WorldWideScience

Sample records for arthroscopy

  1. Shoulder arthroscopy

    Science.gov (United States)

    ... ball and socket joint) A torn or damaged biceps tendon A torn rotator cuff A bone spur ... repair. Using arthroscopy for rotator cuff repairs or tendinitis usually relieves the pain, but you may not ...

  2. Elbow arthroscopy.

    Science.gov (United States)

    Dodson, Christopher C; Nho, Shane J; Williams, Riley J; Altchek, David W

    2008-10-01

    Arthroscopy of the elbow was originally considered to be an unsafe procedure because of the small size of the elbow joint capsule and its proximity to several crucial neurovascular structures. Over the past decade, however, the procedure has become safer and more effective. These improvements can be attributed to a better understanding of elbow anatomy and of the disorders about the elbow as well as to advances in arthroscopic equipment and surgical technique. The most common indications for elbow arthroscopy include removal of loose bodies, synovectomy, débridement and/or excision of osteophytes, capsular release, and the assessment and treatment of osteochondritis dissecans. More recent advances have expanded the indications of elbow arthroscopy to include fracture management (eg, radial head fractures) and the treatment of lateral epicondylitis.

  3. History of arthroscopy

    Directory of Open Access Journals (Sweden)

    Marić Dušan M.

    2002-01-01

    Full Text Available Arthroscopy has developed as one of the branches of former cystoscopy. During the past 200 years a few people have made invaluable contributions to development of arthroscopy (Bozzini, Takagi, Watanabe After the World War II scientific and technological progress was so fast that arthroscopy proved to be a valuable tool in orthopedics, not only as a diagnostic, but also as a therapeutic procedure.

  4. [Arthroscopy of the elbow].

    Science.gov (United States)

    Bojanić, Ivan; Smoljanović, Tomislav; Mahnik, Alan

    2010-01-01

    Elbow arthroscopy has become an indispensable method of surgical care of injuries and their consequences and damages that affect the elbow. The advantages of elbow arthroscopy in comparison to classical open surgery are multiple. Primarily, arthroscopy allows an excellent view of intra-articular structures and thus a detailed overview of the entire joint which enables us to perform complete surgery without opening the joint. Furthermore, morbidity is significantly smaller, rehabilitation is faster, and return to daily activities is also faster. Basic requirements for successful application of elbow arthroscopy are careful planning of the procedure, very good knowledge of regional anatomy of the elbow, strictly following the rules of performing the procedure, good technique and an experienced surgeon. Pathologies that can currently be addressed arthroscopically include osteochondritis dissecans of elbow, lateral epicondylitis, synovial plica syndrome, elbow osteoarthritis, elbow contracture, as well as the diseases where the synovectomy is needed, such as rheumatoid arthritis, pigmented villonodular synovitis, synovial chondromatosis and hemophiliac synovitis.

  5. Knee arthroscopy - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100117.htm Knee arthroscopy - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The knee is a complex joint made up of the ...

  6. Arthroscopy and patellar chondropathy.

    Science.gov (United States)

    Zollinger, H; Schmohl, P

    1980-11-01

    Arthroscopy has proved to be a reliable method to determine acute and chronic retropatellar damage to cartilaginous tissue. The discrepancy between clinical and radiological findings, subjective disorders, and the actual morphological changes, seem to make arthroscopy desirable in analysing an objective and documentable initial situation. Long-term examinations will have to show how reliable prognostic statements are, and how justifiable the operative or conservative measures indicated by arthroscopic examination can be.

  7. Hip Arthroscopy: A Brief History.

    Science.gov (United States)

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day.

  8. Education in wrist arthroscopy

    NARCIS (Netherlands)

    Obdeijn, M.C.

    2014-01-01

    The subject of this thesis is an initiative for improving the education of residents in surgical skills and knowledge by using the current technical possibilities. The choice of wrist arthroscopy was driven by the fact that novel techniques have recently been developed within hand and wrist surgery

  9. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels

    2016-01-01

    and Pincer resection in 93.5% of the cases. Labral refixation or repair was done in 70.3% of the cases. The most common type of acetabular chondral damage was grade II lesions (36.6%). Grade III and IV changes were seen in 36.1% of the cases. The preoperative iHOT12 was 45 (mean) based on all 12 items. EQ-5D....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  10. Elbow arthroscopy: indications, techniques, outcomes, and complications.

    Science.gov (United States)

    Adams, Julie E; King, Graham J W; Steinmann, Scott P; Cohen, Mark S

    2015-01-01

    Elbow arthroscopy is a tool useful for the treatment of a variety of pathologies about the elbow. The major indications for elbow arthroscopy include débridement for septic elbow arthritis, synovectomy for inflammatory arthritis, débridement for osteoarthritis, loose body extraction, contracture release, treatment of osteochondral defects and selected fractures or instability, and tennis elbow release. To achieve favorable outcomes after elbow arthroscopy, the surgeon should be aware of contraindications, technical considerations, anatomic principles, and the need for proper patient positioning and portal selection. Elbow arthroscopy is an effective procedure for the treatment of inflammatory arthritis, osteoarthritis, and lateral epicondylitis.

  11. Hip Arthroscopy: Tales From the Crypt.

    Science.gov (United States)

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

  12. ARTHROSCOPY IN DIAGNOSTICS OF GONARTHROSIS

    Directory of Open Access Journals (Sweden)

    E Yu Panasyuk

    2000-01-01

    Full Text Available Aim: Analysis of arthroscopy importance of knee joints for characteristics of stage of cartilage destruction and synovitis in gonarthrosis cases. Material and methods: Arthroscopical study included 24 gonarthrosis pts (I-III degree by A.Larsen by "STORZ ” apparatus with photoinstrumental set. Six basic zones of knee joint were analyzed: patella, trochlear are, a lateral and medial articular tibial and femoral surfaces. Criteria of assessment included presence and distribution of cartilage damage according to 5 degrees: normal cartilage (0, fibrillar cartilage (I degree, surface fissures and/or surface erosions (2 degree, deep cartilage tissures and/or erosions baring subchondral bone (3 degree, baring subchondral bone (4 degree. Synovitis intensity was analyzed by three degrees: low, moderate or high. Results: It was determined that in different zones of knee joint the character and depth of cartilage destruction is not the same. In 100% of patients with gonarthrosis independently of radiological stage there were changes in patellar cartilage. Pathology' of articular cartilage in the area of lateral condyle of the femur in the lateral and medial areas of the tibia was found in the I-st, Il-nd and Ill-d stages with the same incidence. Development of fissures of cartilage was found in all gonarthrosis stages and even in the 1-st stage the incidence was the same as in the 111-d disease degree. Erosions were found in more than a half of pts with the I-st and Il- nd stages of gonarthrosis (57% and 67% correspondingly. Even in the I-st gonarthrosis stage in all areas of knee joint excluding lateral articular surface of the tibia changes characteristic for the Ill-d degree of cartilage destruction were found with different frequency. Incidence of subclinical synovitis according to arthroscopy data in the /, 11, III radiological stages of gonarthrosis was 57%, 33.5% and 100% correspondingly. Fissures and erosions were found in all pts with expressed

  13. Postoperative pectoral swelling after shoulder arthroscopy.

    Science.gov (United States)

    Ercin, Ersin; Bilgili, Mustafa Gokhan; Ones, Halil Nadir; Kural, Cemal

    2015-01-01

    Fluid extravasation is possibly the most common complication of shoulder arthroscopy. Shoulder arthroscopy can lead to major increases in the compartment pressure of adjacent muscles and this phenomenon is significant when an infusion pump is used. This article describes a case of pectoral swelling due to fluid extravasation after shoulder arthroscopy. A 24-year-old male underwent an arthroscopic Bankart repair for recurrent shoulder dislocation. The surgery was performed in the beach chair position and lasted two hours. At the end of the procedure, the patient was found to have left pectoral swelling. A chest radiography showed no abnormality. Pectoral swelling due to fluid extravasation after shoulder arthroscopy has not previously been documented.

  14. Iliotibial band syndrome following hip arthroscopy: An unreported complication

    Directory of Open Access Journals (Sweden)

    Roberto Seijas

    2016-01-01

    Conclusions: This is a newly described observation within followup of hip arthroscopy. These findings may help orthopedic surgeons when planning rehabilitation after hip arthroscopy, including stretching exercises to prevent this syndrome.

  15. Rehabilitation following hip arthroscopy - A systematic review

    Directory of Open Access Journals (Sweden)

    Jeffrey S Grzybowski

    2015-05-01

    Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a

  16. MRI VERSUS ARTHROSCOPY: A COMPARISON OF FINDINGS

    Directory of Open Access Journals (Sweden)

    Somashekhara Reddy

    2016-06-01

    Full Text Available The purpose of this study is to correlate the findings of Magnetic Resonance Imaging with Arthroscopy in internal derangements of knee and to assess the sensitivity, specificity and accuracy of Magnetic Resonance Imaging in comparison to Arthroscopy. METHODS AND MATERIALS Fifty six patients with history of suspected internal derangement of knee were evaluated prospectively with MRI and correlated with arthroscopy during a one and half a year period from March 2012 to September 2013.1.5 Tesla MRI machine using a closed extremity coil is used. Sequences used in MRI of the knee include Turbo-spin echo (TSE, FFE (Gradient echo and Short Tau Inversion Recovery (STIR sequences in Axial, Sagittal and Coronal planes using a slice thickness of 3 mm with a 0.3 mm slice gap. Arthroscopy of the knee with standard anteromedial and anterolateral portals with the patient in supine position done in all the cases. RESULTS The diagnostic sensitivity, specificity and accuracy of MRI in detecting cruciate ligament and meniscal injuries as compared to Arthroscopy are as follows: Anterior Cruciate Ligament (ACL: 97.29%, 89.47%, 94.64%; Posterior Cruciate Ligament (PCL: 100%, 100%, 100%; Medial Meniscus (MM: 100%, 93.33%, 98.21% and Lateral Meniscus (LM: 93.10, 92.59, 92.85. Most common lesions found were ACL and Medial Meniscal tears (posterior horn of MM being the most common site. SUMMARY AND CONCLUSION  MRI is a useful non-invasive modality having high sensitivity, specificity and accuracy in diagnosing cruciate ligament and meniscal injuries.  MRI should be considered as the first line of investigation in all patients with suspected internal derangements of knee.  MRI being easily available and non-invasive is useful as a pre-operative screening modality, thus improves the quality of diagnostic and therapeutic arthroscopies and further reduces the morbidity.  Arthroscopy is the standard diagnosing tool in all patients with suspected internal

  17. 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...

  18. 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...

  19. Hip arthroscopy in children and adolescents.

    Science.gov (United States)

    Kocher, Mininder S; Kim, Young-Jo; Millis, Michael B; Mandiga, Rahul; Siparsky, Patrick; Micheli, Lyle J; Kasser, James R

    2005-01-01

    Hip arthroscopy has become an established procedure for certain indications in adults, but experience in children and adolescents has been more limited. The purpose of this study is to report the early-term results of hip arthroscopy in children and adolescents. A consecutive case series of 54 hip arthroscopies in 42 patients 18 years old and younger over a 3-year period at a tertiary-care children's hospital with a minimum of 1 year of follow-up was reviewed. Patients were assessed with the modified Harris hip score (HHS) before and after surgery. Overall results and results by common diagnoses were analyzed. Indications for surgery included isolated labral tear (n = 30), Perthes disease (n = 8), hip dysplasia with labral tear after prior periacetabular osteotomy (n = 8), inflammatory arthritis (n = 3), spondyloepiphyseal dysplasia (n = 2), avascular necrosis (n = 1), slipped capital femoral epiphysis (n = 1), and osteochondral fracture (n = 1). Overall, there was a significant improvement in HHS from 53.1 to 82.9 (P < 0.001), with 83% of patients improved. By diagnosis, significant improvement in HHS was seen for patients with isolated labral tears undergoing labral debridement (before surgery 57.6; after surgery 89.2; P < 0.001), for patients with Perthes disease undergoing chondroplasty and loose body excision (before surgery 49.5; after surgery 80.1; P < 0.001), and for patients with hip dysplasia after prior periacetabular osteotomy undergoing labral debridement (before surgery 51.8; after surgery 79.8; P < 0.001). Complications included transient pudendal nerve palsy (n = 3), instrument breakage (n = 1), and recurrent labral tear (n = 3). Hip arthroscopy in children and adolescents appears to be safe and efficacious for certain indications in the short term.

  20. Arthroscopy Journal Prizes Are Major Decisions.

    Science.gov (United States)

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-01-01

    According to the Harvard Business Review, the optimal number of people in a decision-making group is no more than 8. Thus, it is no surprise that 18 Arthroscopy journal associate editors had difficulty making a major decision. In the end, 18 editors did successfully select the 2015 winner of the Best Comparative Study Prize. All studies have limitations, but from a statistical standpoint, the editors believe that the conclusions of the winning study are likely correct.

  1. 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.

  2. Effects of irrigation fluid in shoulder arthroscopy

    Science.gov (United States)

    Gupta, Surbhi; Manjuladevi, M; Vasudeva Upadhyaya, KS; Kutappa, AM; Amaravathi, Rajkumar; Arpana, J

    2016-01-01

    Background and Aims: Extravasation of irrigation fluid used in shoulder arthroscopy can lead to life-threatening airway and systemic complications. This study was conducted to assess the effect of irrigation fluid absorption on measurable anthropometric parameters and to identify whether these parameters predict airway/respiratory compromise. Methods: Thirty six American Society of Anaesthesiologists physical status one or two patients aged 15–60 years undergoing shoulder arthroscopy under general anaesthesia were recruited. Measured variables preoperatively (baseline) and at the end of surgery were neck, chest, midarm and midthigh circumferences, weight, haemoglobin and serum sodium. Temperature, endotracheal tube cuff pressure, airway pressure, duration of surgery, amount of irrigation fluid and intravenous fluid used were also noted. Measured parameters were correlated with the duration of surgery and the amount of irrigation fluid used. Results: Postoperatively, the changes in variables showed a significant increase in the mean values (cm) for neck, chest, midarm and midthigh circumference (mean ± standard deviation: 2.35 ± 1.9, P cm, P compared to the baseline. No significant change was found in the serum sodium levels (P = 0.92). No patient experienced airway/respiratory compromise. Conclusion: Regional and systemic absorption of irrigation fluid in arthroscopic shoulder surgery is reflected in the degree of change in the measured anthropometric variables. However, this change was not significant enough to cause airway/respiratory compromise. PMID:27053783

  3. Isolated Pulmonary Embolism following Shoulder Arthroscopy

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    Nicole H. Goldhaber

    2014-01-01

    Full Text Available Pulmonary embolism (PE following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.

  4. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...... year after HA concerning symptoms of nerve dysfunction, possible localization, and erectile dysfunction. Fifty patients participated and returned fully completed questionnaires. Patients reporting symptoms of nerve dysfunction 1 year after HA were re-examined. RESULTS: Twenty-three of 50 patients (46......%) reported symptoms of nerve dysfunction during the first week after HA; this was reduced to 14 patients (28%) after 6 weeks, 11 patients (22%) after 26 weeks, and 9 patients (18%) after 1 year. One patient experienced temporary erectile dysfunction. No difference in traction time between patients...

  5. Valid MR imaging predictors of prior knee arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Discepola, Federico; Le, Huy B.Q. [McGill University Health Center, Jewsih General Hospital, Division of Musculoskeletal Radiology, Montreal, Quebec (Canada); Park, John S. [Annapolis Radiology Associates, Division of Musculoskeletal Radiology, Annapolis, MD (United States); Clopton, Paul; Knoll, Andrew N.; Austin, Matthew J.; Resnick, Donald L. [University of California San Diego (UCSD), Division of Musculoskeletal Radiology, San Diego, CA (United States)

    2012-01-15

    To determine whether fibrosis of the medial patellar reticulum (MPR), lateral patellar reticulum (LPR), deep medial aspect of Hoffa's fat pad (MDH), or deep lateral aspect of Hoffa's fat pad (LDH) is a valid predictor of prior knee arthroscopy. Institutional review board approval and waiver of informed consent were obtained for this HIPPA-compliant study. Initially, fibrosis of the MPR, LPR, MDH, or LDH in MR imaging studies of 50 patients with prior knee arthroscopy and 100 patients without was recorded. Subsequently, two additional radiologists, blinded to clinical data, retrospectively and independently recorded the presence of fibrosis of the MPR in 50 patients with prior knee arthroscopy and 50 without. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detecting the presence of fibrosis in the MPR were calculated. {kappa} statistics were used to analyze inter-observer agreement. Fibrosis of each of the regions examined during the first portion of the study showed a significant association with prior knee arthroscopy (p < 0.005 for each). A patient with fibrosis of the MPR, LDH, or LPR was 45.5, 9, or 3.7 times more likely, respectively, to have had a prior knee arthroscopy. Logistic regression analysis indicated that fibrosis of the MPR supplanted the diagnostic utility of identifying fibrosis of the LPR, LDH, or MDH, or combinations of these (p {>=} 0.09 for all combinations). In the second portion of the study, fibrosis of the MPR demonstrated a mean sensitivity of 82%, specificity of 72%, PPV of 75%, NPV of 81%, and accuracy of 77% for predicting prior knee arthroscopy. Analysis of MR images can be used to determine if a patient has had prior knee arthroscopy by identifying fibrosis of the MPR, LPR, MDH, or LDH. Fibrosis of the MPR was the strongest predictor of prior knee arthroscopy. (orig.)

  6. Editorial Commentary: Arthroscopy Is a Generally Effective Treatment for Septic Arthritis.

    Science.gov (United States)

    Lubowitz, James H

    2015-07-01

    Hip bacterial septic arthritis is an indication for arthroscopy in combination with medical management. After arthroscopy, patients must be vigilantly observed; some patients require more than one irrigation and debridement.

  7. 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 ...

  8. DIAGNOSTIC AND THERAPEUTIC ARTHROSCOPY IN SYMPTOMATIC PATIENTS AFTER KNEE ARTHROPLASTY

    Science.gov (United States)

    Severino, Fabricio Roberto; Souza, Clodoaldo José Duarte de; Severino, Nilson Roberto

    2015-01-01

    Objectives: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. Methods: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. Results: The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p < 0.001). Most of the patients (12) were arthroscopically diagnosed with fibrosis known as “cyclop”; on the remaining five patients, anterior synovitis was found. All patients were treated by resection. Conclusions: Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis (“cyclops”) or synovitis, which can be treated by using the same procedure, resulting in pain relief. PMID:27022517

  9. MR imaging before arthroscopy in knee joint disorders?

    Energy Technology Data Exchange (ETDEWEB)

    Rappeport, E.D. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark); Mehta, S. [Stockport Acute Services NHS Trust (United Kingdom); Wieslander, S.B. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark); Schwarz Lausten, G. [Dept. of Orthopaedic Surgery, Herlev Hospital, Univ. of Copenhagen (Denmark); Thomsen, H.S. [Dept. of Diagnostic Radiology, Harlev Hospital, Univ. of Copenhagen (Denmark)

    1996-09-01

    Purpose: To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee. Material and Methods: All papers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read. Results: Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage. Conclusion: Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken. (orig.).

  10. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    Science.gov (United States)

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments.

  11. Post-operative pain after knee arthroscopy and related factors.

    Science.gov (United States)

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

    2008-06-13

    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 analysed. Supplementary analgesia was required for 23% of the patients, more often in the recovery room and between 2 and 8 hours postoperatively. Of all factors analyzed, only time was statistically significant in determining the level of post-operative pain. Supplementary analgesia was required only in patients that underwent operative arthroscopy, and more often in patients with tourniquet time of more than 40 minutes. In conclusions, post-operative time is the most significant factor related to the post-arthroscopy knee pain.

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

    Directory of Open Access Journals (Sweden)

    Bharat Sutariya

    2014-02-01

    Full Text Available 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 independent observations was analysed. Results: Supplementary analgesia was required for 23% of the patients, more often in the recovery room and between 2 and 8 hours postoperatively. Of all factors analyzed, only time was statistically significant in determining the level of post-operative pain. Supplementary analgesia was required only in patients that underwent operative arthroscopy, and more often in patients with tourniquet time of more than 40 minutes. Conclusion: In conclusions, post-operative time is the most significant factor related to the post-arthroscopy knee pain. [Natl J Med Res 2014; 4(1.000: 75-78

  13. Low dose spinal anesthesia for knee arthroscopy

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-06-01

    Full Text Available Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

  14. Current status of temporomandibular joint arthroscopy in the United Kingdom.

    Science.gov (United States)

    Thomas, Sangeetha M; Matthews, N Shaun

    2012-10-01

    In an era during which minimally invasive procedures are increasingly becoming the norm, arthroscopy of the temporomandibular joint (TMJ) seems to be infrequently used for diagnosis and treatment of disorders of the TMJ. The reasons for this are not clear. The purpose of this study was to find out the current state of arthroscopy of the TMJ in the UK and, more specifically, how often it is used, the indications for its use, the level of experience of practising surgeons, and the reasons for not using it. Information was gathered between 2009 and 2010 from a postal and e-mail questionnaire to all oral and maxillofacial consultants in the UK. Of the 346 consultants, 215 (60%) responded to the questionnaire. Forty-two said that they currently used arthroscopy of the TMJ, and 33 of those (81%) have more than 5 years' experience. During the past year, a total of 8 consultants nationally have done 20 arthroscopies or more. Thirty-three of the procedures (81%) were done for both diagnosis and treatment. Lack of perceived need of patients and lack of interest in this specialty were the main reasons given for not doing arthroscopy, lack of training being a key secondary reason. The Storz and Olympus systems were the most commonly used within the UK. Results seem to support the opinion that arthroscopy of the TMJ is under-used, and consideration should be given to ensuring that trainees are instructed in its use, which is important in the diagnosis and treatment of disorders of the TMJ.

  15. Venous Thromboembolism After Knee Arthroscopy in Undiagnosed Familial Thrombophilia.

    Science.gov (United States)

    Jetty, Vybhav; Glueck, Charles J; Freiberg, Richard A; Wang, Ping

    2016-11-01

    Venous thromboembolism is uncommon after knee arthroscopy, and there are no guidelines for thromboprophylaxis in elective routine knee arthroscopy. Preoperative evaluation of common thrombophilias should provide guidance for postarthroscopy thromboprophylaxis in otherwise healthy patients who are at high risk for venous thromboembolism. This study assessed 10 patients with venous thromboembolism after total hip or knee arthroplasty. Patients were assessed if venous thromboembolism occurred within 6 months after knee arthroscopy (n=10) or total hip or knee arthroplasty (n=21). This study assessed gene mutations (factor V Leiden, prothrombin G20210A, plasminogen activator inhibitor, methylenetetrahydrofolate reductase) and serologic thrombophilias (high levels of factors VIII and XI, homocysteine, anticardiolipin immunoglobulin G and immunoglobulin M antibodies, and lupus anticoagulant; low antigenic protein C, S, and free S; and antithrombin III deficiency). The same coagulation data were obtained for normal subjects (n=110). The major thrombophilias in the arthroscopy group were factor V Leiden heterozygosity (40%), high factor VIII level (50%), and high homocysteine (30%). The respective values in control subjects were 2% (P=.0004), 7% (P=.0011), and 5% (P=.02). When the arthroscopy group was compared with the 21 patients who had venous thromboembolism after total hip or knee arthroplasty, the sole difference was factor V Leiden heterozygosity, which was 40% vs 0%, respectively (P=.007). Although venous thromboembolism after knee arthroscopy is uncommon, to identify high-risk patients and guide postoperative thromboprophylaxis, the authors suggest routine preoperative measurement of 3 common familial thrombophilias: factor V Leiden, factor VIII, and homocysteine. [Orthopedics. 2016; 39(6):e1052-e1057.].

  16. Arthroscopy in diagnosis and treatment of hip disorders

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Lauritzen, J.; Juhl, M.

    1989-01-01

    Fourteen hip arthroscopies between January 1985 and May 1988 were reviewed. Included were ten women and four men with an age ranging from 12 to 76 years. Indications were avascular necrosis; loose bodies; osteoarthrosis, arthritis, or pain; and snapping hip. The diagnosis was verified in five cases...

  17. Asisstance Arthroscopy in Juvenile Tillaux Fractures

    Science.gov (United States)

    Mañero, Luciano Martin; Arroquy, Damian; Barrios, Juan Manuel; Botta, Juan Martin; Caceres, Carlos Alberto

    2017-01-01

    short boot. By the third week the plug removal. After the sixth week began with partial load with Walker boot for a month and later full charge. Results: Fracture healing was evident in the eighth week. Now in his eighth postoperative month and has an excellent performance according to the AOFAS score of 96 points, with no pain, full range of motion and return to sport after 4th month. Discussion: There are reports such as A. Kaya et.al (2007) with excellent results (AOFAS 99.3) in a series of 10 patients treated by open reduction and internal fixation and in other hand A. Panagopoulus, L.van Kiekerk (2007) reports excellent results (AOFAS 100) in patients treated under arthroscopic assistance. Assistance arthroscopy in Tillaux fractures allows a reduction more accurate than that provided by percutaneous techniques fluoroscopy guided only by avoiding the problems associated with open techniques (lesion of the superficial peroneal nerve and necrosis of the fragment). It also allows patients to an early return to activities with a lower risk of stiffness and secondary osteoarthritis due to the reduction achieved under direct arthroscopic visualization.

  18. Editorial Commentary: Put Me in Coach! Hip Arthroscopy Gets Patients Back in the Game.

    Science.gov (United States)

    Kane, Patrick; Philippon, Marc J

    2017-04-01

    A significant proportion of patients undergoing hip arthroscopy for treatment of femoroacetabular impingement are athletes attempting to return to sport. Emerging data suggest hip arthroscopy has a high success rate in athletes returning to play at all competitive levels and ages. Although several factors are important in determining return to athletics, the results of hip arthroscopy appear promising in all athletes, from weekend warriors to elite professionals.

  19. Arthroscopy of the wrist: anatomy and classification of carpal instability.

    Science.gov (United States)

    Cooney, W P; Dobyns, J H; Linscheid, R L

    1990-01-01

    Carpal instability can be defined as the lack of ligamentous and skeletal support adequate to maintain a wrist stable to external forces of pinch and grasp. This instability may be static or dynamic. It has been classified as (a) carpal instability, dissociated (CID), a situation in which one or more of the ligaments are torn, and (b) carpal instability, nondissociative (CIND), a situation in which the ligaments are intact but stretched. Carpal instability can also be the result of carpal bone malalignment from various causes. Arthroscopy can be particularly useful in assessing carpal instability, however arthrography with contrast medium, fluoroscopy, and stress loading should precede this arthroscopic assessment. Arthroscopy allows visualization of the volar radiocarpal and ulnocarpal ligaments of the wrist, and the arthroscopic examination can be combined with manual manipulation of the carpal bones to detect laxity of those ligaments, to examine stability of the scapholunate and lunotriquetral interosseous ligaments, and to show instability of the distal radioulnar joint.

  20. [Acute rhabdomyolysis after spinal anesthesia for knee arthroscopy].

    Science.gov (United States)

    Bouché, P M; Chavagnac, B; Cognet, V; Banssillon, V

    2001-08-01

    We report an observation of acute rhabdomyolysis of gluteus maximum muscles occurring in a non-obese patient installed in supine position that underwent knee arthroscopy under spinal anaesthesia. The patient had insulin-dependent diabetes melitus with documented microangiopathy. The interest of this observation resides in the occurrence of the syndrome after a short period of time (one hour) of installation in the supine position in a patient that did not have any of the generally described risk factors of rhabdomyolysis.

  1. Pneumoperitoneum and acidosis during arthroscopy with CO2.

    Science.gov (United States)

    Lotman, D B

    1987-01-01

    Two cases of knee arthroscopy are reported in which the patient sustained both pneumoperitoneum and acidosis. In each case, a pump was used to maintain a set intraarticular pressure of CO2. In neither case was the pneumatic tourniquet inflated. The conclusion is drawn that, to avoid these two complications, arthroscopists should routinely exsanguinate the extremity and inflate the pneumatic tourniquet when using this type of pump.

  2. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  3. Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology

    Science.gov (United States)

    Bhonsle, Sachin; Mehta, Sonu

    2016-01-01

    Introduction Shoulder pain can cause significant pain, discomfort and reduce the ability to perform activities of daily living, thus making it the third most common cause of musculoskeletal consultation. The current gold standard diagnostic investigation is arthroscopy. MRI is a proved sensitive and accurate non-invasive tool in investigating shoulder pathology, but false and misleading results are equally reported. Aim The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Materials and Methods Thirty nine consecutive patients, between 18-80 years of age, presenting with chronic shoulder pain or instability of more than 6 weeks, or with clinical signs of impingement or tear were included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results Out of 39 patients, Rotator cuff (RC) tear was the most common pathology. MRI showed excellent sensitivity in the diagnosis of rotator cuff tears (0.91) and osteochondral defects (OCD), very good sensitivity for Bankart’s lesion (0.8) and had poor sensitivity to detect SLAP tear (0.15). MRI was specific for all shoulder pathologies. MRI detected RC tears with kappa score of 0.73, Bankart’s tear and OCD’s with kappa score of 0.83 and 1.0 respectively and SLAP lesion with kappa score of 0.14. The accuracy of MRI was highest in diagnosing OCD’s (1.0), followed by RC tear (0.9), Bankart’s tear (0.9) and accuracy was least in diagnosing SLAP lesion (0.7). False negative results were more than false positives. Conclusion The present study supports that MRI is effective in diagnosing rotator cuff tears, Bankart’s tear and ostechondral defects but was not found to be helpful in diagnosing SLAP lesions. MRI and arthroscopy have complimentary roles

  4. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    Science.gov (United States)

    Mella, Claudio; Villalón, Ignacio E.; Núñez, Álvaro; Paccot, Daniel; Díaz-Ledezma, Claudio

    2015-01-01

    The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI) and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage. PMID:27163082

  5. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    Directory of Open Access Journals (Sweden)

    Mella Claudio

    2015-01-01

    Full Text Available The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage.

  6. Plasma bupivacaine levels following single dose intraarticular instillation for arthroscopy.

    Science.gov (United States)

    Meinig, R P; Holtgrewe, J L; Wiedel, J D; Christie, D B; Kestin, K J

    1988-01-01

    Arthroscopy of the knee was performed using 30 ml single dose intraarticular instillations of 0.5% or 0.25% solutions of bupivacaine (Marcaine). A total of 18 patients (mean age, 34 years), divided into two groups, participated in this study. Venous plasma levels were measured at 0, 10, 20, 30, 45, 60, 90, 120, and 240 minute intervals following a single instillation into the knee joint. All patients had suspected traumatic internal derangement of the knee. Electrocardiogram tracings, blood pressure, and neurologic assessment were monitored at each venous sampling interval or more often if clinically indicated. The type and amount of supplemental anesthesia were also recorded. None of our 18 patients required a general anesthetic because of pain although the following procedures were performed: meniscectomy, plica release, abrasion chondroplasty, loose body retrieval, and limited meniscal repair. A new methodology for the measurement of plasma bupivacaine using the gas chromatograph mass spectrometer is described. Monitoring specific molecular mass fragments allows the measurement of picogram per milliliter levels of bupivacaine. The highest peak plasma concentration occurred 20 minutes after instillation of 30 ml of 0.5% bupivacaine. The 625 +/- 225 ng/ml level was well below the 2,500 to 4,000 ng/ml reported to elicit early subjective CNS symptoms of bupivacaine toxicity. Thus, a single dose intraarticular instillation of 30 ml 0.5% or 0.25% bupivacaine is convenient, efficacious, and pharmacologically safe for routine clinical arthroscopy.

  7. Hip Arthroscopy in athletes with Femoroacetabular Impingement: functional outcomes

    Science.gov (United States)

    Magi, Gonzalo; Carucci, Juan Pablo; Berro, Manuel; Bergues, Sebastián

    2017-01-01

    Introduction: Hip pathology is being recognized with more frequency as source of disability and functional limitation in athletes. It has been stated that the overload made with certain positions during some sports activities can develop condral damage. Moreover, the sum of bone deformity and repetitive movements of the hip requiered in sports may increase the risk of causing injuries. These can be treated with hip arthroscopy. Despite of this, there is a lack of evidence about the time taken to return to sports activity and the level reached afterwards by those patients treated with this procedure. Objective: Describe the clinical evolution, the time taken to return to sports activity and the level reached a year after the treatment of femoroacetabular impingement (FAI) with hip arthroscopy in 23 athletes. Method: 23 athletes were included in the study, defined as those patients with a minimum of 6 hours a week of sports practice, who were treated for FAI with hip arthroscopy between 2010 and 2015 by the same surgeon at our institution. The diagnosis was clinical (positive impingement test, hip pain and functional limitation of the hip), radiological (cam and pincer) and with magnetic nuclear resonance (labral tears). Preoperative modified Harris hip score was registered in all cases. Tonnis radiographic score was used. All patients had type 0 or 1 Tonnis hips. After 3 months of ineffective non operative treatment the arthroscopy was performed. Patients were treated in dorsal decubitus with orthopedic table. Labral reconstruction with anchors and femoral and acetabular osteoplasty was made. After surgery, patients were able to walk with support for 4 weeks and began physiotherapy. A year after surgery, all patients were questioned about the time taken to return to sports activity and the level of activity reached at that time compared to the one they had before symptoms appeared. The modified Harris hip score was also registered. Results: Ten patients played

  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. Should arthroscopy in adolescents: Three years of clinical experience

    Directory of Open Access Journals (Sweden)

    Анастасия Ивановна Брянская

    2016-06-01

    Full Text Available Background.Shoulder joint injuries and shoulder instability often occur in adolescents.Materials and methods. During a 3-year period, we performed arthroscopic surgery on 42 patients with shoulder joint injuries.Results and discussion. The majority (76.2% of the patients on whom we performed arthroscopic shoulder joint surgery were male. This is likely due to more aggressive physical activity among males. Most of the patients were injured during exercise (n = 27, 64.3%. Arthroscopy is a highly effective surgical method for the treatment of shoulder joint injuries. Prolonged non-operative treatment with no well-established indications and an incorrect diagnosis can lead to rapid progression of degenerative and dystrophic changes of the shoulder joint and may result in shoulder joint dysfunction.

  10. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Seitsalo Seppo

    2007-12-01

    Full Text Available Abstract Background Arthroscopy is often used to treat patients with chronic patellofemoral pain syndrome (PFPS. As there is a lack of evidence, we conducted a randomized controlled trial to study the efficacy of arthroscopy in patients with chronic PFPS. Methods A total of 56 patients with chronic PFPS were randomized into two treatment groups: an arthroscopy group (N = 28, treated with knee arthroscopy and an 8-week home exercise program, and a control group (N = 28, treated with the 8-week home exercise program only. The arthroscopy included finding-specific surgical procedures according to current recommendations. The primary outcome was the Kujala score on patellofemoral pain and function at 9 months following randomization. Secondary outcomes were visual analog scales (VASs to assess activity-related symptoms. We also estimated the direct healthcare costs. Results Both groups showed marked improvement during the follow-up. The mean improvement in the Kujala score was 12.9 (95% confidence interval (CI 8.2–17.6 in the arthroscopy group and 11.4 (95% CI 6.9–15.8 in the control group. However, there was no difference between the groups in mean improvement in the Kujala score (group difference 1.1 (95% CI -7.4 - 5.2 or in any of the VAS scores. Total direct healthcare costs in the arthroscopy group were estimated to exceed on average those of the control group by €901 per patient (p Conclusion In this controlled trial involving patients with chronic PFPS, the outcome when arthroscopy was used in addition to a home exercise program was no better than when the home exercise program was used alone. Trial registration Current Controlled Trials ISRCTN 41800323

  11. [Rupture of the quadriceps tendon after lateral retinaculum release by arthroscopy].

    Science.gov (United States)

    Trobisch, P D; Baumann, M; Weise, K; Fischer, R

    2010-06-01

    Complications after arthroscopic surgery of the knee joint are infrequent. Quadriceps tendon ruptures after knee arthroscopy are rarities. Only two cases have been published in the medical literature. This article presents a case of a quadriceps tendon rupture that occurred in a 19-year-old patient 5 weeks after lateral release of the retinaculum by arthroscopy. The late occurrence differentiates this case from the other previously published cases.

  12. Elbow arthroscopy: a new setup to avoid visual paradox and improve triangulation.

    Science.gov (United States)

    Sinha, Apurv; Pydah, Satya Kanth V; Webb, Mark

    2013-05-01

    Elbow arthroscopy is a useful diagnostic and therapeutic tool for various conditions. Conventional arthroscopy with the patient in the prone or lateral position where the screen is placed on the opposite side makes it difficult to interpret the image, results in visual paradox, and is associated with difficult triangulation. We present a modified setup for the operating room to help eliminate these problems and improve triangulation.

  13. Quality and Quantity of the Elbow Arthroscopy Literature: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Erickson, Brandon J; Chalmers, Peter N; Cvetanovich, Gregory L; Frank, Rachel M; Romeo, Anthony A; Harris, Joshua D

    2016-01-01

    The purpose of this article is to perform a systematic review and meta-analysis of elbow arthroscopy literature to answer the following questions: "Across the world, what demographic of patients are undergoing elbow arthroscopy, what are the most common indications for elbow arthroscopy, and how good is the evidence?" The authors hypothesized that patients who undergo elbow arthroscopy will be chiefly age elbow arthroscopy will be a release/débridement, and the evidence regarding elbow arthroscopy will be poor. Also, no significant differences will exist in elbow arthroscopy publications, subjects, outcomes, and techniques based on continent/country of publication. A systematic review was registered with the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) and performed with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using 3 publicly available databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence I-IV were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using 1-way analysis of variance (ANOVA) to compare between continents and Pearson's correlation coefficients to evaluate changes over time. In total, 112 studies were included (3093 subjects; 3168 elbows; 64% male; mean 34.9 ± 14.68 years. Mean 33.4 ± 26.02 months follow-up. Most studies were level IV evidence (94.6%) and had a low Modified Coleman Methodology Score (MCMS) (mean 28.1 ± 8.06). From 1985 through 2013, the number of publications significantly increased with time (P = .004) in all continents. The 3 most common indications for elbow arthroscopy were osteochondritis dissecans (OCD), lateral epicondylitis, and release and débridement. The number of reported cases for the 3 most common indications significantly increased over time but did not differ

  14. The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

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    Haviv Barak

    2010-07-01

    Full Text Available Abstract Objective To assess the incidence of total hip arthroplasty (THA in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA. Design Retrospective clinical series Methods Follow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years. The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis. Results Ninety (16% of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA. Conclusions In our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures.

  15. Evaluation of the symptomatic supraspinatus tendon - a comparison of ultrasound and arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Venu, K.M.; Howlett, D.C.; Garikipati, R.; Anderson, H.J.; Bonnici, A.V

    2002-11-01

    Purpose: A prospective study was undertaken to determine the accuracy of ultrasound compared with arthroscopy in the evaluation of the symptomatic supraspinatus tendon, and to identify whether ultrasound diagnosis was helpful in pre-operative planning. Methods: A total of 276 consecutive patients with shoulder impingement symptoms underwent ultrasound examination of the supraspinatus tendon. Of these patients, 41 proceeded to open or arthroscopic surgical procedure on clinical grounds, and in this group direct comparison with ultrasound findings was made. Results: There was full correlation between ultrasound and arthroscopy in the diagnosis of a normal supraspinatus tendon, full-thickness tear, tendinopathy and tendon rupture. There was some discrepancy between the two techniques. Two patients with partial thickness tear on ultrasound had a full thickness tear at arthroscopy. Ultrasound was able to identify intra-substance partial thickness tears in three patients with supraspinatus tendon said to be normal at arthroscopy. Ultrasound helped plan the surgical approach and operative time needed in cases of supraspinatus tendon rupture and full thickness tear. Conclusion: In this study ultrasound was effective in the evaluation of the symptomatic supraspinatus tendon, and was also able to diagnose intra-tendinous lesions not visible at arthroscopy.

  16. 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.

  17. Elbow arthroscopy: setup, portal placement, and simple procedures.

    Science.gov (United States)

    Ahmad, Christopher S; Vitale, Mark A

    2011-01-01

    Elbow arthroscopy has become an accepted treatment for numerous elbow conditions, including loose bodies, lateral epicondylitis, contractures, painful osteophytes, synovitis, osteochondritis dissecans, synovial plica, and osteoarthritis. It is absolutely necessary that the treating surgeon have complete knowledge of elbow anatomy. Three options exist for patient positioning: supine, prone, and lateral decubitus. Standard arthroscopic probes, grasping forceps, punches, and motorized shavers and burrs are used in the procedure. Retractors are essential for visualizing, exposing, and protecting nerves. Specially designed capsular biters can be used to develop a plane between the capsule and the surrounding soft tissues to facilitate capsulotomy and capsulectomy. Among elbow arthroscopists, the sequence of portal placement varies; however, there is little variation in the exact location of portal placement because of neurovascular constraints. Loose body removal and extensor carpi radialis brevis release for lateral epicondylitis are common procedures suitable for the beginning arthroscopist. For beginning and advanced procedures, the surgeon's skill and competence must be at a level consistent with the procedure to avoid complications.

  18. Hip arthroscopy with labral repair for femoroacetabular impingement

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto;

    2014-01-01

    males (median age 38, range 15-59)] underwent hip arthroscopy and labral repair, by the same experienced surgeon. Standardised, but unstructured, post-operative rehabilitation instructions were provided. Function and pain were evaluated using modified Harris Hip Score (mHHS) and visual analogue scale...... (VAS) pre-operatively and post-operatively at 3, 6, and 12 months. RESULTS: A main effect of time was seen for mHHS and pain (VAS) at 3, 6, and 12 months (p operatively to 74.5 (1.9) after 3 months (p ... months from 74.5 (1.9) to 80.1 (1.9) (p = 0.004), with no additional changes from 6 to 12 months [80.1 (1.9)-78.7 (1.9), (n.s.)]. Also, the mean (SE) VAS improved significantly from pre-operative 57.9 (2.6) to 30.0 (2.6) after 3 months (p

  19. Low incidence of deep vein thrombosis after knee arthroscopy without thromboprophylaxis - A prospective cohort study of 335 patients

    NARCIS (Netherlands)

    M.R. Hoppener; H.B. Ettema; C.P. Henny; C.C.P.M. Verheyen; H.R. Buller

    2006-01-01

    Background There is little data on the risk of deep vein thrombosis after knee arthroscopy. Patients and methods We performed a prospective cohort study to establish the incidence of venous thrombo-embolic (VTE) complications after knee arthroscopy in daycare, as detected by bilateral complete compr

  20. Anterior cruciate ligament tears: MRI versus arthroscopy. Vordere Kreuzbandruptur: MRT versus Arthroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Tosch, U.; Felix, R. (Strahlenklinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany)); Schauwecker, W.; Dreithaler, B. (Chirurgische Klinik und Poliklinik, Universitaetsklinik Rudolf Virchow, Berlin (Germany))

    1992-05-01

    Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T[sub 1]- and T[sub 2] weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.).

  1. Development and validation of a computer-based learning module for wrist arthroscopy.

    Science.gov (United States)

    Obdeijn, M C; Alewijnse, J V; Mathoulin, C; Liverneaux, P; Tuijthof, G J M; Schijven, M P

    2014-04-01

    The objective of this study was to develop and validate a computer-based module for wrist arthroscopy to which a group of experts could consent. The need for such a module was assessed with members of the European Wrist Arthroscopy Society (EWAS). The computer-based module was developed through several rounds of consulting experts on the content. The module's learning enhancement was tested in a randomized controlled trial with 28 medical students who were assigned to the computer-based module group or lecture group. The design process led to a useful tool, which is supported by a panel of experts. Although the computer based module did not enhance learning, the participants did find the module more pleasant to use. Developing learning tools such as this computer-based module can improve the teaching of wrist arthroscopy skills.

  2. Fibrous scar in the infrapatellar fat pad after arthroscopy. MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Guangyu; Niitsu, Mamoru; Ikeda, Kotaro; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Endo, Hideho

    2000-02-01

    We describe the MR appearance of fibrous scars in the infrapatellar fat pad after arthroscopy. The subjects were 96 patients who underwent arthroscope-assisted anterior cruciate ligament (ACL) reconstruction and were examined by oblique sagittal MR imaging at different follow-up intervals. Two observers evaluated the characteristics of the fibrous scars in the infrapatellar fat pad. All fibrous scars with low signal intensity were accentuated at the portal and coursed horizontally through the infrapatellar fat pad. The fibrous scar within the fat pad occurred and peaked within 6 months after arthroscopy. It then subsided gradually and had disappeared by one year later in nearly half of the patients. Identifying MR imaging characteristics of fibrous scars in the fat pad after arthroscopy may be clinically helpful to differentiate these scars from other abnormalities that involve the infrapatellar fat pad. (author)

  3. Clinical examination, MRI and arthroscopy in meniscal and ligamentous knee Injuries – a prospective study

    Directory of Open Access Journals (Sweden)

    Bastawrous SS

    2008-05-01

    Full Text Available Abstract Data from 565 knee arthroscopies performed by two experienced knee surgeons between 2002 and 2005 for degenerative joint disorders, ligament injuries, loose body removals, lateral release of the patellar retinaculum, plica division, and adhesiolysis was prospectively collected. A subset of 109 patients from the above group who sequentially had clinical examination, MRI and arthroscopy for suspected meniscal and ligament injuries were considered for the present study and the data was reviewed. Patients with previous menisectomies, knee ligament repairs or reconstructions and knee arthroscopies were excluded from the study. Patients were categorised into three groups on objective clinical assessment: Those who were positive for either meniscal or cruciate ligament injury [group 1]; both meniscal and cruciate ligament injury [group 2] and those with highly suggestive symptoms and with negative clinical signs [group 3]. MRI was requested for confirmation of diagnosis and for additional information in all these patients. Two experienced radiologists reported MRI films. Clinical and MRI findings were compared with Arthroscopy as the gold standard. A thorough clinical examination performed by a skilled examiner more accurately correlated at Arthroscopy. MRI added no information in group 1 patients, valuable information in group 2 and was equivocal in group 3 patients. A negative MRI did not prevent an arthroscopy. In this study, specificity, positive and negative predictive values were more favourable for clinical examination though MRI was more sensitive for meniscal injuries. The use of MRI as a supplemental tool in the management of meniscal and ligament injuries should be highly individualised by an experienced surgeon.

  4. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  5. Arthroscopy of the temporomandibular joint. Examination of 2 patients with suspected disk derangement.

    Science.gov (United States)

    Hellsing, G; Holmlund, A; Nordenram, A; Wredmark, T

    1984-02-01

    2 patients with a history of reciprocal temporomandibular joint (TMJ) clicking were visually examined with arthroscopy of their right side TMJs. Clinical and radiographic examination revealed no signs of arthrosis deformans. One patient with significantly reduced opening ability combined with occasional disappearance of TMJ clicks showed advanced arthrotic changes of cartilage which were not visible radiographically. The other patient with unimpaired function also had a severe arthrotic lesion in the clicking joint. In neither case did the disk appear to be displaced. It is concluded that arthroscopy yields additional information for TMJ diagnosis which cannot be achieved by clinical and radiographic examination alone.

  6. 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.

  7. Severe cerebral desaturation during shoulder arthroscopy in the beach-chair position

    DEFF Research Database (Denmark)

    Dippmann, Christian; Winge, Søren; Nielsen, Henning Bay

    2010-01-01

    During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease...

  8. Arthroscopy of the elbow joint–video analysis of the anatomy and function

    OpenAIRE

    Hesse, Beatrix; Lampert, C.

    2002-01-01

    The anatomical structures of the elbow joint were dissected in layers in human cadavers. The surgical dissection was divided into to deep and superficial areas. Each step was documented by digital video and photographs. The functional and anatomical preparation allowed us to establish the limits and scope of diagnostic and therapeutic procedures by arthroscopy.

  9. Survivorship of Primary Hip Arthroscopy in New York State - A Population-Based Study

    Science.gov (United States)

    Nawabi, Danyal H.; Degen, Ryan; Pan, Ting; Ranawat, Anil S.; Kelly, Bryan T.; Lyman, Stephen

    2016-01-01

    Objectives: Hip arthroscopy utilization has significantly increased over the past decade, with annual rates increasing as much as 300-600% in that time period. While large sample data demonstrates significant improvement in clinical outcomes out to two years post-operatively, with low rates of associated post-operative complications, there is little information on the long-term survival of primary hip arthroscopy procedures. The purpose of this study is to report on the rates of revision hip arthroscopy and conversion to resurfacing or total hip arthroplasty (THA) following hip arthroscopy in the State of New York. We will also report on prognostic variables that may contribute to the need for repeat surgery. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database, a census of all hospital admissions and ambulatory surgery in New York State, was used to identify cases of outpatient primary hip arthroscopy. Demographic information was collected for these patients. After case identification, unique identifiers were utilized to identify those patients that underwent revision hip arthroscopy or subsequent ipsilateral hip resurfacing or THA. The risks of each of these outcomes were modeled with use of age, sex, socio-economic status, hospital and surgeon volume as potential risk factors. Patients were also tracked for 30-day and 90-day complications requiring re-admission. Results: We identified 8,267 hip arthroscopy cases from 1998-2012 performed by 295 surgeons in 137 different surgical centers. Demographics revealed that 46.1% of patients were male, with 80.2% carrying private insurance. Annual hip arthroscopy rates increased 88-fold over the observation period, with a 750% increase over the last 10 years. Revision surgery (scope or arthroplasty) was required in 1,087 cases (13.1%) at a mean of 622 ± 603 days. More specifically, revision hip arthroscopy was required in 310 cases (3.8%) at a mean of 649 ± 586 days after the index procedure

  10. Outcome of arthroscopy in patients with advanced osteoarthritis of the hip.

    Science.gov (United States)

    Daivajna, Sachin; Bajwa, Ali; Villar, Richard

    2015-01-01

    Hip arthroscopy has continued to expand its horizons in treating many conditions other than femoroacetabular impingement (FAI). However, the results of hip arthroscopy are known to be poor if the degree of articular cartilage damage is significant. We wanted to assess, whether the procedure might have a role in the management of young and active patients with advanced osteoarthritis (OA) and whether it should be offered as a treatment modality. 77 consecutive patients with Tönnis grade 2 and 3 osteoarthritis of the hip who had undergone hip arthroscopy were included in the study. Patients' medical notes, plain radiographs and outcome scores (modified Harris hip score (mHHS), non-arthritic hip score (NAHS)) preoperatively and postoperatively at six weeks, six months, one year and annually thereafter, were analysed. 77 patients consisted of 63 men and 14 women with mean follow-up of 2.8 years (2.2 to 4.2) and mean age at surgery of 43 years (19 to 64). The mean preoperative mHHS and NAHS scores were 58 (28 to 87) and 64 (27 to 93) respectively. The mean improvements in both the mHHS and NAHS scores were significant (p = 0.003 and p = 0.0001 for mHHS at one and two years, p = 0.002 and p = 0.0003 for NAHS at one and two years, respectively). There were 34 patients (44%) who required a total hip replacement at mean of 18 months (6 to 48) after hip arthroscopy. We conclude that hip arthroscopy improves outcome scores in 56% of patients with severe OA of the hip (Tönnis grade 2 and 3) for at least two years after surgery. We thus consider the procedure to be a reasonable option for patients with hip OA, although success of the procedure will be less than if undertaken for certain other conditions.

  11. Intra-articular block for knee arthroscopy: a study on 41 patients

    Directory of Open Access Journals (Sweden)

    Emami A

    2009-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: During recent three decades, parallel to the improvement of arthroscopic techniques, intra-articular block by direct injection of anesthetics into the joint has been used in knee arthroscopy. In this study the efficacy of intra- articular block by complex of bupivacaine, lidocaine and adrenaline in knee arthroscopy has been assessed. "n"nMethods: Forty one healthy adults (age range: 18-55 years with knee problems selected for diagnostic arthroscopy. Anesthesia was induced by direct injection of 10ml 2% bupivacaine, 10ml 0.5% lidocaine plus 1/100000 adrenaline into the knee joint.  Duration of operation and volume of serum used for irrigation during the procedure; pain and analgesics requirement, during and after arthroscopy; VAS (Visual Analogue Scale score, at time of discharge from recovery and also patient's and surgeon's satisfaction were assessed. "n"n Results: Sixty eight percent and 29% of cases reported mild and moderate degree of pain perception during arthroscopy, respectively, and only one case for which general anesthesia was performed, reported severe pain. VAS mean was 2.78. Seventy eight percent of cases and the surgeon in 80% of procedures had excellent or good satisfaction with

  12. Meniscal and cruciate ligaments tears diagnosed with MR imaging versus arthroscopy; Uszkodzenie lakotek i wiazadel krzyzowych w stawie kolanowym w badaniu MR i artroskopii

    Energy Technology Data Exchange (ETDEWEB)

    Ziemianski, A.; Kruczynski, J.; Bruszewski, J. [Akademia Medyczna, Poznan (Poland)

    1993-12-31

    MR studies of knee joints in 37 patients were performed. The clinical diagnostics was traumatic lesions of menisci or cruciate ligaments. Arthroscopy of the knee joint was performed in 21 patients. MR showed meniscal lesion in 25 patients and anterior cruciate ligament (ACL) lesions in 18 patients. Arthroscopy showed meniscal lesions in 16 of 21 patients and ACL lesions in 11 of 21 patients. MR correlated with arthroscopy in 16 of examined menisci and 15 of 21 examined ACL. (author).

  13. Editorial Commentary: Big Data Suggest That Because of a Significant Increased Risk of Postoperative Infection, Steroid Injection Is Not Recommended After Ankle Arthroscopy.

    Science.gov (United States)

    Brand, Jefferson C

    2016-02-01

    A recent study addressing infection rate after intra-articular steroid injection during ankle arthroscopy gives pause to this practice, with an odds ratio of 2.2 in the entire population that was injected with a steroid simultaneously with ankle arthroscopy compared with patients who did not receive an ankle injection. Big data, used in the study upon which the Editor comments here, suggest that because of a significant increased risk of postoperative infection, steroid injection is not recommended after ankle arthroscopy.

  14. Dry arthroscopy with a retraction system for matrix-aided cartilage repair of patellar lesions.

    Science.gov (United States)

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-02-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix-induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the lesion. To overcome these issues, we developed a novel arthroscopic approach for matrix-aided cartilage repair of patellar lesions. This technical note describes the use of dry arthroscopy assisted by a minimally invasive retraction system. An autologous matrix-induced chondrogenesis procedure is used to illustrate this novel approach.

  15. Dry Arthroscopy With a Retraction System for Matrix-Aided Cartilage Repair of Patellar Lesions

    OpenAIRE

    Sadlik, Boguslaw; Wiewiorski, Martin

    2014-01-01

    Several commercially available cartilage repair techniques use a natural or synthetic matrix to aid cartilage regeneration (e.g., autologous matrix–induced chondrogenesis or matrix-induced cartilage implantation). However, the use of matrix-aided techniques during conventional knee joint arthroscopy under continuous irrigation is challenging. Insertion and fixation of the matrix can be complicated by the presence of fluid and the confined patellofemoral joint space with limited access to the ...

  16. 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.

  17. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    Science.gov (United States)

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

    2016-08-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  18. Editorial Commentary: Shoulder Arthroscopy, Shoulder Hemiarthroplasty, and Total Shoulder Arthroplasty for Glenohumeral Osteoarthritis.

    Science.gov (United States)

    Lubowitz, James H

    2015-06-01

    Shoulder arthroscopy offers a safe, effective, and less invasive alternative to arthroplasty in patients under 60 years of age with glenohumeral arthritis. However, indications include joint space of greater than 2 mm. For patients who do not meet arthroscopic indications, total shoulder arthroplasty is more effective than hemiarthroplasty. Performance and publication bias may effect generalizability of these findings. Biologic treatment options seem on the horizon.

  19. Negative-pressure pulmonary oedema in a patient undergoing shoulder arthroscopy

    Directory of Open Access Journals (Sweden)

    Anoop Raj Gogia

    2012-01-01

    Full Text Available An 18-year-old ASA-I patient who underwent elective left shoulder arthroscopy developed severe airway obstruction post-extubation due to fluid extravasation from the shoulder joint into the neck and airway tissue. Re-intubation for relief of obstruction resulted in negative-pressure pulmonary oedema. The patient was electively ventilated in the intensive care unit and recovered uneventfully. A high index of suspicion along with monitoring of neck circumference can prevent this kind of complication.

  20. Topographic anatomical study of the sciatic nerve relationship to the posterior portal in hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Berliet Assad Gomes

    2014-12-01

    Full Text Available Objective: To evaluate the anatomic topographic relation between the sciatic nerve in relation to the piriform muscle and the posterior portal for the establishment of hip arthroscopy. Methods: We dissected 40 hips of 20 corpses of adult Brazilians, 17 male and three female, six black, six brown and eight white. We studied the anatomical relationship between the sciatic nerve and the piriform muscle with their variations and the distance between the lateral edge of the sciatic nerve and the posterior portal used in hip arthroscopy. We then classified the anatomical alterations found in the path of the sciatic nerve on the piriform muscle. Results: Seventeen corpses had bilateral relationship between the sciatic nerve and the piriform muscle, i.e., type A. We found the following anatomical variations: 12.5% of variant type B; and an average distance between the sciatic nerve and the portal for arthroscopy of 2.98cm. One body had type B anatomical variation on the left hip and type A on the right. Conclusion: the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.

