11 to 68 years (average,43.2 years).All popliteal cysts were unilateral,including 14 cases of right knee and 28 cases of left knee.Eleven patients had recurrent popliteal cyst,and all of them underwent initial open surgery,and the duration from the initial surgery to recurrence ranged from 6 to 35 months (average,18 months).According to the Rauschning and Lindgren classification,there were 3 cases of grade Ⅰ,18 cases of grade Ⅱ and 21 cases of grade Ⅲ.Based on the MRI,the long diameter of the popliteal cysts ranged from 4.2 to 7.9 cm (average,5.4 cm),the transverse diameter 2.1 to 2.5 cm (average,2.3 cm) and anteroposterior diameter 1.6 to 2.2 cm (average,2.0 cm).All popliteal cysts were at posteriomedial parts of the knees,and 11 cases of popliteal cyst communicated with the knee joint cavity.Before operation,1 to 2 ml methylene blue was injected into the cyst,which was used to determine the channel intraoperatively according to the site where methylene blue flowed out.The intraarticular diseases were thoroughly treated when the inner wall of the popliteal cyst was cleaned.Results The intraarticular diseases were found in all patients intraoperatively,including medial meniscus tear in 28 cases,lateral meniscus tear in 9 cases and lateral discoid meniscus in 4 cases.There were no blood vessel complications,nerve complications and incision complications.All patients were discharged 2 or 3 days postoperatively.All patients were followed up for 10 to 30 months (average,18 months).No recurrence of popliteal cyst occurred at final follow-up.According to the Rauschning and Lindgren classification,there were 38 cases of grade 0 and 4 cases of grade Ⅰ.Conclusion The

  16. 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.

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

    Science.gov (United States)

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

    2016-07-01

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

  18. A Case of Nonisland Pedicled Foot Fillet Flap for Below-Knee Amputation Stump Wound: Treatment Option for Compartment Syndrome after Fibular Free Flap Surgery

    OpenAIRE

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-01-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was ...

  19. 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.

  20. THE CURATIVE EFFECT OF MINIMALLY INVASIVE TREATMENT OF 27 CASE OF GOUTY ARTHRI-TIS OF KNEE JOINT%微创治疗膝关节痛风性关节炎27例疗效观察

    Institute of Scientific and Technical Information of China (English)

    陶建峰; 王爱军; 陈德生; 赵立彦

    2014-01-01

    目的:探讨关节镜手术治疗膝关节痛风性关节炎的方法及疗效。方法应用关节镜微创技术对27例膝关节痛风性关节炎患者行关节清理、滑膜切除、半月板修整或切除及关节软骨修整,术后辅助药物治疗及功能康复练习。结果27例痛风性关节炎患者术中均可见不同程度的尿酸盐结晶沉积,术后肿痛症状均得到明显缓解,关节功能得到改善,随访6~36个月均得到满意疗效。结论对于内科治疗无效,反复发作或痛风石形成的膝关节痛风性关节炎,关节镜手术治疗具有诊断明确、创伤小、方法简单、效果显著等优点,可作为膝关节痛风性关节炎的外科治疗首选方法。%Objective To investigate the methods and efficacy of arthroscopic surgical treatment of knee gouty arthritis .Methods Arthroscopic minimally invasive techniques which included joint clean -up ,sy-novectomy ,trimming or removal of the meniscus and articular cartilage dressing were used in 27 patients with knee gouty arthritis ,postoperative assisted drug treatment and functional rehabilitation exercises .Re-sults Twenty -seven patients with gouty arthritis were seen in different levels of urate crystal deposition , postoperative swelling and pain symptoms were eased significantly improved joint function ,the outcome of followed up for 6~36 months were satisfied .Conclusions Arthroscopic surgery in the treatment of gouty arthritis of the knee has a clear diagnosis ,less invasive ,simple method ,significant effect .It can be used as the preferred method of surgical treatment of knee gouty arthritis .

  1. [Comprehensive arthroscopic management of shoulder osteoarthritis].

    Science.gov (United States)

    Ríos, D; Martetschlager, F; Millett, P J

    2012-01-01

    Shoulder osteoarthritis has been considered as a cause of severe pain and loss of shoulder function. Many patients with shoulder osteoarthritis are young and have demanding activities, which leads to questioning the choice of arthroplasty. This is why in this paper we describe the comprehensive arthroscopic management (CAM) that combines arthroscopic debridement, capsular release, osteoplasty of the lower humeral head, and auxiliary nerve decompression. In our experience this technique has shown short-term promising results as it decreases pain and allows patients to resume high performance demanding activities.

  2. 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

  3. Relationship Between the Middle Genicular Artery and the Posterior Structures of the Knee

    Science.gov (United States)

    de Carvalho, Rogério Teixeira; Ramos, Leonardo Addêo; Novaretti, João Victor; Ribeiro, Leandro Masini; Szeles, Paulo Roberto de Queiroz; Ingham, Sheila Jean McNeill; Abdalla, Rene Jorge

    2016-01-01

    Background: The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA. Purpose: To investigate the anatomy of the MGA and its relation to the posterior structures of the knees, mainly the posterior capsule and femoral condyles, and to establish safe parameters to avoid harming the MGA. Study Design: Descriptive laboratory study. Methods: Dissection of the MGA was performed in 16 fresh, unpaired adult human cadaveric knees with no macroscopic degenerative or traumatic changes and no previous surgeries. The specimens were meticulously evaluated with emphasis on preservation of the MGA. The distances from the MGA to the medial and lateral femoral condyles were measured. The Mann-Whitney test was used for statistical analysis. Results: In all specimens, the MGA emerged from the anterior aspect of the popliteal artery, distal to the superior genicular arteries, and had a short distal trajectory toward the posterior capsule where it entered proximal to the oblique popliteal ligament. The artery lay in the midportion between the condyles. The distance between the posterior aspect of the tibia and the point of entry of the MGA into the posterior joint capsule was 23.8 ± 7.3 mm (range, 14.72-35.68 mm). There was no correlation between an individual’s height and the distance of the entrance point of the MGA into the posterior joint capsule to the posterior superior corner of the tibia. Conclusion: The middle genicular artery lies in the midportion between the medial and lateral femoral condyles. Clinical Relevance: This knowledge is important for the preservation of the blood supply during posterior knee surgical procedures and to settle a secure distance between the posterior aspect of the tibia and the MGA input. This could decrease and

  4. Arthroscopic debridement for bilateral calcific tendinitis of the subscapularis tendons: a case report.

    Science.gov (United States)

    Tung, Kam-Lung; Woo, Siu-Bon

    2015-04-01

    We report on a 36-year-old man who underwent arthroscopic debridement for bilateral calcific tendinitis of the subscapularis tendons. The patient had a positive coracoid impingement test for both shoulders. Radiology showed calcific deposits at the insertion of both subscapularis tendons, close to the lesser tuberosities and just posterior to the coracoid tips. The patient underwent sequential arthroscopic coracoplasty and removal of calcific deposits in the subscapularis tendons. The patient returned to work 6 weeks after each surgery. At 2 years, the patient had no shoulder pain, with full range of motion and full power of the subscapularis muscles. The coracoid impingement test was negative for both shoulders. There was no evidence of recurrence.

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

    Science.gov (United States)

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

    2015-03-01

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

  6. Pyoderma gangraenosum as a complication to knee arthroscopy

    DEFF Research Database (Denmark)

    Madsen, Jakob Torp; Skov, Ole; Andersen, Klaus E

    2009-01-01

    Pyoderma gangraenosum (PG) is a rare immunologic ulcerative disease, which sometimes develop as a complication to surgery. PG is often misdiagnosed as an infected wound, but treatment is completely different. We report a case of PG as a complication to arthroscopic partial meniscectomy...

  7. Gait Analysis of Conventional Total Knee Arthroplasty and Bicruciate Stabilized Total Knee Arthroplasty Using a Triaxial Accelerometer

    Science.gov (United States)

    Saito, Hidetomo; Aizawa, Toshiaki; Miyakoshi, Naohisa; Shimada, Yoichi

    2016-01-01

    One component of conventional total knee arthroplasty is removal of the anterior cruciate ligament, and the knee after total knee arthroplasty has been said to be a knee with anterior cruciate ligament dysfunction. Bicruciate stabilized total knee arthroplasty is believed to reproduce anterior cruciate ligament function in the implant and provide anterior stability. Conventional total knee arthroplasty was performed on the right knee and bicruciate stabilized total knee arthroplasty was performed on the left knee in the same patient, and a triaxial accelerometer was fitted to both knees after surgery. Gait analysis was then performed and is reported here. The subject was a 78-year-old woman who underwent conventional total knee arthroplasty on her right knee and bicruciate stabilized total knee arthroplasty on her left knee. On the femoral side with bicruciate stabilized total knee arthroplasty, compared to conventional total knee arthroplasty, there was little acceleration in the x-axis direction (anteroposterior direction) in the early swing phase. Bicruciate stabilized total knee arthroplasty may be able to replace anterior cruciate ligament function due to the structure of the implant and proper anteroposterior positioning. PMID:27648328

  8. Virtual reality simulation of arthroscopy of the knee.

    Science.gov (United States)

    Mabrey, Jay D; Gillogly, Scott D; Kasser, James R; Sweeney, Howard J; Zarins, Bertram; Mevis, Howard; Garrett, William E; Poss, Robert; Cannon, W Dilworth

    2002-01-01

    The virtual reality arthroscopic knee simulator (VR-AKS) consists of a computer platform, a video display, and two force-feedback (haptic) interfaces known as "PHANToMs" that also monitor the position of the instruments in the user's hands. The forces that the user would normally apply to the lower limb during arthroscopy are directed through an instrumented surrogate leg. Proprietary software provides the mathematical representation of the physical world and replicates the visual, mechanical, and behavioral aspects of the knee. This includes moderating the haptic interface and simultaneously executing a collision-detection algorithm that prevents the instruments from moving through "solid" surfaces. Modeling software interacts with this algorithm to send the appropriate images to the video display, including knee pathology such as meniscal tears and chondral defects as well as normal anatomy. Task-oriented programs monitor specific performance such as executing a proper examination of the knee or shaving a torn meniscus.

  9. 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.

  10. 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.

  11. Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus: a toxic shock-prevented case.

    Science.gov (United States)

    Goto, Masafumi; Gotoh, Masafumi; Mitsui, Yasuhiro; Shibata, Hideaki; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

    2014-01-01

    Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus (GAS) is rare. GAS sometimes causes group A β-hemolytic streptococcal toxic shock syndrome. We encountered a case of pyogenic knee arthritis caused by GAS that resolved after appropriate treatment (emergency arthroscopic synovectomy and medication) administered within 48 h of onset. In cases of a history of another infection with acute knee joint pain, the possibility of GAS-induced pyogenic knee arthritis should be considered, and proper treatment should be administered immediately.