  1. Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial

    Directory of Open Access Journals (Sweden)

    Knobe Matthias

    2012-09-01

    Full Text Available Abstract Background The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS or arthroscopic methods can increase the anatomical knowledge uptake. Methods Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK was taught by eight experienced physicians. The control group (CON acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK took place in two separate lessons (75 minutes each, shoulder and knee joint and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ, and after cross-over an objective structured clinical examination (OSCE. Differences in student’s perceptions were evaluated using Likert scale-based items. Results The ASK-group (n = 70, age 23.4 (20–36 yrs. performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20–53 yrs. and the CON-group (n = 88, 22.8 (20–33 yrs.; p = 0.019. After an additional arthroscopy teaching 1% of students failed the MC exam, in contrast to 10% in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p Conclusions The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous

  2. Comparison of MR arthrography with arthroscopy of the hip for the assessment of intra-articular loose bodies

    Energy Technology Data Exchange (ETDEWEB)

    Neckers, Andrew C. [Columbus Radiology Corporation, Columbus, OH (United States); Polster, Joshua M.; Winalski, Carl S.; Sundaram, M. [The Cleveland Clinic Foundation, Diagnostic Radiology/A21, Cleveland, OH (United States); Krebs, Viktor E. [The Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2007-10-15

    To assess the specificity and sensitivity of MR arthrography of the hip in comparison with arthroscopy for the evaluation of intra-articular loose bodies. Over a 3-year period, 81 consecutive patients underwent a total of 82 hip arthroscopies by a single orthopedic surgeon for intractable hip pain. Of the 82 arthroscopies, 70 had pre-operative MR arthrograms. Of these, 57 were available for retrospective review, after which they were compared with the operative notes of the subsequent arthroscopies. Of 82 arthroscopies 16 (20%) demonstrated intra-articular loose bodies, while, in the study group, nine of 57 had loose bodies (16%). There was a total of seven discordant cases (five false negatives and two false positives). The sensitivity of MR arthrography for detection of intra-articular loose bodies was 44%, while the specificity was 96%. While the specificity of MR arthrography for the detection of intra-articular loose bodies was high (96%), the sensitivity was not nearly as good (44%). (orig.)

  3. CT arthrography and virtual arthroscopy in the diagnosis of the anterior cruciate ligament and meniscal abnormalities of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Whal; Chung, Jin-Wook; Kang, Heung-Sik; Hong, Sung-Hwan; Choi, Ja-Young [Seoul National University, Seoul (Korea, Republic of); Kim, Ho-Sung; Kim, Seok-Jung; Kim, Hyung-Ho [Aeromedical Center, Seoul (Korea, Republic of)

    2004-03-15

    To determine the diagnostic accuracy of CT arthrography and virtual arthroscopy in the diagnosis of anterior cruciate ligament and meniscus pathology. Thirty-eight consecutive patients sho underwent CT arthrography and arthroscopy of the knee were included in this study. The ages of the patients ranged from 19 to 52 years and all of the patients were male. Sagittal, coronal, transverse and oblique coronal multiplanar reconstruction images were reformatted from CT arthrography. Virtual arthroscopy was performed from 6 standard views using a volume rendering technique. Three radiologists analyzed the MPR images and two orthopedic surgeons analyzed the virtual arthroscopic images. The sensitivity and specificity of CT arthrography for the diagnosis of anterior cruciate ligament abnormalities were 87.5%-100% and 93.3%-96.7%, respectively and those for meniscus abnormalities were 91.7%-100% and 98.1%, respectively. The sensitivity and specificity of virtual arthroscopy for the diagnosis of anterior cruciate ligament abnormalities were 87.5% and 83.3%-90%, respectively, and those for meniscus abnormalities were 83.3%-87.5% and 96.1-98.1%, respectively. CT arthrography and virtual arthroscopy showed good diagnostic accuracy for anterior cruciate ligament and meniscal abnormalities.

  4. Algorithm for establishing the indication for knee arthroscopy in children: a comparison of adolescent and preadolescent children.

    Science.gov (United States)

    Irha, E; Vrdoljak, J

    2000-01-01

    The aim of this study was to select children with pathological lesions of the intra-articular structures from children with identical complaints but with no pathological intra-articular changes. The younger the child, the more difficult it is to make the diagnosis, and the expected distribution of pathology changes increasingly. This is particularly stressed in children aged younger than 13 years. Synovial inflammatory alterations are more frequent, and osteochondral and chondral fractures appear to be more problematic than meniscal and cruciate ligament lesions. Before establishing the indication for knee arthroscopy it is mandatory to implement the algorithm of diagnostic and conservative therapeutic procedures. The indication for knee arthroscopy is considered in cases when complaints persist after conservative treatment, a lesion of intra-articular segments is suspected, and the pathological condition is deemed arthroscopically treatable. Arthroscopy before conservative treatment is justified only in acute cases.

  5. The use of navigation forces for assessment of wrist arthroscopy skills level.

    Science.gov (United States)

    Obdeijn, Miryam C; van Baalen, Sophie J; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J M

    2014-05-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy?What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level?Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3-4 portal and the hook through the 6R portal, and visualization of the hook in the center of the imageNavigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarksThe second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance.

  6. MRI and arthroscopy correlations of the hip: a case-based approach.

    Science.gov (United States)

    McCall, David A; Safran, Marc R

    2012-01-01

    Disorders of the hip joint can be physically disabling for the patient and a diagnostic challenge for the physician. Advances in imaging the hip with MRI can help the physician determine a more specific diagnosis for patients with acute or chronic hip pain. MRI and particularly magnetic resonance arthrography have helped raised awareness of nonarthritic hip problems and have made the diagnosis of hip problems much easier. Intra-articular and extra-articular processes can be evaluated with MRI; multiple sequences are available to increase the sensitivity and specificity for detecting specific pathology around the hip. Because the hip is a deep joint within a large soft-tissue envelope, MRI more precisely delineates the sources of hip pain by evaluating the soft tissues and ligamentous structures around the hip. It is helpful to understand the role of MRI in evaluating common pathologic conditions within the hip joint, including labral tears, chondral lesions, loose bodies, tears of the ligamentum teres, femoral acetabular impingement, developmental dysplasia of the hip, and pigmented villonodular synovitis. Hip arthroscopy, a less invasive technique for treating hip problems, has also contributed to the rapid growth of interest in this area of orthopaedic surgery. Hip arthroscopy can be used to evaluate disorders in the intra-articular region (central and peripheral compartments) and periarticular region (iliopsoas bursa and tendon disorders) as well as those in the peritrochanteric region.

  7. The rigid curette technique for the application of fibrin bioadhesive during hip arthroscopy for articular cartilage lesions.

    Science.gov (United States)

    Asopa, Vipin; Singh, Parminder J

    2014-04-01

    Encouraging midterm results have recently been reported for the arthroscopic treatment of delaminating articular cartilage lesions at the capsulolabral junction of the hip joint using fibrin bioadhesive. The needle used to introduce the bioadhesive is long, flexible, and often difficult to position. We describe a novel technique for introducing the needle that allows accurate placement behind the delaminated articular cartilage pocket during hip arthroscopy.

  8. Combined sciatic femoral nerve block in a case of restrictive cardiomyopathy for arthroscopy and anterior cruciate ligament (ACL reconstruction

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2007-01-01

    Full Text Available Restrictive cardiomyopathy is a rare heart muscle disease resulting in impaired ventricular filling, low cardiac output and a propensity for development of heart failure with minimal fluid overload. Here, we present the management of a case of restrictive cardiomyopathy undergoing arthroscopy and anterior cruciate liga-ment (ACL reconstruction.

  9. MRI evaluation of the knee post double bundle ACL reconstruction: Association of graft findings and comparison with arthroscopy

    Directory of Open Access Journals (Sweden)

    Mohammed Farghally Amin

    2016-06-01

    Conclusion: Increased signal intensity within the anteromedial or posterolateral bundles of a double bundle ACL reconstruction is frequently associated with a partial tear. Impingement of the anteromedial graft is frequently associated with partial tear and increased signal intensity which is proved by arthroscopy/surgery. A low incidence of other complications is seen.

  10. THIRD-DEGREE BURN IN THE REGION OF THE ELECTROSURGICAL PAD DURING SHOULDER ARTHROSCOPY: A CASE REPORT.

    Science.gov (United States)

    Gomide, Leandro Cardoso; Santos, Celso Eduardo Ribeiro Gonçalves; Pereira, Cleber Jesus; Carvalho, Luiz Cláudio Coelho; Queiroz, Sérgio Antônio Souza; Luciano, Roberto da Cunha; Pereira, Daniel Barros; Leocádio, Lélia Pereira

    2011-01-01

    The number of shoulder arthroscopy procedures is increasing and, because of this, the frequency of related complications is also increasing. This report presents a case of third-degree burn from an electrosurgical pad during this procedure and serves as an alert regarding the possible causes and how to try to prevent this rare, but possible complication.

  11. Cruciate ligament reconstruction using LARS artificial ligament under arthroscopy: 81 cases report

    Institute of Scientific and Technical Information of China (English)

    HUANG Jian-ming; WANG Qian; SHEN Feng; WANG Zi-min; KANG Yi-fan

    2010-01-01

    Background There are many different materials used for ligament reconstruction. Currently, autograft, allograft, and artificial ligaments are used in the reconstruction. The objective of this study was to explore the clinical result of cruciate ligament reconstruction under arthroscopy.Methods Eighty-one cases were reconstructed with the LARS ligament under arthroscopy, including 43 cases of anterior cruciate ligament (ACL) injury, 20 cases of posterior cruciate ligament (PCL) injury, and 18 cases of ACL combined with PCL injuries of the knee. The follow up period was 10 to 49 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scales were used for functional evaluation. We examined the anterior and posterior stability of the knee with KT-1000.Results According to the Lysholm knee function score scale, the average preoperative score of (44.6±1.4) increased to a postoperative score of (82.8±2.5) in the ACL group and from (46.6±2.3) to (80.8±2.0) in the PCL group. In the ACL combined with PCL injury group, the preoperative score increased from (45.2±1.2) to (85.5±2.3). According to IKDC score standards, in ACL group we evaluated 19 cases as C and 24 cases as D, preoperatively, and postoperatively 27 cases as A, 14 cases as B and two cases as C. In the preoperative PCL group, we had 11 cases defined as C and nine cases as D that resolved to 12 cases as A, seven as B and one case of C in postoperative evaluation. In the ACL combined with PCL injury group we defined four cases as C and 14 as D during preoperative scoring. These patients had postoperative grades of six cases as A, 10 as B, and two cases as C. All of the results have statistical significance. Conclusions ACL, PCL, or combined ACL and PCL reconstruction using the LARS ligament under arthroscopy is a minimally invasive, safe and effective method to treat cruciate ligament injuries of the knee. Clinical results are satisfactory in the short term.

  12. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined...... with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI...... evaluation was performed before the arthroscopic examination, and the images were interpreted by an experienced magnetic resonance radiologist. No information from the MRI examination was available to the orthopedic surgeons before arthroscopy. The standard of reference for comparison was arthroscopy...

  13. Editorial Commentary: The Efficacy of Nonsteroidal Anti-inflammatory Drugs for Prophylaxis of Heterotopic Ossification in Hip Arthroscopy--Do We Treat Patients or X-rays?

    Science.gov (United States)

    Miller, G Klaud

    2016-03-01

    A systematic review of 5 series comparing the incidence of heterotopic ossification after hip arthroscopy with and without nonsteroidal anti-inflammatory drug prophylaxis showed a statistically significant improvement with the use of prophylaxis.

  14. RESULTS OF SHOULDER STABILIZATION BY A MODIFIED BRISTOW - LATARJET PROCEDURE WITH ARTHROSCOPY

    Directory of Open Access Journals (Sweden)

    R. V. Gladkov

    2014-01-01

    Full Text Available The authors describe the minimally invasive technique for Bristow-Latarjet bone unfree autoplasty with arthroscopy in patients with bone loss more than 25% of anterior-posterior diameter of the glenoid, the poor quality of the capsule or deep defects of Hill-Sachs. The analysis of the early results of treatment in 19 patients and midterm results - in 13 soldiers operated in 2011-2014. Features of the proposed technique are the shortening of surgical approach and the reduction of subscapularis muscle damage. In addition, arthroscopic support allows to attain the precision location of the graft relative to the articular surface of scapula, at the same time restoring the damaged anatomy SLAP, rotator cuff tendons and posterior labrum and restore shoulder ligaments tension and isolate bone graft from the joint cavity, contributing to a better articulation of the humeral head and reducing the risk of nonunion and resorption.

  15. Effect of Mild Hypercapnia on Lung Oxygenation in Sitting Position During Shoulder Arthroscopy Under General Anesthesia

    Science.gov (United States)

    Kwak, Hyun Jeong; Lee, Ji Yeon; Lee, Jong Wha; Kim, Hong Soon; Hur, Ho Jin; Kim, Ji Young

    2017-01-01

    Background Mild hypercapnia is permitted during surgeries in sitting position under general anesthesia to maintain cerebral regional oxygen saturation (rSO2). However, since hypoventilation may cause gas exchange impairment, we evaluated effects of mild hypercapnia on lung oxygenation during shoulder arthroscopy in sitting position. Material/Methods Forty patients were randomly allocated to a normocapnia group (ETCO2 35 mmHg, n=20) or a hypercapnia group (45 mmHg, n=20). The mean arterial pressure (MAP), heart rate (HR), and rSO2 were measured 5 min after intubation in supine position (T0), and at 2, 4, 6, 8, 10, 20, 30, 40, 50, and 60 min of remaining in sitting position (T1–10). Arterial blood gas was analyzed at T0 and T5. The oxygenation index (PaO2/FiO2) and dead-space ventilation ratio (Vd/Vt) were calculated. Results There were no differences in PaO2/FiO2 at T0 and T5 between the 2 groups. At T5, the Vd/Vt was higher in the normocapnia group than in the hypercapnia group (p=0.04). The Vd/Vt at T5 increased from T0 in the normocapnia group. The incidence of cerebral desaturation in the hypercapnia group (0/20) was lower than in the normocapnia group (5/20) (p=0.047). Among rSO2, MAP, and HR, only changes in rSO2 over time between the 2 groups differed significantly (p=0.048). Conclusions Mild hypercapnia did not decrease lung oxygenation in sitting position, probably due to attenuation of the increase in dead-space ventilation ratio. Since hypercapnia maintained rSO2 without changes in oxygenation index and hemodynamic parameters, mild hypercapnia should be maintained during shoulder arthroscopy in sitting position under general anesthesia. PMID:28202896

  16. Knee Arthroscopy

    Science.gov (United States)

    ... below your waist • General anesthesia puts you to sleep The anesthesiologist will help you decide which method would be best for you. If you have local or regional anesthesia, you may be able to watch the procedure on a television monitor. Procedure The orthopaedic surgeon will make a ...

  17. Wrist Arthroscopy

    Science.gov (United States)

    ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ...

  18. Arthroscopy-Assisted Closed Reduction and Percutaneous Nail Fixation of Unstable Ankle Fractures: Description of a Minimally Invasive Procedure

    OpenAIRE

    Kong, Christopher; Kolla, Lee; Wing, Kevin; Younger, Alastair S.E.

    2014-01-01

    When one is surgically managing an unstable ankle fracture, anatomic reduction of the syndesmosis is typically accomplished using an open surgical approach. We propose an arthroscopically assisted technique that restores normal anatomy while using a percutaneously placed intramedullary nail to fix the fibula. The patient is positioned supine, and the ankle is placed under traction by use of a tensor bandage. Standard anteromedial and anterolateral arthroscopy portals are used. The joint is ex...

  19. Spiral CT arthrography of multiplanar reconstruction and virtual arthroscopy technique in diagnosis of knee with internal derangements

    Institute of Scientific and Technical Information of China (English)

    熊传芝; 郝敬明

    2004-01-01

    5Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique in diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci, anterior and posterior cruciate ligaments and cartilage of these 10 bovine knees were injured with a hook. Each of the joints was injected with 100 mi air, then soon scanned with a PQ6000 spiral computed tomography scanner. The data obtained was input into the work station, and multiplanar reconstruction technique was used to illustrate lesions in the knees. The results of CT diagnosis were compared to those found by gross inspection of the specimens. Clinically, 10 knees of 9 patients diagnosed as internal derangement were evaluated with the same method after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results were compared with intraoperative findings. Results:Experimentally,the sensitivity and specificity were 88.9% and 93.9% by detection of meniscal abnormalities, 85.7% and 100% by detection of cruciate ligament lesions, and 72.7% and 100% by detection of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90. 0% and 95.0% by detection of meulscal lesion. As to ligament, the figures were 85.7% and 100% respectively. Images of virtual arthroscopy simulated the images of real arthroscopy. Conclnsious:Spiral CT arthrography of multiplanar reconstruction technique offers fime images of internal structures of the knee, with clear border and internal structure. It is an accurate method for detecting meulscal, cruciate and collateral ligament and cartilaginous lesions that cause internal derangement of the knee.Virtual arthroscopy technique is a hopeful method for detecting reasons of derangement of the knee.

  20. 髋关节镜手术的护理配合%Nursing cooperation of hip arthroscopy operations

    Institute of Scientific and Technical Information of China (English)

    华莎; 高建萍

    2011-01-01

    目的 总结髋关节镜手术的术前、术中、术后护理配合,以加快术中流程、提高手术效率.方法 回顾性分析32例髋关节镜检查滑膜切除病例的护理配合情况.结果 32例患者术中护理配合顺利,无意外发生.结论 良好的手术体位和手术配合,是手术成功的关键.%Objective To explore the experience of nursing cooperation during hip arthroscopy operations, so as to accelerate the operation process and improve operation efficiency. Methods Cooperation of 32 patients undergone synovectomy by hip arthroscopy was reviewed. Results There was no emergency incident during the nursing cooperation. Conclusions The key factors of hip arthroscopy operation are appropriate surgery position and cooperation.

  1. Simultaneous reconstruction of anterior cruciate ligament and posterior cruciate ligament by using allogeneic patellar tendon under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Li-ping; ZHEN Min-qing; XU Zhong-he

    2005-01-01

    Objective: To evaluate operative effects of a new method to reconstruct anterior crucial ligament (ACL) and posterior crucial ligament (PCL) simultaneously by using patellar tendon under arthroscopy.Methods: From November 1999 to November 2003,the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and T radiation. At the same time, 2 patients were treated with medial collateral ligament (MCL)reconstruction, 3 with lateral collateral ligament (LCL)reconstruction, 1 with meniscus suture and 4 with whole or partial resection.Results: All patients were followed up for 12-26months (average 16.5 months ). The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test (ADT) was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°.Conclusions: As for simultaneous reconstruction of ACL and PCL under arthroscopy, ailogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.

  2. Complicações em artroscopia de quadril Complications in hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Marcos Emílio Kuschnaroff Contreras

    2010-01-01

    Full Text Available OBJETIVOS: Determinar a prevalência de complicações ocorridas em uma série de casos consecutivos de artroscopia de quadril; avaliar a evolução da casuística através de uma curva de aprendizado; reconhecer as causas das complicações nas cirurgias do quadril por via artroscópica. MÉTODOS: Foram avaliados 150 casos consecutivos submetidos à artroscopia de quadril no período de maio de 2004 a dezembro de 2008. As complicações encontradas foram classificadas sob três aspectos: sistema orgânico acometido, gravidade, grupos de 50 casos de acordo com a ordem de realização do procedimento. Utilizaram-se para a análise dos dados obtidos a estatística descritiva e o teste exato de Fisher. RESULTADOS: Observaram-se 15 complicações (10% neste estudo. Dez foram complicações neurológicas, duas osteoarticulares, uma vásculo-isquêmica e duas cutâneas. Na classificação de gravidade, três foram classificadas como maiores, 12 intermediárias e nenhuma considerada menor. A incidência das complicações ao longo da curva de aprendizado não apresentou diferença estatística significativa (p = 0,16. CONCLUSÕES:A artroscopia de quadril é um procedimento cirúrgico de baixa morbidade, que cursa, em alguns casos, com complicações. Essas são, frequentemente, neurológicas e transitórias. Elas ocorrem, principalmente, devido à tração articular. A taxa de complicações não diminuiu com o evoluir da casuística.OBJECTIVES: to determine the prevalence of complications in a series of consecutive cases of hip arthroscopy; to assess the progression of the casuistic through a learning curve; and to recognize the causes of complications in arthroscopic hip surgeries. METHOD: 150 consecutive cases were evaluated, who were submitted to hip arthroscopy from May 2004 through December 2008. All the surgical complications described were classified according to three aspects: organic system involved, severity, and every 50 consecutive cases

  3. A Prospective Multi-Center Clinical Trial to Compare Efficiency, Accuracy and Safety Of the VisionScope Imaging System Compared to MRI and Diagnostic Arthroscopy

    Science.gov (United States)

    Xerogeanes, John W.; Safran, Marc R.; Huber, Bryan; Mandelbaum, Bert R.; Robertson, William; Gambardella, Ralph A.

    2014-01-01

    Objectives: Until now, arthroscopic surgery has been the gold standard for the diagnosis of intra-articular pathology. When a patient presents with ongoing pain and/or disability despite non-operative care, MRI is commonly used as a diagnostic modality. To date, there is not a minimally-invasive option that can provide detailed information about the intra-articular pathology of a joint. VisionScope Imaging (VSI) is an office-based diagnostic modality that provides comprehensive real-time images and video of a joint with higher accuracy and reliability compared to static MR images. The purpose of this study was to compare the efficacy, accuracy and safety of VSI compared to MRI and surgical diagnostic arthroscopy. Methods: A prospective, blinded, multi-centered study was performed of all patients who had a routine surgical arthroscopy at one of the six participating clinical sites between July 2012 and May 2013. Patients were consented by the physician investigator at each site. Study inclusion criteria consisted of: suspected meniscal tears or articular cartilage damage. Patients were excluded from the study if they had (1) acute traumatic hemarthoses, (2) concomitant ligament injury, (3) active systemic infection, (4) allergy to silicone or any medication used during the procedure,. All patients had a MRI and a comprehensive physical exam prior to their surgical arthroscopy. Each patient underwent a MRI, VSI exam and surgical diagnostic arthroscopy. The attending physician completed standard forms comparing the VSI exam findings to the diagnostic arthroscopy findings on each patient. Two blinded experts unaffiliated with the study reviewed the VSI and MRI images. The arthroscopy served as the “control” comparison between the VSI and MRI findings. Results: There were 110 patients included in this study. The accuracy, sensitivity and specificity of VSI was equivalent to surgical diagnostic arthroscopy and more accurate than MRI (Table 1). When comparing VSI to

  4. [Evaluation of meniscal morphology and relation between the diagnostic findings of magnetic resonance imaging and arthroscopy in lesions of the knee].

    Science.gov (United States)

    Esparragoza-Montero, Ricardo; Rodriguez-Diaz, José; Lanier-Dominguez, Julio; Molero-Campos, María; Puccia-Scimonello, Marianela

    2009-03-01

    Magnetic resonance imaging (MRI) is useful in the diagnosis of meniscal lesions of the knee. The purpose of this study was to relate the findings of MRI and arthroscopy and to evaluate the morphology of the menisci with tears. 39 patients of both genders were included, whose age range was 13 to 74 years old (mean: 42.6 years), with and without a history of trauma, who underwent MRI and arthroscopy of the knee, due to symptoms of articular lesion. The images of magnetic resonances were analyzed independently by two specialists prior to the arthroscopy. The measurements of the medial and lateral menisci were made in each meniscal horn with sagital images in protonic density and fat-suppression. MRI detected 8 cases of tear of the lateral meniscus of the 11 catalogued by arthroscopy, and 11 cases of tears of the medial meniscus of the 13 catalogued by arthroscopy. The sensibility and specificity of MRI for the lateral meniscal tears were 72% and 100%, and for the medial tears were 85% and 89%. The meniscal tears were localized mainly in the posterior horn. The dimensions of the posterior horn of the lateral meniscus were larger in disrupted menisci (height, 7.1 +/- 1.3 mm vs. 6.1 +/- 0.7 mm, p meniscal tear produces morphological changes, particularly in the posterior horn of the lateral meniscus. Magnetic resonance constitutes the imaging technique of choice for the diagnosis of the meniscal tears.

  5. Wrist arthroscopy: a prospective analysis of 53 post-traumatic carpal injuries.

    Science.gov (United States)

    Sennwald, G R; Zdravkovic, V

    1997-09-01

    We carried out a prospective study of 53 consecutive patients who had sustained a serious wrist injury. Patients who presented with a previous condition or who had undergone surgery to the wrist were excluded. History, clinical findings, standard radiographs and arthrography were correlated with the uninjured side and with arthroscopic findings. The radiolunate (RL) angle of the injured wrist differed significantly from that of the "normal" wrist (p = 0.088). POssible correlations within the whole group were studied by multivariate analysis, particularly k-means clustering, a procedure which enables the detection of natural groups. We found that ligamentous tears at the triquetrum in the midcarpal joint significantly (p = 0.004) affected the equilibrium of the proximal row defined by clustering with the RL and scapholunate (SL) angles. The use of multivariate analysis techniques in combination with cross tabulation for the surgery of intracarpal ligamentous abnormalities seen at arthroscopy might help us to define better the function of the ligaments of the wrist. These findings, of little help in daily practice, might be important for clinical research.

  6. COMPLICATIONS RESULTING FROM THE USE OF METAL ANCHORS IN SHOULDER ARTHROSCOPY

    Science.gov (United States)

    Godinho, Glaydson Gomes; França, Flavio Oliveira; Alves Freitas, José Marcio; Aguiar, Paulo Nascimento; de Carvalho Leite, Marcelo

    2015-01-01

    To identify the complications concerning the use of metal anchors in shoulder arthroscopic procedures. Methods: 28 shoulders of 28 patients (23 male and 5 female) have been re-operated in the period between December 1997 and August 2007, at Hospital Ortopédico, Belo Horizonte Hospital and Military Police Hospital in Belo Horizonte, MG, as a result of complications such as loose anchors and prominent anchors. The primary surgeries intended to treat 20 anterior traumatic instabilities (71.5%), one posterior instability (3.5%), one slap injury (3.5%), six procedures for treating injuries on the rotator cuff (21.5%). We used the X-ray classification suggested by Samilson and Prieto and Outerbridge arthroscopic classification for assessing patients' degree of arthrosis. All patients were evaluated by the UCLA (University of California at Los Angeles) index criteria. Results: In all patients, arthroscopic reviews were made. In two cases, after anchors removal, clinical signs of instability were seen, leading to the decision of providing open stabilization by Latarjet-Patte technique. Conclusion: the complications with metallic-suture anchors result from inappropriate surgical techniques applied in arthroscopy. PMID:26998465

  7. Septic arthritis as a severe complication of elective arthroscopy:clinical management strategies

    Directory of Open Access Journals (Sweden)

    Imhoff Andreas B

    2009-03-01

    Full Text Available Abstract Infection of a peripheral joint following arthroscopic surgery presents with an incidence of approximately 0.42% an extremely rare entity. However, septic arthritis is a serious situation possibly leading to an irreparable joint damage. Especially at delayed diagnosis patients' safety can be endangered severely. Only few precise statements regarding diagnosis and therapy have been published so far. Besides an accurate analysis of the patient's anamnesis and the assessment of the C-reactive protein especially arthrocentesis is required for diagnostic workup. For early stage infections arthroscopic therapy is proven to be of value. In addition a calculated and consecutive germ-adjusted antibiotic therapy is essential. In case of persisting signs of infection the indication for re-arthroscopy or conversion to open revision has to be stated in time. The number of necessary revisions is dependent on the initial stage of infection. For pain therapy postoperative immobilization of the affected joint is occasionally essential, if otherwise possibly early mobilization of the joint should be performed.

  8. Catastrophic failure of hip arthroscopy due to iatrogenic instability: can partial division of the ligamentum teres and iliofemoral ligament cause subluxation?

    Science.gov (United States)

    Mei-Dan, Omer; McConkey, Mark O; Brick, Matthew

    2012-03-01

    Hip arthroscopy is an evolving surgical tool, and with any new procedure, it is important to learn from the complications encountered. A patient with mild hip dysplasia and a symptomatic labral tear underwent uneventful hip arthroscopy and labral repair including partial debridement of a hypertrophied ligamentum teres. Despite preservation of the labrum, no pincer resection, and a modest capsulotomy, 3 months, subluxation and joint space narrowing were noted. One year, end-stage arthritis was present, requiring total hip replacement. Instability after hip arthroscopy is due to a number of factors, including excessive rim trimming, capsulotomy, overzealous labral resection, or inadequate labral repair. This report emphasizes the importance of the ligamentum teres and small disruptions of the capsule in patients with mild dysplasia.

  9. RESERACH INTO HEMOSTASIS IN THE COURSE OF ARTHROSCOPY%关节镜术中止血方法探讨

    Institute of Scientific and Technical Information of China (English)

    史晨辉; 王永明; 孙吉华; 董金波; 李江华; 李宽新; 孙建华; 何斌

    2001-01-01

    Objective:Arthroscopy accord with the developmental trendency of modern surgery,and this method is better than the opening operating,but must be adopt the hemostatic method in the coures of arthroscopy in order to keep clear field of vision of under arthroscopy.Though traditional technique was a good hemostatic method,it influenced examinnational autehenticity of tissue properties of under arthroscopy and it gave rise to higher complications of postoperation.To investigate a new hemostatic method that overcome defects of technique,it is important significance that improve curation effect of arthroscopic postoperation.To research into hemostatic effect and side effect of arthro-douching liquor plus accessory suprarenin in the course of arthroscopy.Methods:1mg of accessory suprarenin was added into the douching bottle with 1000ml of normal saline.The 1mg/1000ml douching liquor was used at the beginning of the operation.Then,observd the heostatic effect,the changes of BP and heart rate and post-operation complications.Results:In the 159 Knee joint operations (144 cases) the effective rate of hemostasis was 97.49%,while the rate of good result was 81.77%.In one case,the BP exceeded normal scope after medication.All heart rates were within normal scope.The incidence rate of hemarthrosis was 9.03%.No other complication occurred.Conclusions:Hemostasis of douhing liquor plus accessory suprarnin could be applied to most operations of under the arthroscopy.It is easy to perform,no time limit,safe,good hemostatic effect and could effectively avoid various complications arising from hemostasis with technique.%目的:探讨关节冲洗液加副肾素止血法在关节镜术中的止血效果及其副作用。方法:用1mg/ml的副肾素1支加入装有1?000ml生理盐水的冲洗吊瓶中,配成1mg/1?000ml浓度,在镜下手术开始时使用,观察术中止血效果、血压、心率变化及术后并发症。结果:144例159膝术中止血有效率97.49%

  10. The Bristow-Latarjet method in the treatment of shoulder instability that cannot be resolved by arthroscopy. A review of the literature and technical-surgical aspects.

    Science.gov (United States)

    Salvi, A E; Paladini, P; Campi, F; Porcellini, G

    2005-01-01

    Arthroscopy has surpassed traditional types of open surgery in the treatment of shoulder instability because of its mini-invasiveness and shorter rehabilitation time. Despite this, in some cases, such as those involving significant glenoid erosions and extensive capsular lesions, arthroscopic methods fail the objectives, and methods that were believed to have been surpassed are again used, such as the Bristow-Laterjet procedure. It is the purpose of this article to describe use of the method in light of the possibilities offered by arthroscopy.

  11. Artroscopia do quadril na epifisiólise grave Hip arthroscopy in severe epiphysiolisis

    Directory of Open Access Journals (Sweden)

    Eiffel Tsuyoshi Dobashi

    2010-12-01

    Full Text Available Apresenta-se o caso de um indivíduo de 12 anos de idade, do sexo masculino, com diagnóstico de epifisiólise femoral proximal grau III em sua forma crônica agudizada, associada à limitação funcional grave e restrição importante do arco de movimento do quadril. O paciente foi submetido à osteotomia de ressecção de uma cunha trapezoide do colo femoral tipo Dunn por via artroscópica, seguido da redução e fixação percutânea com parafuso de 6,5mm. Houve melhora significativa do quadro clínico logo no primeiro pós-operatório, o que permitiu a reabilitação precoce. Os autores apresentam uma breve revisão de literatura e propõem esta técnica como um método adjuvante viável no tratamento da epifisiólise femoral proximal grave, encorajando o desenvolvimento de estudos sobre o tema.We present a case report of a 12-year-old boy diagnosed with slipped capital femoral epiphysis grade III, with an acute-on-chronic presentation, associated with severe functional impairment and significant reduction in hip range of motion. The patient underwent a Dunn-type trapezoidal wedge femoral neck subtraction osteotomy by hip arthroscopy, followed by closed reduction and fixation with a 6.5mm percutaneous screw. There was significant improvement of the clinical picture on the first postoperative day, allowing for early rehabilitation. After a brief review of the literature, the authors propose this novel surgical technique as a viable method to treat severe slipped capital femoral epiphysis, encouraging the development of new studies on the subject.

  12. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    Science.gov (United States)

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft.

  13. The direct environmental impact of hip arthroscopy for femoroacetabular impingement: a surgical waste audit of five cases.

    Science.gov (United States)

    de Sa, Darren; Stephens, Kellee; Kuang, Michelle; Simunovic, Nicole; Karlsson, Jon; Ayeni, Olufemi R

    2016-07-01

    Health care facilities produce significant waste (2200 kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20-70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in real time: (i) normal/landfill waste; (ii) recyclable cardboards and plastics; (iii) biohazard waste; (iv) sharp items; (v) linens and (vi) sterile wrapping. The surgical waste (except laundered linens) from five FAI surgeries totaled 47.4 kg, including 21.7 kg (45.7%) of biohazard waste, 11.7 kg (24.6%) of sterile wrap, 6.4 kg (13.5%) of normal/landfill waste, 6.4 kg (13.5%) of recyclable plastics and 1.2 kg (2.6%) of sharp items. An average of 9.4 kg (excluding laundered linens) of waste was produced per procedure. Given the considerable biohazard waste produced by FAI procedures, additional recycling programs, continued adherence to proper waste segregation and an emphasis on 'green outcomes' is encouraged to demonstrate environmental responsibility and effectively manage and allocate finite resources.

  14. Analgesic control after hip arthroscopy: a randomised, double-blinded trial comparing portal with intra-articular infiltration of bupivacaine.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2011-06-07

    Abstract: The optimum anaesthetic and analgesic management following hip arthroscopy is yet to be determined. There is, in addition, some concern over the use of intraarticular local anaesthetic. We compared the analgesic efficacy of intra-articular infiltration compared with portal infiltration of bupivacaine following hip arthroscopy. Patients were randomised to receive either 10ml of 0.25% bupivacaine either into the joint or around the portal sites following completion of surgery. 73 patients were recruited (40 intra-articular). The portal infiltration group required significantly more rescue analgesia immediately after surgery (2.33mg vs.0.57mg, p=0.036). Visual Analogue Scale pain scores were not significantly different at 1 and 2 hours following surgery, but at 6 hours the portal group had significantly lower VAS scores (p=0.0036). We believe that the initial pain following surgery results from capsular injury and this explains the need for more rescue analgesia in the portal infiltration group. Further work is needed to establish the ideal regimen. A combination of portal and intra-articular infiltration may be the most efficacious.

  15. 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.

  16. A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients

    NARCIS (Netherlands)

    Tijssen, M.P.W.; Cingel, R.E. van; Visser, E de; Nijhuis-Van der Sanden, M.W.G.

    2016-01-01

    OBJECTIVES: To describe data of short- and midterm results of hip arthroscopy patients based on patient-reported hip function, hip functional performance and return to sports activities. DESIGN: Observational cohort study. SETTING: Sports medical center. PARTICIPANTS: 37 recreational athletes (21 me

  17. Working conditions of bipolar radiofrequency on human articular cartilage repair following thermal injury during arthroscopy

    Institute of Scientific and Technical Information of China (English)

    Huang Yuelong; Zhang Yujun; Ding Xiaoquan; Liu Songyang; Sun Tiezheng

    2014-01-01

    Background The thermal injury during bipolar radiofrequercy results in chondrocyte death that limits cartilage repair.The purpose was to determine the effects of various factors of bipolar radiofrequency on human articular cartilage after thermal injury,offering suitable working conditions for bipolar radiofrequency during arthroscopy.Methods Osteochondral explants from 28 patients undergoing total knee arthroplasty (TKA) in Department of Orthopaedic,Peking University Reople's Hospital from October 2013 to May 2014,were harvested and treated using bipolar radiofrequency in a light contact mode under the following conditions:various power setting of levels 2,4 and 6; different durations of 2 seconds,5 seconds and 10 seconds; irrigation with fluids of different temperatures of 4℃,22℃,and 37℃; two different bipolar radiofrequency probes ArthroCare TriStar 50 and Paragon T2.The percentage of cell death and depth of cell death were quantified with laser confocal microscopy.The content of proteoglycan elution at different temperatures was determined by spectrophotometer at 530 nm.Results Chondrocyte mortality during the treatment time of 2 seconds and power setting of level 2 was significantly lower than that with long duration or in higher level groups (time:P=0.001; power:P=0.001).The percentage of cell death after thermal injury was gradually reduced by increasing the temperature of the irrigation solutions (P=0.003),the depth of dead chondrocytes in the 37℃ solution group was significantly less than those in the 4℃ and 22℃ groups (P=0.001).The proteoglycan elution was also gradually reduced by increasing the temperature (P=0.004).Compared with the ArthroCare TriStar 50 group,the percentage of cell death in the Paragon T2 group was significantly decreased (P=0.046).Conclusions Thermal chondroplasty with bipolar radiofrequency resulted in defined margins of chondrocyte death under controlled conditions.The least cartilage damage during thermal chondroplasty

  18. Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mowinckel Petter

    2010-10-01

    Full Text Available Abstract Background Surgery for type II SLAP (superior labral anterior posterior lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months and long-term (2 years efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy for alleviating pain and improving function for type II SLAP lesions. Methods/Design A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version and the Western Ontario Instability Index (WOSI at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ, the generic EuroQol (EQ-5 D and EQ-VAS, return to work and previous sports activity, complications, and the number of reoperations. Discussion The results of this trial will be of international importance and the results will be translatable into clinical practice. Trial Registration [ClinicalTrials.gov NCT00586742

  19. Value of Fat-Suppressed Proton-Density-Weighted Turbo Spin-Echo Sequences in Detecting Meniscal Lesions: Comparison with Arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, F.K.W.; Schaefer, P.J.; Brossmann, J.; Frahm, C.; Hilgert, R.E.; Heller, M.; Jahnke, T. [Univ. Hospital of Schleswig-Holstein, Kiel (Germany). Dept. of Diagnostic Radiology

    2006-07-15

    Purpose: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging (MRI) compared to arthroscopy in the detection of meniscal lesions. Material and Methods: In a prospective study, 31 knee joints were imaged on a 1.5T MR scanner before arthroscopy using the following sequences: (a) coronal and sagittal FS-PDw TSE (TR/TE: 4009/15 ms); (b) coronal T1w SE (TR/TE: 722/20 ms), and sagittal PDw TSE (TR/TE: 3800/15 ms). Other imaging parameters were: slice thickness 3 mm, FOV 160 mm, matrix 256x256. A total of 186 meniscal regions (62 menisci; anterior horn, body, posterior horn) were evaluated. Standard of reference was arthroscopy. Sensitivity, specificity, negative predictive value (npv), positive predictive value (ppv), and accuracy were calculated. Results: Arthroscopically, meniscal lesions were detected in 55/186 segments (35 medial and 20 lateral meniscal lesions). Sensitivity, specificity, npv, ppv, and accuracy for combination of coronal and sagittal FS PDw TSE were 91.4%, 98.3%, 95%, 97%, and 93.5% for the medial meniscus, and 90%, 98.6%, 97.3%, 94.7%, and 96.8% for the lateral. The results were comparable to the combination of coronal T1w SE and sagittal PDw TSE for the medial (88.6%, 98.3%, 93.4%, 96.9%, 91.4%) and the lateral (90%, 95.9%, 97.2%, 85.7%, 92.5%) meniscus. Conclusion: FS PDw TSE-MR sequences are an excellent alternative for the detection of meniscal lesions in comparison with diagnostic arthroscopy.

  20. Value of fat-suppressed PD-weighted TSE-sequences for detection of anterior and posterior cruciate ligament lesions-Comparison to arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, Fritz K.W. [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany)]. E-mail: f.schaefer@rad.uni-kiel.de; Schaefer, Philipp J. [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Brossmann, Joachim [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Frahm, Christian [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Muhle, Claus [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Hilgert, Ralf Erik [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Heller, Martin [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany); Jahnke, Thomas [Department of Diagnostic Radiology, University Hospital of Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel (Germany)

    2006-06-15

    Objective: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging for the detection of anterior and posterior cruciate ligament lesions in comparison to arthroscopy. Materials and methods: In a prospective study 31 knee joints were imaged on a 1.5 T MR scanner (Vision[reg], Siemens, Erlangen) prior to arthroscopy using following sequences: (a) sagittal FS-PDw/T2w TSE (TR/TE: 4009/15/105 ms); (b) sagittal PDw/T2w TSE (TR/TE:3800/15/105 ms). Further imaging parameters: slice thickness 3 mm, FOV 160 mm, matrix 256 x 256. A total of 62 anterior and posterior cruciate ligaments (ACL/PCL) were evaluated, standard of reference was arthroscopy. Sensitivity, specificity, positive (ppv) and negative predictive value (npv) and accuracy were calculated. Results: Twenty-one cruciate ligament ruptures were detected in arthroscopy, 19 ACL- and 2 PCL-ruptures (on MRI 34/124, 25/62 ACL, 9/62 PCL lesions). For all four sequences in the 31 patients with arthroscopic correlation sensitivity, specificity, ppv, npv and accuracy were 86%, 98%, 95%, 93% and 94% for detection of tears, and 84%, 100%, 100%, 80% and 90% for ACL-ruptures respectively. The two PCL-ruptures were true positive in all sequences, one intact PCL was diagnosed as torn (false positive). Conclusions: Fat-suppressed PDw/T2w TSE-MR sequences are comparable to PDw TSE sequences for the detection of ACL/PCL-lesions.

  1. Curative effect of the gluteal muscle contracture with arthroscopy%关节镜治疗臀肌挛缩症的疗效

    Institute of Scientific and Technical Information of China (English)

    王晓旭; 谭文甫; 谭光华

    2012-01-01

    目的 探讨关节镜下治疗臀肌挛缩症的疗效.方法 2008年1月开始该院采用关节镜下治疗臀肌挛缩症18例患者35侧病变.手术在组织腔室内操作,对挛缩组织逐层进行切割松解,术后尽早行功能锻炼.结果 所有患者均获得了随访2~ 16个月,优良率88.89%.术后无伤口血肿、感染及神经损伤等合并症.结论 关节镜下治疗臀肌挛缩症,切口小,创伤小,出血少,并发症少,术后恢复快.%[Objective] To discuss the treatment of the gluteus muscle contracture with arthroscopy. [Methods] 18 patients (35 hips) of the gluteus muscle contracture were treated under the arthroscopy in our hospital from January 2008. All cases were operated on for the soft tissue release by cutting them layer by layer in the soft tissue cave under the arthroscopy; Function exercise started after operation as soon as possible. [Results] All the cases were followed up from 2~16 months with the effective rate of 83.33%. There were no complications such as hematoma, infection or nerve injure after operations. [ Conclusions ] Arthroscopy can be used to treat gluteus muscle contracture. It is characterized by small wound size, slight pain, scanty bleeding, few complications, quick recovery and satisfactory effect.

  2. “Floating popliteus tendon injury” in a mutiple-ligament knee injury: one case report and arthroscopy-assisted reconstruction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin; FENG Hua; HONG Lei; WANG Xue-song; ZHANG Hui

    2011-01-01

    A patient with both a femoral attachment injury (peel-off injury) and musculotendinous junction avulsion of the popliteus,a so-called “floating popliteus tendon injury”,received arthroscopy-assisted popliteus reconstruction.The injured ligaments were addressed in the same procedure,including mini-open direct repair of the femoral avulsed fibular collateral ligament (FCL),suture repair of the grade 3 medial collateral ligament (MCL),and reconstruction of the posterior cruciate ligament (PCL).

  3. Diagnostic Efficiency of MR Imaging of the Knee. Relationship to time Interval between MR and Arthroscopy; Eficacia diagnostica de la RM de rodilla. Relacion con el intervalo de tiempo entre la RM y la artroscopia

    Energy Technology Data Exchange (ETDEWEB)

    Barrera, M. C.; Recondo, J. A.; Aperribay, M.; Gervas, C.; Fernandez, E.; Alustiza, J. M.

    2003-07-01

    To evaluate the efficiency of magnetic resonance (MR) in the diagnosis of knee lesions and how the results are influenced by the time interval between MR and arthroscopy. 248 knees studied by MR were retrospectively analyzed, as well as those which also underwent arthroscopy. Arthroscopy was considered to be the gold standard, MR diagnostic capacity was evaluated for both meniscal and cruciate ligament lesions. Sensitivity, specificity and Kappa index were calculated for the set of all knees included in the study (248), for those in which the time between MR and arthroscopy was less than or equal to three months (134) and for those in which the time between both procedures was less than or equal to one month. Sensitivity, specificity and Kappa index of the MR had global values of 96.5%, 70% and 71%, respectively. When the interval between MR and arthroscopy was less than or equal to three months, sensitivity, specificity and Kappa index were 95.5%, 75% and 72%, respectively. When it was less than or equal to one month, sensitivity was 100%, specificity was 87.5% and Kappa index was 91%. MR is an excellent tool for the diagnosis of knee lesions. Higher MR values of sensitivity, specificity and Kappa index are obtained when the time interval between both procedures is kept to a minimum. (Author) 11 refs.

  4. Significance of arthroscopy in the diagnosis of unilateral knee arthritis%关节镜对诊断单膝关节炎病因的意义

    Institute of Scientific and Technical Information of China (English)

    陈国强; 张红卫; 黎志峰; 郭冬梅; 余旸弢

    2010-01-01

    Objective To investigate the role of arthroscopy in the diagnosis of unilateral knee arthritis of unknown causes.Methods During December 2005 to February 2008,74 patients of unilateral knee arthritis of unknown origins were treated with arthroscopy.And magnetic resonance imaging(MRI) scans were performed for all of them before knee arthroscopy.The diagnosis was made by the synovial appearance in gross examination in arthroscopy combined with synovial pathology,synodal fluid analysis and clinical manifestations.Results Among these patients,71 cases were definitely diagnosed and 3 cases had unknown causes.Thirty-nine cases(52.9%)were of rheumatoid arthritis(RA),7(9.5%) of seronegative spondyloarthropathy(SPA),7 patients(9.5%) of septic arthritis,6 patients(8.1%)of RA coexisting gout arthritis,5 patients(6.5%) of gout arthritis,5 patients (6.5%) of tuberculosis of knee joint,1 patient(1.3%)of pigmented villonodular synovitis and l patient(1.3%) of multicentric reticulohistiocytosis.Conclusion Arthroscopy provides valuable diagnostic information in unilateral knee arthritis of unknown causes.RA is the major cause of unilateral knee arthritis of unknown causes.Synovial appearance in gross examination in arthroscopy,synovial pathology and crystals are helpful to make a diagnosis.%目的 探讨关节镜检查对病因不明的单膝关节炎的诊断价值.方法 对74例病因不明的单膝关节炎患者进行关节镜手术探查,每位患者术前均行MRI检查.结合临床表现及术中镜下所见的滑膜形态特征、活检组织病理及其他实验室检查和影像学资料,对单膝关节炎作出病因诊断.结果 74例患者中71例经关节镜检查后诊断明确,3例诊断未明,关节镜诊断率为95.9%.其中诊断类风湿关节炎(RA)39例(52.9%),血清阴性脊柱关节病、化脓性关节炎各7例(各占9.5%),RA合并痛风性关节炎6例(8.1%),痛风性关节炎、膝关节结核各5例(各占6.5%),色素沉着绒毛结节性滑膜炎1

  5. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hyeon; Shin, Myung Jin; Choi, Byeong Kyoo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Lee, Sang Hoon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Bin, Sung Il [University of Ulsan College of Medicine, Department of Orthopedic Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch. We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat's line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat's line. The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3 /36.5 /249.0 mm{sup 2}/7.7 mm (group 1); 19.3 mm/0.3/52.9 /40.2 /323.4 mm{sup 2}/4.8 mm (group 2); and 20.3 mm/0.3/51.4 /39.1 /350.8 mm{sup 2}/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05). Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups. (orig.)

  6. Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice

    Directory of Open Access Journals (Sweden)

    Haage Patrick

    2010-04-01

    Full Text Available Abstract Background In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee. Methods In a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15 on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed. Results Inter-observer agreement between readers 1 and 2 was good (kappa = 0.65 within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively, the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52. Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed. Conclusions According to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis.

  7. Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy

    Directory of Open Access Journals (Sweden)

    Nilton Orlando Júnior

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVES: To ascertain the sensitivity, specificity, accuracy and concordance of the physical examination (PE and magnetic resonance imaging (MRI in comparison with arthroscopy, in diagnosing knee injuries. METHODS: Prospective study on 72 patients, with evaluation and comparison of PE, MRI and arthroscopic findings, to determine the concordance, accuracy, sensitivity and specificity. RESULTS: PE showed sensitivity of 75.00%, specificity of 62.50% and accuracy of 69.44% for medial meniscal (MM lesions, while it showed sensitivity of 47.82%, specificity of 93.87% and accuracy of 79.16% for lateral meniscal (LM lesions. For anterior cruciate ligament (ACL injuries, PE showed sensitivity of 88.67%, specificity of 94.73% and accuracy of 90.27%. For MM lesions, MRI showed sensitivity of 92.50%, specificity of 62.50% and accuracy of 69.44%, while for LM injuries, it showed sensitivity of 65.00%, specificity of 88.46% and accuracy of 81.94%. For ACL injuries, MRI showed sensitivity of 86.79%, specificity of 73.68% and accuracy of 83.33%. For ACL injuries, the best concordance was with PE, while for MM and LM lesions, it was with MRI ( p < 0.001. CONCLUSIONS: Meniscal and ligament injuries can be diagnosed through careful physical examination, while requests for MRI are reserved for complex or doubtful cases. PE and MRI used together have high sensitivity for ACL and MM lesions, while for LM lesions the specificity is higher. Level of evidence II - Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard.

  8. Artroscopia da articulação escapulotorácica: relato de casos Arthroscopy of the scapulothoracic joint: case reports

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Andreoli

    2009-01-01

    Full Text Available A artroscopia escapulotorácica é um procedimento que apresenta indicações restritas, para ressecção de corpos livres, tumores benignos, bursites e escápulas em ressalto. Os autores relatam quatro casos de artroscopia da articulação escapulotorácica; no primeiro caso, foi realizada apenas a visualização do tumor benigno (osteocondroma; no segundo caso, a ressecção artroscópica de um osteocondroma; no terceiro caso, a bursectomia artroscópica devido à bursite escapulotorácica; e no quarto caso, bursectomia e escapulectomia súpero-medial parcial artroscópica devido à escápula em ressalto.Scapulothoracic arthroscopy is a procedure presenting restricted indications, for resecting free bodies, benign tumors, bursitis, and snaping scapula. The authors report four cases of scapulothoracic joint arthroscopy; in the first case, only a benign tumor (osteochondroma could be visualized; in the second case, arthroscopic resection of an osteochondroma was found; in the third case, arthroscopic bursectomy due to scapulothoracic bursitis, and; in the fourth case, bursectomy and partial superomedial arthroscopic scapulectomy due to snaping scapula.

  9. Nursing after Anterior Cruciate Ligament Reconstruction Surgery under Arthroscopy%关节镜下前交叉韧带重建患者的护理

    Institute of Scientific and Technical Information of China (English)

    辛海霞; 段元君; 张晓霞; 国美娥

    2012-01-01

    目的 探讨关节镜下前交叉韧带重建术后正确的护理方法.方法 回顾性分析并总结2007年10月至2010年12月济南军区总医院骨创伤外科收治的59例关节镜下前交叉韧带重建患者的临床资料.结果 59例患者均顺利拆线出院,术后膝关节功能恢复良好.结论 围术期正确的护理与康复指导对患者膝关节的功能康复具有关键的作用.%Objective To explore the proper nursing methods after anterior cruciate ligament reconstruction surgery by arthroscopy. Methods The clinical data of 59 patients after anterior cruciate ligament surgery under arthroscopy from October 2007 to December 2010 in the hospital were analyzed and summarized retrospectively. Results Fifty-nine patients were discharged from hospital smoothly, and their knee joint function were well recovered. Conclusion The proper nursing in perioperative period and functional rehabilitation training play a critical part in successful recovery of patients after anterior cruciate ligament surgery.

  10. Preoperative physical therapy treatment did not influence postoperative pain and disability outcomes in patients undergoing shoulder arthroscopy: a prospective study

    Directory of Open Access Journals (Sweden)

    Valencia C

    2016-07-01

    contrast, age, pain intensity, disability, and pain-associated psychological factors did not differ between pre-op PT treatment groups (P>0.05. Subacromial bursectomies were more commonly performed in patients having pre-op PT treatment (P<0.05. Pre-op PT treatment did not influence length of post-op PT treatment and did not affect 3-month and 6-month pain intensity and disability outcomes. Differences in distribution of pre-op PT for males and females and subacromial bursectomy did not influence 3-month or 6-month postsurgical outcomes. Conclusion: Receiving pre-op PT treatment did not influence post-op PT treatment or pain and disability outcomes at 3 months and 6 months. This prospective cohort study provides no evidence of benefit for pre-op PT on post-op PT treatment or postsurgical outcomes. Females or patients receiving certain surgical procedures are more likely to undergo pre-op PT treatment. However, these differences did not influence postoperative outcomes in this cohort. Keywords: preoperative physical therapy, postoperative pain, postoperative disability, shoulder arthroscopy

  11. Level of clinical evidence presented at the International Society for Hip Arthroscopy Annual Scientific Meeting over 5 years (2010–2014)

    Science.gov (United States)

    Kay, Jeffrey; de SA, Darren; Shallow, Scott; Simunovic, Nicole; Safran, Marc R.; Philippon, Marc J.; Ayeni, Olufemi R.

    2015-01-01

    The International Society for Hip Arthroscopy (ISHA) Annual Scientific Meeting is at the forefront of informing today’s orthopaedic surgeons and society of the rapid advances in the exponentially growing field of hip arthroscopy. The purpose of this study was to evaluate and observe any trends in the level of clinical evidence in the papers and posters presented at the ISHA Annual Scientific Meeting from 2010 to 2014. The online abstracts of the paper and poster presentations presented at the ISHA Annual Scientific Meetings were independently evaluated by two reviewers (582 total resulting presentations). Two reviewers screened these results for clinical studies and graded the quality of evidence from level I (i.e. randomized trials) to IV (i.e. case series) based on the American Academy of Orthopaedic Surgeons classification system. Four hundred and twenty-eight presentations met the inclusion criteria and were evaluated. Overall, 10.1% of the presentations were level I, 12.8% were level II, 30.1% were level III and 47.0% were level IV evidence. Over time, from 2010 to 2014, we observed an increase in the percentage of level II paper presentations, an increase in the proportion of level III poster presentations, and a decrease in the proportion of both level IV paper and poster presentations. Significant non-random improvement in the level of evidence presented was noted for the poster presentations (P = 0.012) but not for the paper presentations (P = 0.61) over the study period. Statistical trends demonstrate ISHA’s increased awareness and commitment to presenting higher quality evidence as the availability of this evidence increases. PMID:27011857

  12. Timing of Reconstruction of Anterior Crucite Ligament Under Arthroscopy%关节镜下前交叉韧带重建术的时间选择

    Institute of Scientific and Technical Information of China (English)

    王仁鹏; 曹南开; 吕景波

    2015-01-01

    目的:通过不同时间前交叉韧带(ACL)重建的术后患者优良率的比较,探讨ACL重建的最佳时机。方法对86例(早期(A组)54例,晚期(B组)32例)ACL损伤患者在关节镜下手术重建后并对结果进行分析。结果术后随访6个月,根据Lysholm评分,两组分别取得90.3%和79.6%的优良率,差异有统计学意义(P<0.05)。结论于早期进行前交叉韧带(ACL)重建术会影响患者部分关节功能,而晚期进行重建会增加继发性损伤的发生率。综合判断,早期重建疗效优于晚期。%Objective To compare the excellent and good rate of different timing of reconstruction of anterior cruciate ligament (A-CL) reconstruction under arthroscopy so as to explore the optimal time. Methods The results of reconstruction of ACL under arthroscopy of 86 patients, 45 of whom were assigned to group A who received operation early, and 32 of whom were assigned to group B who received operation later, were analyzed. Results All patients were followed up for 6 months, according to Lysholm score, the excellent and good rate of the two groups was 90.3%and 79.6%. Conclusion Anterior cruciate ligament in the early (A-CL) reconstruction will affect the part of joint function in patients with advanced reconstruction, and may increase the incidence of secondary injury. Comprehensive judgment shows that early reconstruction effect is better than the late.

  13. The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

    Directory of Open Access Journals (Sweden)

    Riyami Masoud

    2006-09-01

    Full Text Available Abstract Background Ankle sprains are common in sports and can sometimes result in a persistent pain condition. Purpose Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series. Methods Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain. Results 43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49% and rugby (14%. The main subjective complaint was exertion ankle pain (93%. Effusion (75% and joint line tenderness on palpation (92% were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9. 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39% and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months, 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks. However 43% still suffered minor symptoms. Conclusion Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain

  14. 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折%Treatment of anterior cruciate ligament tibial eminence avulsionfractures with hollow screw through arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李云华; 刘春磊; 王贵清; 王湘江; 邹华

    2013-01-01

    Objective To observe the clinical effect of treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.Method 13 cases with anterior cruciate ligament tibial eminence avulsion fractures were treated through arthroscopy from February 2010 to March 2011.Fractures were reduction and fixed with hollow screw through arthroscopy.All the cases were followed-up more than 1 year.The evaluation of knee function was taken with Lysholm score system.Result All the cases were followed-up with mean time 16months (12~25months).The preoperative Lysholm scores ranged from 23 to 65,with a mean of (48.45±5.23),and the postoperative Lysholm scores ranged from 83 to 96,with a mean of (91.34±6.53).11 cases were excellent,1 good and 1 fair,the excellent and good rate was 92.3%.Conclusion It is an effiective method in the treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.it may produce less trauma and with quick healing.%目的 观察关节镜下空心螺钉固定ACL胫骨止点撕脱骨折的临床效果.方法 2010年2月~2011年3月,关节镜下空心螺钉固定ACL胫骨止点撕脱骨折13例,在关节镜下复位骨折块,空心螺钉固定骨折块.通过1年以上随访行疗效评定.患者膝关节功能以Lysholm评分系统评分.结果 全部病例获完整随访,平均随访16m(12~25m).Lysholm膝关节功能评分:术前23~65分,平均(48.45±5.23)分;术后83~96分,平均(91.34±6.53)分.优11例,良1例,中1例,优良率92.3%.结论 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折创伤小、恢复快,是一种可行的方法.

  15. Avaliação do uso do Hylano GF-20 no pós-operatório de artroscopia de joelho por artrose The evaluation of Hilan GF-20 in the postoperative knee arthroscopies for arthrosis

    Directory of Open Access Journals (Sweden)

    Wilson Abou Rejaili

    2005-01-01

    Full Text Available O presente estudo avaliou os benefícios do uso do Hylano GF-20 no pós-operatório de artroscopias do joelho para lavagem e desbridamento por artrose.Foram estudados 20 pacientes submetidos à artroscopia em 20 joelhos que apresentavam artrose até grau 3 da classificação com sintomas de dor e bloqueio no referido joelho e não obtiveram melhora ao tratamento conservador, sendo então realizada lavagem associada a desbridamento leve condral e meniscal de acordo com a necessidade de cada caso.Os pacientes foram divididos em 2 grupos sendo que em um dos grupos foi feita apenas a artroscopia e noutro grupo artroscopia associada ao uso de 3 infiltrações realizadas semanalmente de Hylano GF-20.Os pacientes foram avaliados nas variáveis dor em repouso noturna, dor durante movimento com sobrecarga de 10% do peso corporal, dor durante o movimento mais doloroso do joelho afetado com escala visual e a variável quantidade diária de diclofenaco potássico ingerida para alívio da dor no joelho afetado. Os resultados estatísticos mostraram melhora significativa em todas as variáveis estudadas nos pacientes do grupo submetidos ao uso de infiltrações com o Hylano GF-20 no pós-operatório de artroscopias do joelho por artrose no período de 6 meses.This study evaluated the benefits of the Hylano GF-20 use in the postoperative period of knee arthroscopies for irrigation and debridement due to arthrosis. Twenty knees of twenty patients underwent arthroscopy. They presented arthrosis up to 3rd classification degree, pain and had their knees blocked. The segmental treatment showed no improvement ,consequently irrigation associated with mild condral and meniscus debridement was performed according to each case. The patients were divided into two groups: arhtroscopy was performed in one; in the other, arthroscopy associated with the use of three weekly infiltrations of Hylano GF-20. The patients were evaluated according to the following variables: pain

  16. 关节镜下微创治疗中度髌骨软化症%Arthroscopy-assisted minimally invasive treatment of chondromalacia patella

    Institute of Scientific and Technical Information of China (English)

    肖勋刚; 成明华; 李康杰; 何波勇; 周毅; 刘建伟

    2010-01-01

    Objective To study the arthroscopy-assisted minimally invasive treatment of chondromalacia patella. Methods The clinical data of 140 patients with chondromalacia patella, with a mean age of 51.9 ± 5.71 years ( range, 41 to 62 years), undergoing surgical or Non-surgical treatment in our hospital from June 2005 to December 2008 were analyzed. In non-surgical group, 72 cases (96 knees) underwent intra-articular injection of sodium hyaluronate and other non-surgical treatment. In surgical group, 68 cases (84 knees) underwent variorus Arthroscopy-Assisted minimally invasive surgery, according to the extent of the patella cartilage injury and the situation of the patellofemoral joint. Joint functional exercise were carried out after operations. Regular follow-up were done after leaving hospital. Lysholm scoring system was used to evaluate the clinical effects. Judet's evaluation criteria was used to evaluate the improvement of range of motion. Results In non-surgical group, the knee function have been improved 24. 82%. In surgical group the knee function have been improved 35.37%. At the postoperative and final follow-up, the effect in surgery group was significantly better than non-surgical group. Conclusion For the chondromalacia patella with Ⅱ, Ⅲ class cartilage injury, minimally invasive arthroscopic surgery is a good treatment method, which can reduce pain, improve function, slow down the progress of the disease, and improve the quality of life of patients.%目的 研究关节镜辅助下微创治疗中度髌骨软化症的疗效.方法 对本院2005年6月至2008年12月收治的140例患者,年龄41~62(51.9±5.71)岁;病程4~11(6.3±4.12)年.采用不完全随机分组的方法,分为非手术组72例(96膝),采用关节腔注射玻璃酸钠等非手术治疗;手术组68例(84膝),术前根据髌骨软骨损伤程度和髌股排列情况,选择合适的微创手术方式.术后均进行合理的关节功能锻炼等,出院后定期随访.依据Lysholm评

  17. 探析关节镜下前交韧带重建术的康复护理%Rehabilitated Nursing Care in the Reconstruction of Anterior Cruciate Ligament Under the Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    苏敏; 郝桂兰; 杨娟; 季丹丹; 吴晓荣

    2014-01-01

    Objective To explore postoperative rehabilitated nursing care in the reconstruction of anterior cruciate ligament under the arthroscopy.Method 35 patients with reconstruction of anterior cruciate ligament under the arthroscopy received systemic rehabilitation training.Results The patients' knee joint have good function,no discomfort and no infection occurred after the operation. Conclusion Rehabilitation training is very important for the patients with reconstruction of anterior cruciate ligament to recover the function and prevent form complications.%目的:探讨关节镜下前交叉韧带重建术后的康复护理方法。方法总结35例关节镜下前交叉韧带重建术的患者,制定系统的功能锻炼方法进行康复训练。结果35例患者患侧膝关节活动范围均恢复良好,可正常生活,患膝无不适感和感染现象发生。结论正确的康复护理是韧带重建术后功能恢复的重要保证。

  18. Artroscopia da articulação fêmoro-tíbio-patelar de cão Arthroscopy of stifle joint in dogs

    Directory of Open Access Journals (Sweden)

    C.M.F. Rezende

    2006-10-01

    Full Text Available Artroscopia diagnóstica ou terapêutica foi realizada em 51 articulações fêmoro-tíbio-patelar (FTP de cão. Os animais foram submetidos à anestesia geral e empregou-se solução Ringer lactado para distensão articular após a coleta do líquido sinovial. Endoscopicamente, a FTP foi dividida em cinco compartimentos: o recesso suprapatelar, articulação fêmoropatelar, compartimento medial, área intercondilar e compartimento lateral. Ruptura de ligamento cruzado cranial foi a mais freqüente patologia observada (46 casos que em três casos estava associada a prolapso de menisco, em três casos observou-se sinovite e em dois osteocondrose dissecante do côndilo lateral. Dificuldades de introdução do artroscópio, de visibilização das estruturas e infiltração excessiva do tecido subcutâneo foram complicações observadas. Verificou-se, ainda, um caso de necrose tecidual grave. Nos casos crônicos, a observação das estruturas foi dificultada pela presença dos elementos celulares. A ampliação das imagens possibilitou o diagnóstico de lesões ainda em fase incipiente e daquelas não conclusivas ao exame radiográfico.Diagnostic or therapeutic arthroscopy of stifle joint (SJ was performed in 51 dogs. Animals were submitted to general anesthesia and ringer lactate solution was injected for articular distention after synovial fluid punction. SJ was divided in five main areas according to endoscopies: suprapatellar pouch, femuropatellar joint, medial compartment, intercondilar notch and lateral compartment. Cranial cruciate ligament rupture was most frequent (46 cases detected pathology. In three cases it was related to medial meniscus prolapse. Synovitis was observed in three cases and dissecant osteocondrosis of the lateral femure condyle in two animals. Difficulties for arthroscope introduction, visualization of the structures and excessive infiltration of the subcutaneous tissue were complications observed. It was also noted a

  19. Artroscopia no tratamento da tendinite calcária refratária do ombro Arthroscopy in thetreatment of refractory calcific tendonitis of the shoulder

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2010-01-01

    Full Text Available OBJETIVOS: Analisar os resultados do tratamento artroscópico de pacientes com tendinite calcária do ombro. MÉTODOS: Entre setembro de 2001 e junho de 2006, 55 pacientes com tendinite calcária do ombro, resistentes ao tratamento conservador, foram avaliados, com seguimento de 12 a 70 meses. A média de idade foi de 42 anos, variando de 30 a 64 anos; 44 pacientes eram do sexo feminino (80%, sendo 37 ombros direitos (67,27%, com dominância em 63,63% dos casos. A dor foi o principal sintoma, sendo que o tempo decorrido entre o início dos sintomas e a artroscopia foi em média de 38 meses (cinco a 120 meses. Quanto aos tendões acometidos, o supraespinal em 42 casos, o infraespinal em 11 e a associação entre eles em dois casos. A acromioplastia foi realizada em apenas 12 casos (21,82%, enquanto a bursectomia subacromial, em todos os casos. RESULTADOS: Segundo os critérios da UCLA, houve 46 casos excelentes e seis bons, totalizando 52 resultados satisfatórios (94,54%. CONCLUSÃO: O tratamento artroscópico da tendinite calcária do ombro sugere ter altos índices de resultados satisfatórios, sendo um método eficaz. A acromioplastia associada não se faz necessária.OBJECTIVE: To evaluate the results of arthroscopic treatment in patients with calcific tendonitis of the shoulder. METHODS: Between September 2001 and June 2006, 55 patients with calcific tendonitis of the shoulder that was resistant to prior conservative treatment were evaluated, with follow-up of 12 to 70 months. The mean age was 42 years, ranging from 30 to 64 years; 44 patients were female (80%, with 37 right shoulders, with a predominance of 63.63% . Pain was the main symptom, and the mean time between onset of symptoms and arthroscopy was 38 months (five to 120 months. In relation to the affected tendons, the supraspinatus tendon was predominant, with 42 cases, the infraspinatus in 11, and an association between the two in 2 cases. Acromioplasty was carried out in 12

  20. Anatomy of anterolateral portals of elbow arthroscopy%肘关节镜前外侧入路的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    吴关; 鲁谊

    2016-01-01

    目的:初步探讨肘关节镜前外侧入路向前方的变化范围。方法选用10具新鲜上肢标本,在肘关节屈曲90°下,测量近端前外侧入路、前外侧入路、外侧入路与桡神经的距离;测量改良后3个入路前方5 mm 与桡神经的距离。结果标准入路的近端前外侧入路、前外侧入路、外侧入路与桡神经的距离平均值分别为:12.8 mm、8.5 mm、3.8 mm,改良后的近端前外侧入路、前外侧入路、外侧入路与桡神经的距离平均值分别为4.1 mm、2.2 mm、-0.5 mm。结论肘关节近端前外侧入路与前外侧入路之间的连线区可向前方5 mm 进行操作,越靠远端距离桡神经越近;前外侧入路与外侧入路距离桡神经较近,不建议向前方改变入路。%[Abstract ] Background From the 1 980s, elbow arthroscopic surgery has been rapidly developing and widely applied.Indications for elbow arthroscopic surgery include:loose bodies,stiff elbow,elbow synovitis,and elbow cartilage injury etc.In recent years,more and more scholars try to apply elbow arthroscopy in more complex operations,such as ligament repair,reconstruction,and fracture fixation and so on.Currently,there are quite a few reports on reduction and fixation of radial head fracture, humerus capitellum fracture, ulna coronoid fracture under elbow arthroscopy. Recently,we started to conduct elbow arthroscopic fracture reduction and internal fixation,and found that due to the varying types of fracture morphologies and locations,the conventional lateral elbow approach sometimes cannot access satisfactory fixation angles.Due to the narrow space in the elbow joint and complex anatomical relationship of the peripheral nerves,nerve injury is common in elbow surgery and consequences are often serious.Therefore,we aim to explore better approaches to protect the radial nerve based on study of anatomical specimens. Here we used either an improved anterolateral elbow approach that entered at a more

  1. 自制新型冷敷袋在膝关节镜术后患者中的应用%Application of self-made ice-bag to postoperative patients receiving knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    徐瑞璟; 陈叶玲; 方杜娟; 罗凯燕

    2011-01-01

    目的 探讨更有效的减轻膝关节镜术后关节肿痛的冷敷方法.方法 将296例膝关节镜术后患者随机分为对照组(144例)和观察组(152例).对照组采用毛巾包裹清水冰袋进行冷敷,观察组采用自制新型冷敷袋进行冷敷,术后当天冰敷2h,术后第1~5天每天冰敷2次,每次2小时.结果 两组术后第3天舒适度,术后6h、24 h、48 h疼痛程度,术后24 h、48 h肿胀程度及负压引流量比较,差异有统计学意义(均P<0.01).结论 新型冷敷装置具有使用安全、舒适,且镇痛、消肿和减少渗出等特点,可广泛应用于膝关节镜术后患者.%Objective To explore a more effective cryotherapy for relieving patients pain after knee arthroscopy. Methods A total of 296 patients undergoing knee arthroscopy were randomly divided into a control group (n=144) and an observation group (n=152). Patients in the control group were given ice bags wrapped with towel for cryotherapy, while their counterparts in the observation group employed self-made ice bags for cryotherapy. All patients received 2 hours cryotherapy on the postoperative day, and on the second to fifth postoperative day the cryotherapy was performed for 2 hours each time, twice a day. Results Significant differences were found in degree of comfort on the third postoperative day, in degree of pain at the postoperative 6th, 24th, 48th hour, and in swelling and drainage volume at the postoperative 24th and 48th hour between the two groups (P<0. 01 for all). Conclusion The self-made ice bag for cryotherapy is safe and comfortable, and beneficial to pain relief, antioncotic and effusion reduction. It can be used in patients undergoing knee arthroscopy.

  2. 关节镜下部分重建治疗膝关节前交叉韧带不完全断裂%Selective reconstruction for incomplete injury to anterior cruciate ligament of the knee under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张羽飞; 王福生; 王立德; 张卫国; 汤欣

    2008-01-01

    Objective To explore the clinical skills and effects of arthroscopie diagnosis and se-lective reconstruction of incomplete anterior cruciate ligament (ACL) injury of the knee. Methods From June 2004 to December 2006, 267 eases of incomplete ACL lesion of the knee were admitted to our hospital and diagnosed under the arthroscopy. Of them, 29 cases (10.9%) were diagnosed as incomplete ACL injury (21 as anterior medial branch (AMB) rupture and 8 as posterior lateral branch (PLB) rupture). The damaged ligaments were reconstructed selectively under arthroscopy. Eleven eases underwent reconstruction with LARS ligament and 18 with autologous hamstring ligament. The undamaged ligament branches were reserved. Results All cases were followed up for an average period of 15 (12 to 30) months. Rehabilitation lasted 12 months. Statistically significant differences existed between preoperative Lysholm scores and postoperative l,yshotm scores (P < 0.05). Conclusions Selective reconstruction of the damaged ACL parts can keep integrity of double branches of the ligament, improve the joint function and avoid terminal complications. Appropriate treatment and early reconstruction of the damaged ACL under arthroscopy are clinically important for early recovery of the knee stabilization.%目的 探讨前交叉韧带(ACL)不完全断裂的关节镜下诊断及镜下部分蕈建治疗的疗效和意义. 方法 2004年6月至2006年12月,经关节镜确诊ACL不完伞断裂29例,其中前内侧束断裂21例,后外侧束断裂8例.全部患者于关节镜下重建损伤部分的韧带组织,选用LARS韧带蕈建11例,自体四股腘绳肌腱移植重建18例,术中完整保留未断裂部分的切带纤维束. 结果全部患者均获随访,平均随访15个月(12~30个月),治疗康复12个月时,门诊进行统一标准膝关节功能评定,膝关节Lysholm评分手术前、后比较差异有统计学意义(P<0.05). 结论正常ACL的前内侧束和后外侧束各自有不同的功

  3. Queimadura de terceiro grau na região da placa eletrocirúrgica durante artroscopia de ombro: relato de caso Third-degree burn in the region of the electrosurgical pad during shoulder arthroscopy: a case report

    Directory of Open Access Journals (Sweden)

    Leandro Cardoso Gomide

    2011-01-01

    Full Text Available O número de artroscopias de ombro está aumentando e, por causa disso, a frequência de complicações relacionadas também aumenta. O presente caso relata uma queimadura de terceiro grau na região da placa eletrocirúrgica durante esta cirurgia e alerta sobre possíveis causas e como tentar prevenir esta rara, mas possível complicação.The number of shoulder arthroscopy procedures is increasing and, because of this, the frequency of related complications is also increasing. This report presents a case of third-degree burn from an electrosurgical pad during this procedure and serves as an alert regarding the possible causes and how to try to prevent this rare, but possible complication.

  4. Magnetic resonance imaging and arthroscopy in patients with cruciate ligament injury of knee joints%MRI检查在膝关节交叉韧带损伤中的应用

    Institute of Scientific and Technical Information of China (English)

    杨赞礼; 黄武斌; 郑宁; 郭仰丹

    2011-01-01

    目的:观察MRI检查在膝关节交叉韧带损伤诊断中的应用情况.方法:收集2009年1月至2011年3月广东省揭阳市人民医院收治的74例膝关节交叉韧带损伤患者的临床资料,以关节镜检查的诊断结果作为金标准,分析比较MRI检查的准确率.结果:本组74例膝关节交叉韧带损伤患者中,关节镜诊断阳性率、临床体检阳性率、MRI检查初次诊断阳性率分别为100%( 74/74)、99%( 73/74)、86%(64/74),MRI检查与前两者比较,差异具有统计学意义(P<0.05).MRI检查的诊断假阳性率为14%(10/74).患者MRI影像表现较为复杂,如韧带连续性中断、信号增高、外形不规则、韧带水平走向等,尤其是急性损伤的高信号及积液的高信号常常影响MRI检查结果.结论:MRI检查对于膝关节前后交叉韧带损伤的诊断和手术方案的准备都治必不可少,但需结合临床的分析,可疑患者必要时应进行膝关节镜检查,以免造成漏诊.%Objective; To determine the diagnostic accuracy of magnetic resonance imaging ( MRI) and arthroscopy in patients with cruciate ligament injury of knee joint. Methods: We collected the clinical profiles of 74 patients with cruciate ligament injury of knee joint admitted to Jieyang People's hospital between January 2009 and March 2011. The diagnostic accuracy of MRI was explored by using arthroscopy as the gold standard. Results; Of the 74 patients with cruciate ligament injury of knee joints, the positive rate of arthroscopy (100% , 74/74) differed statistically from that of physical examination (99% , 73/74) and initial MRI (86% , 64/74) (both P<0.05). MRI was found to have a false positive rate of 14% (10/74). MRI manifestations exhibited a complex myriad of discontinuous ligament, increased signal intensity, irregular shapes, horizontal ligament travelling, and in particular, high-intensity signals suggesting acute injury and effusion that may have impact on the results. Conclusion; MRI

  5. Clinical nursing of local pressure cooling on controlling of joint swelling after knee arthroscopy%局部加压冷疗对控制膝关节镜术后关节肿胀的临床护理

    Institute of Scientific and Technical Information of China (English)

    朱春燕; 周婷

    2015-01-01

    目的:探讨局部加压冷疗对控制膝关节镜术后关节肿胀的临床护理效果。方法:收治行膝关节镜手术患者50例,随机分为对照组和试验组各25例。对照组予常规治疗及护理,同时予以传统冰袋冷疗;试验组给予AIRCAST加压冷疗装置局部加压冷疗。结果:试验组关节疼痛及肿胀程度均优于对照组,差异有统计学意义(P<0.05)。结论:与传统冷疗相比,膝关节镜治疗术后采用局部加压冷疗能有效减轻患者疼痛、消除关节肿胀。%Objective:To investigate the clinical nursing effect of local pressure cooling on controlling of joint swelling after knee arthroscopy.Methods:50 patients with knee arthroscopic operation were selected.They were randomly divided into the control group and the experimental group with 25 cases in each.The control group were received routine treatment and nursing,and also given the traditional ice cold therapy at the same time;However,the experimental group were given local pressure cooling therapy with AIRCAST cryotherapy and compression device.Results:The differences in joint pain and swelling degree were statistically significant between the two groups(P<0.05).Conclusion:Compared with the traditional therapy,given local cryotherapy after knee arthroscopy treatment can reduce the pain of patients more effectively,and it also can eliminate joint swelling.

  6. Treatment of calcifying tendonitis of shoulder with arthroscopy and comparison of efficacy%肩关节钙化性肌腱炎的关节镜治疗及急慢性期疗效比较

    Institute of Scientific and Technical Information of China (English)

    陈建海; 张一翀; 张殿英; 付中国; 杨明; 党育; 姜保国

    2015-01-01

    Background Calcifying tendonitis of rotator cuff is a common disease that causes pain .It frequently occurs in people at 30‐50s ,especially in women .The acute calcifying tendonitis is characterized by persistent severe pain of shoulder joint of unknow n reason .In case of severe symptoms ,emergency treatment is needed .Most patients with acute phase diseases have good efficacy for conservative treatment .However ,patients who do not respond to conservative treatment or with symptoms unrelieved that severely influence work and life ,surgery that removes the calcifying lesion under the arthroscopy is recognized as the effective treatment .Recently ,with the development of arthroscopy ,removal of calcium compounds under the arthroscopy has become a common surgery and leads to good efficacy .This study was performed to assess the efficacy of removal of calcified lesion under arthroscopy for calcifying tendonitis of rotator cuff in patients with acute and chronic phases of diseases ,and to determine the difference in shoulder joint function between acute and chronic phases after surgery .Methods General data:Cases with calcifying tendonitis who received treatment from September 2009 to June 2014 were included in this study .The inclusion criteria included :(1) who had history of severe shoulder joint pain;(2) who did not respond to conservative therapy ;(3) who received arthroscopy .The exclusion criteria included :(1) who had complicated injury of rotator cuff ;(2) who received open surgery .28 cases who met inclusion criteria were enrolled .The patients were assigned to the acute group and the chronic group by the time from the acute onset to removal of calcified lesion under arthroscopy .The acute group received removal of calcified lesion within 3 months after the onset of shoulder pain .The chronic group received removal of calcified lesion 3 months after the onset of shoulder pain that limited range of motion .28 cases had different degrees of pain and limited

  7. The preliminary comparative study between MRI and arthroscopy manifestation for rotator cuff injury%肩袖损伤MR I与关节镜下表现对比的初步研究

    Institute of Scientific and Technical Information of China (English)

    刘佳超; 陈建海; 黄伟; 王天兵; 姜保国

    2013-01-01

    目的:通过比较肩关节术前 MRI检查与关节镜下肩袖所见的异同,了解 MRI 对肩袖损伤诊断的准确性,并进一步明确肩袖损伤关节镜治疗的适应证。方法回顾性分析2007年7月至2010年12月北京大学人民医院创伤骨科行关节镜检查或治疗患者的59例肩部疾病患者,将MRI表现与关节镜所见进行对照分析。结果59例患者中,术前 MRI 检查明确诊断肩袖损伤36例,经关节镜证实肩袖撕裂35例,肩袖组织关节镜下结果完整,未见明显撕裂者1例;术前 MRI 检查未发现肩袖撕裂而关节镜下见撕裂7例,MRI检查与关节镜均未见肩袖撕裂者16例。MRI 对肩袖损伤诊断的敏感度为88.3%,特异度为94.1%,阳性预测值97.2%,阴性预测值69.6%。结论 MRI 是诊断肩袖损伤的有效辅助检查,但仍存在一定程度的漏诊,关节镜检查是诊断肩袖损伤最为可靠的辅助检查手段。%Objective Rotator cuff, a sleeve-like structure composed of supraspinatus, infraspinatus muscle,teres minor and subscapularis,is the major anatomical structure to maintain shoulder stability.Rotator cuff pathologies are frequently encountered in patients with pain at the shoulder.The rotator cuff can be visualized with different imaging techniques such as ultrasonography (US),arthrography,arthroscopy,computed tomography (CT)and magnetic resonance imaging (MRI).MRI had quickly become the favored method for preoperative diagnosis of the rotator cuff inj ury,with high soft tissue resolution ratio,sensitivity and accuracy.It is clinically significant to correctly understand the MRI manifestation of patients with the painful shoulder.We retrospectively analyzed the MRI examination and arthroscopy findings of 5 9 rotator cuff inj uries treated in one hospital.Methods (1)Subjects:From July 2007 to December 2010,a total of 59 patients (25 males and 34 females,aged from 24 to 83 years old,mean age 54.33 years),who underwent arthroscopic surgery for

  8. Comparative Analysis of the Findings of Low-Field Intensity Magnetic Resonance Imaging and Arthroscopy in Knee Joint Injury%膝关节损伤低场MRI表现与关节镜检查的比较分析

    Institute of Scientific and Technical Information of China (English)

    蒋华平; 杨宏美; 徐荣泰

    2011-01-01

    [目的]比较分析膝关节损伤低场MRI表现与关节镜检查结果.[方法]对267例共295个膝关节低场MRI表现与关节镜检查作回顾性分析.[结果]低场MRI表现对膝关节损伤诊断有较高的敏感度、特异度及准确度,但较关节镜的检查结果,有一定的偏差率.[结论]低场MRI表现结合临床症状和关节解剖特点,对膝关节损伤有明确的术前诊断价值.%[Objective]To comparatively analyze the findings of low-field intensity magnetic resonance ima-ging(MRI) and arthroscopy in knee joint injury. [Methods] The findings of low-field intensity MRI and ar-throscopy in 267 cases(295 knee joints) of knee joint injury were analyzed retrospectively. [Results] The findings of low-field intensity MRI had a certain sensitivity, specificity and accuracy in the diagnosis of knee joint injury, but there was some deviation between low-field intensity MRI and arthroscopy. [Conclusion] Low-field intensity MRI combined with clinical symptoms and anatomic features of knee joints has certain value in the preoperative diagnosis of knee joint injury.

  9. Arthroscopy combined with limited incision in the treatment of multiple ligament knee injuries%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

    Objection To evaluate the method and short-term effect of arthroscopy combined with limited incision in the treatment of multiple ligament knee injuries. Methods The clinical data of 25 patients with multiple ligament injuries were reviewed retrospectively. All of the anterior and posterior cruciate ligaments were reconstructed under arthroscopy with anterior tibial muscle tendon allografts. The ligaments around the knee,the meniscus and the cartilages were repaired through a limited incision. The International Knee Documentation Committee (IKDC) grades and Lysholm scores were recorded before and after operation respectively. Results All the patients were followed up from 24 to 30 months with an average time of 27.4 months,and their knee function improved obviously. All the IKDC grades were grade D before operation and then turned to grade A in 10 cases,grade B in 12 cases and grade C in 3 cases postopera-tively. The average Lysholm score was ( 92±1. 8 ) and got improved si gnificantly (P < 0.05 ) . Conclusion Reconstruction the cruciate ligaments with anterior tibial muscle tendon allografts under the arthroscopy through a limited incision could significantly improve the function of knees with good outcomes.%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例,B级12例,C级3例,Lysholm评分平均为(92±1.8)分,与术前相比差异有统计学意义(P<0.05).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损伤韧带,可以明显

  10. Hollow screw and suture fixation for treatment of tibial intercondylar eminence fractures under arthroscopy%关节镜下空心螺钉与缝线内固定治疗胫骨髁间棘骨折

    Institute of Scientific and Technical Information of China (English)

    陈维东

    2013-01-01

    BACKGROUND:Intercondylar eminence fractures of the tibia are often treated by arthroscopic surgery, but the fixation methods are controversial. OBJECTIVE:To compare curative effect of hol ow screw and suture fixation in treatment of tibial intercondylar eminence fractures under arthroscopy. METHODS:A total of 46 patients with tibial intercondylar eminence fractures were recruited from the Third People’s Hospital of Yancheng, China from June 2010 to January 2013. According to the patient’s wil ing and physician’s suggestions, the involved patients were divided into hol ow screw group (n=25) and suture fixation group (n=21), undergoing hol ow screw and suture fixation under arthroscopy, respectively. RESULTS AND CONCLUSION:According to Ikeuchi grade, the excellent and good rate after fixation showed no significant differences between the two groups (P>0.05), but the functional training time in hol ow screw group was significantly shorter than that in suture fixation group (P  目的:比较关节镜下应用空心螺钉与缝线内固定治疗胫骨髁间棘骨折的临床疗效。  方法:收集盐城市第三人民医院自2010年6月至2013年1月收治的46例胫骨髁间棘骨折患者,根据患者意愿及医师建议分为空心螺钉组(n=25)和缝线组(n=21),分别在关节镜下行空心螺钉与缝线内固定。  结果与结论:空心螺钉组与缝线组胫骨髁间棘骨折患者固定后 Ikeuchi 膝关节评分优良率差异无显著性意义(P >0.05),但空心螺钉组患者固定后功能训练时间明显比缝线组短(P <0.05)。提示关节镜下空心螺钉治疗胫骨髁间棘骨折比缝线有利于胫骨髁间棘骨折患者的恢复。

  11. 关节镜技术监视下治疗内踝骨折的临床疗效分析%Analysis of clinical effects of arthroscopy formedial malleolar fracture

    Institute of Scientific and Technical Information of China (English)

    胡丹; 郝跃峰; 司卫兵; 秦卫; 焦健; 顾雪平

    2016-01-01

    Objective To analysis the clinical effects of arthroscopy for medial malleolar frac-ture. Methods A total of 72 patients with medial malleolar fracturewere selected and randomly divided into the observation group and control group,with 36 cases in each group. Patients in the observation group received internal fixation under arthroscopy,while in the control group received open reduction and inter-nal fixation. Results Operative time,blood loss and fracture healing time in the observation group were significantly better than the control group[(44. 2 ± 6. 3)min vs(64. 6 ± 5. 2)min,(18. 4 ± 2. 3)ml vs (34. 7 ± 3. 9)ml,and(78. 5 ± 9. 3)d vs(91. 4 ± 10. 4)d,P 0. 05). Conclu-sion For medial malleolar fracture,arthroscopycan shorten the operation time,reduce intraoperativeblood loss,fasten fracture healing,and promote the recovery of joint function.%目的:分析关节镜技术治疗内踝骨折的临床效果。方法内踝骨折患者72例。随机分为观察组及对照组,每组各36例。对照组患者接受切开复位内固定治疗,观察组患者在关节镜下行内固定治疗。比较两组患者的治疗效果。结果观察组患者手术时间、术中出血量及骨折愈合时间分别为(44.2±6.3)分钟、(18.4±2.3)ml 和(78.5±9.3)天,对照组患者分别为(64.6±5.2)分钟、(34.7±3.9)ml 和(91.4±10.4)天,两组比较差异有统计学意义(P 0.05)。结论关节镜下治疗内踝骨折可缩短手术时间,减少术中出血,加快骨折愈合,促进踝关节功能恢复。

  12. 膝关节损伤磁共振与关节镜结果的对照分析%Comparative Analysis of Magnetic Resonance Imaging and Arthroscopy of Knee Joint Injury Results

    Institute of Scientific and Technical Information of China (English)

    范传朝; 康子民

    2014-01-01

    目的:对膝关节损伤磁共振与关节镜结果进行对比分析。方法:收集我院2012年10月~2013年10月期间诊治的膝关节损伤患者44例作为研究对象,采用回顾性的方式分析患者的临床资料,对比分析磁共振与关节镜检查结果。结果:对比2种检测结果发现,磁共振在诊断前交叉韧带、膝内侧副韧带、膝外侧副韧带中出现了3例假阳性情况,磁共振在膝关节韧带损伤的灵敏度为100.0%,特异度为95.4%,符合率为96.8%。结论:磁共振检查膝关节损伤具有很高的灵敏度、特异性和符合率,关节镜检查相对较差,可作为膝关节损伤的筛查方式。%Objective:To make a comparative analysis of magnetic resonance imaging and arthroscopy of knee joint injury results . Methods:in our hospital from 2012 October -2013 year in October during the diagnosis and treatment of patients with knee injury in 44 cases as the object of study , a retrospective analysis of clinical data of patients of the way , the analysis of magnetic resonance imaging and arthroscopic findings contrast .Result:s the results of two kinds of detection , magnetic resonance cross appeared 3 false positive cases liga-ment, medial collateral ligament , knee lateral collateral ligament in the diagnosis , magnetic resonance in the sensitivity of the ligament in-jury of the knee joint was 100%, the specificity was 95.4%, the coincidence rate is 96.8%.Conclusion:MRI knee injury has a very high sensitivity , specificity and coincidence , arthroscopy relatively poor , can be used as a screening method of knee joint injury .

  13. Extravasamento de líquido no mediastino e derrame pleural durante artroscopia de ombro: relato de caso Fluid leakage into the mediastinum and pleural effusion during shoulder arthroscopy: a case report

    Directory of Open Access Journals (Sweden)

    Leandro Cardoso Gomide

    2007-08-01

    Full Text Available O presente trabalho tem o objetivo de apresentar uma rara, porém possível complicação respiratória durante uma artroscopia de ombro executada na posição de "cadeira de praia". Houve extravasamento de líquido para o mediastino durante o procedimento quando se usava a bomba de infusão, ocasionando dificuldade respiratória. O tratamento foi conservador, com retardamento da extubação, internação em unidade de terapia intensiva, diuréticos e medidas de suporte. No quarto dia de pós-operatório, a paciente estava assintomática em relação a tal complicação.This study is intended to present a rare but possible respiratory complication during a shoulder arthroscopy performed in the beach chair position. Fluid leaked into the mediastinum during the procedure when the infusion pump was being used, which caused respiratory difficulty. Treatment was conservative, with extubation delay, stay at the Intensive Care Unit, diuretic drugs, and support action. In the fourth postoperative day, the patient was asymptomatic regarding such complication.

  14. Effect of remnant preservation and remove in anterior cruciate ligament reconstruction under arthroscopy%关节镜下保留与清除断裂前交叉韧带残端重建术后疗效比较

    Institute of Scientific and Technical Information of China (English)

    杨勇; 徐红革; 邱志杰; 王良恩; 杨彬

    2016-01-01

    Objective:To compare the clinical effects of remnant preservation and remnant remove in anterior cruciate ligament( ACL) reconstruction under arthroscopy. Methods:The clinical data of 70 ACL rupture patients followed by 12 months were retrospectively analyzed. The observation group ( 35 cases ) and control group ( 35 cases ) were treated with ACL reconstruction through remnant preservation and remove,respectively. The joint stability,joint function and proprioception recovery between two groups were analyzed. Results:All patients were followed up for 12 to 27 months. The difference of joint stability between two groups was not statistically significant(P>0. 05). At the end of following up,the joint function in observation group was better than that in control group(P0.05);末次随访时观察组患者术后关节功能均优于对照组(P<0.01);观察组患者术后本体感觉优于对照组(P<0.01)。结论:关节镜下保留与清除残端重建ACL均能取得较好的临床疗效,恢复关节稳定性;但保留残端手术更有利于术后膝关节功能及本体感觉的恢复。

  15. 膝关节镜下前交叉韧带重建术的护理配合%Nursing cooperation in anterior cruciate ligament reconstruction with knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    杨红梅

    2011-01-01

    目的 探讨和总结膝关节镜下重建前交叉韧带的手术配合经验,以进一步提高配合水平.方法 通过对15例自体韧带重建前交义韧带的手术配合,总结配合要点、经验.结果 本组患者术后平均15.0d出院.无1例交叉感染,术后2个月Lysholm膝关节功能良好.结论 充分的术前准备,严格执行无菌操作,准确熟练地配合手术,正确使用仪器和器械是手术成功的关键.%Objective To explore and summarize nursing cooperation in anterior cruciate ligament reconstruction with knee arthroscopy in order to improve coordination level. Methods Key cooperation points and experience were summarized through 15 cases of autologous ligament reconstruction with anterior cruciate ligament surgery. Results The average time was 15.0 d before all patients were discharged. No crossing infection occurred. After two months Lysholm knee function was good. Conclusion Adequate preoperative preparation, strictly enforced aseptic manipulation, accurate and proficient surgery cooperation, correct use of instruments and equipments are key to any successful operation.

  16. Efficacy and safety of "Five-Sequential-Portal Method" in elbow arthroscopy%肘关节镜"序贯五入路法"的有效性与安全性分析

    Institute of Scientific and Technical Information of China (English)

    汪华清; 唐康来; 龚继承; 谭晓康; 许建中

    2008-01-01

    目的 探讨肘关节镜"序贯五入路法"在肘关节损伤和疾病治疗中的有效性与安全性.方法 2004年4月至2007年5月期间收治53例肘关节镜手术患者,包括肘关节强直24例,骨折15例,肘关节游离体7例,桡骨小头脱位2例,关节结核8例,类风湿关节炎4例,骨化性肌炎5例,色素沉着绒毛结节性滑膜炎3例,滑膜软骨瘤1例.手术入路采用"序贯五入路法",由肘后"软点"建立第一入路后,关节镜监视下于前外侧建立第二入路,通过第二入路绕过冠突由内向外建立第三入路.再在肘后肱三头肌腱两侧建立后外侧人路和后内侧人路,作为第四、五入路.按顺序探查肘关节腔,并进行相应处理.其中3例转为切开手术.术后采取无痛性康复训练,对手术前、后肘关节Mayo功能评分进行比较.结果 46例患者术后获6~34个月(平均11.65个月)随访,Mayo评分:术前45~85分,平均(66.8±11.5)分,良14例,可21例,差11例;术后55~100分,平均(84.5~10.5)分,优16例,良21例,可8例,差1例.术后2例出现一过性神经麻痹症状,其中尺神经深支和桡神经深支各1例,3个月后恢复.结论 采用"序贯五入路法"肘关节镜下显露满意、视野清晰,手术效果好;手术入路安全,并发症少,值得在肘关节镜手术中推广使用.%Objective To evaluate the efficacy and safety of "Five-Sequential-Portal Method" which was designed by us in arthroscopy for elbow diseases. Methods From April 2004 to May 2007, 53 patients were treated for elbow diseases with an arthroscopic procedure in our hospital. The final diagnoses included 24 cases of elbow contracture, 15 elbow fracture, 7 loose body, 2 subluxation of capitulum radii, 8 tuberculous arthritis, 4 rheumatoid arthritis, 5 myositis ossificans, 3 pigmented villonodular synovitis and 1 synovial chondromatosis. We used self-designed "Five-Sequential-Portal Method" to establish the portals of elbow arthroscopy. The arthroscopy was inserted

  17. Radial head fixation under arthroscopy for Mason Ⅱ radial head fractures%肘关节镜治疗Mason Ⅱ型桡骨头骨折的早期临床效果

    Institute of Scientific and Technical Information of China (English)

    鲁谊; 姜春岩; 冯华; 王满宜

    2010-01-01

    Objective To evaluate the early therapeutic effects of arthroscopic procedure used for Mason Ⅱ radial head fractures. Methods From October 2006 to October 2008, 36 cases of fresh Mason Ⅱ radial head fractures were treated under arthroscopy by 2 protocols. Group A (16 cases) used prone position, brachial plexus anaesthesia and 4 portals while group B (20 cases) side-lying position, general anaesthesia and 3 portals. After debridement and anatomical reduction, the fractures were fixed by absorbable screws. The range of motion (ROM) was compared at 12 and 24 weeks postoperatively among all the patients.Comparisons were also done between the 2 groups at 12 and 24 weeks postoperatively in the ROM and Mayo elbow performance score(MEPS). Results Fine union was achieved in all the 36 cases without complications. The average ROM of flexion-extension was 128.4°± 12. 7° at 12 weeks and 132.5°± 10. 2°at 24weeks, without any significant difference ( t = 2. 713, P = 0. 539); the average ROM of rotation was 115.3°± 24.0° at 12 weeks and 118.1 °± 19. 3° at 24 weeks, without any significant difference ( t = 5.120, P =0. 778) . No significant differences were found between the 2 groups at either 12 or 24 weeks in ROM of flexion-extension, ROM of rotation or MEPS points ( P > 0. 05). Conclusions Short term results show that a satisfactory functional outcome can be achieved by arthroscopy via proper portals in treatment of Mason Ⅱ radial head fractures. Advantages of arthroscopy are minimally invasive approaches, direct visualization of the fracture and early recovery.%目的 探讨应用关节镜技术治疗Mason Ⅱ型桡骨头骨折的临床疗效.方法 对2006年10月至2008年10月收治的36例新鲜Mason Ⅱ型桡骨头骨折进行回顾性分析,根据不同操作方式分为A组(俯卧位、臂丛麻醉、4个手术入路)和B组(侧卧位、全身麻醉、3个手术入路).其中A组16例,男11例,女5例,平均(37.4±6.5)岁;B组20例,男15例,女5例,

  18. The pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy%关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    林瑞新; 董伊隆; 杨国敬

    2010-01-01

    目的 探讨关节镜下双套环技术治疗后十字韧带(posterior cruciate ligament,PCL)胫骨止点撕脱性骨折的方法和临床疗效.方法 2007年1月至2009年7月,自行设计关节镜下双套环技术治疗23例后十字韧带胫骨止点撕脱性骨折,男15例,女8例.年龄28~52岁,平均39.3岁.Meyers-McKeever分型:Ⅱ型4例,Ⅲ型14例,Ⅳ型5例.结合手术前后膝关节Xx线片和MRI,以及手术前后Lysholm评分和Tegner膝关节功能评分,对关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折的疗效进行分析.结果 所有患者手术均在1小时内完成,所有病例均无止血带损伤、血管神经损伤和感染等并发症,术后两周拆线,创口均Ⅰ/甲愈合.所有患者均获得随访,随访时间12~23个月,平均16.5个月.Lysholm膝关节评分从术前(50.3±6.1)分提高到术后半年随访的(89.7±8.3)分(t=18.34,P=0.0007).Tegner膝关节评分从术前(1.7±0.5)分提高到术后半年随访的(5.7±1.3)分(t=13.77,P=0.0008).两组膝关节功能评分有统计意义.结论 关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折具有创伤小、疗效良好且固定可靠等优点,其为后十字韧带胫骨止点撕脱性骨折的治疗提供一种可靠的选择.%Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy. Methods From January 2005 to July 2009, 23 patients were treated with the pair ringer technology for bony avulsion of the posterior cruciate ligament by arthroscopy. There were 15 male and 8 female, with an average of 39.3 years (ranging from 28 to 52 years). There were 4 cases of type Ⅱ, 14 type Ⅲ, and 5 type Ⅳ according to Meyer-Mckeever classification. The outcome measures were X-ray and MRI testing, Lysholm and Tegner knee function score. Results All the operations were finished in an hour. There were no complications as

  19. Nursing of tibial avulsion fracture of anterior cruciate ligament with arthroscopy%关节镜下治疗前交叉韧带胫骨止点撕脱性骨折的护理

    Institute of Scientific and Technical Information of China (English)

    孙文萍; 林芃; 陈传霞

    2012-01-01

    目的 探讨关节镜下治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的临床护理.方法 通过对12例ACL胫骨止点撕脱性骨折的患者采取术前心理护理、术前准备、术前适应性训练,术后一般护理、患肢与疼痛的观察护理和康复护理相结合,并在工作中小断总结护理经验,提高护理水平.结果 本组12例患者平均随访16个月,所有骨折均获愈合,未出现骨折移位等并发症.结论 科学、系统、细致的护理措施及有效的功能锻炼是确保治疗成功的关键,有利于ACL胫骨止点撕脱性骨折患者关节功能的恢复,减少并发症的发生.%Objective To explore the clinical nursing of tibial avulsion fracture of anterior cruciate ligament (ACL) with arthroscopy. Methods Twelve patients with tibial avulsion fracture of anterior cruciate ligament were provided with preoperative psychological nursing, perioperative preparation, preoperative adaptive exercise, general postoperative nursing, limb and pain nursing, and rehabilitation nursing. The nursing experience has been summarized in order to improve nursing management. Results An average of 16 -month follow -up of all the 12 patients revealed that all fractures were healed with no complications such as fracture dislocation. Conclusion Scientific, systematic, careful nursing measures and effective functional exercise are essential to a successful treatment, which is conducive to the recovery of patients with tibial avulsion fracture of anterior cruciate ligament and the reduction of complications.

  20. Lateral retinacular release and patella ligament reconstruction under arthroscopy for recurrent patellar dislocations%外侧支持带松解联合髌骨韧带重建修复复发性髌骨脱位

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:关节镜检查能够直接动态观察髌股关节的对合关系,准确了解髌股关节异常是否可以完全纠正。目的:分析关节镜下外侧支持带松解联合髌骨韧带重建对复发性髌骨脱位的临床疗效。方法:复发性髌骨脱位患者共58例,随机将其分为对照组和观察组各29例,对照组患者给予常规手术行外侧支持带松解联合髌骨韧带重建,观察组患者给予关节镜下外侧支持带松解联合髌骨韧带重建。结果与结论:治疗前两组患者的Lysholm评分和Kujala评分的比较,差异均无显著性意义(P >0.05);治疗12个月后两组患者的Lysholm评分和Kujala评分均升高,且观察组升高的更明显(P 0.05);治疗12个月后两组患者的适合角和外侧髌股角CT测量值均降低,且观察组降低的更明显(P 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.

  1. 19例异体跟腱关节镜下重建膝后交叉韧带临床分析%Posterior cruciate ligament reconstruction with allogenic achilles tendon under arthroscopy in 19 cases

    Institute of Scientific and Technical Information of China (English)

    孙英华; 王莉; 范晓华; 焦兆德

    2009-01-01

    目的 探讨关节镜下应用同种异体跟腱重建膝后交叉韧带(PCL)的方法及疗效.方法 回顾2004年1月至2008年1月在关节镜下应用同种异体跟腱重建PCL 19例,术中切取标准化的柱状跟骨,确保移植物在股骨及胫骨骨道内紧密固定,术前及术后12个月时用Lysholm评分评定膝关节功能.结果 随访19例患者术前平均评分61分(54~69分),术后12个月时92分(76~95分),总优良率89%.结论 关节镜下应用同种异体跟腱重建PCL可有效改善膝关节稳定性.术中股骨及胫骨骨道精确定位、术后系统康复治疗是确保手术疗效的关键.%Objective To evaluate the method and its effect of posterior cruciate ligament (PCL) reconstruction with allogenic achilles tendon under arthroscopy.Methods We reviewed ninteen patients who were underwent arthroscopic PCL reconstruction using the allogenic achilles tendon from January 2004 to January 2008.A special technique was allowed for the standardized harvest of cylindrical calcaneus bone,ensuring adequate press-fit fixation within the femoral and tibial tunnels,and the function of the knee joint was assessed according to the Lysholm score.Results Ninteen patients were followed up.Before operation,the mean Lysholm score was 61 points (54~69 points).Twelve months later after operation,the score was 92 points (76~95 points).The excellent and good results were obtained in 89%.Conclusion Our study indicates that arthroscopic PCL reconstruction with allogenic achilles tendon can effectively improve the stability of the knee joint.It is important to achieve favorable result that the precise position is taken in the femoral and tibial tunnels in operation,and systematic rehabilitation training is performed after operation.

  2. Effect of pre- and post-operative phenylbutazone and morphine administration on the breathing response to skin incision, recovery quality, behavior and cardiorespiratory variables in horses undergoing fetlock arthroscopy. A pilot study.

    Directory of Open Access Journals (Sweden)

    Clara eConde-Ruiz

    2015-11-01

    Full Text Available This prospective blinded randomized study aimed to determine whether the timing of morphine and phenylbutazone administration affects the breathing response to skin incision, recovery quality, behavior and cardiorespiratory variables in horses undergoing fetlock arthroscopy.Ten Standardbred horses were premedicated with acepromazine (0.04 mg kg-1 IM and romifidine (0.04 mg kg-1 IV. Anesthesia was induced with diazepam (0.05 mg kg-1 and ketamine (2.2 mg kg-1 IV at T0. Horses in group PRE (n = 5 received morphine (0.1 mg kg-1 and phenylbutazone (2.2 mg kg-1 IV after induction and an equivalent amount of saline after surgery. Horses in group POST (n = 5 received the inversed treatment. Anesthesia was maintained with isoflurane 2% in 100% oxygen. Hypotension (mean arterial pressure < 60 mmHg was treated with dobutamine. All horses breathed spontaneously. Dobutamine requirements, respiratory rate (fR, heart rate (HR, mean arterial blood pressure, end tidal CO2, inspired (i and expired (e tidal and minute volume (VT and V̇E, inspiratory time (IT and the inspiratory gas flow (VTi/IT were measured every five minutes. Data were averaged during four 15 minutes periods before (P1, P2 and after the incision (P3, P4. Serial blood-gas analyses were also performed. Recoveries were unassisted, video-recorded and scored by three anesthetists blinded to the treatment. The post-operative behavior of the horses (25 demeanors, HR and fR were recorded at three time points before induction (T0-24h, T0-12h, and T0-2h and six time points after recovery (TR (TR+2, 4, 6, 12, 24, 48 h.Data were compared between groups using a Wilcoxon test and within groups using a Friedman test or a Kruskal-Wallis signed rank test when applicable.Tidal volumes (VTe and VTi were higher in PRE than in POST during all the considered periods but the difference between groups was only significant during P2 (VTe in ml kg-1 in PRE: 13 [9, 15], in POST: 9 [8,9], p = 0.01. None of the other

  3. Arthroscopy Cleaning Calcaneal Tubercle on Individualized Forming after Decompression Treat-ment of Intractable Haglund's Syndrome of the Achilles Tendon%内镜下跟骨后上结节成形减压术治疗顽固性 Haglund 综合征

    Institute of Scientific and Technical Information of China (English)

    王铭; 李海滨; 刘会欣; 付洪睿; 杨学桥; 潘洪阁

    2015-01-01

    Objective To study the surgical effect of arthroscopy calcaneal tubercle cleaning on individualized forming af-ter decompression treatment of intractable Haglund's syndrome of the Achilles tendon. Methods Twenty-two cases underwent arthroscopy cleaning calcaneal tubercle on individualized forming after decompression treatment. American Foot and Ankle Sur-gery Society(AOFAS)ankle-foot function score was assessed preoperatively and postoperatively. Results Patients were fol-lowed up for 13. 6 months(6 ~ 18months). American Foot and Ankle Surgery Society(AOFAS)ankle-foot function score im-proved significantly. 90. 9% of patients presented excellent or good results. Conclusion Arthroscopy cleaning of calcaneal tu-bercle on individualized form with decompression treatment of intractable Haglund's syndrome of the Achilles tendon can a-chieve satisfactory results.%目的:研究内镜下跟骨后上结节成形减压术治疗顽固性 Haglund 综合征的手术治疗效果。方法我科于2013年1月至2014年8月对22例顽固性 Haglund 综合征患者采用内镜下跟骨后上结节成形减压术治疗,其中男14例,女8例;年龄15~64岁,平均41.7岁。对22例患者术前、术后均进行美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足功能评分。结果所有患者均获得随访,随访时间6~18个月,平均13.6个月。术前 AOFAS 踝-后足功能评分平均56分,术后平均86.4分,评分明显提高。优16例,良4例,可2例,优良率为90.9%。结论内镜下跟骨后上结节成形减压术治疗顽固性 Haglund 综合征可获得良好的临床效果。

  4. 关节镜内侧髌骨支持带缝合与石膏固定治疗急性髌骨脱位比较%Comparison of Arthroscopy Medial Patella Ligament Strengthening and Plaster Immobilization in Treating Acute Patellar Luxation

    Institute of Scientific and Technical Information of China (English)

    张虎; 叶明钧; 叶挺

    2016-01-01

    Objective To investigate the clinical effect of arthroscopy medial patela ligament strengthening and plaster immobilization in treating acute patelar luxation.Methods82 cases with acute patelar luxation in our hospital from August 2013 to August 2014 were selected as study objects.They were divided into two groups,41 cases in each group. Control group was given plaster immobilization treatment and observation group was given arthroscopy medial patela ligament strengthening. Compared the clinical effect of the two groups.Results Patela slant angle of observation group was obviously better than control group after 1 year treatment,the difference was statisticaly significant(P<0.05). Lysholm score of observation group was obviously higher than control group, the difference was statisticaly significant(P<0.05).Conclusion Compared with plaster immobilization, arthroscopy medial patela ligament strengthening in treating acute patelar luxation has better significant effect.%目的:研究分析关节镜内侧髌骨支持带缝合和石膏固定治疗急性髌骨脱位的临床效果。方法选取2013年8月~2014年8月我院收治的急性髌骨脱位患者82例,随机分为两组,各41例。对照组采用石膏外固定治疗,观察组采用关节镜内侧髌骨支持带缝合术治疗,对比两组临床治疗效果。结果观察组在治疗后1年髌骨倾斜角优于对照组,差异有统计学意义(P<0.05);观察组各项Lysholm评分均高于对照组,差异有统计学意义(P<0.05)。结论相比于石膏外固定治疗,关节镜内侧髌骨支持带缝合术治疗急性髌骨脱位效果良好,可提高治疗效果。

  5. 关节镜下膝关节前交叉韧带断裂同种异体肌腱重建术的临床研究%A clinical study on reconstruction of anterior cruciate ligament with homologous under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张明; 王岩峰; 韩晓锐

    2011-01-01

    [ Objective ] To explore the clinical effect of anterior cruciate ligament with homologous ligaments under arthroscopy. [ Method ] Eighteen patients with anterior cruciate ligament injury were reviewed retrospectively. All were reconstructed by homologous ligaments under arthroscopy. The Lysholm score were recorded before and after operation. [ Result] All the patients were followed up for average of 25 months, statistically significant differences were seen in Lysholm score between preoperatively and postoperatively (average 41 ± 1.1 preoperatively and 92 ± 2.6 postoperatively) (P <0.01 ). The difference was significant.Symptoms were relieved and the function of knee joint was improved. The unstable symptom of two knees was still anterior drawer positive. [ Conclusion ] Reconstruction of anterior cruciate ligament with homologous ligaments is effective for avoiding complications of autografts. The operation under arthroscopy has advantages of less injury, rapid recovery and satisfactory effect.%[目的]探讨膝关节镜下采用同种异体肌腱重建前交叉韧带的方法和效果.[方法]回顾性分析2007年3月~2009年4月18例关节镜下应用同种异体肌腱重建前交又韧带的情况,应用山西骨组织库提供的同种异体肌腱进行前交叉韧带重建,观察并记录治疗前后的症状、体征变化,采用Lvsholm关节评分评价疗效.[结果]全部病例均获得随访,平均随访25个月,Lysholm关卫评分山术前(41±1.1)分提高到术后(92±2.6)分(P<0.01),在统计学上有显著差异所有病例均无膝前区疼痛,2例体检仍出现阳性体征,关节功能明显改善,症状基本消失.[结论]关节镜下同种异体肌腱重建前交又韧带创伤小,稳定性好,并发症少,疗效优良.可避免自体移植物取材后造成的并发症.