  12. Arthroscopic release of the deltoid contracture

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-jun; YAN Hui; CUI Guo-qing; AO Ying-fang

    2010-01-01

    Background The deltoid contracture is an uncommon disorder. Long-standing contracture produces winged scapula,abduction and extension contracture of the shoulder. Surgical release has been considered the treatment of choice.However, the method of approach has not been well defined. The purpose of this study was to evaluate the results of arthroscopic release of the deltoid contracture.Methods A retrospective study was undertaken to evaluate the results of arthroscopic release in six patients (seven shoulders) who had a contracture of the deltoid muscle. All patients had arthroscopic release. The abduction-contracture and horizontal-adduction angle was measured after operation. The average duration of follow-up was 16 months (range,from 4 to 41 months).Results The preoperative abduction contracture resolved completely in three shoulders. Two had a residual abduction contracture of 5° to 7° and two had a poor result with 15° abduction-contracture angle. The average postoperative abduction-contracture angle was 6° (range, 0° to 15°). The preoperative horizontal-adduction contracture was corrected,permitting at least 130° of adduction, in five shoulders. The remaining two shoulders had a postoperative horizontal-adduction angle of 120° and 110°. Overall, the average postoperative horizontai-adduction angle was 130°(range, 110° to 140°).Conclusion Arthroscopic release is an effective surgical technique to treat the deltoid contracture.

  13. 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

  14. Complicated septic arthritis after knee arthroscopy in a 75-year-old man with osteoarthritis and a popliteal cyst.

    Science.gov (United States)

    Papadopoulos, Antonios; Karachalios, Theofilos S; Malizos, Constantinos N; Varitimidis, Sokratis

    2015-01-01

    A 75-year-old man presented in shock secondary to septic arthritis of the knee. The patient, with a known history of knee osteoarthritis, was treated elsewhere for mechanical locking symptoms and effusion with arthroscopic debridement, and developed septic arthritis, which disseminated to the leg and foot after a tear in the capsule, and a ruptured pyogenic popliteal cyst. Open debridement of the knee joint, and drainage of the abscesses of the leg and foot, were performed. Antibiotic-loaded cement beads were left in the residual space. Debridement was repeated and cement beads removed after 4 days, and finally the infection was eradicated without any serious consequences for the patient. There is debate over arthroscopic intervention for osteoarthritic knees. The presence of a popliteal cyst, which is a rather common finding in the latter, could be related to a significant number of complications, such as septic arthritis.

  15. Will 'Unloading' Shoes Help Your Arthritic Knees?

    Science.gov (United States)

    ... anti-inflammatory medications may also help, as might physical therapy designed to improve flexibility and motion range. In severe cases, patients undergo invasive knee surgery ranging from joint-lining removal to partial or ...

  16. 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....

  17. La influencia de la superficie articular y la membrana sinovial en la evolución de pacientes afectos por bloqueo crónico de la articulación temporomandibular tratados mediante artroscopia Influence of the joint surface and the synovial membrane on the evolution of patients affected by chronic temporomandibular joint block who were treated with arthroscopic surgery

    Directory of Open Access Journals (Sweden)

    R. González-García

    2010-03-01

    during follow-up. Even though the average levels of pain were less in the group of patients with level I/II synovitis and level I/II chondromalacia compared to the group of patients with level III/IV synovitis and level III/IV chondromalacia throughout follow-up, the difference was not statistically significant. In the same way, higher values of maximum oral opening were observed in the group with level III/IV synovitis and level III/IV chondromalacia, but this difference was no statistically significant either. Conclusions: After arthroscopic surgery on the TMJ there was a significant decrease in pain as well as a significant increase in MOO one month after surgery in those who suffered any type of synovitis and/or chondromalacia. After TMJ arthroscopic we did not observe any statistically significant differences in terms of pain and function between patients with light joint surface and synovial membrane affectation and those who had severe joint surface and synovial membrane affectation.

  18. Measurement of perioperative flexion-extension mechanics of the knee joint.

    Science.gov (United States)

    Giori, N J; Giori, K L; Woolson, S T; Goodman, S B; Lannin, J V; Schurman, D J

    2001-10-01

    Perioperative knee mechanics currently are evaluated Perioperative knee mechanics currently are evaluated by measuring range of motion. This is an incomplete measurement, however, because the torque applied to achieve the motion is not measured. We hypothesized that a custom goniometer and force transducer could measure the torque required to passively flex a knee through its full range of motion. This measurement was done in the operating room immediately before and after surgery in 20 knees having total knee arthroplasty and 9 having surgery on another limb. Surgery changed the mechanics of 8 knees, whereas unoperated knees remained unchanged. This measurement technique is safe, easy, and repeatable. It improves on the current standard of perioperative knee measurement and can be applied to investigate the effects of surgery and rehabilitation on ultimate knee motion.

  19. Computer-assisted navigation in knee arthroplasty: a critical appraisal.

    Science.gov (United States)

    Venkatesan, Muralidharan; Mahadevan, Devendra; Ashford, Robert U

    2013-10-01

    The purpose of this review was to appraise the use of computer-assisted navigation in total knee arthroplasty and to assess whether this technology has improved clinical outcomes. Studies were identified through searches in MEDLINE, Embase, and PubMed. Numerous studies have shown improved leg and component alignment using navigation systems. However, the better alignment achieved in navigated knee arthroplasty has not been shown to lead to better clinical outcomes. Navigated knee arthroplasty had lower calculated blood loss and lower incidence of fat embolism compared with conventional knee arthroplasty using intramedullary jigs. It may be most valued when dealing with complex knee deformities, revision surgery, or minimally invasive surgery. Navigated knee arthroplasty, however, is only cost-effective in centers with a high volume of joint replacements. Overall, computer-assisted navigated knee arthroplasty provides some advantages over conventional surgery, but its clinical benefits to date are unclear and remain to be defined on a larger scale.

  20. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.

    Science.gov (United States)

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-02-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  1. Functional state of knee arthritis patients and related factors

    Science.gov (United States)

    Lee, Jiyeon; Kim, Jung-Hee; Chung, EunJung; Lee, Byoung-Hee

    2017-01-01

    [Purpose] The objective of this study is to provide a direction for efficient management of arthritis through the analysis of multiple factors related to the functional state of patients. [Subjects and Methods] The Visual Analog Scale, Knee Society Knee Score & Function Score, Hospital for Special Surgery, Short Form-36 Health Survey and Western Ontario McMaster Universities Osteoarthritis Index for a total of 135 patients with knee arthritis were determined with a survey. [Results] There is a significant correlation between age, pain, Knee Society Knee Score, Hospital for Special Surgery, Knee Society Function Score, and Western Ontario McMaster Universities Osteoarthritis Index score. [Conclusion] It is necessary to improve the factors that affect knee function and quality of life, and a study on knee joint muscle strength is suggested as a follow-up study. PMID:28265166

  2. Integrative Approach in Haemophillic Arthropathy of The Knee: a Case Report

    Directory of Open Access Journals (Sweden)

    Andri Maruli T Lubis

    2016-05-01

    Full Text Available Haemophilic arthropathy is the most prevalent joint disorder in haemophilia. This disorder is characterized by chronic synovitis and progressive destruction of joint cartilage. We report a case of arthroscopic synovectomy to reduce bleeding frequency in haemophilic arthropathy of the knee. Patient was a 15 years old male with haemophilic arthropathy of the left knee. We performed an arthroscopic synovectomy under tightly regulated factor VIII replacement therapy. There were villous synovial hypertrophy at all part of the joint, multiple bone and cartilage defect, and also anterior cruciate ligament (ACL and posterior cruciate ligament (PCL deficiency found intraoperatively. After 6 month follow up, subjective complain and bleeding frequency decreased significantly. The visual analog scale improved from 5-6 to 1-2, and the International Knee Documentation Committee Score increased from 49 to 66. Bleeding frequency decreased from 4-8 times per month to less than 1 time per month. Arthroscopic synovectomy performed in this case could reduce the pain, decrease the frequency of bleeding, and improve patient’s functional outcome. Key words: arthroscopic synovectomy, haemophilic arthropathy, haemophilia, anterior cruciate ligament, posterior cruciate ligament.

  3. Anatomical Knee Variants in Discoid Lateral Meniscal Tears

    Science.gov (United States)

    Chen, Xu-Xu; Li, Jian; Wang, Tao; Zhao, Yang; Kang, Hui

    2017-01-01

    Background: Discoid lateral meniscus was a common meniscal dysplasia and was predisposed to tear. There were some anatomical knee variants in patients with discoid lateral meniscus. The aim of this study was to analyze the relationship between anatomical knee variants and discoid lateral meniscal tears. Methods: There were totally 125 cases of discoid lateral meniscus enrolled in this study from February 2008 to December 2013. Eighty-seven patients who underwent arthroscopic surgery for right torn discoid lateral meniscus were enrolled in the torn group. An additional 38 patients who were incidentally identified as having intact discoid lateral menisci on magnetic resonance imaging (MRI) findings were included in the control group. All patients were evaluated for anatomical knee variants on plain radiographs, including lateral joint space distance, height of the lateral tibial spine, height of the fibular head, obliquity of the lateral tibial plateau, squaring of the lateral femoral condyle, cupping of the lateral tibial plateau, lateral femoral condylar notch, and condylar cutoff sign. The relationship between anatomical variants and meniscal tear was evaluated. These anatomical variants in cases with complete discoid meniscus were also compared with those in cases with incomplete discoid meniscus. Results: There were no significant differences between the two groups in lateral joint space distance (P = 0.528), height of the lateral tibial spine (P = 0.927), height of the fibular head (P = 0.684), obliquity of the lateral tibial plateau (P = 0.672), and the positive rates of squaring of the lateral femoral condyle (P = 0.665), cupping of the lateral tibial plateau (P = 0.239), and lateral femoral condylar notch (P = 0.624). The condylar cutoff sign was significantly different between the two groups, with the prominence ratio in the torn group being smaller than that in the control group (0.74 ± 0.11 vs. 0.81 ± 0.04, P = 0.049). With the decision value of the

  4. 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

  5. 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.

  6. 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

  7. Delayed diagnosis of a pseudoaneurysm with recurrent hemarthrosis of the knee joint.

    Science.gov (United States)

    Becher, Christoph; Burger, Ulrike L; Allenberg, Jens R; Kaufmann, Guenter W; Thermann, Hajo

    2008-06-01

    This is a case report of recurrent hemarthrosis of the knee joint over 3 months. The patient, a 47-year-old male had three arthroscopic procedures with multiple joint punctures over a 3-month-period prior to our initial consultation. The first procedure (arthroscopic synovectomy) was done for suspected infection following a series of hyaluronic acid injections. Recurrent hemarthrosis developed subsequent to this. Upon further evaluation, a pseudoaneurysm of the superior middle genicular artery was detected and successfully treated with selective angiographic embolization.

  8. Current evaluation of sonography of the meniscus. Results of a comparative study of sonographic and arthroscopic findings.