  6. An experimental study to compare inflammatory response due to liquid or gas joint distension in horses submitted to arthroscopy Estudo experimental para comparar a resposta inflamatória decorrente da distensão líquida ou gasosa em cavalos submetidos à artroscopia

    Directory of Open Access Journals (Sweden)

    Renata Bello Rossetti

    2012-12-01

    Full Text Available PURPOSE: To assess comparatively the inflammatory response that follows CO2 or Ringer's lactate joint capsular distension of horses submitted to experimental arthroscopy METHODS: Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention in one joint and fluid distention in the contralateral joint. Synovial fluid was evaluated at 0, six, 12, 24 and 48 hours post-operative. RESULTS: The use of CO2 for arthroscopy causes an acute and mild synovitis alike to the liquid capsular distension, showing similar synovial fluid increase of leukocytes, TP, and TNF-α. Although synovial fluid PGE2 content was higher in joints submitted to CO2 distension, lower levels of hemoglobin and leukocytes oxidative burst after surgery indicates that CO2 arthroscopy decreased intra-articular bleeding and activation of infiltrating leukocytes. CONCLUSIONS: The use of CO2 for arthroscopic examination causes acute and mild synovitis that is similar to the effects caused by the liquid capsular distension. CO2 also seems to decrease intra-articular bleeding and activation of leukocytes.OBJETIVO: Avaliar comparativamente a resposta inflamatória decorrente da distensão líquida ou gasosa em cavalos submetidos ao exame artroscópico. MÉTODOS: Cada animal foi submetido a uma artroscopia bilateral tarsocrural empregando uma distensão com gás em uma articulação e líquido na articulação contralateral. O líquido sinovial foi avaliado as zero, seis, 12, 24 e 48 horas do pós-operatório. RESULTADOS: A utilização de CO2 para a artroscopia provoca uma sinovite aguda e leve tal como a distensão capsular por líquido, mostrando um aumento similar de leucócitos, TP (proteína total e TNF-a. Embora no líquido sinovial a quantidade de PGE2 tenha sido maior nas articulações submetidas à distensão por CO2, níveis mais baixos de hemoglobina e explosão oxidativa de leucócitos após a cirurgia indica que a artroscopia com CO2 diminuiu o

  7. Comparison of Cryo/Cuff System with Ice Compress in Postoperative Care of Knee Arthroscopy Patients%膝关节镜术后应用循环加压冷疗系统和冰敷冷疗的对比研究

    Institute of Scientific and Technical Information of China (English)

    田润溪; 郝玉芳; 郭红

    2013-01-01

    Objective To compare the clinical efficacy of Cryo/Cuff system with that of ice compress for patients after knee arthroscopy.Methods From 2012 March to 2012 November,64 patients with knee arthroscopy were randomized into Cryo/Cuff system group and traditional ice compress group with 32 patients in each group.All patients accepted cryotherapy every 8 hours and knee exercises under the direction of nurses.Visual Analogue Scale(VAS) score was used to measure the pain scale on 24 h and 48 h postoperatively.The perimeter difference between the injuried and uninjuried side was used to evaluate the swelling degree on 24 h and 48 h postoperatively.Hospital for Special Surgery (HSS) score and comfortability was assessed on 48 h after arthroscopy.Results The between-group comparisons at baseline revealed no significant difference preoperatively (P>0.05).The pain and swelling degree were statistically significant on 24 h and 4 8 h (P<0.05).The scores of HSS in two groups were not statistically significant on 48 h after operation(P>0.05),while the scores of comfortability statistically significant (P<0.05).Conclusion Cryo/Cuff system can relieve pain and swelling degree in early stages after knee arthroscopy compared with traditional ice compress therapy.Patients are more likely to accept the system,so they could begin early functional exercises to achieve earlier recovery.%目的 比较膝关节镜术后应用循环加压冷疗系统和冰敷冷疗的临床效果.方法 2012年3-11月行膝关节镜手术符合要求的64例患者,随机分为循环加压冷疗组和冰敷冷疗组,每组各32例.两组均于术后每8h进行冷疗,常规进行功能锻炼.疼痛采用视觉模拟评分进行评估,肿胀情况用患侧、健侧肢体大腿周径的差值来评估.分别在术后24 h和48 h对两组进行疼痛和肿胀程度的评估,在术后48 h评估膝关节功能和舒适度.结果 两组研究对象术前基线资料可比(P>0.05).两组研究对象术后24h

  8. La artroscopia en el daño interno de la ATM: resultados clínicos de un estudio prospectivo Arthroscopy for the internal derangement of TMJ: clinical outcome from a prospective evaluation

    Directory of Open Access Journals (Sweden)

    F.J. Avellá Vecino

    2004-04-01

    adequately control symptoms. Our objective is to demonstrate the efficacy of arthroscopic lysis and lavage treatment for a homogeneous group of patients diagnosed of TMJD according to clinical-radiographic parameters. Design. This article reports a prospective study of 22 articulations (13 patients diagnosed of internal derangement of TMJ and treated with lysis and lavage arthroscopy from February 1996 to April 2001. Before and after treatment as well as during the follow-up (range: 12-63 months, mean: 27 months, the following parameters were considered: pain, MIO, protrusive and laterotrusive mobility, noises, and MRI. Results. We performed a descriptive statistical study of continuous variables, comparing the pre- and postsurgery values with Wilcoxon and Mc Nemar tests, demonstrating a significant improvement during follow-up. Mann Whitney U Test was used for comparing pain and MIO between early and advanced stages, demonstrating a significantly greater improvement for early stages. The MRI results at one year of follow-up supports improvement in 27% (II-III Wilkes stages. According to Murakami criteria we obtained 23% excellent outcome, and 77% favorable outcome. Conclusions. Joint lysis and lavage is a useful and effectiveness method for treatment of internal derangement for early stages as well as for late stages, improving pain, MIO, protrusive and laterotrusive movements, and noises significantly. The improvement of MIO with arthroscopic lysis and lavage is greater for early stages.

  9. Complicações decorrentes do uso de âncoras metálicas em artroscopias de ombro Complications resulting from the use of metal anchors in shoulder arthroscopy

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    Glaydson Gomes Godinho

    2009-04-01

    Prieto and Outerbridge arthroscopic classification for assessing patients' degree of arthrosis. All patients were evaluated by the UCLA (University of California at Los Angeles index criteria. RESULTS: In all patients, arthroscopic reviews were made. In two cases, after anchors removal, clinical signs of instability were seen, leading to the decision of providing open stabilization by Latarjet-Patte technique. CONCLUSION: the complications with metallic-suture anchors result from inappropriate surgical techniques applied in arthroscopy.

  10. Systematic Reviews Keep Arthroscopy Up to Date.

    Science.gov (United States)

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-02-01

    Sometimes systematic reviews seem overprevalent, and some systematic reviews can be "inconclusive," which does not improve clinical decision making. On the other hand, systematic reviews can make a positive impact on patient outcomes by summarizing clinically relevant literature for arthroscopic surgeons and related researchers.

  11. Knee Arthroscopy Cohort Southern Denmark (KACS)

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Christensen, Robin; Nissen, Nis;

    2013-01-01

    Meniscus surgery is a high-volume surgery carried out on 1 million patients annually in the USA. The procedure is conducted on an outpatient basis and the patients leave the hospital a few hours after surgery. A critical oversight of previous studies is their failure to account for the type of me...

  12. The Characteristics of Pathological Grade of Knee Joint Pigmented Villonodular Synovitis under Arthroscopy-Clinical Case Report of 15 Cases%膝关节色素沉着绒毛结节性滑膜炎关节镜下病理学分级——附15例临床病例报告

    Institute of Scientific and Technical Information of China (English)

    田向东; 马玉峰; 王庆甫; 时宗庭; 杜春林; 黄沪; 杨骁侠; 杨会敏; 宋妍

    2013-01-01

    Objective:To discuss the characteristics of pathological grade of knee joint pigmented villonodular synovitis (PVNS) under arthroscopy.Methods:All the cases were collected who received arthroscopy from 2007 to 2012,among which 18 cases of PVNS confirmed by pathology were retrospectively analyzed.The 18 cases were examined by X-ray and MRI.Results:The imaging findings of knee joint X-ray and MRI,pathological findings after arthroscopy and the severity and the extent of PVNS of 18 cases were compared.The pathological findings of synovial cells were all PVNS.The limited and diffused fulvous synovial hyperplasia,congestion and hypertrophy,or soft tissue nodule and the synovial cluster conglomerate or villous prominent could be seen under arthroscopy.There was obvious effusion in articular but no invasion to other organizations within the joint.Four cases out of 15 with X-ray showed consistent findings with the above findings.For MRI,all 15 cases had consistent findings.Synovial hyperplasia and invaded intra-articular fat pad were seen in 5 cases,which were confirmed in no patients with X-ray and 5 with MRI.Synovial hyperplasia and invaded meniscus and cruciate ligaments were seen in 4 cases,which were confirmed in no patients with X-ray but 3 with MRI.Synovial hyperplasia and invaded cartilage and bones were seen in 2 cases,which were confirmed in no patient with X-ray but 2 with MRI.Conclusion:(1) MRI findings are more consistent with findings of arthroscopy than X-ray findings,so the MRI diagnostic specificity of PVNS is higher.(2) Knee joint PVNS can be classified into 3 grades with arthroscopy findings,thus different treatments can be selected according to the grades.(3) Arthroscopic surgery is the best treatment for PVNS at present.%目的:探讨膝关节色素沉着绒毛结节性滑膜炎(PVNS)关节镜下病理学分级特征.方法:搜集我院2007年-2012年所有关节镜病例,对18例经病理证实的PVNS患者的病例资料进行回

  13. 2479例膝关节镜手术患者关节软骨损伤的流行病学分布特征%Articular cartilage lesions: clinical epidemiology of 2 479 patients undergoing knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    易守红; 郭林; 陈光兴; 段小军; 杨柳; 戴刚

    2011-01-01

    Objective To identify the clinical epidemiological features of articular cartilage lesions of knee. Methods The data of 2 479 cases (2 556 knees) concerning surgery video and medical records of total knee arthroscopy from October 2005 to December 2009 were retrieved from the database of our center. The prevalence, importance population information, age and location distribution, common illnesses and frequently encountered diseases were analyzed retrospectively in these difference stage cases of articular cartilage lesions.Results In the total cases the prevalence of articular cartilage lesions accounted for 55.1%. There was no significant difference in gender ratio between those with articular cartilage lesions and those without. The average age of articular cartilage lesions was 41.31 ± 15.88, and the most common age bracket ranged from 30 to 59 years old. More was found in the right knee than in the left ( P < 0.05 ). The predilection locations of articular cartilage lesions were the femoral trochlea, lateral tibia platform and patella. The common illnesses included meniscus injury, crnciate ligament tear and primary osteoarthritis. The highly frequent diseases were tuberculosis of joint, rheumatoid arthritis, joint adhesions and stiffness, patellofemoral joint abnormality and meniscus injury. The prevalence of articular cartilage lesions in different stages was 27.45% for grade Ⅰ,29.94% for grade Ⅱ , 14.71% for grade Ⅲ and 27.89% for grade Ⅳ. There were significant differences in gender ratio, mean age and age bracket, and predilection locations and numbers among the articular cartilage lesions in different stages ( P < 0.05 ). Conclusion Clinically, articular cartilage lesions are common in the knee joint. The range of age distribution is wide. Young people are major population, and no gender difference is seen. Gender constituent ratio is different for the cartilage lesions at different severity and for different lesions, and age

  14. Clinical effect study on reconstruction of anterior cruciate ligament with allo-autologous tendon grafts under arthroscopy%关节镜下异体与自体肌腱联合编织重建前交叉韧带疗效研究

    Institute of Scientific and Technical Information of China (English)

    梁杰; 陈波; 尚峥晖

    2012-01-01

    目的 观察自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)的疗效.方法 回顾性分析我院2006年2月~2010年6月收治入院的自体胭绳肌肌腱与同种异体移植物关节镜下重建膝关节前交叉韧带(ACL)患者30例临床资料,均采用美国强生公司生产的Rigidfix及Intrafix系统固定,评价项目包括手术时间、发热天数、大腿周径患健侧比值、Lachman试验、中立位前抽屉试验(ADD)和国际膝关节评分委员会(IKDC)评分、Lysholm及Tegner评分.随访时间为12~24个月.结果 30例患者术后膝关节稳定性均得到明显好转;手术前后大腿周径患健侧比值、IKDC评分、lysholm评分及Tegner评分等指标比较差异均有统计学意义(P < 0.05);随访(14.5±2.3)个月,膝前区疼痛5例,手术感染性关节炎1例,给予抗生素及激素治疗1个月后痊愈.术后随访发现肌腱没有免疫排斥反应.结论 自体胭绳肌肌腱与同种异体移植物联合关节镜下重建膝关节前交叉韧带有较好的疗效.%Objective To observe therapeutic effects for reconstruction of anterior cruciate ligament (ACL) with alto-hamstring tendon and antologous tendon grafts under arthroscopy. Methods The clinical data of 30 patients with reconstruction of anterior cruciate ligament (ACL) with alto-hamstring tendon and antologous tendon grafts under arthroscopy were collected and analyzed retrospectively in our hospital from February 2006 to June 2010. All cases were fixed by Rigidfix and Intrafix system of Johnson & Johnson production. Evaluation project included the operation time, the duration of fever, the ratio of thigh diameter between paretic and non paretic side, Lachman test, neutral anterior drawer test (ADD), Lysholm, Tegner and international knee documentation committee (IKDC) scores. All had been followed up for 12 to 24 months. Results Knee stability of 30 patients was improved obviously after operation. The the

  15. Clinical observations of medial compartment knee osteoarthritis by proximal fibular osteotomy with arthroscopy%膝关节镜结合腓骨近端截骨术对膝关节内侧间室骨关节炎的疗效

    Institute of Scientific and Technical Information of China (English)

    佟刚; 解强

    2016-01-01

    Objective To explore the clinical short-term result of proximal fibular osteotomy with arthroscopy in the treatment of knee osteoarthritis.Methods From August 2015 to March 2016 thirty six patients with medial compartment knee osteoarthritis were treated by proximal fibular osteotomy with arthroscopy in Department of Orthopaedics,Beijing Tongren Hospital,Capital Medical University.The preoperative and postoperative visual analogue scale (VAS) and the hospital for special surgery (HSS) knee score were compared in follow-up.Results The follow-up period was 3 and 10 months.The postoperative HSS knee scoreincreased significantly [(56.1 ± 11.1) score vs (83.0 ± 5.9),(83.7 ± 3.9) score] (P < 0.05) and the VAS scoredecreased significantly [(7.9 ± 0.8) score vs (2.4 ± 0.7),(1.8 ± 0.9) score] (P < 0.05) compared with pre-operation.There are 3 cases of superficialperonealnerve injury and recovered 3 months after operation.Conclusion Proximal fibular osteotomy with arthroscopy in the treatment of medial compartment knee osteoarthritis can provide satisfactory early effects.%目的 探讨膝关节镜结合腓骨近端截骨术治疗膝关节内侧间室骨关节炎的疗效.方法 回顾2015年8月至2016年3月首都医科大学附属北京同仁医院骨科采用膝关节镜结合腓骨近端截骨术治疗膝关节内侧间室骨关节炎的患者36例,记录并比较术前及术后的疼痛视觉模拟评分(VAS)、美国特种外科医院(HSS)膝关节评分.结果 所有患者均获得随访,随访时间3~ 10个月.HSS评分由术前(56.1±11.1)分增至术后3个月(83.0±5.9)分及末次随访(83.7±3.9)分;VAS评分由术前(7.9±0.8)分降至术后3个月(2.4±0.7)分及末次随访(1.8±0.9)分.术后患者的HSS评分均明显升高、VAS评分均显著降低(P<0.05).3例患者出现腓浅神经损伤表现,术后3个月均恢复正常.结论 膝关节镜结合腓骨近端截骨术治疗膝关节内侧间室骨关节炎早期疗效满意.

  16. 精细化康复护理模式在行关节镜下异体肌腱重建前交叉韧带术患者中的应用%Application of fine rehabilitation nursing mode in the patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李爱珍; 马志芳

    2015-01-01

    Objective:To study the application of fine rehabilitation nursing mode in the patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy.Methods:120 patients with tendon allograft reconstruction of anterior cruciate ligament under arthroscopy were selected.They were randomly divided into the control group and the experimental group with 60 cases in each.The control group was given routine nursing mode.The experimental group was given fine rehabilitation nursing mode.The knee stability and functional recovery,the health education awareness of patients,the satisfactions of patients or family on the nursing work of two groups were compared.Results:120 patients were all followed up. Using lysholm knee function score,the excellent and good rate of knee joint function in the experimental group reached 90.0%,the control group reached 60.0%.The health education awareness of patients in the experimental group was 98%,the control group was 85%.The satisfaction of the nursing work in the experimental group was 97%,the control group was 91%.Conclusion:The fine rehabilitation nursing mode has a actively promote role on the postoperative knee joint function recovery of tendon allograft reconstruction of anterior cruciate ligament under arthroscopy.It improves the health education awareness of patients and the satisfactions of patients or family on the nursing work.%目的:研究精细化康复护理模式在行关节镜下异体肌腱重建前交叉韧带术患者中的应用。方法:收治行该术患者120例,随机分为对照组和试验组各60例,对照组采用常规护理模式,试验组采用精细化康复护理模式,比较两组膝关节稳定性及功能恢复情况、患者对健康教育知晓率及患者或家属对护理工作的满意度。结果:120例患者均得到随访,采用lysholm膝关节功能评分,试验组膝关节功能优良率达90.0%,对照组达60.0%;患者对健

  17. 膝关节镜检查结合关节外微创技术对膝关节多韧带损伤的分期修复效果分析%Effect Analysis on the Staged Repair of Knee Joint Multi-ligament Injuries by Knee Arthroscopy in Combination with Extra-articular Minimally Invasive Technique

    Institute of Scientific and Technical Information of China (English)

    曹辉; 陶海; 张向阳; 叶佳; 赵迎春; 郑剑; 陶凤华

    2016-01-01

    目的:分析膝关节镜检查结合关节外微创技术对膝关节多韧带损伤的分期修复的临床效果。方法:收集2012年1月-2014年3月于笔者所在医院接受治疗的膝关节多韧带损伤患者42例(52膝),均给予膝关节镜检查结合关节外微创技术治疗,手术后均给予Lysholm与IKDC量表评分,评价膝关节修复效果。结果:Lysholm评分:平均分数为89.1分。IKDC评级:31个膝关节A级,17个膝关节B级,4个膝关节C级。Lachman试验:32个膝关节(-),16个膝关节(+),4个膝关节(++)。侧方应力试验:52个膝关节的活动度均得到有效恢复,其屈曲受限均<10°,伸直受限均<5°。52个膝关节内、外侧应力试验均表现(-)。结论:采用膝关节镜检查结合关节外微创技术治疗膝关节多韧带损伤,具有良好的临床疗效,值得临床推广应用。%Objective:To analyze the clinical effect on the staged repair of multi-ligament injuries by knee arthroscopy in combination with extra-articular minimally invasive technique.Method:A total of 42 patients(52 knee joints) with knee joint multi-ligament injuries admitted to our hospital from January 2012 to March 2014 were selected as subjects,they all received knee arthroscopy in combination with extra-articular minimally invasive technique.Lysholm scale and IKDC scale were used after operation to evaluate the repair effect of knee joint.Result:The average Lysholm score was 89.1 points.As for the IKDC grading,31 knee joints were classified as grade A,17 knee joints were classified as grade B and 4 knee joints were classified as grade C.The results of Lachman test were as follows:32 knee joints were (-),16 knee joints were (+) and 4 knee joints were (++).According to the lateral stress test,the motion range of 52 knee joints was effectively improved,with flexion limitation<10° and extension limitation<5°.All the 52 knee joints showed negative results (-) in the internal and

  18. 中药离子导入结合关节镜治疗膝关节骨性关节炎124例临床观察%Treatment of knee osteoarthritis by combination of iontophoresis of traditional Chinese medicine and arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张印; 王连菊; 张新茹; 郝玉杰; 田力铭

    2011-01-01

    To investigate the effect of knee osteoarthritis treated by combination of iontophoresis of traditional Chinese medicine and arthroscopy. Methods 248 cases of knee osteoarthritis were randomly divided into two groups. Two groups received minimally invasive arthroscopic surgery. And treatment group received iontophoresis of traditional Chinese medicine for promoting blood circulation for removing obstruction in collaterals. Results 72 cases of treatment group was significantly effective, effective in 31 cases, improvement in 17 cases, ineffective in 4 cases, total effective rate was 96.77% ;52 cases of control group was significantly effective, effective in 36 cascs,improvement in 11 cases, ineffective in 15 cases, total effective rate was 87.90% ;There was significant difference between two groups ( P < 0.05). Conclusion The combination of iontophoresis of traditional Chinese medicine and arthroscopy has definite effect on knee osteoarthritis, and reflects the advantages of integrative western and traditional Chinese medicine treatment.%目的 观察中药离子导入结合关节镜微创手术治疗膝关节骨性关节炎的临床疗效.方法 将248例膝关节骨性关节炎患者随机分为对照组和治疗组各124例,2组均给予关节镜微创手术治疗,治疗组在此基础上加用活血通络方中药离子导入.结果 治疗组明显有效72例,有效31例,改善17例,无效4例,总有效率96.77%;对照组明显有效52例,有效36例,改善11例,无效15例,总有效率87.90%,2组总有效率比较差异有统计学意义(P<0.05).结论 关节镜微创手术结合自制活血通络方中药离子导入治疗膝关节骨性关节炎疗效肯定.

  19. 应用半腱肌、股薄肌和髌韧带在关节镜下 重建前交叉韧带65例%Reconstruction of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament in 65 cases

    Institute of Scientific and Technical Information of China (English)

    夏亚一; 孙正义; 黑坂昌弘; 松井允三

    2001-01-01

    目的探讨应用髌韧带(bone-patellar tendon-bone, BTB)和半腱肌、股薄肌(bone-hamstring-bone, BHB)在关节镜下修复前交叉韧带(anterior cruciate ligament, ACL)损伤的临床疗效、手术要点及关节功能改善情况。方法在膝关节镜直视下,选用自体BTB和BHB行ACL重建手术65例,其中BTB重建30例,BHB重建31例,股四头肌腱重建4例。结果随访时间1个月~3年,手术前Lachman和 Pivot shift试验从阳性转为阴性,按日本骨科学会膝关节疗效评定标准,优48例,良7例,可10例。本组病人2个月后均恢复原来日常活动,半年后恢复体育活动。结论应用BTB、BHB在关节镜下修复ACL损伤,术中等长点的选择是手术关键,坚强固定是早期康复训练的前提。%Objective To observe the function recovery of anterior cruciate ligament under arthroscopy using patellar ligament and hamstring ligament.   Methods A total of 65 cases, of which 30 cases were with BTB, 31 with BHB and 4 with quadriceps tendon were reconstructed under arthroscopy. Results The results showed that all cases attained excellent results. Lanchman test and pivot shift test changed from positive to negative with 1 month to 3 years of follow-up. And all patients return to primary life activity in 2 months and sports in 6 months after ACL reconstruction. Conclusions The key to immediate rahabilitation and operative success is a firm fixation and a right select of isometric point.

  20. Analysis of therapeutic effect of rehabilitation treatment improving function of knee joint following reconstruction anterior crucial ligament with allogenic achilles tendon under arthroscopy%跟腱重建前十字韧带术后康复治疗恢复膝关节功能的疗效分析

    Institute of Scientific and Technical Information of China (English)

    常青; 黄迅悟; 张晓鸥; 郑光新

    2002-01-01

    Objective Combining the reconstruction of anterior crucial ligament(ACL) with functional rehabilitation,we recover the injured knee as possible as can.Methods 38 patients received ACL reconstruction with allogenci Achilles tendon under arthroscopy.We reconstructed the injured ACL and the injured medial crucial ligament(MCL) by utilization of length of achiles tendon.Then we carried out different rehabilitations in accordance with special needs of the patients.Results The follow up was performed for more than 7 months in 34 cases.Lysholm method was used to evaluate patients' function before and after operation.Results showed average score was 53.8 preoperatively, and 84.2 postoperatively,the good rate was 84.4% .In the objective examination,anterior drawer test(ADT),31 cases were positive preoperatively,1 was positive postoperatively;lachman test:34 were positive preoperatively,1 was positive postoperatively;4 were weak positive postoperatively.There were 3 cases with pain of knee joints and 4 cases with limitation of activity of knee joints(5~ 20 degree) postopratively.Conclusion Combination of reconsgruction of ACL with allogenic achilles tendon and the functional rehabilitation can gain remarkable curative effect.

  1. 晚期创伤性踝关节炎应用关节镜辅助踝关节融合术治疗的临床观察%The Observasion of the Clinical Effect to Arthroscopy With Ankle Arthrodesis of Advanced Stage of Traumatic Anklebone Arthritis

    Institute of Scientific and Technical Information of China (English)

    吕国福

    2015-01-01

    Objective To observe the effect of arthroscopic with ankle arthrodesis treating by advanced stage of traumatic anklebone arthritis. Methods 32 cases of patients with advanced stage of traumatic ankle arthritis were selected into the study, and treated by arthroscopic ankle fusion, the treatment effect was analyzed. Results The time of operation was(122±24)min,the amount of bleeding was(50±15)ml. After 1 year,VAS score was(2.6±1). Conclusion The clinical effect of arthroscopy with ankle arthrodesis for the treatment of advanced stage of traumatic anklebone arthritis is significant.%目的:观察关节镜辅助踝关节融合术治疗晚期创伤性踝关节炎的效果。方法选取32例晚期创伤性踝关节炎患者做研究对象,均采用关节镜辅助踝关节融合术治疗,分析治疗效果。结果手术时间(122±24)min,出血量(50±15)ml;术后1年疼痛VAS评分为(2.6±1.0)分。结论关节镜辅助踝关节融合术治疗晚期创伤性踝关节炎效果显著。

  2. Perioperative stress reaction results from minimally invasive surgery in the arthroscopy on knee joint%接受膝关节微创外科手术患者围术期的应激反应

    Institute of Scientific and Technical Information of China (English)

    刘文和; 曹锡文; 李康华; 雷光华; 李杨; 王福剑

    2007-01-01

    BACKGROUND: As it results in minimal trauma and physical influence or interference, and a better curative effect, the minimally invasive surgery is preferred in clinic. However, the perioperative stress reaction of minimally invasive surgery needs further study.OBJECTIVE: To evaluate the levels of neurohormone, C-reactive protein (CRP) and the changes of resting energy expenditure (REE) resulted from the operative stress reaction due to minimally invasive surgery in arthroscopy on knee joint.DESIGN: Controlled observation and analysis.SETTING: Department of Orthopaedics, Affiliated Hospital of Xiangnan University and Department of Orthopaedics,Xiangya Hospital of Central South University.PARTICIPANTS: Sixteen patients with meniscal lesions in knee and 26 with cruciate ligament injury, which were closed injury, were selected from the Department of Orthopaedics of Affiliated Hospital of Xiangnan University and Xiangya Hospital of Central South University between January 2003 and April 2004. Meniscal lesions were diagnosed according to the physical examination, drawer test combined CT and MRI examination, and the patients were in accordance with the indication of arthrotomy; cruciate ligament injury according to the physical examination, grinding test combined CT and MRI examination. Those with open injury, body multiple injury, combined injury and emergency operation were excluded. Ten patients with meniscal lesions and 12 with cruciate ligament injuries underwent minimally invasive surgery on knee joint as minimally invasive surgery group (MIS). The others were given traditionally invasive surgery on knee joint as the traditional group. The informed consent was obtained from the patients.METHODS: Fasting venous blood was taken on the morning of 1 day before, and 1 and 3 days after operation, which was analyzed within 2 hours after sampling. ①All hormones were quantitatively assayed. Serum insulin was determined by competitive radioimmunoassay (RIA); growth

  3. 本体感觉训练在关节镜下前交叉韧带重建术后患者中的应用研究%The practice research about proprioception training in the reconstruction of anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    单萍; 肖海涛

    2016-01-01

    Objective: To discuss the effciency of proprioception training methods for patients atfer the operation of anterior cruciate ligament reconstruction (ACL) under arthroscopy.Methods: From May 2014 to May 2015, 70 patients who underwent the operation of reconstruction of ACL were randomly divided into 2 groups, 35 patients for each group. Experiment group used the proprioception training methods customized by our department, the control group used the routine nursing. hTe patients followed up for 6 months atfer surgery. Position sense/stability and ROM of knees were tested before the surgery and 6 months atfer the surgery. hTe Berg balance scale and Lysholm score were tested before the surgery and 3, 6 months atfer the surgery.Results: hTere were 70 patients followed up for 6 months. There were significant difference in position sense/stability and ROM between the 2 groups (P<0.05) atfer 6 months of surgery. hTree and six months atfer surgery, the berg balance scale and the Lysholm of experiment group was higher than that of the control group (P<0.05).Conclusion: Making a correctly and personal proprioception training planning can help patients of ACL reconstruction under arthroscopy recovery quickly.%目的:探讨关节镜下前交叉韧带重建术后本体感觉训练和康复训练的方法及其效果。方法:选取2014年5月至2015年5月入住我院骨科70例关节镜下前交叉韧带重建术后患者,使用随机数字表法分成两组,实验组35人,给予本科室制定的本体感觉训练计划,对照组35人,给予常规骨科护理。出院后随访6个月。观察患者术前及6个月结束时的位置觉测定、膝关节稳定度、膝关节活动度,并且评定术前、术后3个月及6个月结束时Berg平衡量表及膝关节Lysholm评分。结果:70人均完成6个月随访。术后6个月时,实验组关节位置觉、稳定度与活动度明显高于对照组,差异有统计学意义(P<0.05)。术后3个月及6

  4. 品管圈在降低膝关节镜术后患者早期功能锻炼缺失率中的应用%Application of Quality Control Circle in Reducing Early Functional Exercise of Patients with Knee Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    谌艳; 王钦

    2015-01-01

    目的:探讨品管圈在降低膝关节镜术后患者早期功能锻炼缺失率中的应用效果。方法成立品管圈,通过品管圈活动步骤,运用质量管理常用工具对骨科膝关节镜术后功能锻炼存在问题进行改进.并将改进前后状况进行比较。结果骨科膝关节镜术后患者早期功能锻炼缺失率由开展前的42.90%,降低到19.12%,目标达成率为118.84%,进步率为65.87%。此外,品管圈活动前后所有圈员就解决问题能力、责任心、沟通协调、自信心、团队凝聚力、积极性、品管手法、和谐度等均有明显提高。结论运用品管圈对骨科膝关节镜术后患者早期功能锻炼缺进行管理,医护康配合,不仅提高了患者依从性、功能锻炼正确率及完成率,同时也提高了患者满意度,减少住院费用,提高床位周转率,符合医院等级评审要求,提升了优质护理质量内涵。%Objective To explore the quality control circle in reducing postoperative knee arthroscopy patients with early functional exercise in the application ef ect of the loss rate.Methods To set up quality control circle, circle activities step by QC, using quality management tools used by the improvement of the existing problems of functional exerciseDepartment of orthopedics after arthroscopic knee surgery.And the improved conditionwere compared before. Results The Department of orthopedics after arthroscopic knee surgery in patients with early functional exercise car ied out in front of the loss rate by 42.90%, reduced to 19.12%, the target rate is 118.84%, the improvement rate was 65.87%. In addition, before and after the QCC al members on the problem solving ability, sense of responsibility, communication and coordination, team cohesion, self-confidence, enthusiasm, quality control tools, harmonious degree increased. Conclusion The use of quality control circle of early functional exercise of patients in the Department of

  5. A comparison between combined nerve block and spinal and epidural anesthesia for knee arthroscopy in elderly patients%联合神经阻滞与腰硬联合麻醉用于老年患者膝关节镜手术的比较

    Institute of Scientific and Technical Information of China (English)

    王新华

    2009-01-01

    [Objective] To compare the efficiency of combined lumbar plexus and sciatic nerve block and spinal and epidu-ral anesthesia for knee arthroscopy in elderly patients. [Methods] sixty old patients , 68 ~ 81years old, ASA Ⅰ~Ⅲ, scheduled for knee arthroscopic surgery were randomly divided into groups N and SEA. In group N patient s were under-gone lumbar plexus combined sciatic nerve block with the help of nerve stimulator. In group SEA, patient s were under-gone Spinal and epidural anesthesia. MAP, HR, onset time and duration of sensory and motor block and analgesia time were compared. [Results] The onset time of sensory and motor nerve block of group SEA was shorter than that of group N (P < 0.05), and the duration of group N was longer than that of group SEA (P < 0.05) . The patients' MAP, HR of group SEA were smoother than that of group N (P < 0.05) . [Conclusions] Combined nerve block for knee arthroscopy in elderly patients will produce a better anesthetic effect, a more smooth MAP and HR and a longer analgesia time.%[目的]老年患者膝关节镜手术中应用神经刺激仪定位下的腰丛联合坐骨神经阻滞与腰硬联合麻醉的麻醉效果的比较.[方法]60例拟行单侧膝关节镜手术的老年患者,年龄68~81岁,ASA Ⅰ~Ⅲ级,随机分为腰丛联合坐骨神经阻滞(N)和腰硬联合麻醉(SEA)两组.N组采用神经刺激仪定位下的腰丛和坐骨神经阻滞麻醉,SEA组行腰麻联合硬膜外麻醉.比较两组在不同时间段的NAP、HR、感觉、运动神经阻滞评分及镇痛时间.[结果]N组在手术过程中的MAP、HR较SEA组平稳;SEA组感觉、运动阻滞起效时间更短(P<0.05),N组感觉、运动阻滞维持时间更长(P<0.01).[结论]联合神经阻滞用于老年患者膝关节镜手术,麻醉效果良好,对血液动力学影响小,且镇痛维持时间长.

  6. Comparison and Analysis of the Effect of Magnetic Resonance Technique and Arthroscopy on the Diagnosis of Knee-joint Ligament Injury%磁共振技术与关节镜在膝关节韧带损伤诊断中的效果分析

    Institute of Scientific and Technical Information of China (English)

    王石磊

    2013-01-01

    目的:探究并分析磁共振技术与关节镜在膝关节韧带损伤诊断中效果的临床疗效.方法:选取我院收治的膝关节韧带损伤患者110例作为临床检测对象.随机分成A、B两组,A组患者55例,采用磁共振技术检测膝关节韧带损伤,即为试验组.B组患者55例,采用传统的关节镜检测膝关节韧带损伤,即为对照组.术后一年时间内,对患者进行定期物理治疗,同时定期随访,观察两组患者检测后的膝关节韧带治疗情况.结果:经过一年的试验观察,利用磁共振技术检测膝关节韧带损伤准确度程度较好,P<0.05,具有统计学意义.结论:经磁共振技术检测膝关节韧带损伤的临床准确效果显著,能够缩短康复时间,具有一定的安全性及稳定性,值得在临床上推广.%Objective: To explore and analyse magnetic resonance technique and arthroscopy clinical curative effects on the diagnosis of knee-joint ligament injury. Method: 110 cases of those knee-joint ligament injury patients who have been accepted and treated in our hospital as clinical detect objectives. Divided them into group A and group B randomly, group A has 55 cases, adopted magnetic resonance technique to test their knee-joint ligament injury,namely as experimental group. Group B has 55 cases,used traditional arthroscopy to test their knee-joint ligament injury, namely as control group. Proceeded regular physical treatment and regular follow-up visit to all patients within one year of the operation, observed knee-joint treatment situations in two groups after the test. Result: After one year of test observation, the accurate degree of adopting magnetic resonance technique to test knee-joint ligament injury was better,P<0. 05,it has statistics meaning. Conclusion: Adopting magnetic resonance technique to test knee-joint ligament injury has accurate and obvious clinical effects, and it can shorten the rehabilitation time.

  7. Vídeo-artroscopia da articulação fêmoro-tíbio-patelar em cães após secção do ligamento cruzado cranial guiada por artroscopia Videoarthroscopy of the stifle joint in dogs after cranial cruciate ligament rupture guided by arthroscopy

    Directory of Open Access Journals (Sweden)

    N.F. Borges

    2008-10-01

    Full Text Available Avaliaram-se e classificaram-se por meio da vídeo-artroscopia as alterações da articulação fêmoro-tíbio-patelar (FTP, 21 dias após secção experimental do ligamento cruzado cranial (LCCr em cães, tendo como referência os parâmetros encontrados no exame artroscópico imediatamente anterior à secção. Ao exame artroscópico, foi possível visibilizar os cotos remanescentes do LCCr e as alterações articulares, como aumento da vascularização, aumento das vilosidades na membrana sinovial, bem como fibrilação e osteófitos, principalmente nas bordas trocleares do fêmur. Os resultados sugerem que a artroscopia é um método preciso de avaliação macroscópica dos tecidos articulares moles e duros.By the use of videoarthroscopy, the changes of the stifle joint after experimental rupture of cranial cruciate ligament (CCL in dogs were evaluated and classified, based on the parameters found at the arthroscopic examination right before the rupture. By the arthroscopic examination, it was possible to visualize the remainings of the CCL and joint changes such as increase of the vascularity and synovial proliferation increase in the synovial membranes, as well as fibrillation and irregularities on the joint surfaces and osteophyte formation, mainly on the trochlear ridges. The results suggest that arthroscopy is a precise method for macroscopic evaluation of the smooth and bone joint tissues

  8. Complications of Elbow Arthroscopy in 46 Cases:A 10-Year Medical Record Review of 269 Cases%46例肘关节镜手术并发症的分析——10年269例肘关节镜手术回顾

    Institute of Scientific and Technical Information of China (English)

    徐雁; 王健全; 崔国庆; 印钰

    2011-01-01

    目的 探讨肘关节镜手术并发症发生情况及其原因.方法 回顾研究1998年6月~2008年11月269例肘关节镜中46例(17.1%)并发症的发生、处理及预后.男32例,女14例,年龄(32.9±15.1)岁(13~61岁).其中骨关节炎20例,关节粘连8例,肱骨外上髁炎4例,类风湿关节炎4例,急性创伤5例,肱骨内上髁炎1例,剥脱性骨软骨炎2例,色素绒毛结节性滑膜炎1例,肘关节不稳1例.最多见为一过性神经损伤36例,其中累及桡神经7例,尺神经7例,腋神经1例,肢体远端末梢神经感觉障碍21例;迟发性尺神经炎5例;伤口术后渗液1例,皮下血肿1例;残留游离体5例.2例肘关节发生了2种并发症.结果 36例一过性神经损伤患者中的32例在术后1~7天内缓解,最迟1例桡神经深支损伤术后8个月好转.3例迟发性尺神经炎行尺神经前移术,1例伤口血肿行血肿清除术,2例游离体残留行游离体二次取出术,余保守治疗,均治愈.结论肘关节镜的并发症以一过性神经损伤最多见,还有迟发性尺神经炎、伤口并发症、游离体残留.这些并发症绝大多数都是轻微可逆的,故肘关节镜是一种安全有效的技术.%Objective To investigate the major complications after elbow arthroscopy and their causes. Methods Though June 1998 to November 2008, we performed elbow arthroscopy on 269 patients, of whom, complications occurred in 46 cases [ 17. 1% , 32 male and 14 female, aged 32.9 ± 15. 1 in average (13 to 61 years)]. We reviewed the occurrence, treatment, and prognosis of the complications. Among the 46 cases, osteoarthritis was found in 20 patients, flexion contracture in 8, rheumatoid synovitis in 4, tennis elbow in 4, acute trauma in 5, osteoarthritis dissecans in 2, humeral medial epicondylitis in 1, villonodular synovitis in 1, and elbow instability in 1. We noticed that the most common complication was transient neural injury (36 cases), including injury to the musculospiral nerve (7

  9. Effect of Celebrex on preoperative pain in patients undergoing knee arthroscopy: a prospective randomized, double-blind, placebo-controlled trial%塞来昔布对膝关节镜手术患者术前疼痛影响的前瞻性随机对照研究

    Institute of Scientific and Technical Information of China (English)

    林子洪; 钱思浓; 王海兴; 李盛; 叶圣龙; 王良泽; 沈梓维; 郑秋坚

    2015-01-01

    Objective To investigate the effect of Celebrex on the preoperative pain in patients undergoing knee arthroscopy.Methods From June 2012 to May 2013,30 patients who would receive knee arthroscopy for simple acute or sub-acute knee injury were enrolled in the study after they had been accessed by Pittsburgh Sleep Quality Index (PSQI),Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale(SAS).They were 8 males and 22 females,aged from 15 to 59 years.They were evenly randomized into a Celebrex group and a vitamin C group (n =15).The patients in Celebrex group took 200mg Celebrex twice a day from day 2 to day 4 after admission.Likewise,those in vitamin C group took vitamin C instead.Visual Analogue Scale (VAS) was used to evaluate their resting and moving pain in the evenings of day 1 and day 4.At the same time,pain threshold and pain tolerance of both lower limbs were recorded by a pain-threshold machine.The 2 groups were statistically compared.Results In Celebrex group,there were statistically significant differences between pre-medication and post-medication in resting VAS (1.22 ± 0.90 versus 1.00 ± 0.81),moving VAS (4.23 ± 1.38 versus 3.68 ± 1.02),pain threshold of the normal lower limb (NL) (1.57 ± 0.56 mA versus 1.79 ± 0.51 mA),pain threshold of affected lower limb (AL) (1.33 ± 0.48 mA versus 1.79 ± 0.57 mA) (all P < 0.05),but there were no statistically significant differences between pre-medication and post-medication in pain tolerance of either of NL and AL (all P > 0.05).In vitamin C group,the above comparisons were statistically insignificant (all P > 0.05).In Celebrex group,the variation values of moving VAS were significantly negatively correlated with those of pain threshold of the NL and AL (rNL =-0.564,PNL =0.028;rAL =-0.746,PAL =0.001).Conclusions Celebrex can reduce preoperative pain and increase pain threshold in patients undergoing knee arthroscopy,playing a role in preventive analgesia.There may be correlations between

  10. 关节镜下自体肌腱单双束重建后交叉韧带:前瞻性队列研究%Single- and double-bundle posterior cruciate ligament reconstruction under arthroscopy: a prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    侯军虎; 吴贵佑; 汪喜顺; 章亚东

    2015-01-01

    背景:有研究认为后交叉韧带损伤在临床疗效上双束重建法并没有表现出其应有的优势,且较单束重建有一些难以克服的缺陷.双束与单束重建孰优孰劣?目前学界还没有给出一个统一的答案.目的:应用前瞻性队列研究探讨自体肌腱单双束重建后交叉韧带的疗效和安全性.方法:后交叉韧带损伤患者81例,按照随机数字表法分为单束重建组41例,双束重建组40例.对比两组患者韧带重建前、重建后24个月关节稳定性、Lysholm及Tegner评分,并比较两组患者住院天数、手术时间、重建后发热天数及需要穿刺的数量.结果与结论:双束重建组患者移动度显著高于单束重建组(F=4.362,P=0.000);两组患者重建后 24 个月Lysholm及Tegner评分较重建前均有显著提高(P 0.05).双束重建组患者手术用时及住院天数及重建后需要行关节腔穿刺的患者数均显著高于单束重建组(P 0.05). These findings indicate that both single- and double-bundle reconstruction under arthroscopy is safe and effective treatment for posterior cruciate ligament injury, but the double-bundle reconstruction is not recommended as the preferred surgical procedure because of longer time and larger trauma.

  11. 腕关节镜下腕三角纤维软骨复合体Palmer ⅠB型损伤的诊断和治疗%Diagnosis and treatment of Palmer type Ⅰ B TFCC injury using wrist arthroscopy

    Institute of Scientific and Technical Information of China (English)

    杨顺; 程亚博; 徐文东; 唐浩琛

    2016-01-01

    目的 探讨腕关节镜技术对腕三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)Palmer Ⅰ B型损伤的诊断及治疗价值.方法 自2013年1月至2015年2月,我们对32例腕TFCC Palmer Ⅰ B型损伤患者,采用腕关节镜技术进行诊断和治疗.根据Palmer分型,合并尺骨茎突骨折10例,合并ⅡA型损伤5例,合并ⅡB型损伤8例,合并ⅡC型损伤6例.腕关节镜视下明确诊断后不伴Ⅱ型损伤患者行经尺侧关节囊镜下缝合术,合并ⅡB型损伤患者行软化成形术,合并ⅡC型损伤患者行清创、软骨成形及尺骨头部分磨除术.术前和术后随访评定采用疼痛视觉模拟评分(visual analogue scale,VAS)、握力及关节活动度分析、改良Mayo腕关节功能评分.结果 术后所有患者均无手术并发症并获得随访,腕关节疼痛明显缓解.术前VAS为(6.0±2.3)分,术后1年为(1.0±1.1)分;术前患侧握力为健侧的(60.3±4.3)%,术后1年为(82.0±4.1)%;腕关节屈伸活动度为术前(62.0±4.3)°,术后1年(105.0±4.3)°;旋转活动度术前(125.0± 16.0)°,术后1年(152.0±18.0)°.经改良Mayo腕关节功能评分评定:优26例,良3例,可3例,优良率为90.6%.结论 应用腕关节镜技术诊断并治疗TFCC Palmer Ⅰ B型损伤安全有效,随访效果确切可靠,值得推广应用.%Objective To evaluate the value of wrist arthroscopy in the diagnosis and treatment of Palmer type] B TFCC injuries.Methods Thirty-two cases of TFCC injury (Palmer type Ⅰ B) that were diagnosed and treated with wrist arthroscopy between January 2013 and February 2015 were analyzed retrospectively.According to Palmer classification,10 cases had accompanying ulnar styloid fracture,5 cases had accompanying type 1] A injury,8 cases had accompanying type Ⅱ B injury,and 6 cases had accompanying type Ⅱ C injury.For cases without accompanying type Ⅱ injury,endoscopic repair of ulnar joint capsule (outside-in or in-outside suturing) was performed

  12. Clinical comparison of arthroscopy versus mini-open surgery for avulsion fracture of the tibial attachment of the posterior cruciate ligament%关节镜与小切口手术治疗后交叉韧带胫骨附丽撕脱骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    洪雷; 张辉; 冯华

    2013-01-01

    目的 比较关节镜与小切口手术治疗后交叉韧带(PCL)胫骨附丽撕脱骨折的临床疗效. 方法 回顾性分析2001年3月至2009年9月收治的84例急性PCL胫骨附丽撕脱骨折患者资料,根据不同时期手术方式不同分为两组:关节镜组35例,男27例,女8例;平均年龄为(29.6±5.6)岁;采用关节镜下骨折复位缝合固定.切开手术组49例,男40例,女9例;平均年龄为(32.2±7.6)岁;采用腘窝内侧小切口入路切开复位空心钉加垫片固定.比较两组患者的临床疗效,膝关节功能采用Lysholm评分和国际膝关节文件编制委员会(IKDC)膝关节功能评分标准评定. 结果 84例患者术后获平均21.5个月(13 ~ 34个月)随访.所有患者骨折均于术后3个月一期愈合.关节镜组和切开手术组末次随访时后抽屉试验阴性率分别为82.9% (29/35)、91.8% (45/49),Lysholm评分平均分别为(95.1±5.6)和(96.1±4.7)分,IKDC分级A级率分别为88.6% (31/35)和91.8% (45/49),膝关节活动度正常率分别为94.3% (33/35)、93.9% (46/49),以上项目两组间比较差异均无统计学意义(P>0.05).而关节镜组和切开手术组患者的手术时间平均分别为(92.4±15.9)、(53.8±14.3) min,两组比较差异有统计学意义(P<0.05).结论 关节镜与小切口手术治疗PCL胫骨附丽撕脱骨折均可以获得满意疗效,但小切口手术的手术时间更短,且骨折固定可靠,能保证患者早期进行膝关节功能锻炼.%Objective To compare the clinical outcomes of arthroscopy versus mini-incision surgery for the treatment of avulsion fracture of the tibial attachment of the posterior cruciate ligament (PCL).Methods From March 2001 to September 2009,84 patients with acute displaced avulsion fracture of the tibial PCL attachment were treated operatively in our department.Thirty-five patients were treated with arthroscopic reduction and suture fixation (Group 1); 49 patients were treated with open reduction

  13. Patellar ligament with vascular pedicle for anterior cruciate ligament reconstruction:the intraoperative use of computer assisted navigation system combinied with arthroscopy%带血管蒂髌韧带修复前交叉韧带损伤:计算机导航辅助关节镜的应用

    Institute of Scientific and Technical Information of China (English)

    张凯; 王伟伟; 王向青

    2016-01-01

    BACKGROUND:The standard angle between the coronal level of tibial tunnel and the joint surface is 65°-70°. The larger angle is easy to cause impacts, and inversely, the medial joint surface of the tibia plateau wil be worn. OBJECTIVE:To investigate the application and effects of patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combined with arthroscopy. METHODS:Forty patients with anterior cruciate ligament injury were selected, and randomly al otted into two groups (n=20 per group). Patients in traditional surgery group underwent reconstruction by the operator’s experiences, and patients in combination surgery group received the patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combinied with arthroscopy, both based on the same location standard. Subsequently, patients underwent CT continuous CT scans, and the tibial tunnel of anterior cruciate ligament was measured to compare the reconstruction effects. RESULTS AND CONCLUSION:The tibial tunnel and femoral tunnel positions in the combination surgery group were significantly higher than those in the traditional surgery group (P  目的:分析计算机联合关节镜利用带血管蒂髌韧带修复交叉韧带方法及效果。  方法:选取40例膝关节前交叉韧带损伤患者资料,随机分为2组,每组20例。两组患者均采用相同定位胫骨隧道标准,传统手术组术中凭借医师经验进行重建,计算机导航辅助关节镜组术中采用计算机联合关节镜利用带血管蒂髌韧带修复,修复后患者行CT连续断层扫描并测量前交叉韧带胫骨隧道,比较两组重建效果。  结果与结论:①计算机导航辅助关节镜组治疗后股骨隧道位置、胫骨隧道位置,显著高于传统手术组(P<0.05);②计算机导航辅助关节镜组治疗后3,6

  14. Clinical observation of knee arthroscopy with double ETHIBOND sutures in the treatment of tibial avulsion fractures of the posterior cruciate ligament%关节镜下双股ETHIBOND线固定治疗后交叉韧带胫骨止点撕脱骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪建龙; 时志斌; 党晓谦; 王坤正

    2016-01-01

    Objective To study the surgical method and clinical results of knee arthroscopy with double ETHIBOND sutures in the treatment of tibial avulsion fractures of the posterior cruciate 1igment ( PCL ).Methods From June 2014 to October 2015, a total of 18 patients with PCL tibial avulsion fractures who were treated with double ETHIBOND sutures under knee arthroscopy were enrolled. There were 10 males and 8 females, whose mean age was ( 32.5 ± 8.7 ) years old. Anteromedial, anterolateral, posteromedial and high posteromedial portals were built before the operation, which aimed to explore the knee joint. Both the avulsed bone block and the tibia bone bed were refreshed via the double posteromedial portals. The 2 bone tunnels ( 4.5 mm in diameter ) was completed with the assistance of PCL director drill guide. Double ETHIBOND sutures were used during the reduction to ifx the avulsed bone by double posteromedial portals. The sutures were pulled out through the 2 bone tunnels and tied in front of the tibia. Reduction and healing of the avulsion fractures and mobility degree of the knee were observed after the operation. Lysholm and the international knee documentation committee subjective knee form ( IKDC ) scores were calculated to evaluate the functional recovery of the knee.Results All the cases were followed up from 8 to 24 months, with an average of ( 14.2 ± 3.2 ) months. All the avulsion fracture healing was achiveved without displacement according to the X-ray and CT scanning, and the average healing time was 2.5 months. The posterior drawer test showed negative results in all the cases. The knee extension was unlimited, and 15° lfexion limitation was found in 1 case due to delayed rehabilitation. The average range of lfexion was ( 135.5 ± 3.5 ) °. The average Lysholm scores were increased from ( 37.8 ± 3.5 ) points to ( 95.6 ± 3.2 ) points (P < 0.001 ), and the average IKDC scores were increased from ( 54.7 ± 6.5 ) points to ( 95.2 ± 4.5 ) points (P < 0

  15. 关节镜结合微创切口治疗膝关节脱位合并多韧带损伤31例临床分析%Arthroscopy combined with limited incision in the treatment of dislocated knee joint with multiple ligament injuries

    Institute of Scientific and Technical Information of China (English)

    罗福昌; 邱华文; 王一民; 黄醒中

    2015-01-01

    Objective To analyze the effect of operation for dislocation of knee joint combined with ligament injury. Methods From 2009 September to 2013 August, 31 patients with multiple ligament injury of knee dislocation were enrolled, they received the reconstruction of anterior and posterior cruciate ligament were achieved under arthroscopy, and at the same time by minimally invasive to repair collateral ligament, lateral collateral ligament, lateral complex injury.Reconstruction ma-terial was selected wiht autologous or allogeneic tendon, rehabilitation training was performed after operation.Results All the patients were followed up for 6-24 months.After 6 months of follow-up, the Lysholm knee score was (85.0 ±1.2) points, at final follow-up, the average socre was (92.0 ±1.8) points, and has a statistical significance difference from the preopera-tive (5.0 ±2.1) phase ( t =5.036, P <0.01);up to 6 months, activity of knee joint after operation was (121.0 ±1.6) °. Conclusion Arthroscopic reconstruction of anterior cruciate ligament and combined with minimally invasive incision repair of ligament injury can significantly improve the function of knee joint with good clinical curative effect.%目的:分析膝关节脱位合并多韧带损伤的手术治疗效果。方法2009年9月—2013年8月收治膝关节脱位合并多韧带损伤患者31例,应用关节镜技术重建前后交叉韧带,并同时通过微创切口修补内侧副韧带、外侧副韧带及内、外侧复合体损伤。重建材料选择自体或异体肌腱,术后进行康复训练。结果所有患者均获得随访,时间6~24个月。术后6个月随访膝关节Lysholm评分平均(85.0±1.2)分,终末随访时平均(92.0±1.8)分,与术前(5.0±2.1)分相比差异具有统计学意义( t =5.036, P <0.01);膝关节活动度术后6个月达(121.0±1.6)°。结论关节镜下重建前后交叉韧带结合微创切口修复多韧带损

  16. Inquiry Right Dexmedetomidine Hydrochloride Used in Knee Arthroscopy Patients Epidural Anesthesia%探究盐酸右美托咪定在膝关节镜手术患者行腰硬联合麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    刘玲玲

    2016-01-01

    目的:探究与分析盐酸右美托咪定在膝关节镜手术患者行腰硬联合麻醉中的应用。方法选取我院自2014年3月~2016年3月收治的90例接受膝关节镜的患者,采取随机数字表法分为对照组与观察组,每组各45例,对照组未给予盐酸右美托咪定做术前处理,观察组给予盐酸右美托咪定做术前处理,对比两组患者Ramsay镇静评分、Scale评分及VAS评分。结果对照组Ramsay镇静评分、Scale运动神经阻滞评分、VAS评分分别为(2.78±0.42)分、(1.38±0.03)分、(1.34±0.23)分,观察组Ramsay镇静评分、Scale运动神经阻滞评分、VAS评分分别为(4.32±0.09)分、(0.37±0.04)分、(0.12±0.03)分,观察组与对照组相比Ramsay镇静评分较高,Scale运动神经阻滞评分及VAS评分较低,差异具有统计学意义(P<0.01)。结论将盐酸右美托咪定应用于膝关节镜手术患者的腰硬联合麻醉中临床效果显著,镇静镇痛效果更好。%Objective To explore and analyze right dexmedetomidine hydrochloride in patients undergoing arthroscopic knee surgery epidural anesthesia applications.Methods 90 cases in our hospital from receiving knee arthroscopy patients from March 2014 to March 2016 admitted taking randomly divided into a control group and the observation group, 45 cases in each group, the control group not given the right pyrimidine hydrochloride Meituo do preoperative treatment, observation group were given the right care pyrimidine hydrochloride by treatment before surgery, compared two groups of patients Ramsay sedation score, Scale score and VAS score.ResultsControl Ramsay sedation score, Scale motor nerve block score, VAS score were (2.78±0.42), (1.38±0.03), (1.34±0.23) points, and observation group Ramsay sedation score, Scale motor nerve block score, VAS score were (4.32±0.09), (0.37±0.04), (0.12±0.03) points, respectively; Ramsay sedation score of the observation group

  17. 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.

  18. Ho:YAG laser arthroscopy of the knee

    Science.gov (United States)

    Sisto, Domenick J.; Blazina, Martin E.; Hirsh, Linda C.

    1994-09-01

    The HO:YAG laser is a near-contact laser with a capacity to ablate or cut tissues. The ablation function allows the surgeon to remove meniscal tissue, lyse and resect adhesions, melt loose bodies, and dissolve inflamed synovium. The cutting function of the laser is utilized to perform a lateral release or resect torn menisci. The laser can also be utilized to drill holes in Grade IV chondromalacic lesions to initiate a healing response. The laser has been embraced by orthopaedic surgeons because of its shape and versatility. The tip is only 2 mm wide and can be delivered into the tight posterior compartments of the knee with no damaging contact with the articular surfaces. The laser coagulates as it works and bleeding is minimized. The laser can function both as a cutting and ablating tool. The laser can also drill holes into subchondral bone to, hopefully, initiate a healing response.

  19. Anterior cruciate ligament: 3-D fiber anatomy, fluorescence arthroscopy & healing

    NARCIS (Netherlands)

    Nguyen, D.T.

    2015-01-01

    One of the current emphases in optimizing anterior cruciate ligament (ACL) reconstructions is closer mimicking the anatomy of the ACL. The aim of Chapter 2 and Chapter 3 is to develop and validate a methodology to quantify the 3-D collagen fiber orientation of ligaments, accurately and at a high res

  20. Remedial sanation arthroscopy in gouty arthropathy of the knee joint

    Directory of Open Access Journals (Sweden)

    V V Lyalina

    2007-01-01

    Zaklyuchenie. Predlozhennaya avtorami metodika sanatsionnoy artroskopii znachitel'no rasshiryaet spektr lechebnykh vozmozhnostey i pozvolyaet optimizirovat' lechebnuyu taktiku pri khronicheskom podagricheskom artrite kolennogo sustava.

  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. Navigation forces during wrist arthroscopy: assessment of expert levels

    NARCIS (Netherlands)

    Obdeijn, Miryam; Horeman, Tim; Boer, de Lisanne L.; Baalen, van Sophie; Liverneaux, Philippe; Tuijthof, Gabrielle J.M.

    2014-01-01

    Purpose To facilitate effective and efficient training in skills laboratory, objective metrics can be used. Forces exerted on the tissues can be a measure of safe tissue manipulation. To provide feedback during training, expert threshold levels need to be determined. The purpose of this study was to

  3. Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy.

    Science.gov (United States)

    Yamakado, Kotaro

    2013-05-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging.

  4. Subcalcaneal Bursitis With Plantar Fasciitis Treated by Arthroscopy

    OpenAIRE

    Yamakado, Kotaro

    2013-01-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent ...

  5. The usage of Bupivacaina as anesthetic agent in knee arthroscopy.

    Directory of Open Access Journals (Sweden)

    José Julio Ojeda González

    2003-12-01

    Full Text Available Introduction: Artroscopy of the knee is a procedure that is frequently developed as a diagnostic and therapeutic means in patients who suffer among other diseases, from chronic sinuvitis, lesions of the meniscus and adherence . A great number of these patients receive medical assistance at the outpatient department of the orthopaedic department where the need of its use is assessed. It is a relatively short procedure that has few risks when it is performed with the appropriate technique. Objective: To show the use of intra articular Bupivacaine 0,25 % in the artroscopy of the knee. Method: Retrospective study carried out at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province from September 2002 to February 2003. This study was developed with 20 patients who were initially assisted at the service of Orthopaedics in which a group of therapeutic procedures were decided. Bupivacaine 0,25 % together with Epinephrine 0,1 % in a dose of 0,1 ml were injected in the intra articular space in a volume of 20 ml distributed in 4 sections with 5 ml each. At the level of the section where the artroscope was inserted , 5 ml of Bupivacaine 0,25 % was applied. Result: the age of the patient ranged 30 to 61 years of age with a media of 44,6 years and a standard deviation of 12,6 years. The introduction and application of the procedure throughout artroscopy was possible in al patients. Conclusion: Bupivacaine is a good local anaesthetic because of its slow action since the onset of application and its prolonged duration, and because of the intensity and the duration of the sensorial block that is superior to the motor block.

  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. Arthroscopy of septic carpitis in donkeys (Equus asinus

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    A.H. Elkasapy

    2014-11-01

    Full Text Available Experimental septic arthritis was induced in the radiocarpal joint of 18 donkeys by intra-articular injection of Staphylococcus aureus (3-4X106 CFU. The inoculated animals were divided into three groups (6 donkeys in each group. The arthroscopic examination was carried out before induction of septic carpitis and 3 days (group I, 14 days (group II, and 28 days (group III after induction of infection. The arthroscopic examination of group I revealed hyperemia of synovial membrane and hypertrophied villi. In group II, severe hyperemia of synovial membrane, hypertrophied villi, pannus in the joint cavity and beginning of articular cartilage erosion were found. In group III, severe hyperemia of synovial membrane, hypertrophied villi and more prominent articular cartilage erosion were present.

  8. The single-bundle and single-tunnel reconstruction of anterior cruciate ligament using achilles tendon allograft with attached calcaneus under arthroscopy%关节镜下带跟骨异体跟腱单束单隧道重建前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    冯会成; 黄迅悟; 孙继桐; 常青; 毕龙; 余方圆

    2013-01-01

    Objective To investigate the effectiveness of anterior cruciate ligament (ACL) reconstruction using achilles tendon allograft with attached calcaneus in promoting the tendon-bone healing through comparing with that of ACL reconstruction using simple tendon allograft under arthroscopy. Methods From January 2008 to December 2009, 41 patients with ACL injuries in accordance with the inclusion criteria were treated. They were randomly divided into 2 groups according to different treatment methods. In the trial group, ACL reconstruction using achilles tendon allograft with attached calcaneus was performed on 21 patients. In the control group, ACL reconstruction using simple tendon allograft was performed on 20 patients. There were no significant differences in such general data as the age, gender, cause of injury, disease duration, preoperative functional score and so on between the 2 groups (P>0.05), which were comparable. The single-bundle and single-tunnel ACL reconstruction was performed in both groups. Results All the incisions in both groups were healed by the first intention 2 weeks postoperatively. The patients were followed up for an average period of 26 months (range; 24-28 months) in the trial group, and 28 months (range; 24-30 months) in the control group. 2 years after the operation, 15 cases (71.4%) were negative in the Lachman test, and 16 cases (76.2%) were negative in the anterior drawer test in the trail group. In contrast, 14 cases (70.0%) and 15 cases (75.0%) were negative respectively in the control group. There were no significant differences in the Lysholm score and International Knee Documentation Committee (IKDC) score between the 2 groups 2 years after the operation (P>0.05). The CT exam showed the bone tunnel diameter was enlarged in different degrees in both groups 2 years after the operation, when compared with that 1 month postoperatively. However, the rate of bone tunnel enlargement in the trial group (4/21, 19.0%) was obviously less than

  9. Articular cartilage injury of the knee:comparison of diagnostic value of 3T MR 3D-FS-SPGR sequence with arthroscopy%3T磁共振3D-FS-SPGR序列对膝关节软骨损伤的诊断价值

    Institute of Scientific and Technical Information of China (English)

    谢海柱; 史英红; 岳凤斌; 张刚; 刘奉立

    2011-01-01

    sequences (FSE-T2 W, FSE-T1WI. FSE-FST2 WI and 3D-FS-SPGR ) in detection of the articular cartilage injury of knee joints compared with the arthroscopic findings. Methods: Sagittal-FSE-T2 WI, sagittal-FSE-T1 WI. sagittal-FS-FSE-T2 WI. sagittal-3D-FS-SPGR. coronal-FS-FSET2 WI, axi-FS-FSE-T2 WI, and arthroscopy were performed in 50 patients with articular cartilage injury in knee joints.Sagittal-3D-FS-SPGR images were reconstructed with MPR. In addition. 20 normal knee joints of healthy volunteers underwent MRI. All the MR images of cartilage injury of the medial and lateral femoral condyles. medial and lateral tibial plateaus. femoral trochlea and patella were compared with results of arthroscopic examination. Results: ① On FS-FSET2 WI. the articular cartilages of the normal knees presented as smooth curve-like hyperintensity. The signal of articular carrtilages of medial and lateral femoral condyles. medial and lateral tibial plateaus consisted of clear three-layered structure showing high-low-high intensity from superficial to deep layer. Meanwhile. the articular cartilages of knees showed as unclear two-layered moderately intensity on FSE-T2 WI and FSE-T1 WI. Evident band-like hyperintensity with three-layered structure of high-low-high intensity from superficial to deep layer were showed on 3D-FS-SPGR; ②The articular cartilages of Grade I injury presented as low or high intensity on FS-FSE-T2 WI. low intensity on 3D-FS-SPGR without laminating. The articular cartilage of Grade Ⅱ~ Ⅳ injury presented as moderately intensity on FSE-T1 WI. high intensity on FSE-T2 WI and FS-FSE-T2 WI. low intensity on 3 D-FS-SPGR; ③ Compared with arthroscopic result. the sensitivity, specificity and Kappa were 91. 4%, 95. 9% and 0. 808(>0. 75) respectively with 3D-FS-SPGR sequence; 88. 9%, 96. 8%and 0. 774(>0. 75) with FS-FSE-T2 WI sequence; 75. 3%, 98. 2% and 0. 548 with FSE-T2WI sequence, 64. 2% , 99. 1 %, 0. 444 with FSE-T1 WI sequence. Conclusion;① The

  10. Analgesia intra-articular com morfina, bupivacaína ou fentanil após operação de joelho por videoartroscopia Analgesia intra-articular con morfina, bupivacaína o fentanil después de operación de rodilla por videoartroscopia Intra-articular analgesia with morphine, bupivacaine or fentanyl after knee video-arthroscopy surgery

    Directory of Open Access Journals (Sweden)

    Rogério Helcias de Souza

    2002-09-01

    por vía intra-articular después de operación de rodilla por videoartroscopia. MÉTODO: Sesenta pacientes fueron divididos de forma aleatoria, en cuatro grupos: GI (n=15 - 10 ml de solución fisiológica; GII (n = 15 - 2 mg de morfina diluidos para 10 ml de solución fisiológica; GIII (n = 15 - 10 ml de bupivacaína a 0,25%; GIV (n = 15 - 100 µg de fentanil diluidos para 10 ml de solución fisiológica, inyectados al término de la operación. Todos los pacientes fueron sometidos a anestesia subaracnóidea con 15 mg de bupivacaína hiperbárica. La intensidad del dolor fue evaluada por la escala analógica visual (inmediatamente después del término de la operación y después 6, 12, 18 y 24 horas, bien como la necesidad de complemento analgésico (dipirona 1 g por vía venosa. Fueron anotados los posibles efectos colaterales. RESULTADOS: No hubo diferencia significativa en la intensidad del dolor entre los grupos, en la casi totalidad de los tiempos estudiados. Hubo diferencia estadística hasta seis horas, cuando el grupo fentanil presentó intensidad de dolor significativamente menor. El grupo morfina necesitó de mayor número de complementos con dipirona. Los efectos colaterales fueron mínimos, sin significación estadística. CONCLUSIONES: No hubo diferencia significativa entre la analgesia promovida por las soluciones estudiadas en la mayoría de los tiempos investigados.BACKGROUND AND OBJECTIVES: Methods to promote knee pain analgesia without impairing motor function have been widely researched. This study aimed at comparing intra-articular morphine, bupivacaine, and fentanyl analgesic effects (as compared to saline solution, after knee video-arthroscopy. METHODS: Participated in this study 60 patients who were randomly distributed in four groups: GI (n = 15 10 ml saline solution; GII (n = 15 2 mg morphine diluted in 10 ml saline solution; GIII (n = 15 10 ml of 0.25% bupivacaine; GIV (n = 15 100 µg fentanyl diluted in 10 ml saline solution, injected at

  11. Tension Pneumothorax After Ultrasound-Guided Interscalene Block and Shoulder Arthroscopy.

    Science.gov (United States)

    Li, Robert; Lall, Ajay; Lai, Everett; Gruson, Konrad I

    2015-10-01

    Interscalene brachial plexus anesthesia is commonly used for outpatient arthroscopic shoulder procedures. Ultrasound guidance has helped to minimize the cardiac, neurologic, and pulmonary complications associated with this block. Although rarely reported, pneumothorax may occur as a result of direct lung injury and even in a delayed fashion. We present a case of tension pneumothorax in a patient undergoing arthroscopic rotator cuff repair under both interscalene regional and general anesthesia. Surgeons and anesthesiologists must remain aware that ultrasound-guided interscalene blocks may be associated with pneumothorax and must initiate treatment expeditiously.

  12. Adaptive space warping to enhance passive haptics in an arthroscopy surgical simulator.

    Science.gov (United States)

    Spillmann, Jonas; Tuchschmid, Stefan; Harders, Matthias

    2013-04-01

    Passive haptics, also known as tactile augmentation, denotes the use of a physical counterpart to a virtual environment to provide tactile feedback. Employing passive haptics can result in more realistic touch sensations than those from active force feedback, especially for rigid contacts. However, changes in the virtual environment would necessitate modifications of the physical counterparts. In recent work space warping has been proposed as one solution to overcome this limitation. In this technique virtual space is distorted such that a variety of virtual models can be mapped onto one single physical object. In this paper, we propose as an extension adaptive space warping; we show how this technique can be employed in a mixed-reality surgical training simulator in order to map different virtual patients onto one physical anatomical model. We developed methods to warp different organ geometries onto one physical mock-up, to handle different mechanical behaviors of the virtual patients, and to allow interactive modifications of the virtual structures, while the physical counterparts remain unchanged. Various practical examples underline the wide applicability of our approach. To the best of our knowledge this is the first practical usage of such a technique in the specific context of interactive medical training.

  13. The Effects of Preemptive Tramadol and Dexmedetomidine on Shivering During Arthroscopy

    Directory of Open Access Journals (Sweden)

    Semsettin Bozgeyik

    2014-01-01

    Full Text Available Background: Shivering, the rate of which in regional anesthesia is 39% is an undesired complication seen postoperatively. Aims: This study aims to compare the ability of preventing the shivering of preemptive tramadol and dexmedetomidine during the spinal anesthesia (SA. Methods: A total of 90 patients with American Society of Anesthesiologists physical status I-II, aged 18-60 years and undergoing elective arthroscopic surgery with SA were divided into three groups randomly. After spinal block, 100 mg tramadol in 100 ml saline was applied in group T- (n = 30 and 0.5 μg/kg dexmedetomidine in 100 ml saline was applied in group D- (n = 30 and 100 ml saline was administered in group P- (n = 30 in 10 min. The hemodynamics, oxygen saturation, tympanic temperature, shivering and sedation scores were evaluated and recorded intraoperatively and 45 min after a postoperative period. Results: In group T and D, shivering scores were significantly lower when compared with group P in the intraoperative 20 th min (P = 0.01. Sedation scores in group D were significantly higher than the baseline values (P = 0.03 and values in group T and P (P = 0.04. Conclusions: Preemptive tramadol and dexmedetomidine are effective in preventing the shivering under SA. In addition, dexmedetomidine was superior in increasing the level of sedation which is sufficient to prevent the anxiety without any adverse effects.

  14. 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

  15. 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.

  16. Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy.

    Science.gov (United States)

    Byrd, John W Thomas

    2015-12-01

    Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral impingement. Each of these evolving areas is highlighted in this chapter.

  17. Contribution of arthroscopy in case of septic appearance arthritis of the wrist: a nine cases series.

    Science.gov (United States)

    Hariri, A; Lebailly, F; Zemirline, A; Hendriks, S; Facca, S; Liverneaux, P

    2013-09-01

    Septic arthritis of the wrist is a diagnostic and therapeutic emergency. Synovectomy and lavage by arthrotomy is often followed by stiffness. The purpose of this study was to evaluate the diagnostic and therapeutic contribution of emergency arthroscopic synovectomy with intraarticular lavage. Nine patients were operated on for wrist pathology with septic appearance. All had signs of local inflammation, three showed locoregional inflammation, three were febrile. In one patient several joints were involved. Seven patients presented with inflammatory or degenerative arthritis. All patients underwent emergency surgery using radiocarpal joint puncture, arthroscopic exploration, intraarticular lavage and synovectomy at both the radiocarpal and midcarpal joints. The results were evaluated by pain, Quick DASH, grip strength, and wrist range of motion. In three cases, joint fluid appeared clear, in three it was turbid, and in three purulent. Gram stain and culture revealed bacteria in four cases. Synovitis was radiocarpal four times, radiocarpal and midcarpal once. In one case, there was radiocarpal and midcarpal chondritis. Average pain was 5.3/10 preoperatively and 2/10 at the last clinical follow-up visit. Mean grip strength was 23.3 kg on the involved side vs. 33.5 kg on the opposite one. Mean flexion was 55° for the involved wrist vs. 68°; mean extension was 52° for the affected wrist vs. 59°. No patient was reoperated on. In all cases, there was no sign of local inflammation, regional lymphadenopathy or systemic infection at the last follow-up. One patient died of colon metastatic cancer. Another patient developed a severe Complex Regional Pain Syndrome type I (CRPS1). Our results suggest three principles of management of wrist arthritis with septic appearance: extended surgical indication, emergency operation and arthroscopic procedure.

  18. Hip Arthroscopy for Incarcerated Acetabular Labrum following Reduction of Traumatic Hip Dislocation: Three Case Reports

    Science.gov (United States)

    Hwang, Jung-Mo; Lee, Woo-Yong; Noh, Chang-Kyun; Zheng, Long

    2016-01-01

    Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation. PMID:27777919

  19. Evaluation of the results from non-arthroplastic treatment (arthroscopy for shoulder arthrosis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol. METHODS: Between 1998 and 2011, 31 patients (32 shoulders with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. RESULTS: There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation ( p< 0.001 and there was a tendency ( p= 0.057 toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. CONCLUSION: Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor strongly suggestive of worse results.

  20. Artroscopia do joelho de ovinos Arthroscopy of the stifle joint in sheep

    Directory of Open Access Journals (Sweden)

    Khadije Hette

    2008-02-01

    Full Text Available O trabalho teve por objetivo avaliar artroscopicamente a articulação do joelho de ovinos hígidos em diferentes idades, com o intuito de determinar, de acordo com os portais estabelecidos, a capacidade de observação das estruturas. Utilizaram-se 18 animais da raça Santa Inês, divididos em três grupos experimentais eqüitativos, conforme a idade cronológica, sendo: Grupo I, 6-8 meses (peso médio de 25 kg; Grupo II, 2 anos (peso médio de 50 kg; e Grupo III, 3,5-5 anos (peso médio de 55 kg. Foram estabelecidos três portais: (1 portal artroscópico primário, craniolateral; (2 portal para fluxo de drenagem; e (3 portal instrumental, craniomedial. Identificaram-se com facilidade a patela, sulco e bordas trocleares, côndilos medial e lateral do fêmur, e tendão do músculo extensor longo dos dedos. Após a remoção da maior parte do coxim gorduroso infrapatelar com emprego do "shaver" foram visibilizados, ainda com dificuldade, os ligamentos cruzados e os meniscos. Para a identificação dos primeiros foram necessárias movimentos de flexão e extensão e para os meniscos manobras de varo e valgo. O grau de dificuldade foi inversamente proporcional ao tamanho da articulação. Sendo assim, foi possível concluir que os portais artroscópicos utilizados possibilitaram a identificação das principais estruturas articulares, independente da idade, e o método em si teve por vantagem a rápida recuperação pós-operatória dos animais.The aim of this study was to evaluate arthroscopically the stifle joint of healthy Santa Ines sheep with different ages, and observe the joint elements according to the established portals. Eighteen Santa Ines sheep were divided into 3 equal groups according to the chronological age: GI - 6 to 8 months old (mean weight 25 kg, G II - 2 years old (mean weight 50 kg, and G III - 3.5 to 5 years old (mean weight 55 kg. Three arthroscopic portals were established: craniolateral primary arthroscopic portal, drainage outflow portal, and craniomedial instrumental portal. The patella, the trochlear groove and ridges, the medial and lateral femoral condyles, and the long digital extensor tendon were easily identified. After removing a great portion of the infrapatellar fat pad using a shaver, the cruciate ligaments and the menisci could be observed, even though with some difficulty. The limbs were flexed and extended to identify the cruciate ligaments. Varus and valgus stress of the joint was used to improve meniscal observation. The difficulty level was inversely proportional to the joint size. In conclusion, the arthroscopic portals allowed identification of the main elements of the knee joint, regardless of animal age, and the arthroscopic method had as advantage early postoperative recovery of the animals.

  1. Asymmetry in Dominant / Non-Dominant Hand Performance Differentiates Novices from Experts on an Arthroscopy Virtual Reality Serious Game.

    Science.gov (United States)

    Pedowitz, Robert; Nicandri, Gregg; Tuchschmid, Stefan

    2016-01-01

    Safe and effective arthroscopic surgery requires ambidextrous motor skills. The current study examined dominant versus non-dominant hand performance on a virtual reality serious game in a group of expert arthroscopic surgeons (n=15) compared to a group of orthopedic surgery residents (n=10). A virtual reality Tetris game was performed with the arthroscopic camera and arthroscope in one hand, using an arthroscopic grasping tool in the opposite hand to manipulate the virtual Tetris blocks onto the game grid. A second run was performed after swapping instruments between hands. The order of hand testing was randomized. There was no statistically significant difference in exercise time, grasper path length, or camera path length between the right and left hands of the expert surgeons. In contrast, there were statistically significant differences in all of these parameters between the two hands for the orthopedic surgery residents, with better performance when the grasping tool was used in the dominant hand. The findings of this study suggest that virtual reality games which incorporate progressive cognitive loading could be used to facilitate training, automation, and objective assessment of surgical motor skills.

  2. Virtual MR arthroscopy of the shoulder: image gallery with arthroscopic correlation of major pathologies in shoulder instability

    OpenAIRE

    Stecco, A; Volpe, D.; Volpe, N.; Fornara, P; Castagna, A; Carriero, A.

    2008-01-01

    Background The purpose of this study was to compare virtual MR arthroscopic reconstructions with arthroscopic images in patients affected by shoulder joint instability. MR arthrography (MR-AR) of the shoulder is now a well-assessed technique, based on the injection of a contrast medium solution, which fills the articular space and finds its way between the rotator cuff (RC) and the glenohumeral ligaments. In patients with glenolabral pathology, we used an additional sequence that provided vir...

  3. Prolonged Epidural Infusion Improves Functional Outcomes Following Knee Arthroscopy in Patients with Arthrofibrosis after Total Knee Arthroplasty: A Retrospective Evaluation.

    Science.gov (United States)

    Saltzman, Bryan M; Dave, Ankur; Young, Adam; Ahuja, Mukesh; Amin, Sandeep D; Bush-Joseph, Charles A

    2016-01-01

    A total of 20 consecutive patients with knee stiffness post total knee arthroplasty (TKA) underwent arthroscopic lysis of adhesions and manipulation plus indwelling epidural were evaluated retrospectively. Epidural catheters were placed preoperatively for an intended 6 weeks of postoperative analgesia to facilitate intensive physical therapy. The mean loss of knee extension immediately before incision was 13.5 ± 9.1 degrees (range, 0-35 degrees) and flexion was 77.65 ± 19.2 degrees (range, 45-125 degrees). At the 6-week and final (mean, 0.47 years) follow-up, the loss of extension was 1.5 ± 5.1 degrees (range, -10 to +7 degrees) and 5.4 ± 4.7 degrees (range, 0-15 degrees), respectively, and flexion was 99.7 ± 12.3 degrees (range, 75-120 degrees) and 98.5 ± 16.1 degrees (range, 75-130 degrees), respectively. Of the 20 patients, 2 missed their 6-week clinic visit. Improvements in motion immediately preoperative to 6-week and final follow-up were each significant (p < 0.01). At examination 6 weeks postoperatively, 94.4% of patients met the definition for clinical motion success and 70% maintained success at final follow-up. Visual analog scale improved significantly from 5.4 to 2.0 (p < 0.01) at 6 weeks postoperative in the 12 patients with this data recorded. On the basis of this data, use of tunneled epidurals with arthroscopic lysis of adhesions for arthrofibrosis after TKA is correlated with a high likelihood of functional success postoperatively as measured by range of motion improvement.

  4. Effects of Preoperative Use of Oral Dextromethorphan on Postoperative Need for Analgesics in Patients With Knee Arthroscopy

    Science.gov (United States)

    Entezary, Saeid Reza; Farshadpour, Saeedeh; Alebouyeh, Mahmood Reza; Imani, Farnad; Emami Meybodi, Mohammad Kazem; Yaribeygi, Habibollah

    2013-01-01

    Background Studies have shown that N-methyl-D-aspartate receptor (NMIDA) plays an essential role in postoperative pain. It seems that use of NMDA receptor antagonists such as Dextromethorphan intensifies the analgesic effects of opioids. Objectives In this study, we evaluated the effect of preoperative administration of Dextromethorphan on postoperative pain reduction. Patients and Methods This double blind randomized clinical trial was conducted on arthroscopic surgery candidates. Participants were randomly allocated to interventions and assigned to two groups of Dextromethorphan and placebo. In Dextromethorphan group, the patients received 1 mg/kg Dextromethorphan orally the night before the operation. Pain severity based on the visual analog scale (VAS) up to 16 hours postoperation, use of opioids, and the first request for analgesics were recorded postoperatively. Results A total of 112 patients in the Dextromethorphan (n = 54) and placebo groups (n = 58) were evaluated. No significant difference was detected between the two groups for age, sex or ASA. The mean amount of opioid consumption was significantly lower in patients who received Dextromethorphan (10.7 ± 5.6 mg) compared to the placebo group (13.1 ± 5.6 mg), (P = 0.03). The mean time until the first opioid request in patients who received Dextromethorphan was longer than that in the placebo group (P = 0.01). Conclusions The study results demonstrated that preemptive use of Dextromethorphan reduced postoperative pain and opioid consumption. PMID:24660143

  5. 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.

  6. 膝关节镜术后冷敷镇痛的效果研究%The effect of cryotherapy after knee arthroscopy: a prospective random trial

    Institute of Scientific and Technical Information of China (English)

    郭轶含; 郑群怡; 倪磊; 张秀英; 吴晓英

    2008-01-01

    目的 比较膝关节镜术后间断冷敷和持续冷敷的镇痛效果.方法 选取我科2007年2-6月膝关节镜术后患者68例,随机分为A、B两组,使用冰袋进行冷敷镇痛.别除18例,最后入组50例,每组25例.A组为术后72h内间断冷敷,每日2次,每次0.5h;B组为术后72h内持续冷敷.别除标准为:①韧带重建;②术后留置引流管;③全身麻醉,神经阻滞等;④口服非甾体类抗炎药物;⑤提前出院者;⑥冷冻疗法荣忌症的患者.采用视觉模拟评分(VAS)于患者术后2h、6h、12h、24h、48h和72h进行镇痛效果评定.结果 术后6-48hVAS评分B组优于A组(P<0.05).结论 采用冷冻疗法缓解膝关节镜术后疼痛,持续冷敷优于每日2次间断冷敷.为A、B两组,使用冰袋进行冷敷镇痛.别除18例,最后入组50例,每组25例.A组为术后72h内间断冷敷,每日2次,每次0.5h;B组为术后72h内持续冷敷.别除标准为:①韧带重建;②术后留置引流管;③全身麻醉,神经阻滞等;④口服非甾体类抗炎药物;⑤提前出院者;⑥冷冻疗法荣忌症的患者.采用视觉模拟评分(VAS)于患者术后2h、6h、12h、24h、48h和72h进行镇痛效果评定.结果 术后6-48VAS评分B组优于A组(P<<0.05).结论 采用冷冻疗法缓解膝关节镜术后疼痛,持续冷敷优于每日2次间断冷敷.

  7. 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 infected patients were obviously higher than that of the uninfected patients .The differences were significant (P<0 .05) .The surgery equipments ,hands of medical staff and the surface of objects were monitored .The qualified rate of bacteria detection was up to 100% in surgical instruments .CONCLUSION Effective caring and infection prevention measures before and after arthroscopic knee surgery can obviously reduce the infection rate of wounds .Disinfection treatment should be taken special attention to prevent wound infections . Skin incision should be protected carefully during operations .All operations should strictly be in accordance with regulations and aseptic technique is crucial to the prevention of wound infections .

  8. Treatment of elbow dysfunction under elbow arthroscopy%关节镜手术治疗肘关节伸直受限的临床研究

    Institute of Scientific and Technical Information of China (English)

    郭林; 陈光兴; 段小军; 何锐; 陈昊; 黄宏波; 张颖; 杨柳

    2010-01-01

    目的 探讨关节镜下手术治疗肘关节伸直受限的临床疗效.方法 2007年9月至2009年12月收治21例肘关节伸直受限患者,病程中均有慢性肘关节过伸落空损伤史,有过伸受限合并疼痛症状,平均伸直滞缺18.2°(10°~25°).全部采用五通道入路法行关节镜探查手术,术中清理前关节腔,必要时松解前方关节囊,清除肱骨滑车骨赘,行肱骨鹰嘴窝和尺骨鹰嘴成形术.术后常规抗感染、康复训练及预防骨化性肌炎治疗.随访时对比手术前、后的肘关节活动度,并采用Mayo评分表对肘关节功能进行评价,总结术后并发症.术前Mayo评分良13例,中5例,差3例.结果 21例患者术后随访6~29个月(平均19.7个月).21例患者肘关节功能恢复良好,过伸度均得到改善,疼痛症状消失.平均伸直滞缺2.4°(0°~5°).术后Mayo评分优17例,良4例,中0例,差0例.未见神经并发症.结论 肘关节镜下手术具有创伤小、出血少、并发症少的特点,配合合理的康复训练,能有效改善肘关节的功能,是治疗肘关节伸直受限的有效术式.%Objective To evaluate early clinical outcome after arthroscopic treatment of elbow dysfunction. Methods From September 2007 to December 2009, 21 patients with elbow dysfunction were treated with an arthroscopic procedure. All patients had chronic history of elbow dysfunction. Extension lag was 18.2°(10°-25°)combined with pain. All patients underwent five-portals arthroscopic release and debridement. Postoperative care including anti-infectin, rehabilitation and prophylaxis of myositis ossificans were prescribed. All elbows were assessed for increase in ROM and Mayo assessment before and after surgery. Mayo score assessment: ≥ 90 points, excellent; 75-89 points, good; 60-74 points, common; < 60,bad. Complications were evaluated. Results At an average follow-up of 19. 7 months(6-29 months), all patients had improvement of extension and relieve of pain. The average lag of extension was 2. 4°(0°-5°).Pre-operative Mayo assessment: good, 13 patients; common, 5 patients; bad, 3 patients. Post-operation Mayo assessment: excellent, 17 patients; good, 4 patients; common, 0 patients; bad, 0 patient. There was no complication in this case serial Conclusions Arthroscopic surgery can minimize trauma and bleeding, and reduce complications. Combined with reasonable rehabilitation, arthroscopic surgery can improve elbow function and appears to be satisfactory management.

  9. 化脓性膝关节炎关节镜下治疗%The treatment of Septic Arthritis of knee with Debridement and Drainage under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    陈琼; 任乐夫

    2008-01-01

    目的 研究关节镜下清理及冲洗术在化脓性关节炎治疗方面的作用.方法 2003年10月-2007年06月采用关节镜下清理加关节镜下置管冲洗术治疗化脓性膝关节炎36例.通过半年以上随访进行疗效评定.结果 随访6-46个月,疗效评定,优良率100%.结论 关节镜下治疗化脓性膝关节炎损伤小、关节清理彻底,恢复快、疗效好,值得进一步推广.

  10. septic arthritis of temporomandibular joint treated with arthroscopy%化脓性颞下颌关节炎的内镜诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    蔡协艺; 杨驰; 王保利; 恽白

    2010-01-01

    目的:探讨化脓性颞下颌关节炎内镜诊断和治疗的临床应用价值.方法:收集我院因化脓性颞下颌关节炎而行关节镜治疗的7例患者,对其临床表现、影像学特点、内镜下表现和治疗方法进行总结分析.结果:化脓性颞下颌关节炎的主要临床症状为关节区疼痛和开口困难;5例患者行磁共振成像,4例显示关节腔积液;2例患者行CT扫描,均显示关节周围间隙蜂窝织炎;7例患者均行内镜检查,2例急性期患者表现为滑膜肿胀和充血,5例慢性期患者主要表现为广泛黏连、软骨破坏和骨质缺损,3例患者关节盘穿孔,2例被诊断为纤维性强直.化脓性颞下颌关节炎内镜治疗方法主要为灌洗、黏连松解和关节面清理术.平均随访期57.4个月,术后无复发.结论:内镜被证实是诊治化脓性颞下颌关节炎的一种有效方法,尤其适用于慢性期患者.

  11. The nursing research of arthroscopy in treating knee osteoarthritis%关节镜治疗膝关节骨性关节炎护理研究

    Institute of Scientific and Technical Information of China (English)

    曾艳美

    2013-01-01

    Objective To investigate the nursing effect of arthroscopic treatment of osteoarthritis of the knee. Methods In our hospital from 2010 June to 2012 December were treated 47 cases of osteoarthritis of the knee were treated by arthroscopic treatment of analgesics,postoperative functional exercise of ice,nursing. Results 47 cases of postoperative pain disappeared or significantly reduced,range of joint function and activity improved significantly, there was no joint dysfunction. Conclusion The quality of nursing care before and after operation,especially nursing after operation to ensure that the effect of operation treatment,improve the quality of life of patients,and promote an early recovery of patients.%目的探讨关节镜治疗膝关节骨性关节炎的护理方法与效果。方法对我院2010年6月-2012年12月收治的47例膝关节骨性关节炎患者采用关节镜治疗,给予服用止痛药、冰敷、功能锻炼等护理。结果47例患者术后疼痛消失或明显减轻,关节功能和范围明显改善,均未发生关节功能障碍。结论通过对关节镜治疗膝关节骨性关节炎患者手术前后的优质护理,尤其是术后的护理,确保了手术治疗效果,提高了患者生活质量。

  12. Arthroscopie therapy of prepatellar bursitis with radiofrequency%关节镜下等离子刀治疗髌前滑囊炎

    Institute of Scientific and Technical Information of China (English)

    陈峰; 金先跃

    2008-01-01

    目的 探讨关节镜下等离子刀治疗髌前滑囊炎的可行性.方法 2005年2月~2007年2月,采用局麻关节镜监视下等离子刀治疗髌前滑囊炎10例.男3例,女7例,年龄25~66岁.镜视下将含有肾上腺素的生理盐水注入囊壁脏层组织,采用囊外剥离和囊内射频汽化切割处理囊壁组织.结果 术后随访10例,无感染和血管神经损伤,疗效满意.结论 局部麻醉关节镜下髌前滑囊切除术方法可行,安全可靠,疗效满意.

  13. Treatment of Prepatellar Bursitis with Debridement under Arthroscopy%关节镜下清理术治疗髌前滑囊炎

    Institute of Scientific and Technical Information of China (English)

    张羽飞; 王福生; 王立德; 乔刚

    2003-01-01

    目的:研究关节镜下治疗髌前滑囊炎的方法.方法:13例髌前滑囊炎患者,男8例,女5例.囊肿最大8cm×10cm,最小5cm×6cm,全部病例均于关节镜下手术切除囊肿,并彻底冲洗,局部加压包扎,术后伸膝位石膏固定.结果:术后随访时间3~21个月.全部病人无1例复发及感染.所有病人膝前皮肤均表现有不同程度的凹陷形成,仅有2例病人残留有膝前Ⅱ°疼痛,1例病人皮肤有麻木感.结论:关节镜下手术治疗髌前滑囊炎,疗效满意,方法简单,并发症少.

  14. 肩关节镜下行SLAP损伤修复术病人的护理%Nursing care of patients undergoing SLAP damage repair under shoulder arthroscopy

    Institute of Scientific and Technical Information of China (English)

    陈英; 陈程; 苏丽西; 刘桂瑛

    2014-01-01

    [目的]探讨肩关节镜下行SLAP损伤修复术病人的护理经验,提高病人的依从性,以提高护理质量.[方法]对13例SLAP损伤病人实施术前心理防护、告知肩部支具的佩戴方法,术后采取功能体位护理、疼痛护理、肩部支具护理、功能锻炼指导等护理方法,预防并发症,评价护理效果.[结果]13例病人经有效的手术治疗和护理干预后,均康复出院.仅有1例病人术后8周出现肩关节肿胀疼痛、肩关节部分功能受限再次入院,遵医嘱予以甘露醇脱水、适当功能锻炼后康复出院.[结论]对肩关节镜下行SLAP损伤修复术病人进行护理,可减轻病人疼痛,促进病人的功能恢复.

  15. Medline Plus

    Full Text Available ... 2011) Knee Injuries and Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, ... 2014) Knee Injuries and Disorders Knee Arthroscopy for Treatment of a Meniscus Tear (Broward Health Medical Center, ...

  16. "Open Access" Requires Clarification: Medical Journal Publication Models Evolve.

    Science.gov (United States)

    Lubowitz, James H; Brand, Jefferson C; Rossi, Michael J; Provencher, Matthew T

    2017-03-01

    While Arthroscopy journal is a traditional subscription model journal, our companion journal Arthroscopy Techniques is "open access." We used to believe open access simply meant online and free of charge. However, while open-access journals are free to readers, in 2017 authors must make a greater sacrifice in the form of an article-processing charge (APC). Again, while this does not apply to Arthroscopy, the APC will apply to Arthroscopy Techniques.

  17. 关节镜下清理配合透明质酸钠治疗膝关节骨关节炎的疗效分析%EfficacyAnalysisUndertheArthroscopyCleaningwithSodiumHyaluronateTreatKneeOsteoarthritis

    Institute of Scientific and Technical Information of China (English)

    吴锋; 潘敬舜

    2013-01-01

    Objective By observing arthroscopic limited debridement with sodium hyaluronate intra-articular injection treatment of osteoarthritis and provide a basis for minimally invasive surgery, the use of sodium hyaluronate repair cartilage. Methods 63 patients with osteoarthritis of arthroscopy and arthroscopic synovial tissue hyperplasia hypertrophy cutting, cleaning, trimming to be intra-articular injection of sodium hyaluronate therapy after surgery. Results After treatment of knee swelling, pain relief, improved knee range. Conclusion Arthroscopic debridement sodium hyaluronate intra-articular injection method of treatment as early as the mid-term knee osteoarthritis signiifcantly improve patient function, and delay the onset of osteoarthritis process.%  目的 通过关节镜下有限清理术配合透明质酸钠关节腔注射治疗骨性关节炎,为微创手术后运用透明质酸钠修复软骨提供一定的依据。方法 对63例骨性关节炎进行关节镜检查,并在关节镜下切削增生肥厚的滑膜组织、清理、修整,术后予以透明质酸钠关节腔注射治疗。结果 治疗后膝关节肿胀、疼痛缓解,膝关节活动度改善。结论 采用关节镜清理术透明质酸钠关节腔注射方法治疗早、中期膝骨性关节炎能明显改善患者功能,延缓骨性关节炎的发病过程。

  18. Reconstruction of Anterior Cruciate Ligament with Cryopreserved Anterior Cruciate Ligament Allografts Under Knee Arthroscopy%关节镜下深低温冷藏异体ACL重建ACL的初步观察

    Institute of Scientific and Technical Information of China (English)

    周建生; 刘泉; 张长春; 肖玉周; 刘振华; 官建中

    2004-01-01

    目的:报告关节镜下深低温冷藏异体前交叉韧带(ACL)重建膝关节ACL的方法和疗效.方法:采用该法手术治疗2例膝关节ACL陈旧性断裂患者.结果:2例患者均于术后6周去拐行走,前抽屉试验及Lachman试验阴性 ;术后6个月复查,临床症状消失,行走步态恢复正常,关节活动度正常.结论:膝关节镜下采用异体ACL重建ACL,可同时达到解剖重建和等长重建的双重目的,手术损伤小,康复快,疗效肯定.

  19. Nursing coordination of synchronized allograft Achilles reconstruction of posterior cruciate ligament by arthroscopy%关节镜下带跟骨异体跟腱重建膝后交叉韧带的护理配合

    Institute of Scientific and Technical Information of China (English)

    万效梅; 李娟

    2014-01-01

    To summarize the surgery nursing experiences of synchronized alograft Achiles reconstruction of posterior cruciate ligament and to improve the quality of coordination during surgery.Methods:41 cases of surgery nursing experiences of synchronized alograft Achiles reconstruction of posterior cruciate ligament including preparing special equipment, alograft ligament, placement of equipment and coordination during surgery between June of 2011 and December of 2012 were reviewed and analyzed.Results:41 patients were successfuly operated with wound healing, no infection of the joint cavity and good recovery from surgery.Conclusion:Missions, psychological care before surgery, careful preoperative preparation, correct preparation of alograft ligament, proper connection of various instruments and closely and effective coordination are al important for the successful operation.%目的:总结关节镜下带跟骨异体跟腱移植重建膝后交叉韧带的手术护理经验,以提高手术配合质量。方法:回顾性分析2011年6月到2012年12月期间,41例关节镜下带跟骨异体跟腱重建膝后交叉韧带护理配合情况,包括各种特殊器械准备、异体肌腱准备工作、仪器设备合理摆放及术中配合等。结果:41例患者均顺利完成手术,伤口一期愈合,未发生关节腔的感染,术后恢复良好。结论:术前做好宣教及心理护理、完善周密的术前准备、异体肌腱正确制备、正确连接各种仪器、密切有效的手术配合是手术顺利进行的重要保障。

  20. Value of arthroscopy in diagnosis of acute traumatic hemarthrosis of knee joint%关节镜在膝关节急性损伤中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张毅; 赵新建; 杨林; 曾明; 黄星球

    2006-01-01

    目的探讨膝关节镜在膝关节急性损伤中的临床诊断价值.方法28例膝关节急性损伤关节积血患者,在1~5 d内行膝关节镜手术.结果2例髌骨软骨骨折,3例胫骨平台关节软骨骨折,4例半月板损伤,1例前十字韧带损伤,3例内侧副韧带损伤.结论对于膝关节急性损伤关节积血的患者,宜尽早实施膝关节镜检查.

  1. 关节镜在急性创伤性膝关节积血诊治中的应用%Application of arthroscopy in diagnosis and treatment of acute traumatic hemarthrosis of the knee joint

    Institute of Scientific and Technical Information of China (English)

    郭舒亚; 贾堂宏; 龚维明; 刘志功

    2003-01-01

    目的评价关节镜在急性创伤性膝关节积血诊治中的应用价值.方法自2002年1月~2003年1月,对26例X线检查无胫骨平台、股骨髁及髌骨骨折的急性创伤性膝关节积血患者施行早期关节镜检查.结果关节镜检查发现MCL损伤19例(73.1%),ACL损伤16例(61.5%),半月板损伤10例(38.5%),其中复合性损伤12例,占46.2%.术前漏诊前交叉韧带损伤6例,半月板损伤5例.结论急性膝关节积血预示膝关节内或其周围结构的严重损伤,早期关节镜检查有利于明确诊断,有助于选择治疗方法及制定相应康复措施.

  2. 膝关节软骨损伤的MR诊断及与关节镜结果对照%MR diagnosis of articular cartilage injury in the knee: compared with arthroscopy

    Institute of Scientific and Technical Information of China (English)

    张敏; 张泽坤; 李石玲; 郭智萍; 张伟; 马晓晖; 蔡朋利; 魏培建; 彭志刚; 孙英彩

    2005-01-01

    目的分析不同MR扫描序列对关节软骨损伤的诊断能力,为关节软骨损伤的临床诊断和治疗提供可靠的影像学依据.方法对临床拟行膝关节镜检查的膝关节疼痛患者进行术前MR成像,对MR图像进行二维和三维重建处理.结果与关节镜对照,34例膝关节软骨损伤患者的MR检查结果:脂肪抑制三维稳态进动快速成像序列(fat-saturated three-dimensional fast imaging with steady-state procession,FS-3D-FISP)敏感度为91.4%、特异度为97%、 Kappa值为0.818,脂肪抑制二维快速小角度激发成像序列(fat-saturated tow-dimensional fast low angle shot, FS-2D-FLASH)敏感度为77.1%、特异度为98%、 Kappa值为0.531,SE-T1WI序列敏感度为70%、特异度为99%、Kappa值为0.518. 本组无明确急性外伤史的关节软骨损伤病例中有77.6%在病变部位出现与损伤软骨区相对应的软骨下骨及骨髓内片状T1WI低信号影,FS-3D-FISP及FS-2D-FLASH序列呈高信号.结论 FS-3D-FISP序列对关节软骨损伤病变的准确性明显优于FS-2D-FLASH和SE-T1WI, 与关节镜诊断结果之间具有良好的一致性.软骨下骨及骨髓内的异常信号是关节软骨损伤重要的间接征象.关节软骨损伤的三维成像有利于临床术前对重度膝关节软骨损伤进行立体定位诊断.

  3. 理疗技术在膝关节炎关节镜清理术后康复中的应用%Effect of Physical Therapy on Rehabilitation of Knee Arthritis Arthroscopy Technique after Debridement

    Institute of Scientific and Technical Information of China (English)

    陈雪; 张定伟; 霍青; 刘莉; 何慧琳; 王木

    2015-01-01

    目的:探讨理疗技术在膝关节炎关节镜清理术后康复中的应用效果。方法选取我院2012年1月~2014年1月收治的150例膝关节炎清理术后患者随机分为观察组87例,对照组63例。对照组患者接受常规治疗及护理,观察组在此基础上接受蜡疗射频电疗,比较两组患者术后康复效果。结果观察组疼痛、肿胀消退时间短于对照组,膝关节功能康复程度优于对照,具有统计学意义(<0.05)。结论膝关节炎术后患者结合应用理疗技术能明显缩短康复时间,提高康复质量。%Objective To investigate physiotherapy techniques in the knee arthroscopic surgery to clean up the rehabilitation of the application results.Methods Our hospital in January 2012 January 2014 of 150 cases treated patients with knee OA clean up 87 cases were randomly divided into two groups,a control group of 63 cases.Control patients received conventional treatment and care, observation group received radio frequency electrotherapy wax treatment on this basis,comparing the two groups of patients after rehabilitation.Results The study group pain,swel ing subsided shorter than the control group,the degree of recovery of knee function than the control,with statistical significance ( <0.05).Conclusion Patients with osteoarthritis of the knee surgery combined application physiotherapy techniques can significantly shorten recovery time,improve the quality of rehabilitation.

  4. Effects of postoperative compression cryotherapy on patients with shoulder joint arthroscopy%肩关节镜术后患者加压冷疗的效果观察

    Institute of Scientific and Technical Information of China (English)

    付佳; 高凡; 李鸿艳

    2015-01-01

    目的 探讨肩关节镜术后患者加压冷疗的效果.方法 于2012年9月至2014年2月将40例肩关节镜术后患者,随机分为实验组和对照组各20例.实验组术后开始冷疗,每8h 1次,每次30min,连续48h;对照组术后给予常规护理.分别在术前及术后24h、48h,采用视觉模拟评分法(visual analogue scale score,VAS)评估疼痛,用3个固定位置点(即以外上髁为起点15cm处、20cm处的上臂围周径、腋窝周径)的肿胀值评估肿胀.结果 实验组术后24h、48hVAS评分平均为(2.9±1.2)分、(2.1±1.3)分;对照组术后24h、48hVAS评分为(4.2±1.6)分、(3.1±1.1)分.实验组术后VAS评分低于对照组,差异有统计学意义(P<0.05).实验组术后24h、48h肿胀值为(1.6±0.7)cm、(1.0±0.5)cm;对照组以外上髁为起点15cm处术后24h、48h肿胀值为(2.4±1.1)cm、(1.8±0.8)cm.实验组术后24h、48h肿胀值为(2.1±1.1)cm、(1.3±0.8)cm;对照组以外上髁为起点20cm处术后24h、48h肿胀值为(2.9±1.2)cm、(2.1±1.1)cm.实验组术后24h、48h肿胀值为(2.4±1.2)cm、(1.8±1.0)cm;对照组腋窝周径术后24h、48h肿胀值为(3.3±1.4)cm、(2.7±1.2)cm.实验组术后肿胀值低于对照组,差异有统计学意义(P<0.05),无冻伤病例.结论 肩关节镜术后应用加压冷疗装置能够减轻患肢疼痛和肿胀,有利于早期功能锻炼,促进肩关节功能恢复.

  5. The usage of Bupivacaina as anesthetic agent in knee arthroscopy. Utilización de la Bupivacaína como agente anestésico en la artroscopia de la rodilla.

    Directory of Open Access Journals (Sweden)

    Carlos M. Hernández

    2003-12-01

    Full Text Available Introduction: Artroscopy of the knee is a procedure that is frequently developed as a diagnostic and therapeutic means in patients who suffer among other diseases, from chronic sinuvitis, lesions of the meniscus and adherence . A great number of these patients receive medical assistance at the outpatient department of the orthopaedic department where the need of its use is assessed. It is a relatively short procedure that has few risks when it is performed with the appropriate technique. Objective: To show the use of intra articular Bupivacaine 0,25 % in the artroscopy of the knee. Method: Retrospective study carried out at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province from September 2002 to February 2003. This study was developed with 20 patients who were initially assisted at the service of Orthopaedics in which a group of therapeutic procedures were decided. Bupivacaine 0,25 % together with Epinephrine 0,1 % in a dose of 0,1 ml were injected in the intra articular space in a volume of 20 ml distributed in 4 sections with 5 ml each. At the level of the section where the artroscope was inserted , 5 ml of Bupivacaine 0,25 % was applied Result: the age of the patient ranged 30 to 61 years of age with a media of 44,6 years and a standard deviation of 12,6 years. The introduction and application of the procedure throughout artroscopy was possible in al patients. Conclusion: Bupivacaine is a good local anaesthetic because of its slow action since the onset of application and its prolonged duration, and because of the intensity and the duration of the sensorial block that is superior to the motor block.
    Introducción: La artroscopia de la rodilla es un proceder que se realiza frecuentemente en la actualidad con fines diagnósticos y terapéuticos, a pacientes portadores de enfermedades como sinovitis crónica, lesiones de menisco, adherencias, entre otros. Un considerable número de estos pacientes son atendidos en consulta de ortopedia, donde se valora la necesidad o no de su realización. Es un proceder relativamente corto y con pocos riesgos cuando se realiza con la técnica adecuada. Objetivo : Demostrar el uso de la bupivacaína al 0,25 % intraarticular en la artroscopia de la rodilla. Métodos: Estudio prospectivo realizado en el Hospital ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos en el período comprendido entre septiembre 02 y febrero del 03 a un grupo de 20 pacientes atendidos inicialmente por el Servicio de Ortopedia y luego por Anestesiología, decidiéndose en conjunto el proceder terapéutico. Se inyectó bupivacaína en el espacio intraarticular, a 0,25 % con epinefrina 0,1 ml al 0,1 %, en un volumen de 20 ml, distribuidos en 4 portales a razón de 5 ml en cada uno. A nivel del portal donde se introdujo el artroscopio, se aplicó 5 mil. de bupivacaína al 0,25 % Resultados: Las edades de los pacientes oscilaron entre 30 y 61 años con una media de 44,6 años y desviación estándar de 12.6 años. Fue posible la introducción y la realización de los procedimientos a través de la artroscopia en todos los pacientes. Conclusión : La bupivacaína resultó un agente anestésico local muy favorecedor, por su inicio de acción lento y una duración prolongada, la intensidad y duración del bloqueo sensorial superior a las del bloqueo motor.

  6. Evaluation and analysis of graft hypertrophy by means of arthroscopy, biochemical MRI and osteochondral biopsies in a patient following autologous chondrocyte implantation for treatment of a full-thickness-cartilage defect of the knee.

    Science.gov (United States)

    Niemeyer, Philipp; Uhl, Markus; Salzmann, Gian M; Morscheid, Yannik P; Südkamp, Norbert P; Madry, Henning

    2015-06-01

    Graft hypertrophy represents a characteristic complication following autologous chondrocyte implantation (ACI) for treatment of cartilage defects. Although some epidemiological data suggest that incidence is associated with first-generation ACI using autologous chondrocyte implantation, it has also been reported in other technical modifications of ACI using different biomaterials. Nevertheless, it has not been described in autologous, non-periosteum, implant-free associated ACI. In addition, little is known about histological and T2-relaxation appearance of graft hypertrophy. The present case report provides a rare case of extensive graft hypertrophy following ACI using an autologous spheres technique with clinical progression over time. Detailed clinical, MR tomographic and histological evaluation has been performed, which demonstrates a high quality of repair tissue within the hypertrophic as well as non-hypertrophic transplanted areas of the repair tissue. No expression of collagen type X (a sign of chondrocyte hypertrophy), only slight changes of the subchondral bone and a nearly normal cell-matrix ratio suggest that tissue within the hypertrophic area does not significantly differ from intact and high-quality repair tissue and therefore seems not to cause graft hypertrophy. This is in contrast to the assumption that histological hypertrophy might cause or contribute to an overwhelming growth of the repair tissue within the transplantation site. Data presented in this manuscript might contribute to further explain the etiology of graft hypertrophy following ACI.

  7. Observation Clinical Therapeutic Effect on Cruciate Ligament Reconstruction Under Knee Arthroscopy%膝关节镜下交叉韧带重建术的临床治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    金睿; 赵德本

    2015-01-01

    目的:观察分析膝关节镜下交叉韧带(ACL)重建术的临床治疗效果。方法对照组32例患者实施膝关节镜下交叉韧带切开重建术,观察组35例患者实施膝关节镜下交叉韧带重建术,比较分析不同手术方法疗效。结果观察组患者的关节活动度、Lysholm评分、护理满意情况优于对照组,并发症发生情况少于对照组,P<0.05,差异具有统计学意义。结论膝关节镜下交叉韧带重建术应用效果显著。%Objective To observe the clinical therapeutic effect on arthroscopic anterior cruciate ligament reconstruction. Methods 32 cases of the control group underwent arthroscopic cruciate ligament reconstruction surgery incision, 35 cases of the observation group were treated with arthroscopic cruciate ligament reconstruction, comparative analysis of curative effect on different operation methods. Results The patients in the observation group joint activity, Lysholm score, nursing satisfaction was better than the control group, the incidence of complications was less than the control group, P<0.05, had difference statistically significance. Conclusion Arthroscopic application effect remarkable of cruciate ligament reconstruction.

  8. Selective anterior cruciate ligament bundle reconstruction using autologous hamstring tendon under arthroscopy%关节镜下自体腘绳肌腱选择性重建前交叉韧带部分束

    Institute of Scientific and Technical Information of China (English)

    张勇

    2015-01-01

      结果与结论:与治疗前相比,治疗后患者Lachman试验阳性率、前抽屉试验阳性率、ADT试验阳性率、Tegner评分、胫骨位移距离均显著下降(P<0.05),IKDC2000、Lysholm、BRISTOL评分显著升高(P<0.05)。结果表明关节镜下自体腘绳肌腱选择性重建前交叉韧带部分束能有效地控制病情和缓解症状,治疗后膝关节功能恢复良好,有利于维持膝关节稳定性。

  9. 关节镜下3种移植物重建膝关节后交叉韧带的效果研究%Comparative study on posterior cruciate ligament reconstruction with three different grafts in arthroscopy

    Institute of Scientific and Technical Information of China (English)

    郑建平; 梅荣成; 廉凯

    2012-01-01

      目的:应用自体骨-髌腱-骨(B-PT-B)、异体腘绳肌腱(ST/G)和LARS韧带进行关节镜下重建后交叉韧带(PCL),比较不同移植物的临床疗效.方法:选择3种不同移植物分别对96例PCL损伤患者行关节镜下重建PCL,术后积极康复训练.结果:各组膝关节Lysholm评分在术后3、9、18个月均较术前改善.异体ST/G组术后3个月Lysholm评分低于另外两组(P<0.05),术后9、18个月与自体B-PT-B组比较差异无统计学意义(P﹥0.05).术后3、9、18个月LARS组Lysholm评分明显高于另外两组(P<0.05).结论:3种不同移植物均能明显改善膝关节功能,近期LARS韧带改善优于自体B-PT–B和异体ST/G.%  Objective:To compare clinical effects with posterior cruciate ligament arthroscopic reconstruction with bone-patellar-tendon-bone autograft,alloge--nous tendon graft and 1igament advanced reinforcement system. Mesthods: From Feb 2003 to june 2010, a total of 96 patients suffered from posterior cruciate ligament rupture underwent reconstruction with three different grafts and followed by accelerated rehabilitation program. Results:The function of knee joint was all improved in 3, 9 and 12 month postoperatively. There was significant difference that Lysholm score of allogenous tendon graft group was lower than that in the other groups in 3 month postoperatively ( P<0.05),and no significant difference was found among B- PT -B group and ST/G group in 9 and 18 month postoperatively . The Lysholm score of LARS group was significantly increased, comparing with the other groups in 3,9 and 18 month postoperatively (P<0.05). Conclusions:The function of knee joint can be obviously improved in PCL arthroscopic reconstruction with B-PT-B autograft, ST/G allograft and LARS artificial ligaments. The LARS artificial ligaments have an advantage in improving the function of knee joint in the near future.

  10. 关节镜下LARS人工韧带移植重建后交叉韧带%Reconstruction of the posterior cruciate ligament with ligament advanced reinforcement system artificial ligament transplantation under knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    尚平; 贺宪

    2007-01-01

    目的:观察关节镜下应用LARS人工韧带重建后交叉韧带患者的膝关节功能恢复情况.方法:选择2005-01/2006-05在南方医科大学附属花都医院骨科行关节镜下LARS人工韧带重建的复杂后交叉韧带损伤患者6例,术前均知情同意并签字.所有重建手术均为二期手术.①先建立胫骨骨隧道.②然后建立股骨骨隧道.③关节镜监视下,将LARS人工韧带的"Y"形双束穿出前外与前内束股骨双隧道,分别于屈膝90°和30°位拉紧固定.术后3 d开始被动活动,1周后行股四头肌主动锻炼.术后定期随访,膝关节功能评估采用Lysholm评分标准,包括8个方面:跛行、支撑、交锁、不稳、疼痛、肿胀、上下梯及下蹲.总分100分,分数愈高,膝关节功能恢复愈好.结果:6例患者均获得随访,无一例脱落,随访时间分别为7,7,10,10.4,12.8,14个月,平均10.2个月.所有患者术后膝关节不稳定症状消失,胫骨后坠征阴性,后抽屉试验阴性.患者术后的膝关节Lysholm功能评分显著高于术前(83.5±4.5,51.6±3.6,P<0.01).结论:关节镜下LARS人工韧带重建后交叉韧带可以更好地恢复膝关节的稳定性,且创伤小,并发症少,疗效满意.