    Science.gov (United States)

    Casser, H R; Sohn, C; Kiekenbeck, A

    1990-01-01

    Sonography of the knee has gained in significance in the diagnosis of the meniscus; experimental and clinical studies have demonstrated that the normal and pathological anatomy of the meniscus can be visualized on a sonogram. The aim of this comparative investigation is to evaluate sonographic lesion diagnosis in comparison with arthroscopic findings, using a standardized examination method. Two hundred and six knee joints were first scanned sonographically using a 7.5 MHz sector transducer. The examining doctor had neither anamnestic nor clinical information in advance. On the following day, the joints were examined arthroscopically, without the findings of the day before being available to the examiner. When the findings were compared, the sensitivity of sonographic diagnosis of lesions was found to be 82.2% and its specificity 87.6%. The patients were of varying ages and had varying anamneses. The results show that sonography of the meniscus is a valuable diagnostic help when the knee-joint symptoms are not clear, given that the correct technical equipment and sufficient experience with this form of examination are at hand. The advantage of sonography is that, in contrast to arthroscopy, it is noninvasive and easily available.

  9. Prosthetic knee design by simulation

    Energy Technology Data Exchange (ETDEWEB)

    Hollerbach, K; Hollister, A

    1999-07-30

    Although 150,000 total knee replacement surgeries are performed annually in North America, current designs of knee prostheses have mechanical problems that include a limited range of motion, abnormal gait patterns, patellofemoral joint dysfunction, implant loosening or subsidence, and excessive wear. These problems fall into three categories: failure to reproduce normal joint kinematics, which results in altered limb function; bone-implant interface failure; and material failure. Modern computer technology can be used to design, prototype, and test new total knee implants. The design team uses the full range of CAD-CAM to design and produce implant prototypes for mechanical and clinical testing. Closer approximation of natural knee kinematics and kinetics is essential for improved patient function and diminished implant loads. Current knee replacement designs are based on 19th Century theories that the knee moves about a variable axis of rotation. Recent research has shown, however, that knee motion occurs about two fixed, offset axes of rotation. These aces are not perpendicular to the long axes of the bones or to each other, and the axes do not intersect. Bearing surfaces of mechanisms that move about axes of rotation are surfaces of revolution of those axes which advanced CAD technology can produce. Solids with surfaces of revolution for the two axes of rotation for the knee have been made using an HP9000 workstation and Structural Ideas Master Series CAD software at ArthroMotion. The implant's CAD model should closely replicate movements of the normal knee. The knee model will have a range of flexion-extension (FE) from -5 to 120 degrees. Movements include varus, valgus, internal and external rotation, as well as flexion and extension. The patellofemoral joint is aligned perpendicular to the FE axis and replicates the natural joint more closely than those of existing prostheses. The bearing surfaces will be more congruent than current designs and should

  10. Arthroscopic Reduction and Internal Fixation of Avulsion Fracture of Anterior Cruciate Ligament from Tibial Eminence with Stainless Steel Wire%关节镜下钢丝固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    卢华定; 史德海; 董云旭; 王昆; 曾春

    2011-01-01

    Objective To investigate the therapeutic efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence with stainless steel wire. Methods Thirteen cases of displaced avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic reduction and internal fixation with stainless steel wire from January 2003 to June 2006.Adjustable brace was used for protection after surgery, and active rehabilitation training was conducted. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments postoperatively. Results Thirteen cases were followed up for 6 to 32 months and the average time was 14 months. No complications of intraarticular infection, iatrogenic injury, anchylosis, loss of knee extension, or nonunion of fracture were found. X-ray films revealed good bone union in all the 13 cases three months after surgery. No knee instability was detected, and knee flexion and extension function was normal in all patients. The Lysholm scores were improved from 39.4±9.98 preoperatively to 95.2±2.94 postoperatively, with significant statistical difference by the student-t test (t = 24.001,P <0.01). Conclusion Arthroscopic reduction and internal fixation with stainless steel wire in the treatment of avulsion fracture of the anterior crnciate ligament from the tibial eminence has advantages of simplicity, broad indications,minimal invasion, and rapid postoperative recovery. It is believed as an ideal choice for such avulsion fracture of the anterior cruciate ligament from the tibial eminence.%目的 探讨关节镜下钢丝内固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效.方法 自2003年1月~2009年6月采用关节镜下复位钢丝内固定治疗13例移位的ACL胫骨止点撕脱骨折,术后可调式支具保护,积

  11. The knee adduction moment during gait is associated with the adduction angle measured during computer-assisted total knee arthroplasty.

    Science.gov (United States)

    Roda, Richard D; Wilson, Janie L Astephen; Wilson, David A J; Richardson, Glen; Dunbar, Michael J

    2012-06-01

    Computer-assisted surgery can be used to measure 3-dimensional knee function during arthroplasty surgery; however, it is unknown if the movement of the knee measured during surgery is related to the in vitro, dynamic state of the knee joint, specifically the knee adduction moment during gait, which has been related to implant migration. The purpose of this study was to determine if the preoperative adduction moment is correlated with the knee abduction/adduction angle measured intraoperatively. A statistically significant correlation was found between the mean (r(2) = 0.59; P = .001) and peak (r(2) = 0.53; P = .003) preoperative knee adduction moment and the mean abduction/adduction angle measured intraoperatively. The association found in this study suggests the potential for incorporating functional information that relates to surgical outcome into surgical decision making using computer-assisted surgery.

  12. 关节镜下自体移植半腱肌和股薄肌重建前交叉韧带%Outcomes of arthroscopic reconstruction of anterior cruciate ligament with autografts from tendons of the semitendinosus-gracilis muscles

    Institute of Scientific and Technical Information of China (English)

    宣华兵; 董利军; 黄德刚; 贺华正; 杨昕

    2012-01-01

    Objective:To assess the clinical effects of reconstructing anterior cruciate ligament( ACL ) with the tendon autografts from the semiten-dinosus-gracilis muscles under arthroscope. Methods-. Between Sept. 2007 and May 2011 ,34 patients with ACL injury underwent treatment in our department by ligament reconstruction with autogenous Semite ndinosus-gracilis muscles. Arthroscopic fixation was performed in tibia epiphysis with sheathed absorbable crushing screw and in femur epiphysis with two transverse screws. All patients were observed for postoperative stability of the knees and treatment effects and followed up for functional recovery of the joint with Lysholm Knee Scoring Scale. Results: Follow-up ranging from 6 to 44 months showed that the total 34 patients obtained better recovery of joint function. Lysholm score before and after the surgery was 53.08 ±4.2 us. 92. 05 ±3.7, which was statistically different ( P < 0. 01 ). Conclusion : Arthroscopic reconstruction of ACL with autogenouseasy performance and fewer complications and thus, is worthy of widerclinical application.%目的:介绍关节镜下半腱肌股薄肌重建前交叉韧带(ACL)的手术方法和效果.方法:2007年9月~2011年5月我科共诊治34例ACL损伤患者,取自体半腱肌与股薄肌腱,在关节镜下使用带鞘可吸收挤压钉(Itrafix系统)固定胫骨端,使用2枚横向钉固定股骨端,重建ACL.观察固定后的稳定性和术后疗效.随访后用Lysholm评分标准评价手术前后关节功能.结果:本组34例,随访6~44个月.关节功能良好,Lysholm评分,术前53.08±4.2,术后92.05±3.7,术后评分明显提高,差异有统计学意义(P<0.01).结论:关节镜下重建前交叉韧带,疗效好,操作简单,并发症少,宜临床推广.

  13. 关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带的临床研究%Clinical study of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    苑广科; 韦良心; 焦兆德; 殷鹏

    2014-01-01

    Objective To explore the treatment method and clinical effect of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament (ACL). Methods A total of 32 cases undergone arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament were in this study. Preoperative and postoperative follow-up and Lysholm score were applied in the analysis of knee joint function and curative effect. Results The result of Lysholm score showed that there were 31 good cases (96.9%) and 1 fair case (3.1%). The good rate was 96.9%. Conclusion The surgery of arthroscopic four bone-tunnel double-bundle tendon allograft reconstruction of anterior cruciate ligament can effectively recover the stability and knee function in anterior-posterior dimension and spin. This reconstruction is close to the reconstruction of anatomic biomechanics. The application of tendon allograft transplant can reduce operation time and trauma, and it is a good choice for double-bundle anterior cruciate ligament reconstruction.%目的:探讨关节镜下应用同种异体跟腱四骨道双束解剖重建前交叉韧带(ACL)的手术方法和临床疗效。方法32例采用关节镜下同种异体跟腱四骨道双束解剖重建方法的前交叉韧带损伤患者,通过术前及术后随访, Lysholm评分表进行膝关节功能的评估和疗效分析。结果按照Lysholm评分表,31例患者(96.9%)分级评价优良,1例一般(3.1%),优良率达到96.9%。结论关节镜下同种异体跟腱四骨道双束解剖重建前交叉韧带,能够有效的恢复膝关节的前后向及旋转稳定性,更接近于解剖生物力学重建,同种异体跟腱移植物的应用可以缩短手术时间,减少创伤,是双束解剖重建ACL的良好选择之一。

  14. Arthroscopic management of calcific tendinopathy of the shoulder--do we need to remove all the deposit?

    Science.gov (United States)

    Rizzello, Giacomo; Franceschi, Francesco; Longo, Umile Giuseppe; Ruzzini, Laura; Meloni, Maria Chiara; Spiezia, Filippo; Papalia, Rocco; Denaro, Vincenzo

    2009-01-01

    Results of arthroscopic management of chronic, recalcitrant calcific tendinopathy of the shoulder in 28 patients were evaluated. Twenty-six patients (average age, 44 years) were ultimately enrolled in the study. Postoperative radiographs were performed to determine the amount of calcium deposit removal. Radiographic examination 2 months after surgery was performed to evaluate further deposit changes. The Constant score showed a statistically significant improvement in all patients. Better results were obtained when complete removal of the calcifications was achieved. On radiographic examination, performed two months after surgery, no calcification deposit increased in size and no translucent deposit changed into a dense deposit. Most of the dense deposits, partially removed, changed into translucent deposits. In this series, we found arthroscopic management was effective in treating calcific tendinopathy.

  15. 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.

  16. 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.

  17. 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 ...

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

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    Tae-Soo Park

    2016-01-01

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

  19. Prevention study of wound infections after knee arthroscopy%膝关节镜术后切口感染的预防研究

    Institute of Scientific and Technical Information of China (English)

    杨光辉; 杨太明; 孔祥如

    2015-01-01

    目的:探讨膝关节镜术后切口感染的原因及护理预防方法,从而降低患者切口感染率。方法选取2009年5月-2012年12月接受膝关节镜术的骨性关节炎患者122例,患者治疗期间进行严格的消毒管理,主要包括对手术医务人员手、治疗使用的医疗设备、手术间空气进行消毒,手术操作前后加强关节镜手术器械的病原菌检测,分析感染患者临床资料,对围手术期影响感染发生的相关因素进行归纳分析。结果122例患者手术后1~7d发生感染8例,感染率为6.5%;感染患者围手术期的手术时间、术中扎止血带的时间等显著高于未感染患者,差异有统计学意义(P<0.05);对手术操作器械、医务人员手及物体表面细菌进行监测,其中手术器械细菌监测合格率达100.0%。结论在膝关节镜术的前后,采取有效的护理和感染预防措施,可显著降低切口感染率,预防切口感染尤其要做好消毒处理工作,注意术中皮肤切口的防护处理,严格按照规定流程进行操作,加强无菌技术操作是预防切口感染的关键。%OBJECTIVE To investigate the causes and methods of prevention of wound infections after arthroscopic knee surgery so as to reduce the infection rate .METHODS From May 2009 to Dec .2012 ,totally 122 cases of patients with osteoarthritis who had received arthroscopic knee surgery were collected .Strict disinfection was con‐ducted during the therapy ,including the disinfection of the hands of medical staff ,the medical equipments that had been used and the air in operation room .The pathogens of the operation equipment were detected carefully .The clinic data and infection related factors were analyzed and concluded .RESULTS Totally 8 cases were found to be infected 1 to 7 days after surgery with the infection rate of 6 .5% .The operation times ,tourniquet bonding time during perioperative period of the

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Mohsen Mrdani Kivi

    2013-09-01

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

  2. Runner's Knee

    Science.gov (United States)

    ... Over the summer he bought a pair of running shoes and took up jogging. He started with ... bending the knee — when walking, kneeling, squatting, or running, for example. Walking or running downhill or even ...