  11. 关节镜下膝后交叉韧带重建患者的康复训练%Rehabilitation exercises for patients undergoing reconstruction of posterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    董凤仙

    2008-01-01

    @@ 膝关节后交叉韧带(PCL)是维持膝关节稳定的重要结构,其断裂后会引起膝关节的后向不稳及旋转不稳,从而影响关节功能,甚至导致膝关节病变.目前PCL断裂修复方法多为关节镜辅助下重建.交叉韧带修复重建术前后的康复训练是保证手术成功、膝关节功能恢复良好的重要措施.我院采用关节镜下单一切口技术双束半腱肌与骨薄肌肌腱重建后交叉韧带16例,术后运用康复训练程序进行阶段性训练,其关节稳定程度及活动范围均恢复良好,可正常生活和工作,现报道如下.

  12. Arthroscopy combined Chinese medicine for treatment of acute septic arthritis of knee%关节镜技术配合中药治疗急性化脓性膝关节炎

    Institute of Scientific and Technical Information of China (English)

    周运勇; 唐刚健; 靳嘉昌; 靳荷; 伍业雄

    2011-01-01

    目的:探讨膝关节镜下清理及术后关节腔内置管持续灌注冲洗配合中药治疗急性化脓性膝关节炎的作用。方法:对42例42膝急性化脓性关节炎行膝关节镜下清理及术后关节腔内置管持续灌注冲洗治疗,配合中药内服,同时结合全身使用抗生素,以及术后系统的康复训练。结果:术后12~24 h患者体温明显下降,2~4 d恢复正常。切口均Ⅰ期愈合,无窦道形成。术后2周患者伸膝功能恢复正常,膝关节屈曲达90度。根据Neer等功能评分:优33例,良7例,差2例。结论:通过关节镜技术配合中药可有效地早期治疗化脓性膝关节炎。该方法清创彻底,创伤小,可及时控制感染,最大限度保持膝关节功能。

  13. 关节镜下清理术治疗急性化脓性膝关节炎的疗效观察%ARTHROSCOPY DEBRIDEMENT IN TREATMENT OF SEPTIC ARTHRITIS OF THE KNEE

    Institute of Scientific and Technical Information of China (English)

    符东林; 李超; 于海洋; 王宏亮; 郭标; 陈坚

    2005-01-01

    目的探讨早期关节镜下清理术加持续冲洗术在急性化脓性膝关节炎中的作用. 方法 1998年10月~2003年10月对21例21膝急性化脓性关节炎在关节镜下行关节清理术,术后置管行持续冲洗术,同时结合全身使用抗生素,以及术后系统的康复训练. 结果术后24~48 h患者体温明显下降,3~6 d恢复正常.血常规检查:术后5~8 d白细胞计数和分类恢复正常,血沉和C反应蛋白2~3周恢复正常.术后8周,膝关节伸膝为0°,膝关节屈曲超过110~135°,平均120.1°,部分患者稍差于健侧.本组均获随访1~3年,无一例再感染,X线片检查未发现明显的关节间隙变窄.根据膝关节Noyes最终功能表评分:优19 例,良和可各1例,优良率为95.2%. 结论早期诊断、关节镜下清理术结合术后持续冲洗术是治疗急性化脓性膝关节炎的有效手段,安全简便,创伤小,术后恢复快,能够迅速控制病情的发展,有利于关节功能的康复.

  14. 关节腔内注射丁丙诺啡对膝关节镜术后疼痛的影响%ANALGESIC EFFECT OF LOW DOSE BUPRENORPHINE INJECTED INTRA-ARTICULARLY AFTER KNEE ARTHROSCOPY

    Institute of Scientific and Technical Information of China (English)

    刘凤梅; 张忠; 谢金瑞

    2004-01-01

    目的:观察关节腔内注射丁丙诺啡(Buprenorphine)对膝关节镜术后的镇痛效果,并与注射小剂量吗啡(Morphine)进行对比分析.方法:48例腰麻下行膝关节镜手术病人,双盲法随机均分为关节腔内注射Buprenorphine(B)、Morphine(M)与生理盐水对照组(C)3组,给药后记录术后2h、4h、8h、12h与24h患者屈膝关节90°状态下的视觉模拟评分(VAS)、对镇痛效果的满意度及术后8h按需注射哌替啶的量.结果: B、M组术后8h哌替啶平均使用量分别为9.4mg与28.1mg,较C组(51.6mg)明显减少;术后4h、8h、12h、24h 患者屈膝90° VAS评分B、M组均显著低于C组,B组亦较M组低,比较统计学差异均非常显著(P<0.001);术后镇痛满意度,B、M组较C组高,组间差异非常显著(P<0.001).结论: 关节腔内注射Buprenorphine可有效缓解膝关节镜术后疼痛,效果优于吗啡.

  15. 局部加压冷疗对控制踝关节镜术后关节肿胀的临床护理%Local Pressure Cold Therapy to Control the Naked Arthroscopy Joint Swelling of Clinical Nursing Research

    Institute of Scientific and Technical Information of China (English)

    车慧虹

    2014-01-01

    目的 探讨局部加压冷疗对控制踝关节镜术后关节肿胀的临床护理效果.方法 选取2013年2月~2014年2月我科采用踝关节镜手术治疗后的患者78例,根据治疗和临床护理方案分为对照组和观察组,各39例.对照组采用常规药物治疗和护理方法.观察组在常规药物治疗和护理的基础上对踝关节镜术后每8h使用加压冷疗系统治疗1次,30min.并观察两组手术后16h、24h、32h、40h、48h患肢的肿胀和疼痛情况,并进行比较.结果 两组疼痛评分及肿胀程度评分在术后16h及24h比较无显著性差异(P>0.05),术后32h、40h、48h观察组明显优于对照组(P<0.05).结论 对踝关节镜术后关节肿胀处采取持续冷敷,能缓解患者踝关节疼痛,减轻肿胀,使其早期进行功能锻炼,有利于踝关节功能早期康复,可降低患者对镇静止痛剂的依赖性.

  16. 两种冷疗方式对膝关节镜术后病人满意度的影响%Influence of two kinds of cold therapy on satisfaction degree of patients after undergoing knee arthroscopy surgery

    Institute of Scientific and Technical Information of China (English)

    李玲利; 宁宁; 何凌霄; 刘晓艳; 吕娟

    2013-01-01

    [目的]比较膝关节镜术后病人使用两种冷疗产品的满意度.[方法]将2009年5月-11月的140例膝关节镜术后病人随机分为两组,观察组采用冷加压自动循环系统,对照组采用传统清水冰袋,冷疗24 h后,采用自行设计的满意度调查表调查两组使用冷疗产品后的满意度.[结果]两组总体满意度差异有统计学意义(P<0.05),两组对冷疗产品防渗出性、舒适度、冰囊与膝关节贴合性、减轻疼痛、减轻肿胀5个方面满意度比较差异有统计学意义(P<0.05);观察组满意度总分(29.51分±2.62分)高于对照组(21.77分±1.92分),差异有统计学意义(P<0.05).[结论]膝关节镜术后病人使用冷加压自动循环系统后的满意度高于使用传统清水冰袋冷疗病人的满意度.

  17. LARS人工韧带同时重建前、后交叉韧带%Reconstruction of both the anterior cruciate ligament and posterior cruciate ligament with ligament advanced reinforcement system artificial ligament transplantation under knee arthroscopy

    Institute of Scientific and Technical Information of China (English)

    尚平; 贺宪; 江永发; 刘志祥; 才忠民; 杨俊龙

    2007-01-01

    目的 探讨关节镜下LARS(Ligament Advanced Reinforcement System,LARS)人工韧带同时重建前(Anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)的方法和临床疗效.方法 从2006年1月至2007年4月,用LARS人工韧带同时重建ACL、PCL2例.应用Lysholm功能评分表评估膝关节功能,采用抽屉实验检查膝关节前后松弛度.结果 2例均获得随访,随访时间分别为8月、3月.2例患者术后患膝关节不稳定症状消失,胫骨后坠征阴性,前、后抽屉试验阴性.膝关节功能评估采用Lysholm功能评分标准,术前平均分别为45.6±7.6分,术后平均为80.3±9.1分.结论 关节镜下应用LARS人工韧带同时重建ACL、PCL可更好地恢复膝关节的稳定性,且创伤小,并发症少,近期疗效满意,但远期效果仍需进一步观察.

  18. 肩关节SLAP损伤MR直接造影与关节镜的对照研究%Comparison research between MR arthrography and arthroscopy for SLAP of shoulder joints

    Institute of Scientific and Technical Information of China (English)

    王玉理; 雷益; 徐化剑

    2013-01-01

    目的 评价MR直接造影在肩关节盂唇SLAP损伤中的诊断价值.方法 回顾性收集35例SLAP损伤患者已行肩关节MR造影和关节镜检查,由两名医生观察分析,通过对照比较,评价肩关节MR造影的灵敏度和特异度、准确度.结果 MR直接肩关节造影灵敏度和特异度、准确度,分别是94%、96%和90%;可靠性指标用Kappa值为0.76.结论 MR直接造影是诊断肩关节SLAP损伤地可靠而准确的检查手段.

  19. Articular cartilage damage with intramedullary lesion (bone bruise) in anterior cruciate ligament rupture

    Energy Technology Data Exchange (ETDEWEB)

    Ide, Shuya; Ohdera, Toshihiro; Tokunaga, Masami; Hiroshima, Shiro; Yoshimoto, Eiji [Fukuoka Orthopaedic Hospital (Japan)

    2002-09-01

    We evaluated the relationship between the intramedullary lesion on MRI and cartilage damage in patients associated with acute anterior cruciate ligament (ACL) rupture. Thirty-two cases documented by MRI and arthroscopy within one month from injury underwent ACL reconstruction using ST-G, and arthroscopy was performed again after surgery. The mean term between reconstruction and postoperative arthroscopy was twelve months. The cartilage damage on arthroscopy was compared with the intramedullary lesion on MRI. Cartilage damage was observed in 9 cases (28.1%) during the initial arthroscopy and in 16 cases (50.0%) during the second arthroscopy. Intramedullary lesion was detected in all 32 cases (total: 73 lesions) on MRI. Intramedullary lesion leading to cartilage damage was common in the geographic-type lateral femoral condyle. There was significant difference between the lateral meniscus tear and the cartilage damage of the lateral compartment. (author)

  20. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  1. Arthroscopic removal of intraarticular fragments following fracture dislocation of the hip

    Directory of Open Access Journals (Sweden)

    Bagaria Vaibhav

    2008-01-01

    Full Text Available We report here a case of posterior dislocation of hip with fracture of posterior lip of acetabulum, with retained fracture fragments after a successful closed reduction. The fractured fragments were removed by arthroscopy of the hip. The technique of hip arthroscopy used in removing the fragments is discussed.

  2. Role of magnetic resonance imaging in the clinical management of the acutely locked knee

    Energy Technology Data Exchange (ETDEWEB)

    McNally, Eugene G.; Nasser, Khalid N.; Dawson, Stewart; Goh, Leslie A. [Department of Musculoskeletal Radiology, Nuffield Orthopaedic Centre and Oxford Radcliffe Hospital, Oxford, OX3 7LD (United Kingdom)

    2002-10-01

    To explore prospectively the hypothesis that MRI of the acutely locked knee can alter surgical decision-making.Design and patients. The study group comprised patients with a clinical diagnosis of knee locking requiring arthroscopy. The decision to carry out arthroscopy was made by an experienced consultant orthopaedic surgeon specialising in trauma and recorded in the patient's notes prior to MRI. Preoperative MRI was carried out using a 1.5 T system. The management was altered from surgical to conservative treatment in 20 (48%) patients on the basis of the MR findings. Arthroscopy was limited to patients with an MR diagnosis of a mechanical block, usually a displaced meniscal tear or loose body. Both patient groups were followed clinically until symptoms resolved.Results. Forty-two patients were entered into the study. MRI identified a mechanical cause for locking in 22 patients (21 avulsion meniscal tears and 1 loose body). All were confirmed at arthroscopy. Twenty patients were changed from operative to non-operative treatment on the basis of the MRI findings. One patient in this group required a delayed arthroscopy for an impinging anterior cruciate ligament stump. The sensitivity/specificity/accuracy of MRI in identifying patients who require arthroscopy was therefore 96%/100%/98% respectively.Conclusion. MRI can successfully segregate patients with a clinical diagnosis of mechanical locking into those who have a true mechanical block and those who can be treated conservatively. MRI should precede arthroscopy in this clinical setting. (orig.)

  3. Recurrent hemarthrosis after total knee arthroplasty caused by the impingement of a remnant lateral meniscus: a case report.

    Science.gov (United States)

    Kawata, Manabu; Inui, Hiroshi; Taketomi, Shuji; Nakamura, Kensuke; Nakagawa, Takumi; Tanaka, Sakae

    2014-03-01

    A case of recurrent hemarthrosis initially presenting after the fifth postoperative month is described. Because of recurrent pain and swelling, the patient underwent an arthroscopy 14 months after total knee arthroplasty (TKA). A remnant posterior lateral meniscus was found to be impinged between the femoral component and the tibial liner, and there was oozing from the hypertrophied synovium around the remnant meniscus. The remnant meniscus and the synovium were carefully cauterized and completely excised. Following the arthroscopy, hemarthrosis has not recurred. A remnant lateral meniscus may be a cause of recurrent hemarthrosis after TKA. Accordingly, in cases of recurrent hemarthrosis after TKA, exploration by arthroscopy should be considered.

  4. Synovial membrane involvement in osteoarthritic temporomandibular joints - A light microscopic study

    NARCIS (Netherlands)

    Dijkgraaf, LC; Liem, RSB; deBont, LGM

    1997-01-01

    Objective. To study the light microscopic characteristics of the synovial membrane of osteoarthritic temporomandibular joints to evaluate synovial membrane involvement in the osteoarthritic process. Study design. Synovial membrane biopsies were obtained during unilateral arthroscopy in 40 patients.

  5. SHORT-TERM OUTCOME OF ARTHROSCOPIC SURGERY OF TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT - A RANDOMIZED CONTROLLED CLINICAL-TRIAL

    NARCIS (Netherlands)

    Stegenga, B; DEBONT, L.G.M.; Dijkstra, P.U.; Boering, G.

    1993-01-01

    Various types of treatment have been proposed for patients with temporomandibular joint (TMJ) osteoarthrosis and internal derangement. We examined the suitability of several assessment instruments developed in previous investigations for treatment-evaluation in a clinical trial comparing arthroscopi

  6. SLAP Tears

    Science.gov (United States)

    ... feeling of having a “dead arm” a er pitching Doctor Examination Your doctor will test your range ... not improve with nonsurgical methods. Arthroscopy. The surgical technique most commonly used for repairing a SLAP injury ...

  7. A Study to Determine the Best Approach for Conducting a Formal Ambulatory Surgery Program at William Beaumont Army Medical Center, El Paso, Texas

    Science.gov (United States)

    1982-05-01

    ORTHGPEDIC Amputation, Toes, Fingers- Amputation Revision, Arm% Leg Amputation Revision, Toes, Fingers Arthrodesis Arthroplasty -Arthroscopy- Diagnostic... Lumbar Sympathetic Nerve Blocks - Stellate 0 APPEINDIX B Physician Questionnaire (Býank) AMBULATORY SURGERY QUESTIONNAIRE (Please Type or Print

  8. 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 ...

  9. Editorial Commentary: Meta-analyses Are on the Rise, but Are We Learning More?

    Science.gov (United States)

    D'Agostino, Ralph B

    2016-03-01

    The number of published meta-analyses in the arthroscopy literature is clearly on the rise. As this increase occurs, it is important to step back and refresh ourselves on the key features of meta-analyses.

  10. "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.

  11. Ambulatory Anesthesia in an Adult Patient with Corrected Hypoplastic Left Heart Syndrome

    Directory of Open Access Journals (Sweden)

    Jennifer Knautz

    2012-01-01

    congenital heart defects are surviving into adulthood and presenting for noncardiac surgeries. We describe one such example of a 26-year-old patient with corrected hypoplastic left heart syndrome presenting for knee arthroscopy and performed under general anesthesia with preoperative ultrasound guided saphenous nerve block. In this case, we review the anesthetic implications of corrected single ventricle physiology, anesthetic implications, as well as discuss the technique and role of saphenous nerve block in patients undergoing knee arthroscopy.

  12. Poor agreement between data from the National Patient Registry and the Danish Patient Insurance Association

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Bartholdy, Jens; Christoffersen, Jens Krogh;

    2012-01-01

    Septic arthritis after knee arthroscopy requires in-patient treatment and should thus be reported to the National Patient Registry (NPR). It also meets the requirements for financial compensation if claimed to the Danish Patient Insurance Association (DPIA). The aim of this study was to assess data...... from the two independent data sources, the NPR and DPIA, with a view to comparing the registration of septic arthritis after knee arthroscopy....

  13. Modern aspects of physical rehabilitation after football injuries of the capsule-ligament knee

    Directory of Open Access Journals (Sweden)

    Parish Mokhammad Reza

    2011-11-01

    Full Text Available It is considered the most typical causes of damage to the musculoskeletal system in football. Showing contemporary approaches to physical rehabilitation, reconstruction of the capsule-ligament knee athletes after surgery by arthroscopy. It is shown the various recovery tools and terms of use. It is established that the widespread development of arthroscopy, requires a balanced complex of physical rehabilitation. Complexes should reduce postoperative complications and gradual adaptation to favor the player to the training load.

  14. 关节镜下清除和保留断裂前交叉韧带残端重建术后疗效对比%Contrast the healing effect between removing and reserving the fractured anterior cruciate ligament under arthroscopy

    Institute of Scientific and Technical Information of China (English)

    姚楚亮; 陈少文; 杨焱鑫; 王华仁; 曾辉; 陈杰; 廖臻; 杨炎彬

    2015-01-01

    目的 探讨前交叉韧带(anterior cruciate ligament,ACL)断裂予施行膝关节镜下ACL单隧道单束重建术,分析清除和保留断裂ACL残端术后的疗效是否存在差异,探索出更适合临床操作的手术方式.方法 2008年1月-2013年6月,对40例ACL断裂施行膝关节镜下单隧道单束ACL重建术,移植物均为取自同侧半腱肌和股薄肌编织成的自体韧带,其中20例(A组)为断裂ACL残端进行清除干净后再施行膝关节镜下单隧道单束ACL重建术,20例(B组)为断裂ACL残端进行尽可能保留前提下施行膝关节镜下单隧道单束ACL重建术,手术均为同一组医师完成,2组手术前后Lysholm评分和IKDC评分结果进行t检验.结果 40例均获随访,时间为12~ 28个月,平均(20.7±3.7)个月,手术前后Lysholm评分和IKDC评分t检验结果,所得P=0.0183和P=0.0177,P值均<0.05,比较差异有统计学意义.结论 ACL断裂采用清除和保留断裂前交叉韧带残端进行自体韧带重建术后的疗效,在关节平衡性、关节自体感觉恢复存在显著性差异.保留ACL残端进行单隧道单束重建ACL,有利于移植肌腱的胫骨和股骨端隧道口的制作;ACL固定于原ACL残端中,避免重建的ACL在髁间窝被撞击;原ACL残端纤维围绕重建的ACL,可以覆盖隧道内口,减少关节液对移植肌腱与隧道愈合的影响.

  15. 关节镜下重建膝关节新鲜与陈旧前交叉韧带训练伤疗效对比分析%Comparison of the clinical outcome of knee joint reconstruction between fresh and old military training injury of ACL with arthroscopy

    Institute of Scientific and Technical Information of China (English)

    王兵; 王善超; 孙卫平; 董桂芝

    2012-01-01

    Objective To compare the clinical outcome of knee joint reconstruction of different operative period in treatment of military training injury of ACL. Methods ACL injuries were treated with knee joint reconstruction with semitendinosus tendon and gra-cilis tendon. 27 patients in the fresh group were treated in (5 ±0. 8) weeks and 19 patients in the old group were done in (76 ± 10.5) weeks. Results According to Lysholm knee function score, the excellent and good rates were 92. 5% in the fresh group and 78. 9% in the old group. The difference showed statistical significance (P < 0. 01). Conclusion Reconstruction of knee joint in military training with anthroscope can play better clinical effect in the early time than in the late time.%目的 比较部队官兵体能训练所致膝关节前交叉韧带(ACL)损伤手术时机对疗效的影响.方法 关节镜下对平均病程(5±0.8)周27例新鲜组和平均病程(76±10.5)周19例陈旧组ACL损伤,均以半腱肌和股薄肌为替代物进行手术重建.结果 按Lysholm评分,新鲜组和陈旧组ACL损伤的优良率分别为92.5%和78.9%,两组比较差异有显著统计学意义(P<0.01).结论 体能训练所致膝关节交叉韧带损伤早期关节镜手术重建的疗效优于晚期重建.

  16. 膝关节镜下自体腘绳肌腱和髌腱移植重建前交叉韧带近期效果对比临床观察%Clinical Observation on Anterior Cruciate Ligament Reconstruction by Autologous Hamstring and Patellar Tendon Transplant under Knee Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    唐刚健; 靳嘉昌; 吕青; 周运勇; 柴晟

    2011-01-01

    Objective:To compare the short-term and long-term curative effects of two different operation modes on anterior cruciate ligament reconstruction. Methods: Lysholm scoring method was performed in the second month, third month and twelfth month respectively after operation to compare the two different operation methods of autologous hamstring-tendon-bone method and hamstring transplant method for anterior cruciate ligament reconstruction. Results: Knee joint score of anterior cruciate ligament reconstruction by hamstring was better than that of patellar tendon group in the second and third month after operation (P0. 05) ; operative incision of patellar tendon group was longer than that of hamstring group (P<0. 05). Conclusion:Both methods are the major operation modes for anterior cruciate ligament reconstruction at present, and hamstring reconstruction has advantages over patellar tendon reconstruction such as small incision and beautiful appearance, which is favorable for the early functional exercise of knee joint after operation as patients' suffering can be reduced. Compared with patellar tendon reconstruction method, operative wound is smaller and bone structure is less injured in hamstring reconstruction method. Therefore, hamstring reconstruction method is more suitable for anterior cruciate ligament reconstruction among teenagers; in addition, if medial collateral ligament and pes anserinus tendon etc. Were injured, and if medial articular structure was unsteady with anterior and posterior cruciate ligaments break at the same time, ligamenta cruci-ata reconstruction should be performed by patellar tendon.%目的:观察对比关节镜下自体腘绳肌腱和髌腱移植2种不同手术方式重建前交叉韧带的术后近、远期疗效.方法:在手术后第2、3、12个月采用Lysholm膝关节评分法分别进行评分,对2种术式进行比较,并对随访资料进行分析.结果:术后第2月、第3月Lysholm膝关节评分腘绳肌腱组为62.14±11.61、72.18±9.91,髌腱组为63.45±6.41、87.59±11.11,2组比较差异有统计学意义(P<0.05);第12月2组Lysholm评分髌腱组87.59±11.11,腘绳肌腱组86.37±10.76,两者比较差异无统计学意义(P>0.05);手术切口:髌腱组9.50±2.01cm,腘绳肌腱组2.52±1.09cm,2组比较差异有统计学意义(P<0.05).结论:两者均为目前前交叉韧带重建的主要方法,但患者腘绳肌重建术切口小外观美观,而且术后更能减轻患者伤肢痛苦利于关节早期功能锻炼,腘绳肌重建由于手术创伤小于髌腱重建,且更少破坏骨性结构,更适合青少年前交叉韧带重建,但如果复合内侧副韧带、鹅足腱等损伤出现关节内侧结构不稳,前后交叉同时断裂我们主张采用髌腱重建韧带重建交叉韧带.

  17. 膝关节镜下应用腘绳肌腱双束重建后交叉韧带:细节及效果%Posterior cruciate ligament reconstruction using a double-bundle hamstring graft under a knee arthroscopy: Detail and effect analysis

    Institute of Scientific and Technical Information of China (English)

    孙炳慧; 黄迅悟; 张利臣; 刘志成

    2009-01-01

    目的:对后交叉韧带结构和生物力学的研究表明,双束重建更接近正常后交叉韧带.半腱肌与股薄肌可对抗股四头肌收缩所导致的胫骨前移,具有稳定膝关节的作用,那么切取半腱肌和股薄肌行双束重建后交叉韧带是否具有相同的效果呢?观察自体半腱肌腱和股薄肌腱双束重建膝关节后交叉韧带的临床疗效.方法:选择2006-03/2007-12内蒙古林业总医院骨科应用半腱肌腱和股薄肌腱Y形重建后交叉韧带随访18个月以上患者9例,男8例,女1例,年龄21-42岁.单纯后交叉韧带损伤4例,合并半月板损伤5例.于患者胫骨附着部游离半腱肌腱和股薄肌腱.在后交叉韧带前束及后束股骨附着部分别钻直径5 mm隧道,在后交叉韧带胫骨附着部钻直径8.0 mm隧道,用半腱肌腱重建后交叉韧带前束,用股薄肌腱重建后交叉韧带后束,在胫骨隧道外保留半腱肌和股薄肌腱的附着点,在股骨隧道外将半腱肌和股薄肌腱打结固定,不需要内固定物.所有患者术前及术后18个月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30°位阳性;术前Lysholm-ll评分平均55分(45~68分),手术后18个月Lysholm-ll评分平均88分(78~94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步随访.月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30°阳性;术前Lysholm-ll评分平均55分(45-68分),手术后18个月Lysholm-ll评分平均88分(78~94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步随访.月做膝关节屈曲30°、60°、90°后抽屉试验,用Lysholm-ll评分评定膝关节功能及运动水平.结果:9例患者均进入结果分析.术前9例患者所有角度后抽屉试验阳性,术后18个月,8例所有角度后抽屉试验阴性,仅1例屈膝30°阳性;术前Lysholm-ll评分平均55分(45-68分),手术后18个月Lysholm-ll评分平均88分(78~94分),总优良率89%.结论:应用胭绳肌腱双束重建后交叉韧带,接近正常后交叉韧带解剖结构,有良好的动态稳定性,临床疗效满意,但因例数有限,远期疗效有待于进一步

  18. 关节镜微创技术在儿童早期急性化脓性髋关节炎中的临床应用%Clinical application of arthroscopy in the treatment with early septic arthritis of the hip in children

    Institute of Scientific and Technical Information of China (English)

    王庆锋; 温鹏

    2016-01-01

    目的 探讨关节镜微创技术在儿童早期急性化脓性髋关节炎中的临床应用及体会.方法 对关节镜诊治儿童早期急性化脓性髋关节炎8例病例,术后评估患者症状改善及并发症发生情况.结果 所有病例均获随访,随访时间3 ~12个月.全部患者术后1周内症状消失,血常规及CRP、ESR等感染指标基本恢复正常.术后Harris髋关节评分(89 ±3.16)分,VAS评分(1.4±0.8)分,与术前Harris评分(52.10±6.50)分、VAS评分(7.8±1.1)分相比显著提高(P<0.05).全部患者术后无血管、神经损伤,无髋关节功能障碍、病理性髋脱位、髋关节迁延性感染及股骨近段骨髓炎、股骨头骨骺坏死等并发症发生.结论 关节镜下微创手术治疗儿童早期急性化脓性髋关节炎疾病,具有诊断准确、创伤小、操作安全可靠、疗效好的优点,有利于患者早期功能康复.

  19. A ressonância magnética e a artrorressonância magnética na lesão labral e condral do quadril: comparação com achados na artroscopia Magnetic resonance imaging and magnetic resonance arthrography in labral and chondral lesion of the hip: comparison with arthroscopy findings

    Directory of Open Access Journals (Sweden)

    Marcos Emilio Kuschnaroff Contreras

    2008-06-01

    Full Text Available OBJETIVO: Estudar a sensibilidade da ressonância magnética (RM e da artrorressonância magnética (artro RM para o diagnóstico das lesões do lábio acetabular e das lesões de cartilagem do quadril. MÉTODOS: Foram incluídos 90 pacientes (90 quadris, submetidos à videoartroscopia do quadril, no período entre maio de 2004 e julho de 2007, na Ultralitho Centro Médico e no Hospital Governador Celso Ramos, ambos em Florianópolis, Santa Catarina. Dos 90 pacientes, 25 (27,7% realizaram RM, sem contraste, 54 (60% realizaram artro RM e 11 (12,22% realizaram os dois exames. Nos pacientes submetidos a artro RM, foi introduzido junto com o contraste um anestésico local (bupivacaína 0,5%, ou ropivacaína 1%, sem adrenalina. Em todos os casos, verificou-se a presença de lesão do lábio acetabular e de lesão condral durante a videoartroscopia. RESULTADOS: Os autores encontraram maior sensibilidade para o diagnostico de lesão do lábio acetabular com a artro RM (96,9%, do que com RM (86,1%, sendo esta diferença estatisticamente significante. Quanto ao diagnóstico de lesão da cartilagem do quadril, a sensibilidade da artro RM foi de 78,4% e a da RM foi de 55,5%, encontrando-se também diferença estatisticamente significante. Houve maior percentagem de falso-negativo na RM, tanto para o diagnostico de lesão labral quanto condral. Não foi encontrado nenhum caso de falso-positivo nesta série. A introdução de anestésico local para a realização de artro RM mostrou alivio da dor em 56,9%dos casos. CONCLUSÃO: Os autores concluíram que a artro RM apresentou maior sensibilidade de diagnóstico que a RM para lesões do lábio acetabular e da cartilagem do quadril. A indiferença ou a piora da dor, após a introdução de anestésico local na artro RM, não foi considerada como fator preditivo para lesões intra-articulares.OBJECTIVE: To study the sensitivity of magnetic resonance imaging (MRI and magnetic resonance arthrography (MRA for the diagnosis of acetabular labrum lesions and of hip cartilage lesions. METHODS: 90 patients (90 hips were included, who had been submitted to hip videoarthroscopy between May 2004 and July 2007, at the Ultralitho Medical Center and at the Governador Celso Ramos Hospital, both in the city of Florianópolis, State of Santa Catarina. Of the 90 patients, 25 (27.7% were submitted to MRI without contrast, 54 (60% were submitted to MRA, and 11 (12.22% were submitted to both MRI and MRA. In patients submitted to MRA, the contrast was given together with a local anesthetic (bupivacaine 0.5%, or ropivacaine 1%, without adrenaline. Acetabular labrum lesion and chondral lesion were seen under videoarthroscopy in all cases. RESULTS: The authors found higher sensitivity to diagnose acetabular labrum lesion with MRA (96.9% than with MRI (86.1%, such difference being statistically significant. With respect to the diagnosis of lesion in the hip cartilage, RMA sensitivity was 78.4%, and MRI sensitivity was 55.5%, which is also a statistically significant difference. There was a higher percent of false negative results in MRI, in the diagnosis of both labral lesion and chondral lesion. No false positive was found in this series. The introduction of a local anesthetic to perform MRA showed pain relief in 56.9% of the cases. CONCLUSION: The authors conclude that MRA presented higher diagnostic sensitivity than MRI for acetabular labrum lesions and hip cartilage lesions. Lack of difference in pain or the worsening of pain after introduction of a local anesthetic for MRA was not considered a predictive factor for intra-articular lesions.

  20. 关节镜下应用带跟骨异体跟腱联合重建前交叉韧带及内侧副韧带%Reconstruction of Both Anterior Cruciate Ligament and Medial Collateral Ligament Using Calcanei Combined Achilles Tendon Allograft under Arthroscopy

    Institute of Scientific and Technical Information of China (English)

    冯会成; 黄迅悟; 孙继桐; 常青; 毕龙; 余方圆

    2013-01-01

    目的:探讨关节镜下应用带跟骨异体跟腱联合重建前交叉韧带(anterior cruciate ligament,ACL)及内侧副韧带(medial col-ateml ligament,MCL)和恢复膝关节前内侧稳定性的效果.方法:选择2007年1月至2010年1月收治符合纳入标准的27例A CL合并MCL损伤患者.其中男18例,女9例;年龄16~48岁,平均32.5岁;右膝15例,左膝12例.患者在排除手术禁忌后,均在关节镜下采用带跟骨异体跟腱一期联合重建ACL和MCL.患者受伤至手术时间7~14天,平均10天.结果:术后2周所有患者切口均Ⅰ期愈合.所有病例获得长期随访,随访时间24~32个月,平均26个月.术后24个月,Lysholm评分由术前的32.10±4.35升至86.25±4.12分,国际膝关节文献委员会(IKDC)评分由术前的33.27±4.25分,升至82.46± 4.13分,术前与术后Lysholm评分及I KDC评分均有显著差别(P<0.05).结论:关节镜下应用带跟骨异体跟腱一期联合重建治疗膝关节脱位能够较好的恢复患者膝关节前内侧稳定行,近期效果良好.

  1. 关节镜下单束与双束同种异体腱重建前交叉韧带的临床观察%Clinical study of single bundle vs double-bundle reconstruction of anterior cruciate ligament with allograft tendons by arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李兴中; 吴恙; 倪东亮; 童鑫; 马安军; 叶必谦; 付驰; 赵德伟; 王卫明

    2015-01-01

    Objective To compare the clinical effects of arthroscopic single tunnel double-bundle reconstruction anatomy system ( Intrafix system) vs Rigidfix plus Intrafix system on the treatment of anterior cruciate ligament (ACL) rupture.Methods From June 2011 to June 2013, 60 patients underwent ACL reconstruction with hamstring tendon allograft in Jinhua central hospital .According to the fixation method , the patients were divided into the Intrafix group ( 30 cases ) and the Rigidfix plus Intrafix group ( 30 cases).The range of motion (ROM) of the knee joint was compared before and after the knee surgery , as well as KT-1000 (flexion 70°30 lbs), anterior drawer test, Lachman test, Lysholm knee score and the symptoms of the involved knee .Results The Intrafix group were followed up for 12 to 36 months, 20.61 ± 8.20 months in average .The difference between the preoperative Lysholm knee score and the postoperative one was statistically significant (t=-29.2, P0.05).The difference of the postoperative Lysholm knee score between the Intrafix group and the Rigidfix plus Intrafix group was not statistically significant (t=0.538, P>0.05) .In the Intrafix group , Lachman test was positive in one patient , and in the Intrafix plus Rigidfix group, the anterior drawer test was positive in one patient .No extension deficit was observed .The ROM and KT-1000 measurement results were normal .Conclusion According to the short-term results, the single tunnel double-bundle reconstruction with Intrafix system and the anatomic single-bundle reconstruction with Rigidfix plus Intrafix are both reliable methods for the ACL reconstruction with allograft tendons.The long-term results need further follow-up.%目的:比较关节镜下运用Intrafix单隧道双束解剖重建系统和Rigidfix+Intrafix系统治疗前交叉韧带( ACL)断裂的临床疗效。方法2011年6月至2013年6月,我院使用同种异体腘绳肌腱重建ACL患者60例,根据固定方式的不同,分为Intrafix组(30例)和Rigidfix +Intrafix (30例)。比较两组患者手术前后膝关节活动度、KT-1000(屈膝70°30磅)、前抽屉实验、Lachman实验、Lysholm膝关节评分及患膝症状。结果 Intrafix组患者随访12~36个月,平均(20.61±8.20)个月。手术前后Lysholm膝关节评分的差异有统计学意义(t=-29.2, P<0.05)。 Rigidfix+Intrafix组患者随访12~36个月,手术前后Lysholm膝关节评分的差异具有统计学意义(t=-25.8,P<0.05)。术后Intrafix组与Rigidfix +Intrafix 组间 Lysholm 膝关节评分无统计学意义( t =0.538, P >0.05)。Intrafix组有1例患者Lachman试验阳性,Intrafix+Rigidfix组有1例患者前抽屉试验阳性,所有患者无伸膝受限现象。关节活动度和KT-1000均在正常范围。结论短期内Intrafix单隧道双束解剖重建与Rigidfix+Intrafix单束重建均为可靠的同种异体腱重建ACL方法,长期结果需进一步观察。

  2. Reconstruction of anterior/posterior cruciate ligament acute injury by arthroscopy with bone-patellar tendon-bone allograft%早期关节镜下同种异体骨-腱-骨重建前后交叉韧带急性损伤

    Institute of Scientific and Technical Information of China (English)

    童汉明; 何锡彬

    2009-01-01

    目的 探讨同种异体骨-腱-骨(B-PT-B)同时重建膝关节前交叉韧带(ACL)、后交叉韧带(PCL)急性损伤的临床疗效.方法 在关节镜下早期使用同种异体B-PT-B重建ACL、PCL急性损伤患者22例.结果 22例均获随访,时间16~18个月.患者屈膝范围从术前79~90(85.5±4.5)°提高到术后134~140(138±1.5)°,Lysholm膝关节功能评分从术前0~23(8.6±3.0)分提高到术后85~96(92.0±3.6)分(P<0.01).未发现感染、移植物断裂、排异反应等.结论 早期关节镜下应用同种异体B-PT-B重建ACL、PCL急性损伤,具有手术操作简便、创伤小、免疫排斥反应小、术后并发症少的优点,能最大限度恢复患者膝关节的本体感觉功能及运动功能.

  3. Clinical observation on reconstructing the anterior and posterior cruciate ligaments of knee joint with allograft-tendon by arthroscopy%关节镜下同种异体肌腱重建膝关节前后交叉韧带的临床观察

    Institute of Scientific and Technical Information of China (English)

    阳波; 谭雄进

    2014-01-01

    目的:比较关节镜下同种异体肌腱移植和自体肌腱移植重建膝关节前后交叉韧带的临床效果。方法将130例膝关节前后交叉韧带断裂的患者按手术方式的不同分为2组,观察组采用同种异体肌腱移植,对照组采用自体肌腱移植,观察患者临床疗效。结果观察组手术时间明显少于对照组(P0.05);2组患者术后Lysholm及Tengner评分均明显高于术前,2组差异有统计学意义(P0.05)。结论同种异体与自体肌腱重建ACL及PCL的疗效相近,是重建ACL及PCL良好的移植物。%Objective To compare the clinical effect of reconstructing the anterior and posterior cruciate ligaments of knee joint with al-lografttendon and autogenous tendon transplantation. Methods 130 patients with anterior and posterior cruciate ligaments of knee fractured were randomly divided into two groups:the observation group were given allogeneic tendon transplantation while the control group were autol-ogous tendon transplantation. Observed the clinical efficacy of the two groups. Results The operation time of the observation group was ob-viously less than control group(P0. 05);the Lysholm and Tengner score of the two groups were significantly higher compared with the preoperative scores with a statistically significant difference (P0. 05). Conclusion Allogeneic tendon transplantation has similar curative effect with autologous tendon transplantation, both of them are good transplantation material for anterior and posterior cruciate ligaments reconstruction.

  4. EFFECTIVENESS OF COMBINED TENODESIS FOR PROXIMAL LESIONS OF BICEPS TENDON WITH MASSIVE ROTATOR CUFF TEAR BY ARTHROSCOPY%关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损

    Institute of Scientific and Technical Information of China (English)

    陈先武; 叶如卿; 许海平; 陆建猛

    2015-01-01

    目的 探讨关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损的的疗效.方法 回顾分析2011年1月-2013年6月,采用关节镜下肌腱联合固定术治疗的48例巨大肩袖损伤伴肱二头肌长头腱近端病损患者临床资料.男22例,女26例;年龄35 ~ 59岁,平均46岁.存在明确创伤史者12例.病程1~ 57个月,平均4.6个月.患肩中重度疼痛,关节活动范围及肌力较健侧下降.根据Goutallier分型标准:0级3例,1级18例,2级27例.记录手术时间以及相关并发症发生情况.采用疼痛视觉模拟评分(VAS)、肩关节活动范围、前屈上举及屈肘力量、Constant-Murley肩关节功能评分、加州大学洛杉矶分校(UCLA)评分、美国肩肘外科医师(ASES)评分、Mayo肘关节功能评分(MEPS)以及MRI复查评价疗效.结果 患者均顺利完成手术,手术时间120~160 min,平均135 min.术后切口均Ⅰ期愈合.1例术后出现肩关节肿胀、切口渗血,经对症处理后愈合.48例患者均获随访,随访时间12~18个月,平均13.9个月.术后6个月复查MRI示肌腱愈合良好.与术前相比,术后12个月VAS评分显著降低,肩关节前屈上举、外旋、体侧内旋以及前屈上举肌力均增加,ASES评分、Constant-Murley评分及UCLA评分亦上升,差异均有统计学意义(P<0.05);而肘关节MEPS评分及屈肘肌力与术前比较,差异无统计学意义(P>0.05).结论 关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损,可获得满意疗效.

  5. 踝关节镜术后采用加压间歇冷疗防治踝关节肿胀的最佳时间探讨%Discussion the best therapy time of intermittent pressurized cold prevention ankle swelling after ankle arthroscopy

    Institute of Scientific and Technical Information of China (English)

    占玉兰; 车慧虹; 刘婉云; 陈奇鸣; 罗锦辉

    2015-01-01

    目的::探讨踝关节镜术后采用加压间歇冷疗防治踝关节肿胀的最佳治疗疗程。方法:选取本院2010年3月~2014年9月72例踝关节镜术后采用加压间歇冷疗患者作为研究对象,随机将其等分为对照组与试验组,对照组采用1d短时间加压间歇冷疗,试验组采用5d长时间加压间歇冷疗。结果:治疗后5 d,试验组疼痛评分和肿胀程度,与对照组比较,差异有统计学意义(P<0.05)。结论:对踝关节镜术后患者采用5 d长时间加压间歇冷疗,可明显缓解患者痛苦,控制踝关节肿胀,值得临床推广应用。%Objective:To investigate the best time of pressurized intermittent cold cure the prevention and treatment of ankle swelling postoperative ankle mirror. Methods:In our hospital from March 2010 to September 2014,72 patients with ankle mirror used pressurized postoperative intermittent cold therapy as the research objects,and they were divided into two groups at random,the control group used 1 d short time pressure intermittent cold therapy,treatment group with 5 days pressure intermittent cold treatment for a long time. Results:5 days after treatment,the patients pain scores and swelling degree,compared with control group,the difference was statistically significant (P<0. 05). Conclusion:The postoperative patients with ankle mirror using 5 d pressure inter-mittent cold therapy,for a long time can obviously relieve patients′pain,control the ankle swelling,worthy of clinical popularization and application.

  6. 前后交叉韧带及半月板损伤的MDCT与关节镜的对比研究%Comparative study between multi-slice spiral CT and knee arthroscopy in diagnosis of anterior and posterior cruciate ligament injury and meniscus injury

    Institute of Scientific and Technical Information of China (English)

    黄瑞庭; 刘玉涛; 张德佳; 杜中立; 张应鹏; 郭宗义; 黄海松

    2013-01-01

    目的 探讨多层螺旋CT在膝关节外伤中前后交叉韧带与半月板损伤的诊断价值.方法 回顾性分析45例经膝关节镜证实的前后交叉韧带和半月板损伤的多层螺旋CT直接征象和间接征象.结果 前后交叉韧带损伤的直接征象表现为韧带断裂、密度欠均匀,韧带附着点撕脱性骨折,间接征象表现为韧带肿胀,周围脂肪间隙模糊欠清;半月板损伤的MDCT直接征象是形态失常、密度不均匀及裂隙征,间接征象是膝关节滑膜增厚、关节囊关节腔内积液、损伤的半月板周围软组织肿胀等.45例患者中,MDCT显示前交叉韧带损伤14例(14/20),后交叉韧带损伤11例(11/15),内侧半月板损伤8个(8/12),外侧半月板损伤12个(12/20),交叉韧带与半月板同时损伤10例,韧带附着点及胫骨平台骨折18例.结论 多层螺旋CT在膝关节外伤中的前后交叉韧带及半月板的损伤有一定的诊断价值,可为缺少磁共振设备的基层医院提供一有用的检查方法.%Objective To evaluate the diagnotic value of multi-slice spiral CT(MDCT) in anterior and posterior cruciate ligament injury and meniscus injury. Methods Retrospective analysis of the CT direct signs and indirect signs in 45 cases diagnosed with anterior and posterior cruciate ligament injury and meniscus injury confirmed by knee arthroscopic was conducted. Results MDCT findings of the direct signs of the anterior and posterior cruciate ligament injury included the ligament rupture, less uniform density, ligament attachment points avulsion fracture. Indirect signs included ligament swelling, fuzzy around the fat space less clear; MDCT findings of the direct signs of the meniscus injury included morphological disorders, uneven density and broken sign. Indirect signs included thickening of the synovium, joint capsule effusion, soft tissue swelling of the injuryed meniscus. In 45 patients, MDCT showed the anterior cruciate ligament injury in 14 cases (14/20), posterior cruciate ligament injury in 11 cases (11/15), medial meniscus injury in 8 cases (8/12), lateral meniscus injury in 12 (12/20), cruciate ligament and meniscus injury in 10 cases, ligament attachment points and tibial plateau fracture in 18 cases. Conclusion MDCT examination is helpful in diagnosis of anterior and posterior cruciate ligament injury and meniscus injury, providing a useful check for the absence of magnetic resonance equipment for primary hospitals.

  7. 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.

  8. USG AND MRI CORRELATION IN THE EVALUATION OF MENISCAL LESIONS OF KNEE

    Directory of Open Access Journals (Sweden)

    Ravichandra

    2014-09-01

    Full Text Available AIMS AND OBJECTIVE: The objective of this study was to evaluate the role of a handheld USG of 7-13 MHz in evaluating meniscal lesions of knee and comparing it to the results obtained with magnetic resonance imaging. MATERIAL AND METHODS: A comparative double blind study was done between ultrasonography and MRI of fifty patients with a history of knee trauma or with suspected knee meniscal lesions, who were referred to the department of Radiodiagnosis. MRI and USG results were finally correlated with arthroscopy findings. All these patients had a significant history and clinical evaluation suggested meniscal lesion of the knee joint. Cases which have been operated previously on the same knee were excluded from this study. RESULTS: Out of the 50 patients, a total of 100 menisci were examined, out of which after final arthroscopy confirmation, 34 had meniscal tears, 3 degenerative tears, and two patients had meniscal cysts both of which were not associated with a tear of the meniscus. CONCLUSION: The specificity of USG matched that of MRI and it can reasonably be applied to confirm the clinical diagnosis before undertaking arthroscopy. However, the lower sensitivity suggests that there is still a need to improve the technique to reduce the number of false-negative diagnoses and thus to avoid unnecessary arthroscopy. USG may be used as a screening tool prior to arthroscopy in selected cases where MRI is a contraindication or is not available or if the patient is not affording.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Contribution of thin slice (1 mm) oblique coronal proton density-weighted MR images for assessment of anteromedial and posterolateral bundle damage in anterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan, E-mail: drgokhangokalp@yahoo.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Demirag, Burak, E-mail: bdemirag@uludag.edu.tr [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Nas, Omer Fatih, E-mail: omerfatihnas@gmail.com [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Aydemir, Mehmet Fatih, E-mail: fatiha@yahoo.com [Department of Orthopedy, Uludag University Medical Faculty, Gorukle, Bursa (Turkey); Yazici, Zeynep, E-mail: zyazici@uludag.edu.tr [Department of Radiology, Uludag University Medical Faculty, Gorukle, Bursa (Turkey)

    2012-09-15

    Purpose: To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries. Materials and methods: We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy. Results: Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05). Conclusion: Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade.

  11. 前交叉韧带损伤的关节镜与MRI诊断分级研究

    Institute of Scientific and Technical Information of China (English)

    杨寅

    2016-01-01

    Object ive To study the diagnosis and classification of the anterior cruciate ligament injury by arthroscopy and MRI.Methods randomly selected from our hospital between December 2010 and December 2015 from 126 patients with knee ligament damage in patients with,for al patients of arthroscopy and MRI diagnosis,observation of 126 cases of knee ligament injury in patients with anterior cruciate ligament injury classification .Results after arthroscopy and MRI in diagnosis of 126 cases of in patients with knee ligament injury of cruciate ligament injury can be divided into 4 degrees,MRI diagnosis of anterior cruciate ligament injury of the accuracy is 98.6%,the sensitivity was 88.7% and the specificity was 76.8%.Conclusion MRI is highly accurate and sensitive in the diagnosis of anterior cruciate ligament injury,and it is worth to be widely used in clinic.

  12. Arthroscopic decompression with indigo carmine for treating paralabral cysts in the shoulder.

    Science.gov (United States)

    Kabuto, Y; Morihara, T; Furukawa, R; Kida, Y; Sukenari, T; Onishi, O; Minami, M; Arai, Y; Fujiwara, H; Kubo, T

    2016-12-01

    Paralabral cysts in the shoulder are a relatively rare pathology. It is sometimes difficult to detect the location of a paralabral cyst in the shoulder using arthroscopy, and it can be difficult to confirm sufficient decompression by arthroscopy. We describe the case of a 64-year-old woman who underwent arthroscopic decompression for a paralabral cyst in the shoulder. Indigo carmine was injected into the cyst under ultrasonography guidance just before the operation. The leakage point of indigo carmine was detected using arthroscopy. Arthroscopic decompression was performed until the indigo carmine was completely discharged. Her shoulder pain, limited range of motion, and muscle weakness during abduction and external rotation improved postoperatively. Magnetic resonance imaging confirmed the disappearance of the cyst. Arthroscopic decompression using an ultrasonography-guided injection of indigo carmine is a useful treatment for a paralabral cyst in the shoulder.

  13. Arthroscopic excision of acetabular osteoid osteoma in a 7-year-old patient.

    Science.gov (United States)

    Aşık, Mehmet; Erşen, Ali; Polat, Gökhan; Bilgili, Fuat; Tunalı, Onur

    2015-11-01

    The purpose of this study was to present the case report of a 7-year-old patient who was treated with hip arthroscopy for an acetabular osteoid osteoma. A 7-year-old patient was referred to our clinic with hip pain. In the assessment of the patient, an acetabular osteoid osteoma was detected in his right hip; it was adjacent to his triradiate cartilage. An arthroscopic surgery was planned as an alternative to open safe hip dislocation. The osteoid osteoma was completely removed with hip arthroscopy. Postoperative CT scanning and histopathological analysis confirmed the diagnosis. Exposure of the acetabulum can be problematic in paediatric patients due to the potential risks of open safe dislocation. Hip arthroscopy can safely be used for benign hip lesions in paediatric patients. Level of evidence Case report, Level V.

  14. 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...

  15. 门诊膝关节镜检查患者应用利多卡因或无防腐剂2-氯普鲁卡因行脊麻的一项前瞻随机双盲对照的比较研究%Spinal Anesthesia with Lidocaine or Preservative-Free 2-Chlorprocaine for Outpatient Knee Arthroscopy: A Prospective,Randomized, Double-Blind Comparison

    Institute of Scientific and Technical Information of China (English)

    Andrea Casati; Guido Fanelli; Giorgio Danelli; Marco Berti; Daniela Ghisi; Matteo Brivio; Marta Putzu; Alessia Barbagallo; 徐伟

    2009-01-01

    背景 在本前瞻、随机、双盲研究中,我们检验了50 mg 1%无防腐剂的2-氯普鲁卡因可以提供比相同剂量1%单纯利多卡因恢复更快的脊髓阻滞这一假设.方法 30例ASA Ⅰ~Ⅱ级准备接受膝关节镜检查的门诊患者随机分组接受50 mg1%单纯利多卡因(n=15)或1%无防腐剂单纯氯普鲁卡因(n=15),手术前静脉注射咪哒唑仑(0.03 mg/kg).由一位不知道分组情况的观察者记录感觉(针刺感觉消失)和运动(改良Bromage评分)阻滞的进程直至阻滞完全消退,同时记录可以自主行走和排尿的时间.手术后24小时和第7天进行电话回访.结果 氯普鲁卡因组2例患者(13%)和利多卡组1例患者(7%)手术中需要辅助芬太尼(100μⅣ)(P=0.99),但没有患者需要改行全麻完成手术.2-氯普鲁卡因的感觉恢复、运动恢复和自主行走时间的中位数(范围)[95(68~170)分钟、60(45~120)分钟和103(70~191)分钟]均比利多卡因者[120(80~175)分钟、100(60~140)分钟和152(100~185)分钟]要快(分别为P=0.019,P=0.0005和P=0.003).氯普鲁卡因组的初次排尿时间[180(100~354)分钟]和利多卡因组[190(148~340)分钟]并无不同(P=0.191).短暂神经症状在利多卡因组患者有5例(33%)而氯普鲁卡因组没有(0%)(P=0.042).结论 50 mg 1%无防腐剂2-氯普鲁卡因鞘内注射后感觉和运动功能恢复和自主行走时间比相同剂量1%利多卡因更快,同时较少发生短暂神经症状.

  16. Effectiveness of Biceps Tendon Tenotomy and Fixation versus Biceps Tendon Repair through Arthroscopy for Shoulder Superior Labrum Anterior Posterior Lesions: A Meta-analysis%关节镜下肱二头肌腱切除及固定术与肱二头肌腱修补术对肩关节上盂唇前后部损伤疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    杨晨; 赵晨; 汤军; 葛新江; 毕擎

    2015-01-01

    目的 系统评价关节镜下肱二头肌腱切除及固定术与肱二头肌腱修补术比较治疗肩关节上盂唇前后部(SLAP)损伤的疗效.方法 计算机检索PubMed、EMbase、Cochrane图书馆(2014年3期)、中国生物医学文献数据库、维普网和中国期刊全文数据库,检索时间均为各数据库建库至2014年12月,并手工检索国内外已发表的有关骨科论文及会议资料,收集肱二头肌腱切除及固定术与肱二头肌腱修补术比较治疗肩关节SLAP损伤疗效的随机对照试验(RCT),由2名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用采用Cochrane协作网提供的RevMan 5.0软件进行Meta分析.结果 最终纳入3个RCT,共计137例患者,Meta分析结果显示与肱二头肌腱修补术相比,肱二头肌腱切除及固定手术治疗肩关节SLAP损伤UCLA肩关节评分[WMD=3.43分,95%CI (2.29,4.56)分,P<0.000 01]、术后肩关节疼痛程度[WMD=1.18分,95%CI (0.30,2.05)分,P=0.009]、术后肩关节功能评价[WMD=0.96分,95%CI (0.51,1.41)分,P<0.000 1]以及术后患者满意度的评价[WMD=1.16分,95%CI (0.31,2.01)分,P=0.007]更优异,而两组在上肢前屈活动度[WMD=0.10分,95%CI(-0.87,1.06)分,P=0.84]、上肢前屈肌力[WMD=0.13分,95%CI(-0.09,0.35)分,P=0.25]的评分方面,其差异均无统计学意义.结论 肱二头肌腱切除及固定术治疗肩关节SLAP损伤疗效优于肱二头肌腱修补术.由于纳入研究数量有限且方法学质量不高,研究结果尚需更多高质量的RCT进一步证实.

  17. The diagnostic value of magnetic resonance arthrography of the shoulder in detection and grading of SLAP lesions: Comparison with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Amin, Mohammed Farghally, E-mail: Mohammed_amin37@yahoo.com [Department of Radiodiagnosis ElMinya University, ElMinya High Road, ElMinya (Egypt); Youssef, Ahmed Omar [Department of Orthropedic Surgery El Minya University, ElMinya (Egypt)

    2012-09-15

    Purpose: The purpose of the study is to determine the usefulness of magnetic resonance arthrography (MRA) in diagnosis and grading of superior labrum anterior to posterior (SLAP) lesions of the Glenoid Labrum Compared with surgery Material and methods: This was a prospective study including fifty nine clinically diagnosed SLAP patients. The study was done during the period from January 2008 to June 2010. All patients were submitted to history taking, clinical examination and conventional MRI examination of the shoulder, MRA was done in patients with negative conventional MRI, all of these patients underwent arthroscopy for diagnosis wither open or arthroscopy for diagnosis and treatment and results were compared with MRA findings. Main outcome measures: Sensitivity, specificity, positive and negative predictive values, and overall accuracy of MR arthrography in detection and grading of SLAP lesions of the gelnoid labrum. Results: Out of fifty nine patients, 25 patients had positive MR findings in conventional MRI, and 34 patients had negative MR findings, who underwent MR arthrography; 10 out of them had normal arthrogram (only 6 of them underwent arthroscopy), 22 had SLAP (superior labrum anterior to posterior) lesions, one had Bankart's lesion and one had internal impingement syndrome. These results were compared with arthroscopy results. The overall sensitivity of MRA in detection of SLAP lesions was 90% while the specificity was 50%, negative predictive value (NPV) was 66.6% and positive predicative value (PPV) was 81.8%. MRA and arthroscopy results were concurrent in 79.3% patients. Conclusion: MR arthrography is a sensitive minimally invasive technique for detection and grading of SLAP lesions, it can help in avoiding patients unnecessary diagnostic arthroscopy.

  18. Extra-articular Synovial Chondromatosis Eroding and Penetrating the Acromion

    Science.gov (United States)

    El Rassi, George; Matta, Jihad; Hijjawi, Ayman; Khair, Ousama Abou; Fahs, Sara

    2015-01-01

    Synovial chondromatosis of the shoulder is an uncommon disorder. It usually affects the glenohumeral joint and is characterized by metaplasia of the synovium leading to the formation of osteochondral loose bodies. Few cases of extra-articular subacromial synovial chondromatosis involving the rotator cuff tendon have been reported in the literature. The treatment of previously reported cases consisted of open bursectomy and removal of loose bodies. We report a case of subacromial synovial chondromatosis without rotator cuff involvement but with severe erosion and fracture of the acromion. Treatment consisted of shoulder arthroscopy to remove all loose bodies, total bursectomy, and debridement of the acromion. Potential benefits of arthroscopy were also evaluated. PMID:26697302

  19. The ligamentum teres of the adult hip.

    Science.gov (United States)

    Bardakos, N V; Villar, R N

    2009-01-01

    Advances in hip arthroscopy have renewed interest in the ligamentum teres. Considered by many to be a developmental vestige, it is now recognised as a significant potential source of pain and mechanical symptoms arising from the hip joint. Despite improvements in imaging, arthroscopy remains the optimum method of diagnosing lesions of the ligamentum teres. Several biological or mechanical roles have been proposed for the ligament. Unless these are disproved, the use of surgical procedures that sacrifice the ligamentum teres, as in surgical dislocation of the hip, should be carefully considered. This paper provides an update on the development, structure and function of the ligamentum teres, and discusses associated clinical implications.