  3. Decreased range of motion following arthroscopic remplissage.

    Science.gov (United States)

    Deutsch, Allen A; Kroll, Derek G

    2008-05-01

    The Hill-Sachs lesion is an impression fracture of the posterolateral margin of the humeral head that commonly results from impaction with the anterior glenoid rim during subluxation or dislocation of the shoulder. This bony defect has been implicated as an etiology of recurrent instability of the shoulder. The "remplissage" technique described by Wolf is an arthroscopic method of filling the Hill-Sachs defect via infraspinatus tenodesis and posterior capsulodesis. The purpose of this technique is to prevent recurrent instability by making the Hill-Sachs lesion extra-articular thereby eliminating engagement of the defect with the anterior glenoid rim. In addition, the infraspinatus tenodesis acts as a checkrein by preventing anterior translation of the humeral head. We report a complication of this recently described technique. A 28-year-old man who failed conservative management underwent an arthroscopic Bankart repair with a concomitant remplissage procedure. Two years postoperatively, the patient continued to struggle with the loss of external rotation. Conservative management with physical therapy and range of motion exercises failed. The patient was treated with an arthroscopic release of the tenodesed infraspinatus, which improved external rotation by 202 in circle intraoperatively. At 6 months postoperatively, the patient has maintained a significant increase external rotation. We hypothesize that the loss in external rotation occurred as a result of the tenodesis of the infraspinatus and posterior capsule into the Hill-Sachs defect. The tenodesed cuff and capsular tissue acted as a mechanical block to external rotation of the shoulder.

  4. 关节镜下异体肌腱修复重建前后交叉韧带断裂的临床观察%Clinical Observation of Arthroscopic Reconstruction of Anterior Cruciate Ligament Rupture with Tendon Allograft

    Institute of Scientific and Technical Information of China (English)

    孙强; 才林; 艾光禹

    2016-01-01

    目的:探讨关节镜下异体肌腱修复重建前后交叉韧带断裂的临床效果。方法选取我院2013年9月-2014年9月经影像学、临床诊断为前后交叉韧带断裂患者18例,均采用深低温冷冻同种异体腱于关节镜下同期重建前后交叉韧带。记录Lachman试验、Lysholm评分结果进行治疗效果的评定。结果术后切口均I期愈合,术前存在的症状、阳性体征基本消失,患膝稳定性正常。其中Lachman试验测试均为阴性或I度阳性。关节活动度:17例达0°-130°,仅有1例0°-120°,手术前后的Lysholm、IKDC评分对比具有统计学意义(P<0.05)。结论关节镜下采用异体肌腱修复重建前后交叉韧带断裂能够恢复膝关节的稳定性及功能,疗效显著,值得临床推广应用。%Objective To investigate the clinical effect of arthroscopic reconstruction of anterior cruciate ligament.Methods 9 cases of -2014 in our hospital from September 2013 to 18 were diagnosed as anterior and anterior cruciate ligament rupture. The anterior and anterior cruciate ligaments were reconstructed with the same time of deep hypothermia and frozen allograft. Evaluation of therapeutic effect of Lachman test and Lysholm score.Results All the incisions healed by I, the symptoms and positive signs of the patients were disappeared, and the stability of the knee was normal. The Lachman test was negative or I positive. Joint mobility: 17 cases reached 0 degrees-130 degrees, only 0 cases of 1 degrees -120 degrees, Lysholm, IKDC before and after surgery, score compared with statistical significance (P<0.05).Conclusion Arthroscopic reconstruction of anterior cruciate ligament with allograft tendon repair can restore the stability and function of the knee joint, and the effect is remarkable. It is worth to be popularized.

  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. Septic arthritis of the knee following anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Matjaz Sajovic

    2009-04-01

    Full Text Available Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament reconstruction, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. From a consecutive case series of 1,283 patients who underwent arthroscopic anterior cruciate ligament reconstruction between January 1997 and May 2008, we report on 3 patients (0.23% with post-operative septic arthritis. All patients had acute infection (≤ 2 weeks, bacterial cultures showed Staphylococcus species in 2 patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side differences averaged 13 mm. Their performance in the single-legged hop test gave excellent results. The goals of treatment for septic arthritis after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.

  7. Prospective Randomized Trial of the Efficacy of Continuous Passive Motion Post Total Knee Arthroplasty: Experience of the Hospital for Special Surgery.

    Science.gov (United States)

    Joshi, Rupali N; White, Peter B; Murray-Weir, Mary; Alexiades, Michael M; Sculco, Thomas P; Ranawat, Amar S

    2015-12-01

    Conflicting evidence has created substantial controversy regarding the use of continuous passive motion (CPM) in the in-patient setting post total knee arthroplasty (TKA). A total of 109 patients were randomly assigned to two groups, CPM or no CPM, applied after TKA. All patients received the same physical therapy protocol (3 sessions per day), with the only exception being the CPM. Both groups had a knee flexion of 115° at 6 weeks and 120° at 3 months, with no significant differences (P=0.69 and P=0.41, respectively). Length of stay was significantly less for the group who did not receive CPM. The use of CPM had no clinically relevant benefits with respect to AROM, clinical outcomes or discharge disposition and was associated with a cost of $235.50 per TKA.

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

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    Rachel M. Frank

    2013-01-01

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

  9. Effects of Low-intensity Pulsed Ultrasound and Cryotherapy on Recovery of Joint Function and C-reactive Protein Levels in Patients after Total Knee Replacement Surgery.

    Science.gov (United States)

    Kang, Jeong Il; Kim, Yong-Nam; Choi, Hyun

    2014-07-01

    [Purpose] We investigated the effect of low-intensity pulsed ultrasound and cryotherapy on joint function recovery and C-reactive protein (CRP) levels of patients with total knee replacement. [Subjects] Forty-six patients with total knee replacement were recruited and allocated to either low-intensity pulsed ultrasound therapy (n=15), cryotherapy (n=15), or a combination of both (n=16). Therapy was administered once a day, 5 times a week for 3 weeks. To determine functional joint recovery and reduction of inflammation, changes in the Korean Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), range of motion (ROM), and CRP were assessed postsurgically and four times over a 3-week period. Using one-way analysis of variance (ANOVA), homogeneity tests were performed based on participants' general characteristics. To recognize changes in time-variant K-WOMAC, ROM, and CRP values between groups, repeated measures ANOVA was performed, and Tukey's test was used for post-test analysis. Values at α=0.05 were considered significant. [Results] We found a difference between groups and times, and the group that received the combined therapies showed greater changes in outcomes than the group that received low-intensity pulsed ultrasound therapy alone. [Conclusion] Applying both low-intensity pulsed ultrasound and cryotherapy can relieve inflammation and enhance joint function in patients who undergo total knee replacement.

  10. Simultaneous bilateral septic arthritis of the knee after intraarticular steroid injection: A clinical report.

    Science.gov (United States)

    Munigangaiah, Sudarshan; O'Sullivan, Theresa A; Lenehan, Brian

    2014-07-01

    Osteoarthritis of knee is one of the common problems in elderly population. Intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee. Septic arthritis is an infective complication of intraarticular corticosteroid injection. Septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis. A higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients. We would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient. Patient was treated successfully with multiple bilateral knee arthroscopic washouts and long-term intravenous antibiotics. This case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection. Patient should be aware of this increased risk of infection.

  11. 微创与传统膝关节置换术失血量比较%Comparative study of blood loss in minimally invasive surgery and conventional total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    王志强; 黄伟; 梁熙; 胡宁; 徐伟; 林良波; 符纯峰; 程强

    2013-01-01

    目的 比较微创全膝关节置换术(minimally invasive surgery total knee arthroplasty,MIS-TKA)与传统全膝关节置换术(conventional total knee arthroplasty,C-TKA)围术期失血量的差异. 方法 回顾性分析2009年1月-2012年1月收治的84例单侧TKA患者围术期失血量,按手术方式分为微创组(42例)和传统组(42例),计算围术期失血量(显性失血量+隐性失血量),对两组患者的失血量和输血量进行比较. 结果 传统组围术期失血量为(1 466±493)ml,输血量为(223±208)ml;微创组围术期失血量为(1 379±475) ml,输血量为(257±239) ml(P>0.05). 结论 MIS-TKA不能减少围术期失血量.%Objective To compare difference of perioperative blood loss between minimally invasive surgery total knee arthroplasty (MIS-TKA) and conventional TKA (C-TKA).Methods A retrospective study was conducted on perioperative bleeding volume in 84 patients undergone unilateral TKA from January 2009 to January 2012.The patients were divided to minimally invasive group (42 patients) and conventional group (42 patients),according to surgical approaches.Perioperative blood loss (evident + occult hemorrhage) was calculated.Blood loss and blood requirement in the two groups were analyzed and compared as well.Results Mean blood loss was (1 466 ± 493) ml in the conventional group and (1 379 ± 475) ml in the minimally invasive group (P > 0.05).Moreover,mean blood requirement in the two groups was (223 ± 208) ml and (257 ± 239) ml respectively (P > 0.05).Conclusion MIS-TKA can not reduce perioperative blood loss.

  12. 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...

  13. The clinical effect analysis of arthroscopic therapy for patellar instability%关节镜下治疗髌骨不稳定的疗效分析

    Institute of Scientific and Technical Information of China (English)

    焦翔; 张雪松; 李明; 王同富; 张艳

    2015-01-01

    Objective To compare and analyze the clinical efficacy for patellar instability of modified Maquet triple and econstructing medial patellofemoral ligament with hamstring tendon autografts assisted by arthroscopic surgery. Methods A retrospective analysis was held in our hospital. We selected 90 hospitalized patients of patellar instability from January 2009 to December 2012. Patients in the experimental group took the arthroscopic assisted econstructing medial patellofemoral ligament with hamstring tendon autografts. While patients in the control group took the improved Maquet triple. We compared lateral patellofemoral angle, patella and patellar suitable degree angle outward of two groups of patients before and after the operation. While for all patients after a 12 months follow-up, we compared Lysholm score (Lysholm knee score scale, LKSS) and Kujala score of two groups of patients. We also reviewed knee and lateral flexion 60° X-ray film in the two groups of patients. Results Postoperative lateral patellar angle was significantly greater than that before surgery, while patella and patellar degree angle suitable for relocation were significantly less than those before operation, P<0.01. Lateral patellar angle, the patella and patellar suitable degree angle outward in the experimental group were much improved than those of the control group, P <0.01. The Lysholm score and Kujala scores after the surgery were significantly higher than those before surgery, P<0.01, and two scores in the experimental group after 12 months were significantly higher, P <0.01. Conclusion The arthroscopic assisted econstructing medial patellofemoral ligament with hamstring tendon autografts reconstruction has a better curative effect in the treatment of patellar instability compared with traditional open operation. It can also effectively prevent recurrence, which is worthy of further promotion.%目的 对比分析改良Maquet三联手术与关节镜辅助下自体腘绳肌腱重建内

  14. 关节镜下治疗骨性膝关节炎56例临床分析%Clinical analysis of arthroscopic treatment of 56 cases with osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    梁现会; 尚志平

    2015-01-01

    Objective:To investigate the clinical effect of arthroscopic treatment on osteoarthritis.Methods:56 cases with osteoarthritis were treated with arthroscopically assisted meniscus repair,synovial hyperplasia,cartilage resection of loose bodies and broken extraction,the removal of osteophytes and lateral retinacular release,postoperative joint Chinese herbal fumigation.Results: According to the evaluation standard of curative effect,among the 62 knees in the group,21 knees were cured excellent,24 knees satisfactory,11 knees acceptable,6 knees poor recovered and the total effective rate was 90.3%.Conclusion:Arthroscopic treatment of knee osteoarthritis has significant curative effect with small trauma and low cost which is an effective method for the treatment of knee osteoarthritis.%目的:探讨关节镜下治疗膝骨性关节炎的临床疗效。方法:对56例骨性膝关节炎采用关节镜下半月板修复、增生滑膜切除、游离体及破碎软骨摘除、切除部分骨赘及外侧支持带松解、术后关节中药熏洗等方法。结果:根据疗效评价标准评价疗效,本组共62个膝,优21个,良24个,可11个,差6个,总有效率90.3%。结论:关节镜下治疗骨性膝关节炎疗效肯定,创伤小,费用低,是治疗膝骨性关节炎的有效方法。

  15. Use of platelet-rich plasma for bioplastic processes stimulation after arthroscopic reconstruction of anterior cruciate ligament (review

    Directory of Open Access Journals (Sweden)

    A. V. Rybin

    2015-01-01

    Full Text Available Based on the analysis of the scientific publications, the authors analyzed the possibilities and effectiveness of platelet- rich plasma (PRP application as a stimulator of engraftment and biological transformation of tendinous autografts and allografts after arthroscopic reconstruction of knee anterior cruciate ligament. The topic of impossibility of spontaneous recovery of torn anterior cruciate ligament of knee, and describe the staging of biological incorporation of tendinous transplant in a bone wall was discussed. The authors presented methods and techniques of accelerating engraftment of free tendinous graft into bone channels described in the literature and the difference of terms of remodeling the autografts and allografts. The effect of different techniques of sterilization and preservation of tendinous allografts on the change of their biological properties was disclosed.

  16. Replacement of the anterior cruciate ligament of the knee with deep frozen bone-tendon-bone allografts.

    Science.gov (United States)

    Than, P; Bálint, L; Domán, I; Szabó, G

    1999-01-01

    Surgical treatment of the torn anterior cruciate ligament (ACL) and consequent knee instability showed great development over the last decade. Arthroscopic techniques and the use of different allogenic tissues became a routine. Between 1995 and 1998, 31 knees in 30 patients underwent ACL reconstruction of the knee with fresh-frozen allografts at the Department of Orthopedics, Medical University of Pécs, Hungary. The operations were performed with arthroscopic technique. This paper retrospectively assesses the outcomes with an average follow up of 28 months, which showed good results in most of the cases. The authors reviewed the literature emphasizing advantages and disadvantages of the method with special interest to possible complications resulting from the use of allografts: graft rejection, graft re-rupture, transmission of infection and synovitis evoked by immune response.

  17. Physiotherapy after subacromial decompression surgery

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Falla, Deborah; Frost, Poul

    2015-01-01

    This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

  18. 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

  19. Improvements in knee biomechanics during walking are associated with increased physical activity after total knee arthroplasty.

    Science.gov (United States)

    Arnold, John B; Mackintosh, Shylie; Olds, Timothy S; Jones, Sara; Thewlis, Dominic

    2015-12-01

    Total knee arthroplasty (TKA) in people with knee osteoarthritis increases knee-specific and general physical function, but it has not been established if there is a relationship between changes in these elements of functional ability. This study investigated changes and relationships between knee biomechanics during walking, physical activity, and use of time after TKA. Fifteen people awaiting TKA underwent 3D gait analysis before and six months after surgery. Physical activity and use of time were determined in free-living conditions from a high resolution 24-h activity recall. After surgery, participants displayed significant improvements in sagittal plane knee biomechanics and improved their physical activity profiles, standing for 105 more minutes (p=0.001) and performing 64 min more inside chores on average per day (p=0.008). Changes in sagittal plane knee range of motion (ROM) and peak knee flexion positively correlated with changes in total daily energy expenditure, time spent undertaking moderate to vigorous physical activity, inside chores and passive transport (r=0.52-0.66, p=0.005-0.047). Restoration of knee function occurs in parallel and is associated with improvements in physical activity and use of time after TKA. Increased functional knee ROM is required to support improvements in total and context specific physical activity.

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

    Science.gov (United States)

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

    2013-09-01

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

  1. 初次全膝关节置换术后并发症及翻修手术的原因分析%Postoperative complications and revision surgery following primary total knee arthroplasty after midterm follow-up

    Institute of Scientific and Technical Information of China (English)

    冯宾; 翁习生; 林进; 金今; 钱文伟; 邱贵兴; 王炜

    2015-01-01

    目的 探讨初次全膝关节置换术后30 d内相关并发症发生情况及翻修手术的相关因素.方法 收集2001年1月至2012年12月在北京协和医院骨科进行初次全膝关节置换术患者的临床资料,假体均为固定平台假体,采用骨水泥固定,排除翻修病例及血友病关节炎患者.共有1 920例患者(2 779例次全膝关节置换手术)纳入研究,男性323例,女性1 607例;年龄25~86岁,平均(66±9)岁.骨关节炎1 720例(89.58%),类风湿关节炎168例(8.75%),强直性脊柱炎12例(0.63%),继发骨关节炎20例(1.04%).随访患者术后30 d内发生的主要系统并发症、局部并发症及发生的翻修手术及相关因素.结果 随访截至2013年12月,共有1 854例患者(2 693个关节)获得随访,失访率为3.44%.术后平均随访67个月,死亡3例.41例(2.21%)患者出现系统并发症,其中最常见的为呼吸系统并发症(0.49%,9/1 854)及心血管并发症(0.38%,7/1 854).术后经超声证实的症状性深静脉血栓形成发生率为3.02% (56/1 854),其中7例发生肺栓塞.术后发生局部并发症24例(1.29%),包括伤口愈合不良、伤口感染、神经损伤.59个关节接受翻修手术治疗,常见原因包括感染后松动(1.19%,32/2 693)和术后关节僵硬(0.37%,10/2693).结论 初次全膝关节置换术后30 d内最常见系统并发症为呼吸系统及心血管系统并发症.感染后松动是术后翻修最常见的原因.%Objective To determine the postoperative complications of primary total knee arthroplasty (TKA) within 30 postoperative days,and the different causes for revision surgery during follow-up.Methods Between January 2001 and December 2012,a total of 1 920 patients underwent 2 779 primary TKA with fixed bearing platform in Peking Union Medical College Hospital,with 323 for male and 1 607 for female.The revision surgery at index time and the hemophiliac arthropathy were excluded for this study.The average age was (66 ± 9

  2. 关节镜下双束及单束单隧道重建膝前交叉韧带的中期疗效观察%Curative effect observation on arthroscopic single-tunnel double-bundle and single-bundle anterior cuciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    杜庆钧; 宋洋; 黄明光

    2014-01-01

    目的:观察使用同种异体肌腱进行关节镜下前交叉韧带(anterior cruciate ligament, ACL)损伤后双束单隧道重建中期疗效。方法通过对2006年3月~2012年3月进行随访的100例应用双束单隧道重建关节镜下前交叉韧带病例(100个膝关节)。所有患者术前及随访时均进行IKDC2000、Tegner和Lyrsholm评分评价比较手术前后膝关节功能,并对结果进行统计学分析。结果随访时患者的IKDC2000、Tegner和Lyrsholm评分较治疗前均明显提高,差异具有统计学意义(P<0.05)。结论膝前交叉韧带胫骨端双束单隧道重建较目前临床应用较广泛的单束单隧道重建可以更好地重建膝关节的稳定性,手术操作简便,最大限度恢复解剖重建,近期、中期疗效佳,远期效果有待进一步观察。%Objective To investigate the efficacy of allergenic tendon in arthroscopic single-tunnel double-bundle reconstruction after anterior cruciate ligament (ACL). Methods From March 2006 to March 2012 follow-up of 100 cases in single tunnel double-bundle anterior curiae ligament reconstruction arthroscopic patients (100 knees) were carried out and follow-up all patients IKDC2000, and Lysol Tiger score evaluation before and after surgery knee function comparison, and the results were analyzed statistically. Results IKDC2000 patients at follow-up, Tiger and Lysol score before treatment were significantly improved, with a significant difference (P<0.05), with a description of statistical significance. Conclusion The anterior cruciate ligament tibia tunnel double-bundle reconstruction of a single clinical applications can be wider than the current single-bundle reconstruction of single-tunnel reconstruction to better stability of the knee, the operation is simple. It can maximize the recovery anatomical reconstruction and medium effect good, but long-term effect still remains to be seen .

  3. Knee flexion deformity and patella alta in spastic cerebral palsy.

    Science.gov (United States)

    Lotman, D B

    1976-06-01

    A study on spastic knee flexion deformity has revealed a recurrence rate of 32 per cent following attempted surgical correction on 170 knees (103 patients). This rate appeared to be unrelated to concomitant surgery for correction of hip and ankle deformity. An additional study demonstrated patella alta in 72 per cent of 100 spastic knees (50 patients) and only 2 per cent and 50 knees of a comparable group of 25 non-spastic patients. It is suggested that restoration of a normal patello-femoral relationship may reduce both the functional disability and recurrence rate of spastic knee flexion deformity when this disease is managed surgically.

  4. 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.

  5. The effectiveness of posterior knee capsulotomies and knee extension osteotomies in crouched gait in children with cerebral palsy.

    Science.gov (United States)

    Taylor, Daveda; Connor, Justin; Church, Chris; Lennon, Nancy; Henley, John; Niiler, Tim; Miller, Freeman

    2016-11-01

    Crouched gait is common in children with cerebral palsy (CP), and there are various treatment options. This study evaluated the effectiveness of single-event multilevel surgery including posterior knee capsulotomy or distal femoral extension osteotomy to correct knee flexion contracture in children with CP. Gait analyses were carried out to evaluate gait preoperatively and postoperatively. Significant improvements were found in physical examination and kinematic measures, which showed that children with CP and crouched gait who develop knee flexion contractures can be treated effectively using single-event multilevel surgery including a posterior knee capsulotomy or distal femoral extension osteotomy.