  20. Chondromalacia of the patella. Natural progression.

    Science.gov (United States)

    Verni, E; Prete, G D; Beluzzi, R; Prosperi, L; Martucci, E; Fedele, L

    1997-01-01

    A total of 42 cases of patellar pain in subjects aged an average of 17.2 years submitted to arthroscopy are analyzed. Femoropatellar balance, where indicated, led to resolution of disorders with full resumption of sports activity. In the remaining cases chondromalacia showed the features of an affection with a spontaneously favorable course, confirming the common orientation towards conservative treatment. Arthroscopy is effective for a correct classification of cartilaginous lesions, and it is a good instrument to use when attempting to achieve recovery of patellofemoral joint when disorders are caused by a lack of equilibrium.

  1. Patellofemoral eklem sorunlarının sınıflandırılması*

    OpenAIRE

    Alturfan, Aziz

    2004-01-01

    Patellofemoral (PF) joint and extensor system disorders are amonyg the leading problems concerning athletic population. For better understanding of the subject, etiology of patellar pain should be well understood. In this paper, classifications of patellofemoral joint disorders, etiologies and misleading features, the place and signifcance of diagnostic arthroscopy in patellofemoral joint disorders are explained.

  2. Early osteoarthritis and microdialysis

    DEFF Research Database (Denmark)

    Helmark, Ida Carøe; Mikkelsen, U R; Krogsgaard, M R

    2010-01-01

    The microdialysis technique was evaluated as a possible method to obtain local measurements of biochemical markers from knee joints with degenerative changes. Seven patients scheduled for arthroscopy of the knee due to minor to moderate degenerative changes had microdialysis catheters inserted un...

  3. Computed tomography of chondropathia patellae

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, H.; Hering, L.

    1983-12-01

    Experimental studies of patellae at autopsy and clinical CT-arthrographic examinations of 36 patients show that CT provides good demonstration of the retropatellar cartilage and its lesions. The value of the method compared with conventional radiographic examinations, arthroscopy and surgery is discussed.

  4. Diagnosis of chondropathia patellae using CT arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Rupp, N.; Zacher, H.; Paar, O.; Aigner, R.

    1985-11-01

    In suspected chondropathia patellae, CT after intraarticular contrast injection considerably facilitates the preoperative diagnosis. This technique is less costly and laborious than arthroscopy and has a high level of reliability. Before taking surgical measures, the clinical symptoms and the extent of cartilage degeneration must be known.

  5. Poor agreement between data from the National Patient Registry and the Danish Patient Insurance Association

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Bartholdy, Jens; Christoffersen, Jens Krogh;

    2012-01-01

    Septic arthritis after knee arthroscopy requires in-patient treatment and should thus be reported to the National Patient Registry (NPR). It also meets the requirements for financial compensation if claimed to the Danish Patient Insurance Association (DPIA). The aim of this study was to assess da...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  7. Femoroacetabular impingement surgery

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian

    2015-01-01

    Femoroacetabuler impingement (FAI) is becoming increasingly recognised as a potential pathological entity for individuals with hip pain. Surgery described to correct FAI has risen exponentially in the past 10 years with the use of hip arthroscopy. Unfortunately, the strength of evidence supporting...

  8. Recurrent anterior glenohumeral instability: the quantification of glenoid bone loss using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Martins e Souza, Patricia [Fleury Medicina e Saude and Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brandao, Bruno Lobo; Motta, Geraldo; Monteiro, Martim [Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ (Brazil); Brown, Eduardo [Grupo Fleury Medicina Diagnostica, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal do Rio de Janeiro, Petropolis, RJ (Brazil)

    2014-08-15

    To investigate the accuracy of conventional magnetic resonance imaging (MRI) in determining the severity of glenoid bone loss in patients with anterior shoulder dislocation by comparing the results with arthroscopic measurements. Institutional review board approval and written consent from all patients were obtained. Thirty-six consecutive patients (29 men, seven women; mean age, 34.5 [range, 18-55] years) with recurrent anterior shoulder dislocation (≥3 dislocations; mean, 37.9; range, 3-200) and suspected glenoid bone loss underwent shoulder MRI before arthroscopy (mean interval, 28.5 [range, 9-73] days). Assessments of glenoid bone loss by MRI (using the best-fit circle area method) and arthroscopy were compared. Inter- and intrareader reproducibility of MRI-derived measurements was evaluated using arthroscopy as a comparative standard. Glenoid bone loss was evident on MRI and during arthroscopy in all patients. Inter- and intrareader correlations of MRI-derived measurements were excellent (intraclass correlation coefficient = 0.80-0.82; r = 0.81-0.86). The first and second observers' measurements showed strong (r = 0.76) and moderate (r = 0.69) interreader correlation, respectively, with arthroscopic measurements. Conventional MRI can be used to measure glenoid bone loss, particularly when employed by an experienced musculoskeletal radiologist. (orig.)

  9. Aspergillus Septic Arthritis of the Hip in an Immunocompetent Middle-aged Female with Undiagnosed Recurrent Pulmonary Aspergillosis

    OpenAIRE

    Yoon, Pil Whan; Song, Joo Ho; Yoon, Kang Sup; Chang, Jae Suk; Kim, Hee Joong; Rhyu, Kee Hyung

    2015-01-01

    We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.

  10. Multimodal pain management after arthroscopic surgery

    DEFF Research Database (Denmark)

    Rasmussen, Sten

    Multimodal Pain Management after Arthroscopic Surgery By Sten Rasmussen, M.D. The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery. NSAID was tested against placebo after knee 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...

  11. 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

  12. MRI of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  13. Elbow Synovial Fold Syndrome

    Science.gov (United States)

    2007-12-01

    osteoarthritis , and snapping triceps tendon. Lateral epicondylitis appears to be the leading mis-diagnosis before proper imaging or arthroscopy is...J Shoulder Elbow Surg 1998;7:427-9. 8. McFarland E, Gill H, Laporte D, Streiff M. Miscellaneous conditions about the elbow in athletes. Clin

  14. Degree of synovitis on MRI by comprehensive whole knee semi-quantitative scoring method correlates with histologic and macroscopic features of synovial tissue inflammation in knee osteoarthritis

    NARCIS (Netherlands)

    Lange-Brokaar, B.J.E. de; Ioan-Facsinay, A.; Yusuf, E.; Visser, A.W.; Kroon, H.M.; Andersen, S.N.; Herb-van Toorn, L.; Osch, G.J.V.M. van; Zuurmond, A.M.; Stojanovic-Susulic, V.; Bloem, J.L.; Nelissen, R.G.H.H.; Huizinga, T.W.J.; Kloppenburg, M.

    2014-01-01

    Objective: To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation. Method: Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy

  15. Proximal Tibiofibular Joint: An overview

    Directory of Open Access Journals (Sweden)

    Tze Wang Chan

    2016-06-01

    Full Text Available Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

  16. [Ultrasound diagnosis of the meniscus].

    Science.gov (United States)

    Casser, H R

    2002-03-01

    As a supplement to clinical findings, sonographic examination of the meniscus is an easily available, noninvasive imaging technique that can be used to optimize preoperative diagnosis and check the indication for arthroscopy. Careful consideration of the technical requirements and systematic performance of the dynamic examination should lead to further improvement of the examination results and to growing clinical significance in the future.

  17. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E

    2016-01-01

    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18-6...

  18. Editorial Commentary: Lesions of the Superior Labrum From Anterior to Posterior (SLAP) Are a Slap in the Face to the Traditional Trinity of History, Examination, and Imaging.

    Science.gov (United States)

    Lubowitz, James H

    2015-12-01

    Superior labrum from anterior to posterior (SLAP) lesions are a slap in the face to the revered trinity of history, physical examination, and imaging. SLAP lesions are difficult to diagnose, and arthroscopy is not only the gold standard, but the current method on which expert arthroscopic shoulder subspecialists rely.

  19. [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)

  20. COMPARATIVE ANALYSES OF DIAGNOSTIC METHODS IN KNEE INJURIES

    Directory of Open Access Journals (Sweden)

    Džoleva-Tolevska Roza

    2016-03-01

    Full Text Available Objective:This study is analyzing the role and significance of the three diagnostic methods (clinical diagnosis, magnetic resonance imaging (MRI and arthroscopy, in establishing accurate diagnosis in knee injuries. The goal is to determine the diagnostic accuracy of each diagnostic method, using arthroscopy as gold standard. Material and Methods: We examined 70 patients with knee injuries. Clinical diagnosis was established using patient’s history and positive clinical tests for meniscal lesions, ACL injury and articular cartilage lesions. All patients underwent MRI on a 1.5 T magnet for MRI diagnosis. This was followed by arthroscopy for making the final diagnosis. Results: We analyzed the results of clinical tests for meniscal, ligamentous and articular cartilage injuries of the patients in both groups. Validity of the clinical tests was compared to the results got from MRI and arthroscopy. Accuracy of clinical diagnosis versus MRI diagnosis for medial(69.6% vs. 68.5% and lateral (84% vs. 82.6%meniscal lesions was almost identical. Accuracy of clinical diagnosis compared with the accuracy of MRI diagnosis for ACL injuries was higher (91.3% vs. 81.4%. Accuracy (85.5% vs. 72.8% of clinical diagnosis versus MRI diagnosis for articular cartilage lesions was better. Conclusion: Affirmation of clinical diagnosis in this study is a result of usage of standard clinical signs and tests which are fundamental in establishing clinical diagnosis of knee injuries. MRI is a diagnostic method which enriches the diagnostic process. Arthroscopy is defined as superior diagnostic method, also a gold standard for comparison of the other two diagnostic methods.

  1. Medial meniscal cyst: a case report.

    Science.gov (United States)

    Spina, Mauro; Sabbioni, Giacomo; Tigani, Domenico

    2008-12-01

    Meniscal cysts are a rare disease constantly combined with a horizontal meniscal lesion. Currently, nuclear magnetic resonance (MRI) is the main diagnostic tool, because of its high sensitivity and specificity, and decompression arthroscopy combined with selective meniscectomy is the treatment of choice. The Authors report a case of a voluminous medial meniscal cyst where instrumental examination, MRI, was fundamental for the preoperative diagnosis of the horizontal meniscal lesion causing the cystic degeneration of the meniscus. The treatment performed was selective meniscectomy of the body and posterior horn of the medial meniscus and decompression of the voluminous cyst by arthroscopy. Physical examination after six months showed the complete resolution of swelling at the medial hemirima, no walking pain and normal range of motion.

  2. Temporomandibular joint osteoarthrosis. Correlation of clinical and arthroscopic findings with degree of molar support

    Energy Technology Data Exchange (ETDEWEB)

    Holmlund, A.; Axelsson, S. (Karolinska Inst., School of Dentistry, Huddinge (Sweden))

    1994-01-01

    The prevalence of temporomandibular joint (TMJ) osteoarthrosis and synovitis was compared in 60 patients with painful chronic locking of the TMJ. 30 patients had reduced molar occlusion, and as controls, 30 age-matched fully dentate patients were examined. Assessment comprised clinical examination (crepitation), tomography (sclerosis and erosions), and arthroscopy (cartilage involvement) of the TMJ. Arthroscopic signs of osteoarthrosis and synovitis were frequent in both groups. The highest frequency of osteoarthrosis was diagnosed by arthroscopy. With regard to clinical signs and symptoms, tomographic signs of osteoarthrosis, and arthroscopic diagnoses, no statistical differences were found between fully dentate subjects and those with reduced molar occlusion. The results do not support the concept that prevention of TMJ osteoarthrosis is an indication for prosthetic replacement of lost molars. 24 refs., 4 tabs.

  3. 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.

  4. Myositis ossificans within the intercondylar notch treated arthroscopically

    Energy Technology Data Exchange (ETDEWEB)

    Leung, Allen H.; Desai, Panna [Hospital for Joint Diseases/New York University, Department of Pathology, New York, NY (United States); Rybak, Leon D. [Hospital for Joint Diseases/New York University, Department of Radiology, New York, NY (United States); Rose, Donald J. [Hospital for Joint Diseases/New York University, Department of Orthopedic Surgery, New York, NY (United States)

    2010-09-15

    We present a case of intraarticular myositis ossificans in the right knee of a child. Myositis ossificans (MO), though relatively rare in childhood and even more uncommon within a joint, should be included in the differential diagnosis of an intra-articular mass when indicated by the typical clinical, radiographic, and histologic findings. An 11-year-old male presented with a history of trauma to his right knee. Four weeks after the initial injury, an MRI demonstrated evidence of an ACL rupture with a ''cystic mass'' within the intercondylar notch along the anterior surface of the torn ligament. At subsequent arthroscopy, the mass noted on MRI was removed. The histology was consistent with MO. The authors believe this to be the first case of MO in the intercondylar notch detected by MRI, treated by arthroscopy, and confirmed by histology. (orig.)

  5. Arthroscopically assisted Sauvé-Kapandji procedure: an advanced technique for distal radioulnar joint arthritis.

    Science.gov (United States)

    Luchetti, Riccardo; Khanchandani, Prakash; Da Rin, Ferdinando; Borelli, Pierpaolo P; Mathoulin, Christophe; Atzei, Andrea

    2008-12-01

    Osteoarthritis of distal radioulnar joint (DRUJ) leads to chronic wrist pain, weakness of grip strength, and limitation of motion, all of which affect the quality of life of the patient. Over the years, several procedures have been used for the treatment of this condition; however, this condition still remains a therapeutic challenge for the hand surgeons. Many procedures such as Darrach procedure, Bower procedure, Sauvé-Kapandji procedure, and ulnar head replacement have been used. Despite many advances in wrist arthroscopy, arthroscopy has not been used for the treatment of arthritis of the DRUJ. We describe a novel technique of arthroscopically assisted Sauvé-Kapandji procedure for the arthritis of the DRUJ. The advantages of this technique are its less invasive nature, preservation of the extensor retinaculum, more anatomical position of the DRUJ, faster rehabilitation, and a better cosmesis.

  6. [Treatment of acute scapholunate ligament tears with simple wiring and arthroscopic assistance].

    Science.gov (United States)

    Mathoulin, C; Messina, J

    2010-04-01

    Scapholunate ligament tears give chronic instability leading in SLAC. The wrist arthroscopy allows to see the lesions, even in early stage, and to treat them, with a simple K-Wires fixation in acute cases. The patients were operated on in outpatient basis with tourniquet and local general anaesthesia. In acute cases, the scapholunate dissociation was reduced by external and internal manoeuvres. The fixation was done with two pins under arthroscopic and fluoroscopic controls. We report a series of 66 acute cases (less than 45 days after trauma). Forty-four patients were males and 22 females. The average age was 39 years old (range 19-46). Our average follow-up in acute cases was 36 months (range 14-61). According the "Mayo Wrist Score", we obtained 92 % of good or excellent results. The wrist arthroscopy is the best technique for early diagnosis, guarantee of best functional results.

  7. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Oae, Kazunori; Uchio, Yuji [Shimane University School of Medicine, Department of Orthopaedics, Shimane, Izumo (Japan); Takao, Masato [Teikyo University, Department of Orthopaedic Surgery, Tokyo, Itabashi-ku (Japan); Ochi, Mitsuo [Hiroshima University, Department of Orthopaedic Surgery, Hiroshima, Minami-ku (Japan)

    2010-01-15

    The purpose of this study was to clarify the efficacy of stress radiography (stress X-P), ultrasonography (US), and magnetic resonance (MR) imaging in the detection of the anterior talofibular ligament (ATFL) injury. Thirty-four patients with ankle sprain were involved. In all patients, Stress X-P, US, MR imaging, and arthroscopy were performed. The arthroscopic results were considered to be the gold standard. The imaging results were compared with the arthroscopic results, and the accuracy calculated. Arthroscopic findings showed ATFL injury in 30 out of 34 cases. The diagnosis of ATFL injury with stress X-P, US, MR imaging were made with an accuracy of 67, 91 and 97%. US and MR imaging demonstrated the same location of the injury as arthroscopy in 63 and 93%. We have clarified the diagnostic value of stress X-P, US, and MR imaging in diagnosis of ATFL injury. We obtained satisfactory results with US and MR imaging. (orig.)

  8. Post-traumatic carpal instability.

    Science.gov (United States)

    Chantelot, C

    2014-02-01

    The complexity of the carpus explains the difficulty treating carpal injuries. Lesions are dominated by perilunate dislocation, scapholunate dislocation, and scaphoid fractures. The other injuries are trivial. Symptoms include pain and loss of wrist strength, reversible for an acute and well-treated lesion. Too often, these ligament injuries are diagnosed late. For delays longer than 6 weeks, ligament repair is ineffective. These old, complex lesions are potentially highly arthritic in the radiocarpal and mediocarpal joints. Improvements in wrist surgery have mitigated these chronic lesions. Various surgical techniques can preserve a functional wrist; wrist arthrodesis is no longer the only solution for these arthritic wrists. Over the past decade, arthroscopy has contributed to better understanding the injuries of the carpus as well as to better healing them. For acute or chronic ligament injuries without degenerative osteoarthritis, arthroscopy is the treatment of the future. This technique involves a long learning curve and the various arthroscopic techniques must be validated.

  9. The post-arthro-CT of the wrist clinical evaluation

    CERN Document Server

    Scheurecker, G

    2001-01-01

    To compare the diagnostic effectiveness of post-arthro-CT (PACT) and 3-compartment wrist arthrography (AG) both separate and combined versus wrist arthroscopy for scapho-lunate ligament (SLL), luno-triquetral ligament (LTL) and triangular fibrocartilage (TFC) defects and chondromalacia of the carpal bones. Material and methods: in 58 patients (16-69 years) the affected wrist was examined initially by conventional 3-compartment wrist arthrography with digital subtraction technique during injection followed by digital stress images. Afterwards spiral arthro-CT was performed in the semi-coronal and axial plane with 1 mm slice thickness and secondary true-coronal and sagittal reconstructions. Within 1 month arthroscopy was performed in general anesthesia utilizing standard joint entry points combined with routine digital picture archiving. All examinations were evaluated for SLL, LTL and TFC defects, PACT and AS for ChM too. Results: AG versus AS: the following detection rates were observed (AG and AS positive/AG...

  10. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris

    OpenAIRE

    2013-01-01

    Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusu...

  11. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

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

  12. Dental Continuing Education Preference Survey

    Science.gov (United States)

    1992-06-01

    the 63A9Ds and 34.9% for the 63A00s, selected Comprehensive Dentistry as their specialty preference. For the 63A9Ds, orthodontics , periodontics , and...Clinical Interest, Periodontal Disease in Children, Preventive Health and Nutrition, Dental Implants, and Major Aspects of Psychological Care. Also...as being of "low need" for the non-specialty general dentists were TMJ Arthroscopy, Genetic Anomalies of Clinical Interest, Periodontal Disease in

  13. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  14. 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...

  15. Intra-articular angiolipoma of the knee: a case report

    Directory of Open Access Journals (Sweden)

    Nishimori Makoto

    2010-04-01

    Full Text Available Abstract We report a case of intra-articular angiolipoma of the knee. This case report describes our experience in excising an intra-articular angiolipoma of the knee joint. Complete resection under arthroscopy was performed in a 30-year-old man. Two years after the surgery, no evidence of recurrence was seen. Intra-articular angiolipomas should be considered in the differential diagnosis of intra-articular masses in adolescents with recurrent hemarthrosis without trauma.

  16. Arthroscopic reduction and fibula nailing in high-risk diabetic ankle fractures: case reviews and technical tip.

    Science.gov (United States)

    Thevendran, Gowreeson; Younger, Alastair

    2012-04-01

    The management of diabetic ankle fractures is difficult given the associated wound and bone healing complications. Even with meticulous soft tissue handling and a stable construct, the fixation sometimes fails because of the poor biological environment. This study reports on 2 cases of Weber type B ankle fractures in patients with diabetes mellitus where the authors elected to treat with arthroscopy-assisted fracture reduction and percutaneous fibula nailing to reduce the risk of wound complications.

  17. A flexible virtual reality tutorial for the training and assessment of arthroscopic skills.

    Science.gov (United States)

    Moody, Louise; Waterworth, Alan

    2004-01-01

    Through definition of a comprehensive tutorial model, the Warwick, Imperial and Sheffield Haptic Knee Arthroscopy Training System (WISHKATS) aims to provide independent, flexible and consistent training and assessment. The intention is to satisfy user acceptance by limiting the constraints by which the system can be utilised, as well as demonstrating validity and reliability. System use can either be under the guidance and feedback offered by the system or of a senior surgeon. Objective metrics are defined for performance feedback and formal assessment.

  18. Diagnostic imaging of shoulder rotator cuff lesions

    OpenAIRE

    Nogueira-Barbosa Marcello Henrique; Volpon José Batista; Elias Jr Jorge; Muccillo Gerson

    2002-01-01

    Shoulder rotator cuff tendon tears were evaluated with ultrasonography (US) and magnetic resonance imaging (MRI). Surgical or arthroscopical correlation were available in 25 cases. Overall costs were also considered. Shoulder impingement syndrome diagnosis was done on a clinical basis. Surgery or arthroscopy was considered when conservative treatment failure for 6 months, or when rotator cuff repair was indicated. Ultrasound was performed in 22 patients and MRI in 17 of the 25 patients. Sensi...

  19. A new era in sports science: the launch of BMC Sports Science, Medicine and Rehabilitation.

    Science.gov (United States)

    Moylan, Elizabeth C; Horne, Genevieve

    2013-03-28

    This Editorial celebrates the launch of BMC Sports Science, Medicine and Rehabilitation within the BMC series of journals published by BioMed Central. BMC Sports Science, Medicine and Rehabilitation incorporates the recently closed Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology (SMARTT) with an expanded scope and Editorial Board. BMC Sports Science, Medicine and Rehabilitation will fill its own niche in the BMC series alongside other companion journals including BMC Physiology, BMC Musculoskeletal Disorders and BMC Surgery.

  20. Biomechanical Factors in Tibial Stress Fracture

    Science.gov (United States)

    2001-08-01

    of days lost due to injury; f~. 5. This injury required treatment at hospital: F* 6. This injury required surgery : H 7. This Injury required...Management, Inc, 1998-1999 The Effect of Different Orthotic Devices on Lower Extremity Mechanics of Rearfoot and Forefoot Strikers, $3,500. Foot Management...and Shape of the Intercondylar Notch and Anterior Cruciate Ligament Injury Knee surgery , sports traumatology and arthroscopy.9:200- 205 Manal, KT

  1. [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.

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

    Science.gov (United States)

    Rossi, Michael J

    2016-01-01

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

  3. DIAGNOSTIC ACCURACY OF CLINICAL AND MAGNETIC RESONANCE IN KNEE MENISCI AND LIGAMENTOUS INJURIES

    Directory of Open Access Journals (Sweden)

    Nilesh

    2016-03-01

    Full Text Available OBJECTIVE The purpose of this study was to evaluate the reliability of clinical diagnosis compared to MRI findings in ligamentous and meniscal injuries with respect to arthroscopic confirmation as a gold standard. METHODS 485 patients with knee injuries were prospectively assessed by clinical evaluation and magnetic resonance imaging and correlated after therapeutic arthroscopy. The overall accuracy, clinically productive values of sensitivity and specificity was derived. The actual value of the test with respect to positive predictive and negative predictive value was also derived, taking arthroscopic findings as confirmatory. The overall partial and total agreement among the clinical, MRI and arthroscopy was documented. RESULTS The overall accuracy for clinical examination was 85, 92, 100 and 100 and accuracy for MRI was 90, 97, 97 and 97 for detecting medial meniscus, lateral meniscus, ACL and PCL tears respectively. Clinically lateral meniscus tears are difficult to diagnose clinically with negative predictive value (90 whereas ACL injuries do not need MRI for diagnosis as evident by a high negative predictive value (100 of clinical examination. Total agreement with the clinical findings confirmed by arthroscopy was 64.40% which was relatively high as compared to total agreement of MRI findings which was only 31.50%. We found similar total agreement versus total disagreement of both clinical and MRI to be only 2.74% indicating very high accuracy in clinical diagnosis of meniscal and ligamentous injuries combined. CONCLUSION The clinical evaluation alone is sufficient to diagnose meniscal and ACL/PCL pathologies and MRI should be considered only as a powerful negative diagnostic tool. The arthroscopy decision should not be heavily dependent on MRI for ligamentous injuries but reverse is true for meniscal lesions. MR evaluation functions as a powerful negative diagnostic tool to rule out doubtful and complex knee injuries.

  4. Case Series: Cyclops lesion - extension loss after ACL reconstruction

    Directory of Open Access Journals (Sweden)

    Dhanda Sunita

    2010-01-01

    Full Text Available Localized anterior arthrofibrosis (cyclops lesion is the second most common cause of extension loss after anterior cruciate ligament (ACL reconstruction. We present and discuss two patients with prior ACL reconstructions, who presented with pain and loss of extension following surgery. MRI and arthroscopy of the knee revealed typical features of a cyclops lesion. The patients showed significant symptomatic improvement following arthroscopic resection of these lesions.

  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. Three-Tesla magnetic resonance imaging of the meniscus of the knee: What about equivocal errors?

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Vanhoenacker, Filip M.; Gielen, Jan L.; Parizel, Paul M. (Dept. of Radiology, Univ. Hospital Antwerp and Univ. of Antwerp, Antwerp (Edegem) (Belgium)), e-mail: pieter.van.dyck@uza.be; Dossche, Lieven (Dept. of Orthopedics, Univ. Hospital Antwerp and Univ. of Antwerp, Antwerp (Edegem) (Belgium)); Weyler, Joost (Dept. of Epidemiology and Social Medicine, Univ. of Antwerp, Antwerp (Wilrijk) (Belgium))

    2010-04-15

    Background: The significance of borderline magnetic resonance (MR) findings that are equivocal for a tear of the knee meniscus remains uncertain. Given their higher signal-to-noise ratio (SNR) and greater spatial resolution, these equivocal meniscal tears could be expected to be less frequent using a 3.0T MR system. Purpose: To investigate the prevalence of equivocal meniscal tears using 3.0T MR, and to study their impact on MR accuracy compared with arthroscopy in the detection of meniscal tears. Material and Methods: The medical records of 100 patients who underwent 3.0T MR imaging and subsequent arthroscopy of the knee were retrospectively reviewed. Two observers interpreted MR images in consensus, and menisci were diagnosed as torn (abnormality on two or more images), equivocal for a tear (abnormality on one image), or intact, using arthroscopy as the standard of reference. The prevalence of equivocal meniscal tears was assessed, and MR accuracy was calculated as follows: first, considering both torn menisci and equivocal diagnoses as positive for a tear; and second, considering only torn menisci as positive for a tear. Results: Evidence of meniscal tears on MR images was equivocal in 12 medial (12%) and three lateral (3%) menisci. Of these equivocal MR diagnoses, tears were found at arthroscopy in eight medial and one lateral meniscus. In our study, the specificity and positive predictive value increased for both the medial and lateral meniscus when only menisci with two or more abnormal images were considered to be torn: from 80% and 89% to 91% and 94% for the medial meniscus, and from 91% and 73% to 93% and 78% for the lateral meniscus, respectively. Conclusion: Subtle findings that are equivocal for a tear of the knee meniscus still make MR diagnosis difficult, even at 3.0T. We recommend that radiologists should rather be descriptive in reporting subtle or equivocal MR findings, alerting the clinician of possible meniscal tear

  7. Identification, Characterization, and Utilization of Adult Meniscal Progenitor Cells

    Science.gov (United States)

    2014-09-01

    School of Dental Medicine. In support of this research, Ashira Gendelman received a Harvard Scholarship in Medicine for summer 2014. 10...Faculty, Georg-August-University, 37075 Goettingen, Germany 3Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA 4Co-first...Rodkey, W.G. (2005). Tissue-engineered collagen meniscus implants : 5- to 6-year feasibility study results. Arthroscopy 21, 515–525. Steinert, A.F

  8. Arthroscopic Treatment of Stiff Elbow

    OpenAIRE

    Blonna, Davide; BELLATO, ENRICO; Marini, Eleonora; Scelsi, Michele; Castoldi, Filippo

    2011-01-01

    Contracture of the elbow represents a disabling condition that can impair a person's quality of life. Regardless of the event that causes an elbow contracture, the conservative or surgical treatment is usually considered technically difficult and associated with complications. When the conservative treatment fails to restore an acceptable range of motion in the elbow, open techniques have been shown to be successful options. More recently the use of arthroscopy has become more popular for sev...

  9. Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography?

    Energy Technology Data Exchange (ETDEWEB)

    Schreinemachers, Saskia A. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Hulst, Victor P.M. van der; Woude, Henk-Jan van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Willems, W.J. [Onze Lieve Vrouwe Gasthuis, Orthopaedic Surgery, Amsterdam (Netherlands); Bipat, Shandra [University of Amsterdam (NL). Department of Radiology, Academic Medical Center (Netherlands)

    2009-10-15

    The purpose of this study was to retrospectively evaluate sensitivity and specificity of a single magnetic resonance (MR) arthrography series in abduction external rotation (ABER) position compared with conventional MR arthrography for detection of supraspinatus tendon tears, with arthroscopy as gold standard, and to assess interobserver variability. Institutional review board approval was obtained; informed consent was waived. MR arthrograms of 250 patients (170 men and 80 women; mean age, 36 years) were retrospectively and independently evaluated by three observers. Oblique coronal T1-weighted fat-suppressed images, proton density, and T2-weighted images and axial T1-weighted images and oblique sagittal T1-weighted fat-suppressed images were analyzed to detect supraspinatus tendon tears. Separately, a single T1-weighted fat-suppressed oblique axial series in ABER position was evaluated. Both protocols were scored randomly without knowledge of patients' clinical history and arthroscopy results. Tears were subclassified, based on articular surface integrity and extension (Lee classification). Interobserver agreement was assessed by kappa statistics for all patients. Ninety-two of 250 patients underwent arthroscopy; sensitivity and specificity of ABER and conventional MR arthrography were calculated and compared using paired McNemar test. Weighted kappa values of ABER and conventional MR arthrography were 0.48-0.65 and 0.60-0.67, respectively. According to arthroscopy, 69 of 92 patients had an intact cuff, and 23 patients had a cuff tear (16 partial thickness and seven full thickness). There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (48-61% and 52-70%, respectively) and specificity (80-94% and 91-95%). Sensitivity and specificity of a single T1-weighted series in ABER position and conventional MR arthrography are comparable for assessment of rotator cuff tears. (orig.)

  10. A new era in sports science: the launch of BMC Sports Science, Medicine and Rehabilitation

    OpenAIRE

    Moylan, Elizabeth C; Horne, Genevieve

    2013-01-01

    This Editorial celebrates the launch of BMC Sports Science, Medicine and Rehabilitation within the BMC series of journals published by BioMed Central. BMC Sports Science, Medicine and Rehabilitation incorporates the recently closed Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology (SMARTT) with an expanded scope and Editorial Board. BMC Sports Science, Medicine and Rehabilitation will fill its own niche in the BMC series alongside other companion journals including BMC Physio...

  11. Self-Reduction of Displaced Bucket-Handle Medial Meniscal Tear in a 71-Year-Old Patient

    OpenAIRE

    2015-01-01

    Background: Bucket-handle meniscal tears are rare in geriatric patients. Displaced bucket-handle meniscal tears are usually treated operatively. Due to the rarity of these tears in elderly patients and conflicting evidence regarding the use of arthroscopy versus conservative treatment, it is valuable to report the clinical presentation, treatment, and outcome of these injuries in elderly patients. Case Description: We describe a 71-year-old man who presented with an acute, displaced, magnetic...

  12. Isoflurane versus sevoflurane with interscalene block for shoulder arthroscopic procedures: Value of process capability indices as an additional tool for data analysis

    OpenAIRE

    Thrivikrama Padur Tantry; Harish Karanth; Sunil P Shenoy; Ayya, Shreekantha V; Shetty, Pramal K; Adappa, Karunakara K

    2016-01-01

    Background and Aims : Hypotensive anaesthesia reduces intra-articular bleed and promotes visualisation during arthroscopy. The haemodynamic effects of inhalational agents isoflurane and sevoflurane were studied extensively, and both were found to reduce mean arterial pressures (MBP) to an equivalent magnitude. We investigated the relative ability of isoflurane vis-a-vis sevoflurane to maintain the target systolic blood pressure (SBP) in patients undergoing shoulder arthroscopic procedures. Me...

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    Niemelä, Tytti; Virén, Tuomas; Liukkonen, Jukka; Argüelles, David; te Moller, Nikae C R; Puhakka, Pia H.; Jurvelin, Jukka S.; Tulamo, Riitta-Mari; Töyräs, Juha

    2014-01-01

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

  15. Idrætstraumatologi og artroskopi--fra videnskab til klinisk behandling

    DEFF Research Database (Denmark)

    Krogsgaard, Michael Rindom

    2012-01-01

    Since the first knee arthroscopy in 1912, it is routine to scope all joints and many extra-articular structures. The effect of arthroscopic procedures in overuse conditions is sparsely documented and should be investigated in randomized studies, but score systems to evaluate clinical effects are ...... are lacking. An increased understanding of tissue reaction to loading and ligament healing as well as neuromuscular control is likely to change the basic principles of treatment and prevention in relation to sports injuries....

  16. 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.

  17. 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.

  18. 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.

  19. Advanced imaging of the scapholunate ligamentous complex

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, Maryam; Maeseneer, Michel de; Boulet, Cedric; Mey, Johan de [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels (Belgium); Staelens, Barbara; Scheerlinck, Thierry [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedics and Traumatology, Brussels (Belgium); Overstraeten, Luc van [Hand and Foot Surgery Unit (HFSU), Tournai (Belgium)

    2015-12-15

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies. (orig.)

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

    Science.gov (United States)

    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.

  1. 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.

  2. Cine MRI: a new approach to the diagnosis of scapholunate dissociation

    Energy Technology Data Exchange (ETDEWEB)

    Langner, I.; Eisenschenk, A. [University Medicine Greifswald, Division of Hand Surgery and Functional Microsurgery, Department of Trauma and Reconstructive Surgery, Greifswald (Germany); Fischer, S.; Langner, S. [University Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2015-08-15

    To evaluate the feasibility of cine MRI for the detection of scapholunate dissociation (SLD) and to compare the sensitivity and specificity of cine MRI with those of cineradiography and arthroscopy. To evaluate feasibility, healthy subjects underwent cine MRI of the wrist. To evaluate sensitivity and specificity, patients with clinically suspected scapholunate ligament (SLL) injury after trauma to the wrist were prospectively included and underwent radiographic examination, cineradiography, and cine MRI. In 25 out of 38 patients, subsequent arthroscopy was performed. Results of cineradiography and cine MRI correlated with those of arthroscopy. Cine MRI was of diagnostic quality in all healthy subjects and patients with good interrater agreement. There was excellent correlation between cineradiography and cine MRI. Scapholunate distance differed significantly between healthy subjects and patients with scapholunate dissociation (p < 0.001), but not between imaging modalities in the patient group. Cine MRI had 85 % sensitivity and 90 % specificity for the detection of SLD. Cine MRI of the wrist is a fast and reliable technique for the detection of SLD with diagnostic accuracy comparable to cineradiography. It can be easily implemented as a routine clinical MRI examination, facilitating diagnostic workup of patients with suspected SLD while avoiding radiation exposure. (orig.)

  3. Diagnostic accuracy of fat-saturated T2-weighted magnetic resonance imaging in the diagnosis of perforation of the articular disc of the temporomandibular joint.

    Science.gov (United States)

    Yura, Shinya; Nobata, Koji; Shima, Tsuyoshi

    2012-06-01

    The accuracy of diagnosing a perforation of the articular disc of the temporomandibular joint (TMJ) is poor with conventional magnetic resonance imaging (MRI). We recently reported that a high signal-intensity area is usually found on fat-saturated T2-weighted MRI in the joint space between the articular disc and cartilage surface in joints in which the disc is displaced. A discrete image with an area of high signal-intensity in the middle of the articular disc may indicate perforation or rupture. The purpose of this study was to compare the accuracy of diagnosis of a perforated articular disc by fat-saturated T2-weighted MRI with that of arthroscopy. We studied 50 joints in 50 patients with closed lock of the TMJ who were examined with MRI and then by arthroscopy using an ultra-thin arthroscope. The agreement between the two methods of diagnosis was assessed using the κ coefficient. Evidence of perforation of the disc on MRI and arthroscopically was found in the same 7 joints; there was complete concordance (κ=1.00, pfat-saturated MRI was therefore the same as that by arthroscopy using an ultra-thin arthroscope.

  4. Rotator cuff injury: fat suppression MR image

    Energy Technology Data Exchange (ETDEWEB)

    Won, Jong Yoon; Suh, Jin Suck; Park, Chang Yun; Lee, Yeon Hee [Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Soo [Inje University College of Medicine, Busan (Korea, Republic of)

    1994-04-15

    We performed the study prospectively to evaluate the advantage of fat suppression MR in the diagnosis of rotator cuff injury. Ten symptomatic patients were studied with both conventional T2WI and FST2WI using chemical shift technique. Each image was analyzed for the assessment of injuries, conspicuity of the lesion, the presence of effusion in subacromical bursae and joint space, and presence of humeral head injury. Arthroscopy was done in 4 patients following MRI. We could made presumptive diagnoses on FSMR as identical as on conventional MR in six cases(1 normal, 2 tendinitis, 2 partial thickness tear, 1 full thickness tear), two of them were confirmed by arthroscopic procedures. Two cases of partial thickness tear proved by arthroscopy were detected on FST2WI, whereas they were considered tendinitis on conventional T2WI. There were another 2 cases who showed tendinitis on FSMR, but normal on conventional T2WI. They, however, were not confirmed by either arthroscopy or surgical procedure. We found the FSMR were superior to conventional T2WI in the conspicuity of lesions and detection of joint effusion and abnormalities on the humeral head. We think FSMR of the shoulder could have significant diagnostic advantages over the conventional spin-echo MR imaging.

  5. Advanced imaging of the scapholunate ligamentous complex.

    Science.gov (United States)

    Shahabpour, Maryam; Staelens, Barbara; Van Overstraeten, Luc; De Maeseneer, Michel; Boulet, Cedric; De Mey, Johan; Scheerlinck, Thierry

    2015-12-01

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies.

  6. Cost-effectiveness in orthopedics: providing essential information to both physicians and health care policy makers for appropriate allocation of medical resources.

    Science.gov (United States)

    Dougherty, Christopher P; Howard, Timothy

    2013-09-01

    Cost-effective analysis has become an important tool in helping determine what procedures are both cost-effective and appropriate in today's cost control health care. The quality-adjusted life-year (QALY) is a standard measure for health-related quality-of-life in medical cost-effectiveness research. It can be used to compare different interventions to determine the cost-effectiveness of each procedure. Use of QALY to compare health care interventions has become the new gold standard. The key words arthroscopy, cost-effectiveness analysis, QALY, shoulder, hip, knee, ankle, elbow, wrist, and pubic symphysis were searched utilizing PubMed and an internet search engine. Cost/QALY ratios were determined and compared with other surgical procedures using techniques other than arthroscopy. Cost/QALYs were found for the shoulder, hip, knee, and elbow. The QALY for the shoulder was $13,092, for a simple knee was $5783, for a hip $21,700, and for an elbow $2031. General costs were found for the ankle, wrist, and pubic symphysis, that could be used to estimate QALYs without the complex formal calculation. On the basis of our findings, arthroscopy is an extremely cost-effective allocation of health care resources.

  7. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears?

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Gielen, Jan L.; Parizel, Paul M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); Vanhoenacker, Filip M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Antwerp (Edegem) (Belgium); AZ St-Maarten Duffel/Mechelen, Department of Radiology, Duffel (Belgium); Dossche, Lieven; Gestel, Jozef van [University Hospital Antwerp and University of Antwerp, Department of Orthopedics, Antwerp (Edegem) (Belgium); Wouters, Kristien [University Hospital Antwerp and University of Antwerp, Department of Scientific Coordination and Biostatistics, Antwerp (Edegem) (Belgium)

    2011-06-15

    To determine the ability of 3.0T magnetic resonance (MR) imaging to identify partial tears of the anterior cruciate ligament (ACL) and to allow distinction of complete from partial ACL tears. One hundred seventy-two patients were prospectively studied by 3.0T MR imaging and arthroscopy in our institution. MR images were interpreted in consensus by two experienced reviewers, and the ACL was diagnosed as being normal, partially torn, or completely torn. Diagnostic accuracy of 3.0T MR for the detection of both complete and partial tears of the ACL was calculated using arthroscopy as the standard of reference. There were 132 patients with an intact ACL, 17 had a partial, and 23 had a complete tear of the ACL seen at arthroscopy. Sensitivity, specificity, and accuracy of 3.0T MR for complete ACL tears were 83, 99, and 97%, respectively, and, for partial ACL tears, 77, 97, and 95%, respectively. Five of 40 ACL lesions (13%) could not correctly be identified as complete or partial ACL tears. MR imaging at 3.0T represents a highly accurate method for identifying tears of the ACL. However, differentiation between complete and partial ACL tears and identification of partial tears of this ligament remains difficult, even at 3.0T. (orig.)

  8. Sensitivity and specificity of vertically oriented lateral collateral ligament as an indirect sign of anterior cruciate ligament tear on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Palle, Lalitha; Reddy, Balaji; Reddy, Jagannath [Focus Diagnostics, Sai Baba Temple Lane, Dwarakapuri Colony, Hyderabad, Andhra Pradesh (India)

    2010-11-15

    To evaluate the correlation between anterior cruciate ligament (ACL) tear and straightened, vertically oriented lateral collateral ligament (LCL). This study included 556 patients who underwent MRI of the knee and were divided into three subsets based on ACL morphology. Subset 1 included patients with unequivocal normal ACL. Subset 2 included patients with unequivocal ACL tears. Subset 3 included patients with doubtful ACL who underwent arthroscopy. MR images were reviewed and sensitivity and specificity of vertically oriented LCL as an indirect sign of ACL tear were calculated. The MRI results were as follows: subset 1, out of 282 patients, 270 had oblique LCL and 12 demonstrated vertical LCL; subset 2, out of 212 patients, 189 demonstrated vertical LCL and 23 revealed oblique LCL; subset 3, out of 62 patients, 28 patients with vertical orientation of LCL had a possible ACL tear. Patients with oblique LCL orientation (34) were reported as probably having normal ACL. On comparison with arthroscopy, in 28 patients who we reported as having possible ACL tears, there were 17 patients with torn ACL. The rest of the 11 patients revealed no ACL tears. In the group of 34 patients in whom we reported possible normal, arthroscopy-confirmed tear in 5 patients. Sensitivity and specificity of vertical LCL as an indirect sign of ACL tear was found to be 88% and the specificity 92.85%. Vertically oriented LCL is a useful indirect MRI sign of ACL tear and aids in making a diagnosis, when ACL appearance is equivocal. (orig.)

  9. Prevalence of the acetabular sublabral sulcus at MR arthrography in patients under 17 years of age: does it exist?

    Energy Technology Data Exchange (ETDEWEB)

    Magerkurth, Olaf [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Hospital Baden, Department of Radiology, Baden (Switzerland); Jacobson, Jon A.; Morag, Yoav; Fessell, David [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Bedi, Asheesh; Sekiya, Jon K. [University of Michigan, Department of Orthopedic Surgery, Ann Arbor, MI (United States)

    2015-04-18

    To retrospectively determine characteristics of contrast-filled acetabular labral clefts in patients under the age of 17 years at MR arthrography (Mra) correlated with arthroscopy, which may impact the thinking regarding the existence of a sublabral sulcus. After IRB approval, 41 patients under the age of 17 who had MRa were identified. The following observations of contrast-filled clefts were assessed: (1) presence/absence, (2) location, (3) depth, (4) abnormal signal within the labrum and (5) shape (linear, gaping, complex). Fisher's exact and the Wilcoxon matched-pairs signed-rank test were performed. Interreader agreement was calculated with Cohen's k. Reader 1 found clefts in 41 %. Depth was less than half in 6 %, more than half in 65 % and full thickness in 29 %. Shape was linear in 53 %, gaping in 18 % and complex in 29 %. Signal changes occurred in 88 %. Reader 2 found clefts in 29 %. Depth was less than half in 17 %, more than half in 58 % and full thickness in 25 %. Shape was linear in 50 %, gaping in 42 % and complex in 17 %. Signal changes occurred in 50 %. None of the clefts fulfilled the criteria for a sublabral sulcus at MRa and arthroscopy. None of the clefts found in our subjects under the age of 17 years met the MRa and arthroscopy criteria for a sublabral sulcus, which supports the theory that such clefts represent labral tears. (orig.)

  10. MAGNETIC RESONANCE IMAGING OF THE INTERNALLY DERANGED KNEE JOINT - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rangappa Hanumappa

    2013-10-01

    Full Text Available ABSTRACT : BACKGROUND & OBJECTIVE : Trauma to knee joint is a significant cause of morbidity in the young, active individuals and athletes. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non - o perative treatment. The most widely u sed diagnostic modalities to assess the joint in jury are arthroscopy and MRI. Arthroscopy, though accurate, is invasive and can cause complications. Magnetic resonance imaging (MRI has now been accepted as the best imaging modality for non - invasive evalu ation of knee injuries. This study was undertaken to study the types and incidence of injuries in traumatic knee joint by MR imaging and to compare with arthroscopy findings in selected cases. METHODS: DESIGN : Prospective study Setting: In a tertiary care hospital, symptomatic patients who were referred from various service referral hospitals and units with history of trauma and clinical suspicion of IDK were referred to department of O rthopedics , Navodaya Medical College, Raichur. Patients: 50 consecutive pa tients with suspicion of IDK following knee trauma were selected for the study from 2011 to 2013. INVESTIGATIONS: Clinical examinations, MRI knee (within 4 days of referral & in selected cases arthroscopy were performed and the findings were compared. Mai n Outcome Measures: Study of spectrum of MRI findings in traumatic knee and correlation of MRI findings with arthroscopy/surgical findings in selected cases. RESULTS : Of the total 50 patients evaluated, most common injury was ACL tear of which complete te ars were more common. PCL tears were less common. Among the Meniscal injuries, MM tears are more common than LM and grade 2 tears are more common in both. MCL tears outnumbered LCL tears and grade 1 and 2 tears are more common in MCL. Osseous/Osteochondra l lesions were seen in 17 patients (34%. Most of these were bony contusions involving the femoral and tibial condyles. INTERPRETATION AND

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

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

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

  12. 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

  13. New approaches to early diagnosis of arthrosis and prospects for its pathogenetic therapy

    Directory of Open Access Journals (Sweden)

    Lilia Vladimirovna Luchikhina

    2014-12-01

    Full Text Available Objective: to study the possible chondroprotective effect of the viscoelastic agent synvisc, by applying the developed methodological and classification approaches to evaluating the intraarticular cartilage by arthroscopy and magnetic resonance imaging (MRI.Subjects and methods. Eighty six patients with knee arthrosis were examined and divided into 2 groups: a study group of 64 patents and a control one of 22 patients. Synvisc was injected into the affected joint in the study group; methylprednisolone acetate in the control group. Arthroscopic and MRI criteria were used to evaluate the articular cartilage. Arthroscopy and MRI were performed before and 6 and 12 months after treatment.Results. The developed methodological approaches are distinguished for their high sensitivity (89.7% and specificity (95.2%, which could estimate changes in arthrosis just at the stage of hyperhydration and dechondral changes and monitor long the chondroprotective effect of synvisc. The agent was noted to have a positive effect at the stage of hyperhydration and dechondral changes and in grade I–II intrachondral changes and to be able to prevent or stop the progression of OA in later (II–III X-ray stages. The effect of synvisc did not depend on disease duration and patient age, but it decreased in the presence of marked articular anatomic and morphological changes. The administration of the agent could reduce or preclude the use of nonsteroidal anti-inflammatory drugs or intraarticular glucocorticoids n 96% of cases.Conclusion. Arthroscopy and MRI make possible to recognize arthrosis in its earliest stage and to monitor the effect of drugs on the cartilage. The use of synvisc in early-stage gonarthrosis allows a long-term symptomatic effect and some structure-modifying activity.

  14. New approaches to early diagnosis of arthrosis and prospects for its pathogenetic therapy

    Directory of Open Access Journals (Sweden)

    Lilia Vladimirovna Luchikhina

    2014-01-01

    Full Text Available Objective: to study the possible chondroprotective effect of the viscoelastic agent synvisc, by applying the developed methodological and classification approaches to evaluating the intraarticular cartilage by arthroscopy and magnetic resonance imaging (MRI.Subjects and methods. Eighty six patients with knee arthrosis were examined and divided into 2 groups: a study group of 64 patents and a control one of 22 patients. Synvisc was injected into the affected joint in the study group; methylprednisolone acetate in the control group. Arthroscopic and MRI criteria were used to evaluate the articular cartilage. Arthroscopy and MRI were performed before and 6 and 12 months after treatment.Results. The developed methodological approaches are distinguished for their high sensitivity (89.7% and specificity (95.2%, which could estimate changes in arthrosis just at the stage of hyperhydration and dechondral changes and monitor long the chondroprotective effect of synvisc. The agent was noted to have a positive effect at the stage of hyperhydration and dechondral changes and in grade I–II intrachondral changes and to be able to prevent or stop the progression of OA in later (II–III X-ray stages. The effect of synvisc did not depend on disease duration and patient age, but it decreased in the presence of marked articular anatomic and morphological changes. The administration of the agent could reduce or preclude the use of nonsteroidal anti-inflammatory drugs or intraarticular glucocorticoids n 96% of cases.Conclusion. Arthroscopy and MRI make possible to recognize arthrosis in its earliest stage and to monitor the effect of drugs on the cartilage. The use of synvisc in early-stage gonarthrosis allows a long-term symptomatic effect and some structure-modifying activity.

  15. Arthroscopic foveal repair of the triangular fibrocartilage complex.

    Science.gov (United States)

    Atzei, Andrea; Luchetti, Riccardo; Braidotti, Federica

    2015-02-01

    Background Foveal disruption of the triangular fibrocartilage complex (TFCC) is associated with distal radioulnar joint (DRUJ) instability. TFCC fixation onto the fovea is the suitable treatment, which is not achieved by conventional arthroscopic techniques. We describe an all-inside arthroscopic technique that uses a suture anchor through distal DRUJ arthroscopy for foveal repair of the TFCC. Materials and Methods Forty-eight patients with TFCC foveal tear and DRUJ instability were selected according to the Atzei-European Wrist Arthroscopy Society (EWAS) algorithm of treatment. Retrospective evaluation included pain, DRUJ instability, range of motion (ROM), grip strength, Modified Mayo Wrist Score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Description of Technique DRUJ arthroscopy was performed to débride the TFCC and the foveal area. Under arthroscopic guidance, a suture anchor was inserted via the distal foveal portal to repair the TFCC onto the fovea. Sutures were tied on the radiocarpal surface of the TFCC. Postoperative immobilization of forearm rotation was maintained for 4 weeks. Heavy tasks were allowed after 3 months. Results After a mean follow-up of 33 months, pain improved significantly but remained moderate in four patients, severe in one. DRUJ instability resolved in 44 patients. Wrist ROM increased. Grip strength, MMWS, and DASH score improved significantly. Excellent and good MMWS equaled 83.3%. Forty-one patients (85.5%) resumed previous work and sport activities. As a postoperative complication, five patients experienced neuroapraxia of the dorsal sensory branch of the ulnar nerve (DSBUN) with full spontaneous recovery. Conclusions With appropriate indications and patient selection, arthroscopic foveal repair of the TFCC may restore DRUJ stability and provide satisfactory results without significant complications.

  16. Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography?

    Energy Technology Data Exchange (ETDEWEB)

    Schreinemachers, Saskia A.; Hulst, Victor P.M. van der; Woude, Henk-Jan van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Jaap Willems, W. [Onze Lieve Vrouwe Gasthuis, Orthopaedic Surgery, Amsterdam (Netherlands); Bipat, Shandra [University of Amsterdam, Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands)

    2009-07-15

    The purpose of this study is to retrospectively compare accuracy of single magnetic resonance (MR) arthrography series in Abduction External Rotation (ABER) with conventional MR arthrography for detection and characterisation of anteroinferior labroligamentous lesions, with arthroscopy as reference standard. Inter-observer variability of both protocols was determined. Institutional review board approval was obtained; informed consent was waived. MR arthrograms, including oblique axial fat suppressed T1-weighted images in ABER position and conventional imaging directions of 250 patients (170 men, 80 women; mean age, 36 years), were retrospectively and independently evaluated by three reviewers. Reviewers were blinded to clinical information and arthroscopic results. Labroligamentous lesions were registered in both ABER and MRa. The lesions were sub-classified (Bankart, Perthes, anterior labrum periosteal sleeve avulsion (ALPSA) or lesions not otherwise specified). Inter-observer agreement was assessed by Kappa statistics for all 250 patients. Ninety-two of 250 patients underwent arthroscopy. Sensitivity, specificity and accuracy of ABER versus conventional MR arthrography were calculated and compared using paired McNemar test. Kappa values of the ABER and conventional MR arthrography ranged from 0.44 to 0.56 and 0.44 to 0.62, respectively. According to arthroscopy, 45 of 92 patients had an intact anteroinferior labrum, and in 44 patients, a labroligamentous lesion (eight Bankart, seven Perthes, 29 ALPSA and three lesions not otherwise specified) was diagnosed. There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (85-89%, 89-96%), specificity (82-91%, 84-89%) and overall accuracy (50-62%, 53-63%). The results of a single MR arthrography series in ABER position are comparable with those of conventional MR arthrography for detecting anteroinferior labroligamentous lesions. (orig.)

  17. Arthroscopic treatment of femoroacetabular impingement in patients older than 60 years

    Science.gov (United States)

    Mardones, Rodrigo; Via, Alessio Giai; Rivera, Alvaro; Tomic, Alexander; Somarriva, Marcelo; Wainer, Mauricio; Camacho, Daniel

    2016-01-01

    Summary Background The indications of hip arthroscopy increased over the past decade. Although mostly recommended for treatment of femoroacetabular impingement (FAI) in young patients, well-selected older patients (> 60 years old) may benefit from this surgery. However, the role of hip arthroscopy for the management of older patients is controversial. The aim of the study is to evaluate the clinical outcomes of a series of patients aged 60 years and older who underwent hip arthroscopy for FAI at mid-term follow-up. Materials and methods Sixty-year-old patients and older, with a joint space greater than 2 mm, and a grade I and II hip osteoarthrosis (OA) according Tönnis scale were included into the study. Twenty-three patients (28 hips) met the inclusion criteria. The T-Student test was used to detect for differences between variables (p<0.05). Results The mean age of the patients was 63.4 years, and the mean follow-up was 4.4 years (2–9 years). We found an improvement in mHHS and VAS score from the baseline to the final follow-up in 87% of patients (p<0.05). Three patients (13%) were submitted to a THA at a mean of 12 months, while the survivorship rate at the final follow-up was 75%. No major complications have been reported. Conclusion Arthroscopic treatment of FAI in patients over 60 years old, with no signs of advanced osteoarthrosis, showed a significant improvement of functional score and pain in most of cases, and it can be consider a reasonable option in well selected patients. Level of evidence: IV case series. PMID:28066746

  18. Comparison of Indirect MR Arthrography With Conventional MRI in the Diagnosis of Knee Pathologies in Patients With Knee Pain

    Directory of Open Access Journals (Sweden)

    Babaei Jandaghi

    2016-03-01

    Full Text Available Background Knee pain is a common problem in the general population. In order to determine the extent of the injury and the appropriate treatment, MRI provides the most accurate imaging method. This may be done through conventional MRI techniques or by injecting a contrast material (MR arthrography. Objectives The purpose of this study was to compare the diagnostic value of these two methods. Patients and Methods The study involved the diagnostic evaluation on 60 patients with knee pain who received treatment over the course of a one-year period. Referred patients were randomly divided into two groups: indirect MR arthrography was performed on one group, and conventional MRI was performed on the other group. Both groups then underwent arthroscopy. The results from both groups were compared with the arthroscopic findings. Results In all of the pathologies studied, the sensitivity, specificity, and the positive and negative predictive values were evaluated. A high rate of accuracy was found between MR arthrography and arthroscopy (P < 0.05 for all knee injuries, however a similar rate of accuracy between conventional MRI and arthroscopy was only seen in patients with damage to the posterior cruciate ligament (PCL, the tibio-femoral articular cartilage, and patella chondromalacia (P < 0.05. The highest rate of accuracy was seen in cases where indirect MR arthrography was used for the diagnosis of anterior cruciate ligament (ACL damage (K = 1. Conclusions Our results have shown that indirect MR arthrography had greater diagnostic accuracy in regards to the sensitivity, specificity, and positive and negative predictive values than conventional MRI in knee pathologies.