  6. 快速康复外科理念在初次行人工全膝关节置换术围术期临床应用%Application of fast-track surgery concept around perioperative total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    何勇; 刘欣伟; 张敬东; 孙保飞; 韩文锋; 刘松波; 刘海立

    2016-01-01

    目的:探讨快速康复外科理念在初次行人工全膝关节置换术( TKA)围术期的临床应用效果。方法选取自2015年7月1日至2015年12月31日沈阳军区总医院骨科初次行人工TKA的60例患者,随机分为快速康复组和传统康复组,每组各30例患者。记录两组患者住院时间、住院费用、以及围术期并发症情况。采用疼痛视觉模拟评分( VAS)评估两组患者的疼痛程度,关节活动度( ROM)评估临床疗效。结果快速康复组住院时间短于传统康复组,差异有统计学意义(P<0.05);手术疗效优于传统康复组,差异有统计学意义(P<0.05);两组住院费用比较,差异无统计学意义( P>0.05)。结论将快速康复外科理念应用于初次行人工TKA围术期,能够加速患者早期康复,缩短患者平均住院时间,降低围术期不良反应的发生率,提高了临床疗效。%Objective To explore the clinical efficacy of the fast-track surgery concept around perioperative total knee ar-throplasty .Methods A retrospective study was performed on 60 cases of patients that received first artificial total knee ar-throplasty in the General Hospital of Shenyang Military Command from July 1 to December 31 ,2015 .Patients were randomly divided into the fast-track surgery group and the traditional rehabilitation group ,with 30 cases in each group .The length of stay,hospital costs and perioperative complications were recorded .Using visual analogue scale ( VAS) to assess the level of pain between the two groups and range of motion ( ROM) to assess the clinical efficacy .Results The hospitalized time in fast-track surgery group was significantly shorter than that in the traditional rehabilitation group ( P0.05 ) .Conclusion The appli-cation of fast-track surgery around perioperative total knee arthroplasty can be beneficial to patients with fast early rehabili -tation,reduce hospitalization time and improve

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

    Science.gov (United States)

    Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

    2016-02-01

    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 and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field.

  8. The Effect of Unilateral Spinal Anaesthesia and Psoas Compartment with Sciatic Block on the Postoperative Pain Management in Total Knee Artroplastic Surgery

    Directory of Open Access Journals (Sweden)

    Ebru Canakci

    2017-01-01

    Full Text Available Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group. The decrease observed in the 5th, 10th, and 20th minute MAP values in the USA group was statistically significant according to the control MAP value. Concerning within group comparisons, the decrease in 5th, 10th, and 20th minute heart rate values in the USA group was statistically significant compared with the control measurement value. The mean beginning time of sensory and motor blocks in the PCS group was found to be at a significantly advanced level compared with that in the USA group. Conclusions. The PCS block technique using bupivacaine hydrochloride ensured a higher haemodynamic efficiency in the perioperative period in high-risk elderly patients undergoing total knee arthroplasty. This trial is registered with ClinicalTrials.gov Identifier: NCT03021421.

  9. The Effect of Unilateral Spinal Anaesthesia and Psoas Compartment with Sciatic Block on the Postoperative Pain Management in Total Knee Artroplastic Surgery

    Science.gov (United States)

    Unal, Dogus; Guzel, Yunus

    2017-01-01

    Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group. The decrease observed in the 5th, 10th, and 20th minute MAP values in the USA group was statistically significant according to the control MAP value. Concerning within group comparisons, the decrease in 5th, 10th, and 20th minute heart rate values in the USA group was statistically significant compared with the control measurement value. The mean beginning time of sensory and motor blocks in the PCS group was found to be at a significantly advanced level compared with that in the USA group. Conclusions. The PCS block technique using bupivacaine hydrochloride ensured a higher haemodynamic efficiency in the perioperative period in high-risk elderly patients undergoing total knee arthroplasty. This trial is registered with ClinicalTrials.gov Identifier: NCT03021421. PMID:28255259

  10. Arthroscopic suture bridge technique for intratendinous tear of rotator cuff in chronically painful calcific tendinitis of the shoulder.

    Science.gov (United States)

    Ji, Jong-Hun; Shafi, Mohamed; Moon, Chang-Yun; Park, Sang-Eun; Kim, Yeon-Jun; Kim, Sung-Eun

    2013-11-01

    Arthroscopic removal, now the main treatment option, has almost replaced open surgery for treatment of resistant calcific tendinitis. In some cases of chronic calcific tendinitis of the shoulder, the calcific materials are hard and adherent to the tendon. Removal of these materials can cause significant intratendinous tears between the superficial and deep layers of the degenerated rotator cuff. Thus far, there are no established surgical techniques for removing the calcific materials while ensuring cuff integrity. Good clinical results for rotator cuff repair were achieved by using an arthroscopic suture bridge technique in patients with long-standing calcific tendinitis. Intact rotator cuff integrity and recovery of signal change on follow-up magnetic resonance imaging scans were confirmed. This is a technical note about a surgical technique and its clinical results with a review of relevant published reports.

  11. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique

    Science.gov (United States)

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

    2016-01-01

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

  12. Lower limb fractures associated with multiligament knee injury

    Science.gov (United States)

    Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

  13. 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

  14. 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;

    2008-01-01

    with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol...... for at 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...

  15. 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

  16. Analysis of the unicompartmental knee arthroplasty results

    Directory of Open Access Journals (Sweden)

    S. A. Firsov

    2015-01-01

    Full Text Available In 2012-2014 total 67 unicompartmental arthroplasty surgeries with use of Oxford knee meniscal bearing were performed. The surgeries were performed by a single surgeon. Minimally invasive approach was used. All patients were evaluated clinically, radiographically and with Oxford Knee score scale, Knee Society score scale and functional scale. Obtained data was processed with nonparametric Mann-Whitney-Wilcoxon test. Results were processed using the statistical analysis application package SPSS, version 10.07. Analysis of of mid-term results showed that the average for Oxford Knee score increased from 16.4 (95% CI 9-23 to 41.3 (95% CI 29-47. Average for Knee Society score scale increased from 42.7 (95% CI 31-55 to 88.6 (95% CI 73-100. No occurrence of early postoperative complications have been reported. Statistically significant improvements of knee function in patients after unicompartmental arthroplasty have been observed. Unicompartmental arthroplasty currently can be considered as an advanced treatment option for medial knee joint pathology. Meniscal bearing cemented prostheses such as Oxford III are preferable.

  17. A systematic literature review of the cost-effectiveness of erythropoietin in orthopedic surgery : There is a need for differentiation between total hip and knee arthroplasty

    NARCIS (Netherlands)

    Degener, F.; Postma, M.J.

    2015-01-01

    OBJECTIVES: Erythropoietin has been widely adapted into clinical practice in orthopedic surgery to prevent anemia and ultimately lower the use of allogeneic blood transfusions. Its safety and efficacy has been shown in various randomized clinical trials. Questions regarding the cost-effectiveness of

  18. 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.

  19. Arthroscopic Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in 16 Cases%关节镜下治疗前交叉韧带下止点撕脱骨折16例

    Institute of Scientific and Technical Information of China (English)

    俞胜宝; 胡四生; 汪炜; 凌健

    2011-01-01

    Objective To observe the surgical skill and the clinical outcomes of arthroscopic treatment of anterior cruciate ligament(ACL) tibial avulsion fracture. Methods From January 2007 to December 2010,16 cases of avulsion fracture of intercondylar eminence( according to Meyers and Mckeever classification, type Ⅰ 1 case, type Ⅱ 13 cases, type Ⅲ 3 cases) received the arthroscopic treatment. The surgical approach was both sides of the patellar ligament, the fracture reduction was performed under arthroscopy,and then the Kirschner wire was inserted from a point medial to the tibial tubercle to hold the intraarticular fracture fragments. The epidural tube was first penetrated through the Kirschner wire hole,and then the guiding tension suture( No. 2 polyethylene line, diameter was 0.5 - 0.7 mm) was penetrated through the epidural tube to fix the bone block. Results Sixteen patients were followed up for 2 to 36 months,14 cases were healed in 12 weeks,other 2 cases in 18 weeks. 14 cases(87.5% ) recovered completely with a good joint stability and negative drawer test; other 2 cases gained a good functional recovery with a good joint stability but positive drawer test. Conclusion Arthroscopic surgery,with a small incision,simple operation,less postoperafive injury,secure internal fixation, is an effective method for the ACL tibial avulsion fracture. The early functional exercise of knee joint should improve the recovery of knee.%目的 观察关节镜下微创治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术方法及疗效.方法 2007年1月-2010年12月,关节镜下治疗ACL下止点撕脱骨折16例,其中按meyem-meckeever分型1型1例,2型13例,3型2例.常规膝关节髌韧带两侧入路进入关节腔,镜下骨折复位,然后自胫骨结节内侧钻入克氏针,达骨折块,自克氏针孔穿入硬膜外麻醉套管,直径0.5~0.7 mm钢丝导引张力缝线(2号聚乙烯线)经硬膜外麻醉套管穿入固定骨折块.结果 术后16例经2~36

  20. Gait and postural control after total knee arthroplasty

    OpenAIRE

    Bjerke, Joakim

    2014-01-01

    The aim of the thesis was to investigate deficits and compensatory strategies after total knee arthroplasty (TKA) in different conditions during gait and quiet standing. Although TKA is considered the gold standard treatment for end-stage knee osteoarthritis, it is associated with a number of implications. Reduced physical function after osteoarthritis is partly, but apparently not fully, remedied by surgery. The two most common deficits are reduced knee muscle strength and limited range of k...

  1. In Vivo Quantitative Ultrasound Image Analysis of Femoral Subchondral Bone in Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Jana Podlipská

    2013-01-01

    Full Text Available A potential of quantitative noninvasive knee ultrasonography (US for detecting changes in femoral subchondral bone related to knee osteoarthritis (OA was investigated. Thirty-nine patients referred to a knee arthroscopy underwent dynamic noninvasive US examination of the knee joint. The subchondral bone was semiautomatically segmented from representative US images of femoral medial and lateral condyles and intercondylar notch area. Subsequently, the normalized mean gray-level intensity profile, starting from the cartilage-bone interface and extending to the subchondral bone depth of ~1.7 mm, was calculated. The obtained profile was divided into 5 depth levels and the mean of each level, as well as the slope of the profile within the first two levels, was calculated. The US quantitative data were compared with the arthroscopic Noyes’ grading and radiographic Kellgren-Lawrence (K-L grading. Qualitatively, an increase in relative subchondral bone US gray-level values was observed as OA progressed. Statistically significant correlations were observed between normalized US mean intensity or intensity slope especially in subchondral bone depth level 2 and K-L grading (r=0.600, P<0.001; r=0.486, P=0.006, resp. or femoral arthroscopic scoring (r=0.332, P=0.039; r=0.335, P=0.037, resp.. This novel quantitative noninvasive US analysis technique is promising for detection of femoral subchondral bone changes in knee OA.

  2. 关节镜联合髌上囊小切口滑膜切除术治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎的疗效分析%Therapeutic effect of synovectomy by arthroscope combined with small incision on suprapatellar bursa for diffuse pigmented villonodular synovitis of knee

    Institute of Scientific and Technical Information of China (English)

    张紫机; 方淑莺; 康焱; 杨子波; 赵潇艺; 何爱珊; 傅明; 廖威明; 张志奇

    2014-01-01

    Objective To investigate the effectiveness of arthroscopy and/or arthrotomy combined with small incision at the suprapatellar bursa in the treatment for diffuse pigmented villonodular synovitis ( PVNS) of the knee.Methods Thirty-two patients with diffuse PVNS of the knee treated between Jan 2006 and Dec 2012 were retrospectively identified. All of these patients were treated by the knee arthroscopy with a small incision at the suprapatellar bursa for synovectomy.The patient demographics, treatment profiles, recurrence rates, complication and progression were recorded.The minimum follow-up time was seven months (median, 49.8 months; range, 7-141 months).Results The recurrence rate was 6.3%after the knee arthroscopy with the small incision in the suprapatellar bursa for synovectomy. Fifty percent of these patients had no pain or swelling, and the arthritic progression occurred in 11.1%of the total within the follow-up period.The most common complication was hemarthrosis (3%of the total), but there was no detectable effect on the recovery.The KSS score of the knee and the function score were (62.7 ±17.7 ) and ( 45.0 ±24.0 ) respectively, and the Lysholm score was ( 64.7 ±15.0 ), preoperatively;the KSS score of the knee and the function score were (85.2 ±10.9) (t=4.456, P<0.001) and (79.5 ±12.3) (t=5.279, P<0.001), and the Lysholm score was (83.2 ±8.4) (t =4.451, P<0.001) in the follow-up period.Conclusion Compared with the literature, the arthroscopy with local incision in the suprapatellar bursa for synovectomy is a viable, comprehensive approach for the diffuse PVNS of the knee and provides both low recurrence rates and complication rates.%目的:探讨应用关节镜结合髌上囊小切口切开滑膜切除治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎( PVNS)患者的疗效。方法本组对2006年1月至2011年12月因膝关节弥漫型PVNS的32例患者进行回顾性分析,该组患者全部采用膝关节镜结合髌上囊局部

  3. Water on the Knee

    Science.gov (United States)

    ... your knee joint. Some people call this condition "water on the knee." A swollen knee may be ... Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don't place continuous weight- ...

  4. Preventing Knee Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

  5. Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Chris Ironside

    2014-12-01

    Full Text Available Introduction: Unicompartmental knee arthroplasty (UKA can be used to treat medial compartment osteoarthritis of the knee. Some of these knees will eventually fail, and need to be revised. There is controversy about using UKA in younger patients as a definitive procedure or as a means to delay total knee arthroplasty (TKA because the outcomes of subsequent revision surgery may be inferior to a primary TKA. Methods: We retrospectively reviewed a series of 46 revision TKA patients following failed UKA (UKA revisions using functional outcomes questionnaires and compared the results with a cohort of age and gender matched primary TKA patients. Our hypothesis was that UKA revision surgery would be inferior to primary TKA surgery. Results: Data was collected on 33 knees after a mean follow-up period of five years. There was no significant difference in the Oxford Knee Score (33.7 vs 37.1, p = 0.09 or the Western Ontario and MacMasters Universities Arthritis Index (WOMAC (24.8 vs. 19.1, p = 0.22. A subgroup analysis demonstrated that UKAs, which fail early, are more likely to produce an inferior outcome following revision surgery than those that survive more than five years. Discussion: We conclude that UKA can be used effectively in appropriately selected patients, as the functional outcome of their subsequent revision to TKA is not significantly inferior to a primary TKA.

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

    Science.gov (United States)

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

    2016-04-01

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

  7. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes.

  8. Microfracture for treatment of knee cartilage defects in children and adolescents

    DEFF Research Database (Denmark)

    Salzmann, Gian M; Sah, Bert-Ram; Schmal, Hagen;

    2012-01-01

    Even though operative microfracture is the most frequent method for treatment of limited knee joint cartilage lesions among adults, data about ouctome in children and adolescents are rare. We performed a retrospective chart review and telephone interview to analyze for the clinical outcome...... analysis did not reveal a significant impact of patient or defect characteristics on clinical outcome. Arthroscopic microfracturing for treatment of limited size symptomatic knee joint cartilage defects among children and adolescents is considered a reasonable surgical option. However, long-term outcome...... following knee joint cartilage defect microfracturing among 10 children. Mean postoperative Lysholm was 92.1±9.9 and Tegner was 7.0±1.9. Clinical outcome differed across knee joint regions, as well as in dependence of varying pre-operative symptom duration, although this was not significant. Regression...

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

    Directory of Open Access Journals (Sweden)

    Jake Sloane

    2010-01-01

    Full Text Available 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 cysts are uncommon intra-articular pathological entities, which are usually asymptomatic and diagnosed incidentally by MRI. This is the first reported case of an ACL cyst being so large as to cause a mechanical block to knee flexion.

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

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    John N Trantalis

    2015-01-01

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

  12. Can Achilles tendon be used as a new distal landmark for coronal tibial component alignment in total knee replacement surgery? An observational MRI study

    Directory of Open Access Journals (Sweden)

    Tiftikçi U

    2017-01-01

    Full Text Available Uğur Tiftikçi,1 Sancar Serbest,1 Veysel Burulday2 1Department of Orthopaedics and Traumatology, 2Department of Radiology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey Background: In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. Materials and methods: This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs. After identification of the mechanical axis, the distances of distal landmarks, which were extensor hallucis longus tendon (EHLT, tibialis anterior tendon (TAT, dorsalis pedis artery (DPA, AT, extensor digitorum longus tendon (EDLT, and malleoli, were measured from the mechanical axis and were statistically evaluated. Results: In proximal measurements, the distances of the landmarks to the mechanical axis (on average were AT, 2.64±1.62 mm lateral; EHLT, 3.89±2.45 mm medial; DPA, 4.69±2.39 mm medial; TAT, 8.24±3.60 mm medial; and EDLT, 14.2±4.14 mm lateral (P<0.001. In distal measurements, the distances of the landmarks to the mechanical axis (on average were AT, 1.99±1.24 mm medial; EHLT, 4.27±2.49 mm medial; DPA, 4.79±2.10 mm medial; TAT, 12.9±4.07 mm medial; and EDLT, 12.18±4.17 mm lateral (P<0.001. Conclusion: In this study, the mechanical axis line, which is the center of talus, passes through the AT. Our MRI investigations showed that the AT, EHLT, DPA, and malleolar center (3–5 mm medial may help in correct alignment. Keywords: total knee arthroplasty, tibial component, alignment, distal references, landmark, MRI, Achilles tendon

  13. Arthroscopic Resection Arthroplasty of the Radial Column for SLAC Wrist

    OpenAIRE

    Cobb, Tyson K.; Walden, Anna L.; Wilt, Jessica M.

    2014-01-01

    Background Symptomatic advanced scapholunate advanced collapse (SLAC) wrists are typically treated with extensive open procedures, including but not limited to scaphoidectomy plus four-corner fusion (4CF) and proximal row carpectomy (PRC). Although a minimally invasive arthroscopic option would be desirable, no convincing reports exist in the literature. The purpose of this paper is to describe a new surgical technique and outcomes on 14 patients who underwent arthroscopic resection arthropla...

  14. 膝关节手术后CPM机应用的护理要点分析%Analysis the Nursing Key Points of Application of CPM After Knee Surgery

    Institute of Scientific and Technical Information of China (English)

    陈晨; 夏洪超

    2015-01-01

    Objective Analysis the nursing key points of application of CPM After knee surgery. Methods Selected 82 cases of bone and joint surgery rehabilitation treatment used the CPM machine from 2013 January to 2014 November, the nursing method and effect of theapplication of CPM treatment were retrospectively analyzed and summarized. Results In the 82 cases, excellent in 33 cases, good in 42 cases, 5 cases, 2 cases were poor, the excellent and good rate was 91.5%. Conclusion Patients with CPM treatment to give effective nursing science, and can accelerate bone healing rate, promote the recovery of joint function, to improve the patients quality of life has an important role.%目的:分析和研究膝关节手术后CPM机应用的护理及效果。方法选取2013年1月~2014年11月膝关节术后患者82例,采用CPM机进行康复治疗,将其应用CPM机治疗时护理方法与效果进行回顾性的分析与总结。结果82例患者中:优42例;良33例;可5例;差2例,优良率为91.5%。结论患者采用CPM机治疗时给予科学、有效护理干预,可加速膝关节术后愈合速度,促进膝关节功能恢复,对提高患者生活质量具有重要作用。

  15. Analysis on clinical efficacy of autogenous hamstring tendon for arthro-scopic anterior cruciate ligament (ACL) reconstruction%关节镜下应用自体腘绳肌腱重建前交叉韧带的临床分析

    Institute of Scientific and Technical Information of China (English)

    肖勍; 李清; 顾晓军

    2014-01-01

    目的:探讨关节镜下应用自体腘绳肌腱重建前交叉韧带的临床疗效。方法选取本院收治的60例膝关节前交叉韧带损伤患者,随机均分为对照组和观察组,对照组给予关节镜下异体肌腱前交叉韧带重建术,观察组给予关节镜下自体腘绳肌腱前交叉韧带重建术,术后追踪随访2年,比较两组患者手术前后患肢X线检查、Lysholm评分以及Tegner功能评分的差异。结果两组患者术后Lachman征和旋转移位试验均为阴性,术后X线检查无退行性改变,术后Lysholm评分和Tegner功能评分均显著高于术前(P0.05)。结论关节镜下应用自体腘绳肌腱重建前交叉韧带的疗效确切,与异体肌腱疗效相当,可有效恢复患者的膝关节功能,性价比更高,适合基层医院应用,值得临床推广使用。%Objective To investigate the clinical efficacy of autogenous hamstring tendon for arthroscopic anterior cru-ciate ligament (ACL) reconstruction.Methods 60 cases of front knee cruciate ligament injury in our hospital were ran-domly divided into control group and observation group.The control group were treated with tendon allograft for arthro-scopic ACL reconstruction.The observation group were treated with autogenous hamstring tendon for arthroscopic ACL reconstruction.All patients were followed up for 2 years.The limb X-ray examination,Lysholm score and Tegner function score before and after surgery of two groups were compared. Results The Lachman sign and rotating shift tests of two groups were both negative.X-ray examination postoperative had no degenerative changes.The Lysholm score and Tegner function score postoperative were significantly higher than preoperative (P0.05). Conclusion Autogenous hamstring tendon for arthroscopic ACL reconstruction has exact effect,which was equal to allogeneic tendon.It can effectively restore knee function with more cost-effective for primary hospital.It worthy of clinical

  16. 依达拉奉对老年患者膝关节置换术后认知功能的影响%Effects of edaravone on postoperative cognitive function in elderly patients undergoing knee replacement surgery

    Institute of Scientific and Technical Information of China (English)

    谭宇桔; 徐志鹏; 姜雨鸽; 张宏

    2015-01-01

    目的:观察氧自由基清除剂依达拉奉预处理对老年患者膝关节置换术后认知功能的影响。方法选择2014年5-9月在我院择期全麻下行全膝关节置换术的老年患者90例,年龄60~79岁,ASAⅠ~Ⅱ级,术前简易精神状态检查表(mini-mental state examination,MMSE)评分≥23分,随机分为2组,依达拉奉组(E组)和对照组(C组),每组45例,分别于麻醉诱导前30 min给予依达拉奉0.5 mg/kg(E组)和等量的氯化钠注射液(C组)。于术前1 d(T0)、术后第1天(T1)、术后第5天(T2)采用国际术后认知功能障碍研究协作组(international study of postoperative cognitive dysfunction,ISPOCD)推荐的量表对患者的认知功能进行评估。结果 T0时两组神经心理学评估量表评分无统计学差异(P>0.05)。两组术后认知功能障碍(postoperative cognitive dysfunction,POCD)发生率在T1时E组11.11%、C组33.33%;在T2时E组6.67%、C组22.22%, T1、T2时,E组POCD的发生率均低于C组(P=0.01,P=0.04)。结论依达拉奉预处理可以降低老年患者膝关节置换术POCD的发生率,改善老年患者的术后认知功能。%Objective To investigate the influence of edaravone on postoperative cognitive function in elderly patients undergoing knee replacement surgery.Methods Ninety ASAⅠ-Ⅱ elderly patients aged from 65 to 79 years old with MMSE score≥ 23 who underwent knee arthroplasty surgery in our hospital from May to September in 2014 were randomly divided into edaravone group (group E, n=45) and control group (group C, n=45). Patients in group E were given edaravone accounting for 0.5 mg/kg while the same amount of sodium chloride injection in group C was given 30 min before anesthesia induction. The cognitive function of the patients was assessed preoperative, on the 1st and 5th postoperative day with the scale recommended by the international study of postoperative cognitive dysfunction. Results On the 1st postoperative day

  17. 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 ...

  18. 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.

  19. Can Achilles tendon be used as a new distal landmark for coronal tibial component alignment in total knee replacement surgery? An observational MRI study

    Science.gov (United States)

    Tiftikçi, Uğur; Serbest, Sancar; Burulday, Veysel

    2017-01-01

    Background In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. Materials and methods This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs. After identification of the mechanical axis, the distances of distal landmarks, which were extensor hallucis longus tendon (EHLT), tibialis anterior tendon (TAT), dorsalis pedis artery (DPA), AT, extensor digitorum longus tendon (EDLT), and malleoli, were measured from the mechanical axis and were statistically evaluated. Results In proximal measurements, the distances of the landmarks to the mechanical axis (on average) were AT, 2.64±1.62 mm lateral; EHLT, 3.89±2.45 mm medial; DPA, 4.69±2.39 mm medial; TAT, 8.24±3.60 mm medial; and EDLT, 14.2±4.14 mm lateral (P<0.001). In distal measurements, the distances of the landmarks to the mechanical axis (on average) were AT, 1.99±1.24 mm medial; EHLT, 4.27±2.49 mm medial; DPA, 4.79±2.10 mm medial; TAT, 12.9±4.07 mm medial; and EDLT, 12.18±4.17 mm lateral (P<0.001). Conclusion In this study, the mechanical axis line, which is the center of talus, passes through the AT. Our MRI investigations showed that the AT, EHLT, DPA, and malleolar center (3–5 mm medial) may help in correct alignment. PMID:28144149

  20. [Diagnosis and treatment of recurrent hemarthrosis after total knee arthroplasty].

    Science.gov (United States)

    Li, Y; Tian, H; Zhang, K

    2016-12-01

    Recurrent hemarthrosis is a relatively rare complication after total knee arthroplasty with the incidence estimated between 0.3% and 1.6%. There are various causes of this complication which can be broadly divided into general and local reasons. If the blood coagulation function was normal, the most common reason of hemarthrosis is the impingement of proliferative synovium between the articulating components of the knee prosthesis. However, some causes are not well understood which make diagnosis and treatment more difficult. Conservative therapy is the preferred treatment including rest, cooling, aspiration, and elevation. If conservative treatment is not successful, as next step an angiography and angiographic embolization of the source of bleeding is indicated. If embolization is unsuccessful, open synovectomy or arthroscopic is the next step. If these approaches are unsuccessful, the previously mentioned steps should be repeated until the cause of recurrent hemarthrosis become clear and the bleeding have been stopped.

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

    Science.gov (United States)

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

    2016-01-01

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

  2. 关节镜下自体移植与同种异体移植膝关节交叉韧带重建术对比研究%The Comparative Study on Arthroscopic Autologous and Allograft Transplant Knee Ligament Reconstruction

    Institute of Scientific and Technical Information of China (English)

    赵元杰; 赵永明

    2014-01-01

    Objective:To compare the clinical efficacy difference between using autologous graft and allograft graft to reconstruct knee cruciate ligament under arthroscopy.Method:Eighty-five patients with ACL/PCL injuries which came from June 2008 to June 2012 in the hospital were divided into the autologous tendon group and allograft tendon group. Recorded and compared the operation time,hospitalization time and the incidence of adverse reactions between the two groups. One years after operation,calculated Lysholm score,Larson score and International Knee Documentation Committee(IKDC)score to appraise the joint function.Result:All the patients were followed up for 12 to 48 months. There was no severe complication, such as vascular nerve injury,infection and rupture of graft occurred in early stage after operations in the patients. Operation time of autologous group was longer than allograft group,hospitalization time was shorter than allograft group,the differences were statistically significant(P0.05).Conclusion:There is no significant differences of treatment effect in the knee cruciate ligament reconstruction between autologous tendon and allogenic tendon transplantation.%目的:探讨关节镜下自体移植与同种异体移植重建膝关节前后交叉韧带的临床疗效差异。方法:选择2008年6月-2012年6月在本院进行关节镜下膝关节交叉韧带重建术的85例患者为研究对象,将其分为自体肌腱组和同种异体肌腱组。记录并比较两组患者的手术时间、住院时间及不良反应发生情况,统计术后1年Lysholm评分、Larson评分及国际膝关节评分委员会(IKDC)评分,评价关节功能。结果:所有患者均获随访,随访12~48个月。均未发生血管神经损伤,无感染、无植入物断裂。自体组患者手术时间较异体组长,住院时间较异体组短,两组比较差异均有统计学意义(P0.05)。结论:自体肌腱移植与同种异体肌腱移植在重

  3. Rare coexistence of gouty and septic arthritis after arthroscopic rotator cuff repair: a case report.

    Science.gov (United States)

    Ichiseki, Toru; Ueda, Shusuke; Matsumoto, Tadami

    2015-01-01

    Coexistence of septic arthritis and gouty arthritis is rare. In particular, no reports have described the development of both gouty and septic arthritis after arthroscopic shoulder surgery. The patient was an 83-year-old man who underwent arthroscopic rotator cuff repair. He had a history of diabetes mellitus (HbA1c: 7.4%), but not of gout, and the GFR was decreased (GFR=46). During the postoperative course fever suddenly developed and joint fluid retention was found. Uric acid crystals were detected when the joint fluid was aspirated, after which when the culture results became available sepsis due to methicillin sensitive Staphylococcus aureus (MSSA) was diagnosed. On the 2(nd) day after fever onset, lavage and debridement were performed under arthroscopy, with the subsequent course uneventful with no recurrence of the infection or gouty arthritis and no joint destruction. When uric acid crystals are found in aspirated joint fluid, gouty arthritis tends to be diagnosed, but like in the present case if infection also supervenes, joint destruction and a poor general state may result if appropriate intervention is not initiated swiftly. Accordingly, even if uric acid crystals are found, the possibility of coexistence of septic arthritis and gouty arthritis should be kept in mind.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  6. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

    Directory of Open Access Journals (Sweden)

    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  7. Arthroscopic suprascapular neurotomy for the painful irreparable rotator cuff tear

    Science.gov (United States)

    Mclaughlin-Symon, Iain; Heasley, Richard; Morgan, Barnes; Ravenscroft, Matt

    2014-01-01

    Background Massive irreparable rotator cuff tears are becoming increasingly difficult to manage. Methods Patients were considered for treatment if they had a painful shoulder in the presence of a compensated cuff tear. All patients had radiological evidence of a massive irreparable cuff tear and underwent suprascapular neurotomy, arthroscopically. Results There were 15 males and 25 females with a mean age of 74 years (range 59 years to 88 years). The mean pre-operative Oxford Shoulder Score (OSS) in all patients was 17.7, with a mean pre-operative visual analogue score (VAS) of 8.0. The mean post-operative OSS was 30.8 [27.42–34.18 = confidence interval (CI) 95%] with a mean VAS of 3.6 (2.64–4.56 CI 95%) at the 3-month (short-term) period (n = 32). The medium-term (1-year) OSS and VAS had improved to 33.6 (32.27–34.93 = CI 95%) and 3.7 (0–8.39 CI 95%) respectively (n = 26). The difference pre- and postoperatively at 12 months was statistically significant (p < 0.001). Patients who underwent biceps tenotomy at the time of surgery had a less significant improvement in their VAS and OSS. Conclusions Suprascapular neurotomy can afford medium-term benefit in over two-thirds of the patients who would otherwise have undergone reverse polarity shoulder replacements. We consider that this is a reproducible technique. PMID:27582962

  8. Arthroscopic Debridement and Synovium Resection for Inflammatory Hip Arthritis

    Institute of Scientific and Technical Information of China (English)

    Mi Zhou; Zhong-li Li; Yan Wang; Yu-jie Liu; Shu-ming Zhang; Jie Fu; Zhi-gang Wang; Xu Cai; Min Wei

    2013-01-01

    Objective To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis. Methods A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflam-matory arthritis. There were 17 cases of ankylosing spondylitis,11 cases of rheumatoid arthritis,and 8 cases of psoriatic arthritis. The joints were irrigated and the inflamed tissues were debrided with anthroscopy. The patients were followed up with Harris hip score,Oxford hip score,Visual Analog Scale (VAS),and magnetic resonance imaging (MRI). Statistical analysis was performed using Student t test. Results All of the 36 cases were followed up for 46-103 months,averaging 67.2±8.4 months. Har-ris and Oxford scores increased from 66.9±12.1 and 69.4±16.4 before operation to 78.4±19.3 and 80.2±18.8 after operation,respectively (P<0.05). VAS score decreased from pre-operative 8.5±2.5 to post-operative 7.2±2.5 (P<0.05). All the patients showed improved joint range of motion. MRI revealed al-leviation of hip synovitis. The results were classified as excellent in 8 patients,good in 17 patients,fair in 8 patient,and poor in 3 according to Harris hip score. Twenty-seven patients were satisfied with the operative outcomes as they regained normal daily activities. Conclusions Arthroscopy-assisted joint debridement and synovium resection is an effective proce-dure for hip lesion in inflammatory arthritis. The inflammatory lesion might be thereby controlled and the symptoms be relieved.

  9. Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

    Science.gov (United States)

    Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

    2016-11-01

    Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.