  19. The utility of MR imaging of the shoulder joint: comparison of the MR imaging between conventional MR imaging and arthrographic MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Dong Sik; Ryu, Kyung Nam; Kim, Ihn Sub; Rhee, Yong Girl [Kyunghee Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    To evaluate the diagnostic value of MRI of the shoulder. Between January and June 1997, shoulder MRI and arthroscopy were performed in a total of 48 patients with shoulder pain (n=3D30) or shoulder instability (n=3D18). Forty-five were males and three were females; their ages ranged from 16 to 67 (mean 32.5) years. The period between shoulder MRI and arthroscopy was between one and 390 (mean, 42.2) days. Twenty-six patents underwent MR arthrography (AMR), and 22 conventional MRI(CMR). Each image was analyzed for rotator cuff injury, glenoid labral injury, SLAP lesion, and biceps tendon injury. On arthroscopy, one disease was found in 34 patients, two were found in six, three diseases were found in seven, and one patient had four diseases. Arthroscopic diagnosis was as follows:rotator cuff injury, 29;SLAP lesion, 12;glenoid labral injury, 10;biceps tendon injury, 4;subacromial bursitis, 2;chronic synovitis, 1;adhesive capsulitis, 1;superior glenohumeral ligament injury, 1;normal, 1. For rotator cuff injury, the sensitivity of MRI was 65.5% and specificity was 93.0% (AMR:66.7%, 95.8%, CMR:65.2%, 86.4%). For SLAP lesion, sensitivity was 58.3% and specificity was 97.2% (AMR:66.7%, 100%, CMR:50%, 93.8%);for glenoid labral injury, sensitivity was 80.0% and specificity was 89.5% (AMR:85.7%, 84.2%, CMR:66.7%, 94.7%), and for biceps tendon injury, the false negative rate was 100%. In cases involving glenoid labral injury, the diagnostic accuracy of shoulder MRI was relatively high;in rotator cuff injury and SLAP lesion, however, diagnosis was limited, and in biceps tendon injury was difficult. We suggest, however, that MR arthrography has certain diagnostic advantages over conventional MRI.=20.

  20. Tears of the Supraspinatus Tendon: Assessment with Indirect Magnetic Resonance Arthrography in 67 Patients with Arthroscopic Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, P. van; Gielen, J.L.; Parizel, P.M. (Dept. of Radiology, Univ. Hospital Antwerp and Univ. of Antwerp, Antwerp (Belgium)) (and others)

    2009-11-15

    Background: Magnetic resonance (MR) arthrography is generally regarded as the gold standard for shoulder imaging. As an alternative to direct MR arthrography, the less invasive indirect MR arthrography technique was proposed, offering logistic advantages because fluoroscopic or ultrasonographic guidance for joint injection is not required. Purpose: To assess the diagnostic performance of indirect MR arthrography in the diagnosis of full- and partial-thickness supraspinatus tears in a symptomatic population. Material and Methods: Two radiologists with different levels of experience independently and retrospectively interpreted indirect MR (1.5T) arthrograms of the shoulder obtained in 67 symptomatic patients who underwent subsequent arthroscopy. On MR, the supraspinatus tendon was evaluated for full- or partial-thickness tear. With arthroscopy as the standard of reference, sensitivity, specificity, and diagnostic accuracy of indirect MR arthrography in the detection of full- and partial-thickness tears of the supraspinatus tendon was calculated. Kappa (kappa) statistics were used for the assessment of the agreement between arthroscopic and imaging findings and for the assessment of interobserver agreement. Results: For full-thickness tears of the supraspinatus tendon, sensitivities, specificities, and accuracies exceeded 90% for both observers, with excellent interobserver agreement (kappa = 0.910). For partial-thickness tears, sensitivities (38-50%) and accuracies (76-78%) were poor for both reviewers, and interobserver agreement was moderate (kappa = 0.491). Discrepancies between MR diagnosis and arthroscopy were predominantly observed with small partial-thickness tears. Conclusion: Indirect MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears. However, the diagnosis of partial-thickness tears with indirect MR arthrography remains faulty, because exact demarcation of degenerative change and partial rupture is difficult. On the

  1. 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。

  2. Clinical and arthroscopic findings in recreationally active patients

    Directory of Open Access Journals (Sweden)

    Fowler Elizabeth M

    2010-01-01

    Full Text Available Abstract Objective To examine the diagnostic accuracy of standard clinical tests for the shoulder in recreational athletes with activity related pain. Design Cohort study with index test of clinical examination and reference standard of arthroscopy. Setting Sports Medicine clinic in Sheffield, U.K. Participants 101 recreational athletes (82 male, 19 female; mean age 40.8 ± 14.6 years over a six year period. Interventions Bilateral evaluation of movements of the shoulder followed by standardized shoulder tests, formulation of clinical diagnosis and shoulder arthroscopy conducted by the same surgeon. Main Outcome Measurements Sensitivity, specificity, likelihood ratio for a positive test and over-all accuracy of clinical examination was examined retrospectively and compared with arthroscopy. Results Isolated pathology was rare, most patients (72% having more than one injury recorded. O'Brien's clinical test had a mediocre sensitivity (64% and over-all accuracy (54% for diagnosing SLAP lesions. Hawkins test and Jobe's test had the highest but still not impressive over-all accuracy (67% and sensitivity (67% for rotator cuff pathology respectively. External and internal impingement tests showed similar levels of accuracy. When a positive test was observed in one of a combination of shoulder tests used for diagnosing SLAP lesions or rotator cuff disease, sensitivity increased substantially whilst specificity decreased. Conclusions The diagnostic accuracy of isolated standard shoulder tests in recreational athletes was over-all very poor, potentially due to the majority of athletes (71% having concomitant shoulder injuries. Most likely, this means that many of these injuries are missed in general practice and treatment is therefore delayed. Clinical examination of the shoulder should involve a combination of clinical tests in order to identify likely intra articular pathology which may warrant referral to specialist for surgery.

  3. Localized form of pigmented villonodular synovitis of the knee: the meniscal mime.

    Science.gov (United States)

    Bouguennec, N; Meyer, A; Graveleau, N

    2014-04-01

    The localized form of pigmented villonodular synovitis of the knee is a rare condition with non-specific symptoms. This makes diagnosis especially difficult when the meniscus is affected. A full assessment with several imaging modalities can help support the preoperative diagnosis. But in the case reported here, the full clinical and paraclinical assessment (X-rays, CT arthrography and MRI) was wrong--the localized form of pigmented villonodular synovitis had mimicked a lateral meniscus injury and was only detected during arthroscopy. The lesion was excised surgically and the diagnosis was confirmed through postoperative histopathology.

  4. Synovial chondromatosis of the temporomandibular joint: a clinical, radiological and histological study.

    Science.gov (United States)

    Martín-Granizo, Rafael; Sánchez, Juan Jesús; Jorquera, Manuela; Ortega, Luis

    2005-01-01

    Synovial chondromatosis (SC) is a cartilaginous metaplasy of the mesenchymal remnants of the synovial tissue of the joints. It is characterized by the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). SC mainly affects to big synovial joints such as the knee and the elbow, being uncommon the onset within the TMJ, where 75 cases have been published. The main symptoms are pain, inflammation, limitation of the movements of the jaw and crepitation. Different methods of diagnosis include panoramic radiograph, CT, MR and arthroscopy of the TMJ. We report a new case of unilateral SC of the TMJ, including diagnostic images, treatment performed and histological analysis.

  5. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  6. Recurrent hemarthrosis in a boy with synovial hemangioma: a case report.

    Science.gov (United States)

    Lin, Heng-Kuei; Wang, Jiaan-Der; Fu, Lin-Shien

    2011-03-01

    We describe an unusual case of hemarthrosis caused by a synovial hemangioma in an 11-year-old boy. The initial presentations were sudden onset of spontaneous knee swelling and painful sensation accompanied by limitation of joint movement. The patient had a history of recurrent swelling with spontaneous remission over the same location in the past year. In addition, diffuse cutaneous hemangioma since infancy was also noted. Synovial involvement of a cutaneous hemangioma was confirmed by multidetector computed tomography and arthroscopy. The patient was started on oral corticosteroid and β-blocker. No recurrence was noted on multidetector computed tomographic images or clinical examination at the 2-month follow-up.

  7. Intra-articular nodular fasciitis of the knee: a rare cause of recurrent hemarthrosis.

    Science.gov (United States)

    Matsuzaki, Tokio; Akisue, Toshihiro; Kishimoto, Kenta; Kishimoto, Shin-ichiro; Imabori, Masaya; Hara, Hitomi; Okada, Yoshiyuki; Hitora, Toshiaki; Kuroda, Ryosuke; Kurosaka, Masahiro; Yamamoto, Tetsuji

    2012-06-01

    A 20-year-old man presented with pain and recurrent hemarthrosis in the right knee. Magnetic resonance imaging of the knee showed a lesion with homogeneous low signal intensity on T1-weighted images and a heterogeneous, low to high signal intensity on T2-weighted images. At arthroscopy, the mass was located between the posterior cruciate ligament and the posterior knee joint capsule. The tumor was excised through a posterior approach and histologically diagnosed as a nodular fasciitis. Intra-articular nodular fasciitis is a very rare clinicopathologic entity. The current case showed the unique clinical feature of recurrent hemarthrosis at initial presentation, which has not been previously reported.

  8. 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...

  9. [Is it possible to diagnose idiopathic chondropathia patellae using radiologic methods?].

    Science.gov (United States)

    Kaufmann, J; Langlotz, M

    1984-10-01

    In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

  10. Tension neuropathy of the superficial peroneal nerve: associated conditions and results of release.

    Science.gov (United States)

    Johnston, E C; Howell, S J

    1999-09-01

    We reviewed eight patients who sustained superficial peroneal nerve neuralgia after an inversion ankle sprain. Surgical exploration found anatomic abnormalities that tethered the nerve from movement during plantarflexion and inversion of the ankle. Most patients' pain improved dramatically after release and anterior transposition of the nerve. Seven joints also underwent arthroscopy, which showed intra-articular disease that was consistent with the original trauma. Five patients had reflex sympathetic dystrophy, three of which resolved after nerve release. Nerve conduction studies were not helpful. Careful physical examination and local nerve blocks were most important in making the diagnosis and prescribing treatment. All conservative measures should be exhausted before surgery is considered.

  11. Tratamento artroscópico da condromatose sinovial do ombro: relato de caso Arthroscopic treatment of synovial chondromatosis of the shoulder: a case report

    Directory of Open Access Journals (Sweden)

    Arildo Eustáquio Paim

    2008-04-01

    Full Text Available Os autores descrevem caso raro de condromatose sinovial do ombro e seu tratamento cirúrgico. A artroscopia possibilitou a visualização de todos os compartimentos da articulação glenoumeral, permitindo a remoção dos corpos livres e realização da sinovectomia.The authors describe a rare case of synovial chondromatosis of the shoulder and its surgical treatment. Arthroscopy enabled the visualization of all compartment of the glenohumeral joint, and allowed the removal of free bodies and the performance of a synovectomy.

  12. Usefulness of MR arthrography of the hip with leg traction in the evaluation of ligamentum teres injuries

    Energy Technology Data Exchange (ETDEWEB)

    Cerezal, Luis; Fernandez-Hernando, Moises [Department of Radiology, Diagnostico Medico Cantabria, Santander, Cantabria (Spain); Perez Carro, Luis [Learnig Trauma Med. Centro de Consultas Medicas CCM, Orthopedic Surgery department, Santander (Spain); Llorca, Javier [University of Cantabria - IDIVAL, Santander (Spain); CIBER Epidemiology and Public Health, Santander (Spain); Llopis, Eva [Alzira Hospital, Department of Radiology, Valencia (Spain); Montero, Juan Antonio [Cantabria University, Anatomy and Cell Biology, Santander (Spain); Canga, Ana [Cantabria University, Anatomy and Cell Biology, Santander (Spain); Department of Radiology Marques de Valdecilla University Hospital, Santander, Cantabria (Spain)

    2015-11-15

    To retrospectively evaluate the diagnostic accuracy of magnetic resonance (MR) arthrography of the hip with leg traction in the evaluation of ligamentum teres lesions and to evaluate whether there is increased articular distraction, possibly indicating secondary instability, in hips with ligamentum teres injuries. Institutional review board approval and informed consent were obtained for this retrospective study. MR arthrograms of the hip with leg traction of 184 consecutive patients, including 108 men (mean age, 32.6 years; range, 19-53 years) and 76 women (mean age, 38.5 years; range, 18-56 years), who underwent hip arthroscopy were assessed for the presence of ligamentum teres lesions. The MR arthrographic findings were independently assessed by two radiologists who were blinded to the arthroscopic results. The inclusion criteria stipulated no previous surgery, arthroscopy within 1 month after MR arthrography, and availability of a detailed surgical report with ligamentum teres findings. The arthroscopy findings served as the reference standard. Sensitivity, specificity, accuracy, and K statistics for interobserver and intraobserver agreement were calculated. At arthroscopy, 32 ligamentum teres injuries were found. The ligamentum teres was normal in 152 (82.6 %) patients and had suffered low-grade partial tears in 15 (8.1 %) patients, high-grade partial tears in 10 (5.4 %) patients, and complete ruptures in 7 (3.8 %) patients. MR arthrography with axial traction demonstrated moderate sensitivity and high specificity for both low-grade (62/93 %) and high-grade (66/96 %) partial tears. Grouping low- and high-grade partial tears increased the diagnostic performance of MR arthrography, yielding a sensitivity of 87 % and a specificity of 95 %. For complete ligamentum teres tears, MR arthrography with leg traction demonstrated high sensitivity (92 %) and specificity (98 %). Articular distraction was significantly increased in patients with complete ruptures of the

  13. Editorial Commentary: Ligamentum Teres Tears and Femoroacetabular Impingement: Complex Coexistence of Impingement and Instability.

    Science.gov (United States)

    Larson, Christopher M

    2016-07-01

    In a large Level IV case series of 2,213 hip arthroscopies with the diagnosis of femoroacetabular impingement, the intraoperative status of the ligamentum teres (LT) was recorded as normal in 11%, frayed and/or partially torn in 88%, and completely torn in 1.5% of hips. Although specific physical examination maneuvers for detecting LT tears were not available early in the study period, thus limiting a detailed assessment of such tests, the authors identified that female gender, a lower lateral center edge angle, a higher Tonnis angle, and capsular laxity were all associated with complete LT tears. This study further supports the complex coexistence of impingement and instability.

  14. 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...

  15. [Consequennce of nontreatment scapholunate instability of the wrist].

    Science.gov (United States)

    Pilný, J; Kubes, J; Hoza, P; Sprláková, A; Hart, R

    2006-12-01

    Authors evaluate the results of patients with acute rupture of the scapholunate (SL) ligament, demonstrated by arthroscopy, in this study. One group of patients was treated with reinsertion of SL ligament by the help of Mitek anchor. In the other group there were patients with diagnosed total rupture of SL ligament which rejected the reinsertion of the ligament. Authors evaluate results of both groups 24 months after the injury. On the basis of clinical and X-ray results, even after such short time, reasonably worse results for the group without performed reinsertion were determined. Even X-ray documented arthrotic changes of scapholunate advanced collapse (SLAC) type were present.

  16. Is it possible to diagnose idiopathic chondropathia of the patella by radiological methods

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, J.; Langlotz, M.

    1984-10-01

    In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

  17. Second-look arthroscopic evaluation of the articular cartilage after primary single-bundle and double-bundle anterior cruciate ligament reconstructions

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-jun; AO Ying-fang; CHEN Lian-xu; GONG Xi; WANG Yong-jian; MAYong; LEUNG Kevin; Kar Ming; YU Jia-kuo

    2011-01-01

    Background Several reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction.No report has been published about the cartilage comparing changes after single-bundle (SB) and double-bundle (DB) ACL reconstructions.The purpose of this study was to evaluate the articular cartilage changes after SB and DB ACL reconstructions by second-look arthroscopy.Methods Ninety-nine patients who received arthroscopic ACL reconstruction were retrospectively reviewed at an average of 14 months after reconstruction,58 patients underwent SB ACL reconstruction and 41 patients underwent DB ACL reconstruction.Hamstring tendon autografts were used in all patients.Second-look arthroscopy was done in conjunction with the tibial staple fixation removal at least one year after the initial ACL reconstruction.Arthroscopic evaluation and grading of the articular cartilage degeneration for all patients were performed at the initial ACL reconstruction,and at the second-look arthroscopy.Results The average cartilage degeneration at the patellofemoral joint (PFJ) was found significantly worsened after both SB and DB ACL reconstructions.This worsening were not seen at medial tibiofemoral joint (TFJ) and lateral TFJ.Grade Ⅱ cartilage damage was the most common.At second-look arthroscopy,the average patellar cartilage degeneration was 1.14±0.14 (at first look 0.52±0.11) for the SB group,and 1.22±0.15 (at first look 0.56±0.12) for the DB group.The average trochlear cartilage degeneration was 1.05±0.16 (at fist look 0.10±0.06) and 0.66±0.17 (at fist look 0.17±0.09),respectively.The average patellar cartilage degeneration showed no significant difference in both groups.However,the average trochlea cartilage degeneration in DB group was significantly less than in SB group.Conclusions Patellofemoral cartilage degeneration continued to aggravate after ACL reconstruction.DB ACL reconstruction could significantly decrease the trochlea

  18. 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.

  19. Septic arthritis of the temporomandibular joint: a case report.

    Science.gov (United States)

    Yang, Sung-Won; Cho, Jin-Yong; Kim, Hyeon-Min

    2016-08-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

  20. ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIE S

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    Saurabh

    2013-02-01

    Full Text Available ABSTRACT : MRI is an accurate, noninvasive imaging modality for evaluation of knee injuries, and determines the patient management, saving them f rom unnecessary arthroscopy. Our study focuses on the fundamental biomechanical forces und erlying the most common injuries and correlate MRI findings with specific traumatic mecha nisms. We conducted a retrospective study on 138 patients having prior history of knee trauma. The studies evaluated cruciate ligament tears, collateral ligament injuries, chondromalacia patella, bone marrow contusions, joint effusions, tendon tear, meniscal tear and osteoarth ritis.

  1. Peroneal spastic flatfoot in adolescents with accessory talar facet impingement: a preliminary report.

    Science.gov (United States)

    Niki, Hisateru; Aoki, Haruhito; Hirano, Takaaki; Akiyama, Yui; Fujiya, Hiroto

    2015-07-01

    This study analyzed imaging, arthroscopic findings, and treatment responses for peroneal spastic flatfoot (PSFF) caused by talocalcaneal impingement at the accessory anterolateral talar facet (AALTF) (accessory talar facet impingement) in 13 adolescents without histories of trauma and tarsal coalition. The AALTF was determined with computed tomography and MRI. Focal abutting bone marrow edema (FABME) on MRI around the AALTF was confirmed. In seven patients who underwent AALTF resection, subtalar arthroscopy was performed. All experienced alleviation PSFF after treatment; reduction in FABME was observed. AALTF resection alone is beneficial for PSFF caused by accessory talar facet impingement when peroneal spasms are restored by an injection of local anesthesia.

  2. SYNOVIAL GIANT CELL TUMOR OF THE KNEE.

    Science.gov (United States)

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2009-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection.

  3. Autogenous osteochondral graft transplantation for steroid-induced osteonecrosis of the femoral condyle: A report of three young patients

    Directory of Open Access Journals (Sweden)

    Fujita Norifumi

    2012-04-01

    Full Text Available Abstract Steroid-induced osteonecrosis of the femoral condyle is a relatively uncommon condition and is often difficult to select appropriate treatment especially in young patients. Three young men (aged 25, 18, and 24 presented with severe pain and dysfunction of the knee diagnosed as steroid-induced osteonecrosis of the femoral condyle by magnetic resonance imaging (MRIs. Full-thickness cartilage defects sized 20 × 10, 15 × 10, and 30 × 20 mm respectively were classified as International Cartilage Repair Society Grade IV lesions and treated with osteochondral autograft transplantation. They were treated successfully with osteochondral autograft transplantation certificated by post-operative MRI and second look arthroscopy.

  4. Imaging Evaluation of Superior Labral Anteroposterior (SLAP) Tears.

    Science.gov (United States)

    Grubin, Jeremy; Maderazo, Alex; Fitzpatrick, Darren

    2015-10-01

    Superior labral anteroposterior (SLAP) tears are common injuries that are best evaluated with magnetic resonance arthrography (MRA), as it provides the most detailed evaluation of the bicipital labral complex. Given the variety and complexity of SLAP tears, distention of the joint with intra-articular dilute gadolinium contrast properly separates the intra-articular biceps tendon, superior labrum, glenoid cartilage and glenohumeral ligaments to optimize assessment of these structures. This allows for increased diagnostic confidence of the interpreting radiologist and provides a better road map for the surgeon prior to arthroscopy. Indirect MRA and high-field magnetic resonance imaging are sensitive and specific alternative modalities if MRA cannot be performed.

  5. Absence of sensory function in the reconstructed anterior cruciate ligament

    DEFF Research Database (Denmark)

    Krogsgaard, Michael R; Fischer-Rasmussen, Torsten; Dyhre-Poulsen, Poul

    2011-01-01

    Cruciate ligaments provide sensory information that cause excitatory as well as inhibitory effects to the activity of the muscles around the knee. The aim of the study was to determine whether these muscular reflexes are reestablished after anterior cruciate ligament (ACL) re-construction. Wire...... electrodes were inserted during arthroscopy into the normal posterior cruciate ligament (PCL) and the reconstructed ACL in 11 patients who had a successful ACL re-construction 8 months to 12 years earlier. After the anesthesia had subsided, the PCL was stimulated electrically through the electrodes...

  6. [Bilateral calcifying tendinitis of the long tendon of the biceps associated with a SLAP lesion].

    Science.gov (United States)

    Mayayo Sinués, Esteban; Soriano Guillén, Antonia Pilar; Vela Marín, Ana Carmen; Martínez Pérez, Belén

    2010-01-01

    Calcifying tendinitis is a common disorder related to deposition of hidroxyapatite crystals, which is most common around the shoulder joint, involving the supraespinosus tendon. It can however, affect almost any tendon at its insertion. Clinical features are variable and include pain and inflammation that often resolves spontaneously. We present a case of bilateral calcifying tendinitis of the long head of the biceps tendon at its insertion on the superior glenoid rim associated with superior labrum antero-posterior tears (SLAP) confirmed by arthroscopy. Calcium deposits were surgically removed and the SLAP lesions were repaired.

  7. Displaced Medial and Lateral Bucket Handle Meniscal Tears With Intact ACL and PCL.

    Science.gov (United States)

    Boody, Barrett S; Omar, Imran M; Hill, James A

    2015-08-01

    Bucket handle lesions are vertical longitudinal tears in the meniscus that may displace centrally into the respective medial or lateral compartment, frequently causing mechanical symptoms, including pain, perceived instability, and mechanical locking. Bucket handle meniscal tears are most commonly from a traumatic etiology and are frequently found with concomitant anterior cruciate ligament (ACL) injuries. Multiple imaging signs and associations have been described for the diagnosis of bucket handle meniscus tears, including coronal truncation, absent bow tie sign, double posterior cruciate ligament (PCL), double ACL, displacement of the bucket handle fragment, and disproportionate posterior horn signs. Among meniscal pathology encountered on magnetic resonance imaging or during arthroscopy, bucket handle meniscal tears are infrequent occurrences. Furthermore, the occurrence of displaced medial and lateral bucket handle tears found on imaging and during arthroscopy is very uncommon and is only sparsely reported in the literature. When displaced medial and lateral bucket handle meniscal segments are visualized within the intercondylar notch along with the ACL and PCL, the radiologic findings are referred to as the "quadruple cruciate" sign or the "Jack and Jill lesion." Of the few case reports described in the literature, only one noted displaced medial and lateral bucket handle meniscus tears with an intact ACL and PCL. The current case report outlines a similar rare case of the quadruple cruciate sign: displaced medial and lateral bucket handle meniscal tears located within the intercondylar notch and an intact ACL and PCL.

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

    Science.gov (United States)

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

    2005-01-01

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

  9. Pre-Osteoarthritis

    Science.gov (United States)

    Brittberg, Mats; Eriksson, Karl; Jurvelin, Jukka S.; Lindahl, Anders; Marlovits, Stefan; Möller, Per; Richardson, James B.; Steinwachs, Matthias; Zenobi-Wong, Marcy

    2015-01-01

    Objective An attempt to define pre-osteoarthritis (OA) versus early OA and definitive osteoarthritis. Methods A group of specialists in the field of cartilage science and treatment was formed to consider the nature of OA onset and its possible diagnosis. Results Late-stage OA, necessitating total joint replacement, is the end stage of a biological process, with many previous earlier stages. Early-stage OA has been defined and involves structural changes identified by arthroscopy or radiography. The group argued that before the “early-stage OA” there must exist a stage where cellular processes, due to the presence of risk factors, have kicked into action but have not yet resulted in structural changes. The group suggested that this stage could be called “pre-osteoarthritis” (pre-OA). Conclusions The group suggests that defining points of initiation for OA in the knee could be defined, for example, by traumatic episodes or surgical meniscectomy. Such events may set in motion metabolic processes that could be diagnosed by modern MRI protocols or arthroscopy including probing techniques before structural changes of early OA have developed. Preventive measures should preferably be applied at this pre-OA stage in order to stop the projected OA “epidemic.” PMID:26175861

  10. 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

  11. Visualization of torn anterior cruciate ligament using 3-dimensional computed tomography

    Directory of Open Access Journals (Sweden)

    Hiroaki Uozumi

    2013-07-01

    Full Text Available Recently, a remnant-preserving anterior cruciate ligament (ACL reconstruction technique has been developed. However, the pre-operative condition of remnant ACL is occasionally difficult to evaluate by magnetic resonance imaging. The purpose of this study is to evaluate the accuracy of pre-operative visualization of remnant ACL using three-dimensional computed tomography (3D-CT. The remnant ACL in 25 patients was examined by 3D-CT before ACL reconstruction surgery. Findings on 3D-CT images and arthroscopy were compared. The 3D-CT images were classified into 4 groups: Group A, remnant fibers attached to the posterior cruciate ligament (PCL; Group B, those located between the PCL and the lateral wall; Group C, those attached to the lateral wall; and Group D, no identifiable remnant fibers on the tibial side. These groups were made up of 4, 3, 9 and 9 patients, respectively. Findings on 3D-CT images were identical to those during arthroscopy in 20 of 25 cases (80%. Remnant ACL can be accurately evaluated using 3D-CT in 80% of cases of torn ACL. This novel method is a useful technique for pre-operative assessment of remnant ACL.

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

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-09-01

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

  13. MDCT arthrography of the wrist: 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; Pogliacomi, Francesco [Orthopaedics, Traumatology and Functional Rehabilitation Unit, Department of Surgical Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Bertellini, Annalisa [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci, 14, 43100 Parma (Italy); Araoz, Philip A. [Department of Radiology, Division of Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States); Averna, Raffaele; Sverzellati, Nicola; Ingegnoli, Anna [Department of Clinical Sciences, Section of Radiological Sciences, University of Parma, Parma Hospital, Via Gramsci, 14, 43100 Parma (Italy); Corradi, Maurizio; Costantino, Cosimo [Orthopaedics, Traumatology and Functional Rehabilitation Unit, Department of Surgical Sciences, University of Parma, Parma Hospital, Via Gramsci 14, 43100 Parma (Italy); Zompatori, Maurizio [Department of Radiological and Histopathological Sciences, Policlinic S.Orsola-Malpighi, University of Bologna, Via Massarenti 9, 40138 Bologna (Italy)

    2010-04-15

    Purpose: To evaluate the diagnostic accuracy and indications of arthrography with Multidetector Computed Tomography (arthro-MDCT) of the wrist in patients with absolute or relative contraindications to magnetic resonance imaging (MRI) studies 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, 43 wrists in patients of both genders (18 females, 25 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. Fifteen patients had prior wrist surgery. The patients had arthralgia, degenerative and traumatic arthropathies as well as limited range of motion, but no radiologically detected fractures. 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 and operated wrists the comparison between arthro-MDCT and arthroscopy showed sensitivity, specificity and accuracy ranging between 92% and 94% for triangular fibrocartilage complex (TFCC), between 80% and 100% for intrinsic ligaments located within the proximal carpal compartment, and between 94% and 100% for articular cartilage. Inter-observer agreement between two radiologists, in the evaluation of all types of lesions, was almost perfect (k = 0.96) and statistically significant (p < 0.05). Conclusions: Arthro-MDCT of the wrist provides an accurate diagnosis to identify chondral, fibrocartilaginous and intra-articular ligament lesions in patients who cannot be evaluated by MRI, and in post-surgical patients.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

  15. Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation

    Directory of Open Access Journals (Sweden)

    Niels Hammer

    2017-01-01

    Full Text Available Introduction. The triangular fibrocartilage complex (TFCC provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT, 3 T magnetic resonance imaging (MRI, and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B. Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach’s usefulness as a diagnostic tool.

  16. Study of the Artroscopic Anatomy of the Knee in Canine Cadavers Using 2.4 Mm Diameter Lens

    Directory of Open Access Journals (Sweden)

    Gabriel Oswaldo Alonso Cuéllar

    2013-05-01

    Full Text Available Mainly by a limited access to new techniques and technologies, veterinary medicine in developing countries, has been far behind from the human medicine. One of the causes is the limited access to technology and specific techniques. Moreover, it is clear that many new technologies have proven their benefits in the two disciplines, making necessary and almost mandatory their massive implementation in humans and animals. The possibility to use human elements for veterinary techniques would improve the technology access and veterinarians training, at lower costs. The purpose of this study is to verify the feasibility to perform a knee arthroscopy in dogs with small human joints arthroscopic lenses. Under protocols established in veterinary 12 knee arthroscopies were performed in canine cadaver, using a wrist and ankle arthroscope human of 2.4 mm in diameter and 30° of angulation. All the structures reported in the literature were possible to visualize using a 2.4 mm arthroscope. In this sense, it is possible to develop training activities and subsequent implementation of endoscopic techniques in canine femorotibiopatellar joint, using a lens of small joints of human medicine.

  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. Microinstability of the hip: a previously unrecognized pathology

    Science.gov (United States)

    Bolia, Ioanna; Chahla, Jorge; Locks, Renato; Briggs, Karen; Philippon, Marc J.

    2016-01-01

    Summary Background Hip microinstability is an established diagnosis; however, its occurrence is still debated by many physicians. Diagnosis of hip microinstability is often challenging, due to a lack of specific signs or symptoms, and patients may remain undiagnosed for long periods. This may lead to early manifestation of degenerative joint disease. Consequently, careful patient and family history must be obtained and diagnostic imaging should follow. After a thorough clinical evaluation of the patient with suspected hip microinstability, the physician should focus on how to improve symptoms and functionality in daily and sports activities. Purpose The purpose of this review article was to give a current update regarding this diagnosis and to provide a complete diagnostic approach in order to effectively treat hip microinstability. Methods We reviewed the literature on the diagnosis, the non-operative and operative indications for the treatment of this complex and often misdiagnosed pathology. Conclusion Conservative treatment is considered the best initial approach, though, surgical intervention should be considered if symptoms persist or other hip pathology exists. Successful surgical intervention, such as hip arthroscopy, should focus on restoring the normal anatomy of the hip joint in order to regain its functionality. The role of the hip joint capsule has gained particular research interest during the last years, and its repair or reconstruction during hip arthroscopy is considered necessary in order to avoid iatrogenic hip microinstability. Various capsular closure/plication techniques have been developed towards this direction with encouraging results. Level of evidence V. PMID:28066740

  19. Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts: sixty cases with 2 years' minimum follow-up.

    Science.gov (United States)

    Nín, J R; Leyes, M; Schweitzer, D

    1996-01-01

    A prospective study was performed on 101 patients who underwent an arthroscopic anterior cruciate ligament (ACL) reconstruction with fresh-frozen patellar tendon allograft (bone-patellar tendon-bone). We present the results of the first 60 patients with a minimum follow-up of 2 years. Thirty-four were men and 26 women with a mean age of 23. In 45 patients, a postoperative arthroscopy was performed, and tissue biopsies of the reconstructed ACL were obtained. Patients were evaluated according to the International Knee Documentation Committee evaluation form. After a mean follow-up of 47 months, the overall results were normal or nearly normal in 85%. Under postoperative arthroscopy, the macroscopic appearance of the implant was similar to that of a normal ligament. The ACL allograft was covered with a normal, well-vascularized synovium. There were no cases of infection, disease transmission or tissue rejection. We conclude that the use of fresh-frozen patellar tendon allografts is a good method of ACL reconstruction.

  20. A CLINICAL STUDY ON FUNCTIONAL OUTCOME AFTER COMBINED ARTHROSCOPIC AND FLUOROSCOPIC ASSISTED REDUCTION AND INTERNAL FIXATION OF CLOSED TIBIAL PLATEAU FRACTURES IN ADULTS

    Directory of Open Access Journals (Sweden)

    Bhavani Prasad

    2015-06-01

    Full Text Available BACKGROUND AND INTRODUCTION: Management of tibial plateau fractures had witnessed tremendous improvement in surgical techniques over the past decades. Conservative treatment of these fractures results in consistently poor results. The present literature supports that absolute anatomi cal reduction and stable fixation of peri articular fractures followed by early post - operative rehabilitation is crucial for good results. And if this is achieved by minimal damage to soft tissue the results are much better. In this study it is achieved by arthroscopy and fluoroscopy. MATERIALS AND METHODS: We have conducted a prospective study between September 2009 to august 2013 including 9 patients with tibial plateau fractures treated with combined arthroscopic and fluoroscopic reduction and internal f ixation with or without bone grafting. And then the radiographic and functional evaluation done. RESULTS: According to Hohl’s clinical and radiographic scoring systems 4 patients were assessed excellent, 3 good, 2 fair. According to Rasmussen’s clinical sc oring system 4 patients excellent, 3 good and 2 fair results. CONCLUSION: The use of arthroscopy and fluoroscopy in the management of tibial plateau fractures results in good outcome. It also helped to simultaneously treat the meniscal injuries. But its use is mainly limited to Shatzkar type1, 2, 3, 4

  1. 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.].

  2. Magnetic resonance imaging for the diagnosis of chondral, meniscal and cruciate ligaments injuries of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Karam, Francisco Consoli; Fridmann, Marcos William; Arbo, Rodrigo Di Mare; Vieira, Jose Francisco [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Faculty of Medicine]. E-mail: franciscokaram@terra.com.br; Silva, Jefferson Luis Braga da; Pires, Luiz Antonio Simoes [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Faculty of Medicine. Hospital Sao Lucas; Abreu, Armando; Abreu, Marcelo [Hospital Mae de Deus, Porto Alegre, RS (Brazil). Servico de Radiologia

    2007-05-15

    Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) of the knee. Materials and methods: Seventy-two patients have been submitted to MRI previously to arthroscopy of the knee performed by a single surgeon and utilized as a comparative standard method. Sensitivity, specificity, values of likelihood and rate of interobserver agreement have been evaluated. Results: The kappa agreement coefficient between MRI and arthroscopy was very good for lesions in the anterior cruciate ligament (0.84), good for lateral meniscus (0.75), reasonable for medial meniscus (0.50) and poor for chondral lesions (< 0.50). MRI has demonstrated high sensitivity for tears in the anterior cruciate ligament (94%) and in the medial meniscus (92%), good sensitivity for lesions in the lateral meniscus (80%), and low sensitivity for lesions in all of the chondral zones (< 50%), while the specificity has been excellent for all the chondral, and ligamentous structures, besides the lateral menisci analyzed (more than 97%), and reasonable (65%) for the medial meniscus. Conclusion: MRI is an useful tool in the clinical diagnosis of intra-articular knee lesions, as already demonstrated by similar results reported both in the Brazilian and international literature. (author)

  3. MRI diagnosis of ACL bundle tears: value of oblique axial imaging

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    Ng, Alex W.H.; Griffith, James F.; Hung, Esther H.Y. [Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China); Law, Kan Yip; Yung, Patrick S.H. [Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR (China)

    2013-02-15

    To investigate the diagnostic accuracy of oblique axial intermediate weighting MR imaging in detecting partial thickness anterior cruciate ligament (ACL) bundle tears. The study protocol was approved by the institutional ethics committee. Sixty-one subjects (43 male, 18 female; mean age 27.4 years; range 9 to 57 years) with clinically suspected ACL tear or meniscal tear between September 2009 and January 2011 were studied with MRI and arthroscopy. Detection of partial tear for the ACL as a whole and for each ACL bundle by protocol A (standard orthogonal sequences) and protocol B (standard orthogonal sequences plus oblique axial intermediate weighted imaging) was compared in a blinded fashion. Performance characteristics for protocol A and protocol B were compared using sensitivity, specificity, accuracy and ROC curves. A two-tailed p value of <0.05 indicated statistical significance. Fifteen (24.6%) normal, 15 (24.6%) partial and 31 complete tears were diagnosed by arthroscopy. Sensitivity, specificity and accuracy of protocol A for the diagnosis of partial tear of the ACL was 33%, 87% and 74%, while for protocol B the values were 87%, 87% and 87% respectively. The area under the curve (AUC) for the diagnosis of partial ACL tear and individual bundle tear was higher for protocol B, although this difference did not reach statistical significance (p > 0.05). The addition of oblique axial imaging to standard MR imaging improves diagnostic accuracy for detecting partial tears of the ACL as well as individual bundle tears of the ACL. (orig.)

  4. Inter- and intraobserver variability of MR arthrography in the detection and classification of superior labral anterior posterior (SLAP) lesions: evaluation in 78 cases with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Holzapfel, Konstantin; Waldt, Simone; Bruegel, Melanie; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Paul, Jochen; Imhoff, Andreas B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Klinikum rechts der Isar, Munich (Germany); Heinrich, Petra [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany)

    2010-03-15

    The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers for the presence and type of SLAP lesions. MR arthrograms were reviewed twice by each reader with a time interval of 4 months between the two readings. Inter- and intraobserver agreement for detection and classification of SLAP lesions were calculated using {kappa} coefficients. Arthroscopy confirmed 48 SLAP lesions: type I (n = 4), type II (n = 37), type III (n = 3), type IV (n = 4). Sensitivity and specificity for detecting SLAP lesions with MR arthrography for each reader were 88.6%/93.3%, 90.9%/80.0% and 86.4%/76.7%. MR arthrographic and arthroscopic grading were concurrent for 72.7%, 68.2% and 70.5% of SLAP lesions for readers 1-3, respectively. Interobserver agreement was excellent ({kappa} = 0.82) for detection and substantial ({kappa} = 0.63) for classification of SLAP lesions. For each reader intraobserver agreement was excellent for detection ({kappa} = 0.93, {kappa} = 0.97, {kappa} = 0.97) and classification ({kappa} = 0.94, {kappa} = 0.84, {kappa} = 0.93) of SLAP lesions. MR arthrography allows reliable and accurate detection of SLAP lesions. In addition, SLAP lesions can be diagnosed and classified with substantial to excellent inter- and intraobserver agreement. (orig.)

  5. MRI in definition of bleeding source, lesion pattern and therapy in haemarthros of the knee; Die MRT beim Haemarthros des Kniegelenks: Bestimmung von Blutungsursachen, Verletzungsmustern und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Bachmann, G. [Abt. Diagnostische Radiologie, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Juergensen, I. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Leier, S. [Orthopaedische Klinik, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany); Rauber, K. [Abt. Diagnostische Radiologie, Klinikum der Justus-Liebig-Universitaet, Giessen (Germany)

    1996-09-01

    Patients with haemarthros of the knee were examined by MRI and arthroscopy to identify the bleeding source and to determine surgical or conservative therapy. A prospective study was performed on 120 patients who underwent MRI and arthroscopy, point lesions and bleeding sources were documented separately on a standardised form. Arthroscopy demonstrated a ruptured anterior cruciate ligament in 86%, meniscal tears in 55%, disruption of collateral ligaments in 17%, osteochondral lesions in 5% and tears of capsule or plicae in 13%. Disruption of cruciate ligaments caused haemorrhage in all but three cases. In contrast, only meniscal tears located very adjacent to the meniscal basement had bled. Those types of osteochondral lesions caused haemorrhage characterised on MRI by destruction of the subchondral plate and overlying cartilage. Severe lesions of the knee were diagnosed by MRI in 71% to 100%, slight lesions in 13% to 40% of the cases. Single, combined and bland lesions were accurately diagnosed in MRI which permitted a correct prediction of surgical and conservative therapy in 96% and 80%. Morphological criteria in MRI permit identification of bleeding sources in haemarthros of the knee. Different lesion patterns can be separated for the planning of therapy. (orig.) [Deutsch] Bei gesichertem Haemarthros des Knies wurde geprueft, ob mit der MRT Angaben zur Blutungsursache moeglich sind und die relevanten Verletzungsmuster fuer die folgende konservative oder operative Therapie exakt beschrieben werden koennen. In einer prospektiven Studie wurden 120 Patienten mit akutem Haemarthros des Knies nacheinander mit der MRT und der Arthroskopie untersucht. Alle Laesionen und Blutungsquellen wurden getrennt fuer beide Methoden auf standardisierten Erhebungsboegen fuer die Arthroskopie registriert. Arthroskopisch wurden Rupturen der vorderen Kreuzbaender in 86%, Meniskusrisse in 55%, Rupturen der Kollateralbaender in 17%, subchondrale Laesionen in 5% und Kapsel- bzw

  6. BIOLOGIC JOINT RECONSTRUCTION: ALTERNATIVES TO ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Brian J. Cole

    2009-06-01

    Full Text Available A comprehensive source of information in the management of cartilage lesions of major joints using nonoperative or surgical techniques other than total joint replacement. The text also includes chapters in basic sciences, imaging and rehabilitation.The editors are aiming to provide a reference about the latest concepts and techniques in the treatment of cartilage lesions including future aspects by a comprehensive approach to the alternative joint restoration procedures such as biological, pharmacological and surgical techniques of cartilage repairing and partial resurfacing etc.Orthopedic surgeons in sports medicine, orthopedic surgeons performing joint replacements, orthopedic resident and fellows will be the main audiences.The text is 349 pages, divided into 34 chapters in 7 sections. Section I is "Background-articular cartilage and allograft processing" including chapters about pathology, patient evaluation, imaging and allograft processing. Section II is "Nonoperative treatment" including chapters about neutraceuticals, pharmacological treatment and rehabilitation. Section III is "Operative treatment-knee" including chapters about arthroscopic debridment, microfracture, osteochondral autograft transplantation, mosaicplasty, osteochondral autograft transfer, osteochondral allografts, autologous chondrocyte implantation, existing cell-based technologies, minimally invasive second-generation autologous chondrocyte implantation, future development in cartilage repair, meniscus transplantation, management of OCD, patellafemoral chondral disease, proximal tibial and distal femoral osteotomies, unicompartmental arthritis current techniques, unicompartmental knee replacement. Section IV is "Operative treatment-Hip" including chapters about hip arthroscopy and arthroscopic partial resurfacing, related osteotomies. Section V is "operative treatment-shoulder" including chapters about arthroscopic debridment and release, biologic resurfacing and

  7. Efficacy of diagnostic magnetic resonance imaging for articular cartilage lesions of the glenohumeral joint in patients with instability

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, Meredith L.; Collins, Mark S.; Wenger, Doris E. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Morgan, Joseph A.; Dahm, Diane L. [Mayo Clinic, Department of Orthopaedic Surgery, Rochester, MN (United States)

    2010-12-15

    The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions. A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy. Mean patient age was 27.0 {+-} 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89). Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non

  8. 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

  9. Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

    Energy Technology Data Exchange (ETDEWEB)

    Gans, Itai; Ganley, Theodore J. [The Children' s Hospital of Philadelphia, Division of Orthopaedics, 34th and Civic Center Boulevard, Philadelphia, PA (United States); Bedoya, Maria A.; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-08-31

    Diagnosis of intra-articular lesions in children based on clinical examination and MRI is particularly challenging. To evaluate the diagnostic performance of MRI and pre-surgical evaluation of the knee in pediatric patients relative to arthroscopic evaluation as the gold standard. We report diagnoses frequently missed or inaccurately diagnosed pre-operatively. We conducted a retrospective review of MRI and pre-surgical evaluation in children and adolescents ages 1-17 years who were treated by knee arthroscopy during a 21/2-year period. All MRIs were reviewed by a pediatric radiologist blinded to clinical findings. Pediatric orthopedic clinic notes were reviewed for pre-surgical evaluation (based on physical exam, radiograph, MR images and radiologist's MRI report). Arthroscopic findings were used as the gold standard. We calculated the percentages of diagnoses at arthroscopy missed on both MRI and pre-surgical evaluation. Diagnostic accuracy between children and adolescents and in patients with one pathological lesion vs. those with >1 lesion was analyzed. We performed a second review of MR images of the missed or over-called MRI diagnoses with knowledge of arthroscopic findings. We included 178 children and adolescents. The most common diagnoses missed on MRI or pre-surgical evaluation but found at arthroscopy were: discoid meniscus (8/30, or 26.7% of cases); lateral meniscal tears (15/80, or 18.8% of cases); intra-articular loose bodies (5/36, or 13.9% of cases), and osteochondral injuries (9/73, or 12.3% of cases). Overall diagnostic accuracy of MRI and pre-surgical evaluation was 92.7% and 95.3%, respectively. No significant difference in diagnostic accuracy between children and adolescents was observed. When multiple intra-articular lesions were present, lateral meniscal tears were more likely to be inaccurately diagnosed (missed or over-called) on both MRI (P = 0.009) and pre-surgical evaluation (P < 0.001). Overall diagnostic accuracy of MRI and pre

  10. 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...

  11. [Management of the meniscal lesion].

    Science.gov (United States)

    Baillon, B; Cermak, K; Vancabeke, M

    2011-01-01

    About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.

  12. Diagnostic value of high-resolution CT and MR compared with standard procedures in meniscal tears

    Energy Technology Data Exchange (ETDEWEB)

    Schuler, M.; Naegele, M.; Lienemann, A.; Muench, O.; Siuda, S.; Hahn, D.; Lissner, J.

    1987-04-01

    The knees of 20 patients with evidence of meniscal tears were examined via high-resolution computed tomography (HRCT); 10 of these were studied by MRI. The HRCT study was performed directly after double-contrast arthrography (AG). For comparison with HRCT, slice orientation for MRI examination was in transverse view; gradient echo sequences using the FISP technique were applied instead of spin echo sequences. All results were correlated to the arthroscopy (AS) findings. In 95% of the cases AG and AS results agreed, HRCT/AS in 85% and MRI/AS in 70%. In certain cases HRCT provided additional information which influenced appropriate surgical treament. MRI is a noninvasive nonionising method but gives a less exact documentation of the lesion than AG and HRCT. The gradient echo mode is superior to the SE mode in respect of outlining meniscal structures, at least in transverse view.

  13. Jacob's disease associated with temporomandibular joint dysfunction: a case report.

    Science.gov (United States)

    Capote, Ana; Rodríguez, Francisco J; Blasco, Ana; Muñoz, Mario F

    2005-01-01

    Jacob's disease is regarded a rare condition in which a joint formation is established between an enlarged mandibular coronoid process and the inner aspect of the zygomatic body. Chronic temporomandibular joint (TMJ) disk displacement has been proposed as etiological factor of coronoid process enlargement. We present a 23-year-old woman with long-standing TMJ dysfunction and restricted interincisal opening, who developed a progressive zygomatic asymmetry. The patient underwent treatment by intraoral coronoidectomy and homolateral TMJ arthroscopy in the same surgery. The histopathological diagnosis of the coronoid sample was cartilage-capped exostoses with presence of articular fibrous cartilage. Although the low prevalence of this entity, it should be considered as a possible diagnosis in patients with progressive limitation of mouth opening, although a TMJ syndrome may be present as a cause of this entity.

  14. 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.

  15. Arthroscopic Fixation for Tibial Eminence Fracture in Non-absorbable Arthrex Sutures Passing Through%关节镜下Arthrex线十字交叉法治疗胫骨髁间棘撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    李贝; 杨康胜; 严志强; 刘伟; 詹铁军; 陈海强; 叶团飞

    2015-01-01

    目的:探讨关节镜下Arthrex线四股双线四骨道十字交叉法治疗胫骨髁间棘撕脱骨折的手术方法和疗效。方法对21例胫骨髁间棘骨折患者行关节镜下复位,利用前交叉韧带胫骨定位器在骨床或骨块上准确确定钻孔位置,Arthrex编织缝线四股双线十字交叉法横穿前交叉韧带基底并经骨床或骨块上的钻孔及骨隧道引出关节外打结、固定。结果21例病例均得到随访,平均随访时间1年10个月,骨折愈合良好,未出现关节反复肿胀及交锁等机械症状,膝关节功能基本恢复至伤前运动水平,未出现其他并发症。结论关节镜下四股双线四骨道十字交叉法治疗胫骨髁间前棘骨折是一种安全、有效的术式。%Objective To evaluate the technique and clinical effects of the treatment of tibial intercondylar eminence frac-ture by the means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through four bone tunnels under arthroscopy. Methods Total 21cases of tibial intercondylar eminence fractures were treated under arthroscopy. By the use of ACL-aimer,the bone tunnels of the tibial or bone block were produced accurately. With the arthroscopy,the avul-sion fracture were fixed by making two lines and four strands of non-absorbable Arthrex sutures cross the basalpart of anterior cruciate ligament and pass through the bone tunnels of the tibial or bone block,pulling out the sutures through those tunnels and fix them outside the joint. Results All of the 21 patients were followed up( mean 18 months). Bone healing was satisfac-tory in all cases. There were no complications. Knee function was adequately restored to preinjury sportive level in all patients. Conclusion The means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through four bone tunnels under arthroscopy is safe and effective to treat the tibial intercondylar eminence fracture.

  16. [The appearances of chondropathia patellae on plain films (author's transl)].

    Science.gov (United States)

    Schumacher, K A; Glöckler, W T; Mutschler, W; Rittmeyer, K

    1979-12-01

    The ability to diagnose chondropathia patellae on plain radiographs was studied in 64 patients in whom the disease had been confirmed either by operation or arthroscopy. All cases of stage III chondropathia were diagnosable by radiological examination; in stage I, 67%, and in stage II, 73% could be diagnosed. The diagnosis depends on the co-existence of marginal irregularities, irregularities of the subchondral bone lamellae, spotty diffuse demineralisation, marginal osteophytes, irregularities at the insertion of the quadriceps tendon and soft tissue changes such as joint effusions. These changes are best identified on the so-called "defilée" view. Disalignment of the axis of the patella and post-traumatic defects are of particular importance for the development of chondropathia, but in the present clinical material, the existence of dysplasia of the patella or of the femoral condyle was not associated with a demonstrable increase of chondromalacia.

  17. Imaging methods for knee-joint diagnostics. Bildgebende Verfahren zur Diagnostik von Kniegelenksverletzungen und -erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Haller, W. (Klinikum rechts der Isar, Muenchen (Germany, F.R.). Orthopaedische Klinik und Poliklinik); Lehner, K. (Klinikum rechts der Isar, Muenchen (Germany, F.R.). Inst. fuer Roentgendiagnostik)

    1989-06-01

    Imaging methods are essential tools for orthopedic diagnostics. For examination of knee-joint disorder, X-ray radiography in four planes is a standard task. Special diagnostic methods are available and can be selected according to the case, and sonography is a method very likely to gain significance. In case of suspected fracture, conventional tomography is the method of choice, although arthroscopy is discussed in this context as a primary examination. CT or NMR imaging are indicated for evaluation of tumors near the knee joint, and latest results show that magnetic resonance tomography is useful for examination of the cruciate ligaments or the cartilage, and CT for imaging of the menisci. CT assisted arthrography for sliding path and cartilage analysis already is an established method for diagnostic evaluation of the chondropathia patellae. (orig./MG).

  18. [Traumatic chondropathia patellae, its significance for medical insurance in expert testimony concerning accident sequellae therapy].

    Science.gov (United States)

    Mbaruk, A

    1980-04-01

    The connection between chondropathia patellae and a trauma is discussed. Apart from direct traumas the indirect ones can also cause a chondropathia patellae as a result of the incongruence in the femoropatellar joint. In compiling the case history a preceding trauma of different forms and intensity can be found out in about 17 per cent out of all chondropathia patellae patients. When giving an expert's opinion on a case of chondromalacia sport and occupational lesions must be differentiated from genuine traumatic chondropathy. A chondropathia patellae is characterized by the above-mentioned patellar syndrome. The arthroscopy is considered the most reliable diagnostic method. The indication for operative treatment must take into consideration both the degree of the chondropathia patellae and the cause of the disorder.

  19. Repair of large full-thickness cartilage defect by activating endogenous peripheral blood stem cells and autologous periosteum flap transplantation combined with patellofemoral realignment.

    Science.gov (United States)

    Fu, Wei-Li; Ao, Ying-Fang; Ke, Xiao-Yan; Zheng, Zhuo-Zhao; Gong, Xi; Jiang, Dong; Yu, Jia-Kuo

    2014-03-01

    Minimal-invasive procedure and one-step surgery offer autologous mesenchymal stem cells derived from peripheral blood (PB-MSCs) a promising prospective in the field of cartilage regeneration. We report a case of a 19-year-old male athlete of kickboxing with ICRS grade IV chondral lesions at the 60° region of lateral femoral trochlea, which was repaired by activating endogenous PB-MSCs plus autologous periosteum flap transplantation combined with correcting the patellofemoral malalignment. After a 7.5 year follow-up, the result showed that the patient returned to competitive kickboxing. Second-look under arthroscopy showed a smooth surface at 8 months postoperation. The IKDC 2000 subjective score, Lysholm score and Tegner score were 95, 98 and 9 respectively at the final follow up. CT and MRI evaluations showed a significant improvement compared with those of pre-operation.

  20. Arthroscopic Classification of the Lesions of the Dorsal Capsulo-Scapholunate Septum (DCSS) of the Wrist.

    Science.gov (United States)

    Van Overstraeten, Luc; Camus, Emmanuel J

    2016-09-01

    The dorsal capsulo-scapholunate septum (DCSS) is an anatomic structure linking the scapholunate ligament and the dorsal capsule of the wrist. It should be a predynamic scapholunate stabilizer. The authors, using their experience for the extrinsic ligaments testing, suggest an arthroscopic testing of the DCSS. The status could be graded in 4 stages according to the trampoline aspect and to the fiber attachment. They report a preliminary study on a series of 53 arthroscopies made between January 2014 and December 2015 with evaluation of scapholunate ligament instability and DCSS laxity. There is a significant correlation between the lesional stage of the DCSS and the arthroscopic predynamic scapholunate instability stage (P<0.01).

  1. MRI features in de Quervain`s tenosynovitis of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Glajchen, N. [Mount Sinai Hospital, New York, NY (United States). Dept. of Radiology; Schweitzer, M. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1996-01-01

    De Quervain`s stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain`s synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain`s disease. De Quervain`s tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  2. 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.

  3. Bilateral Atraumatic Avascular Necrosis of Both the Humeral and Femoral Heads due to the Corticosteroid Usage

    Directory of Open Access Journals (Sweden)

    Okkes Bilal

    2013-08-01

    Full Text Available Avascular necrosis is frequently associated with femoral head involvement and may also be observed in the knee joint, humeral head, wrist and foot. Avascular necrosis may also affect multiple joints. Bilateral involvement of both humeral and femoral heads is a rare condition in the same patient. A patient who complained about a sustained pain in both of his shoulders and hips for a few years applied to our outpatient clinic. The patient who had oral steroid treatment episodically was diagnosed with ulcerative colitis seven years ago. Arthroscopy-assisted decompression to the shoulder joints and core decompression to both hip joints were applied. The range of motions of both humeral and femoral joints was limited and painful prior to the surgical treatment. A follow-up after five years later showed that the patient's range of motions of joints was normal and no further treatment was necessary. [Arch Clin Exp Surg 2013; 2(4.000: 246-250

  4. Osteonecrosis in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Poeschl, M.

    1981-12-01

    The following forms are discussed: spontaneous osteonecrosis (Ahlbaeck's necrosis), which extends subchondrally into one of the femur condyles. It usually occurs in older patients, especially females. Blunt trauma may cause similar lesions. These often occur with cartilage and bone avulsions (flake fractures), which are often diagnosed much later (arthroscopy). Patellar chondropathy is increasing in frequency due to more intensive participation in sports. Pain localized at the apex of the patella (patellar apex syndrome) can develop from chondropathy, tendon lesions or primary juvenile necrosis of the patellar apex. Gas emboli occur near the knee joint during deep sea diving. Similar cartilage infarctions are seen in many hemoglobinopathies. The incidence of this is increasing due to the increased number of people immigrating from regions where these diseases are common. We have also observed vascular juvenile lesions of the epi- and metaphyses in Klippel-Trenaunay-Weber's syndrome. Their radiological appearance is similar to that of necroses.

  5. Techniques and results for open hip preservation

    Directory of Open Access Journals (Sweden)

    David eLevy

    2015-12-01

    Full Text Available While hip arthroscopy grows in popularity, there are still many circumstances under which open hip preservation is most appropriately indicated. This article specifically reviews open hip preservation procedures for a variety of hip conditions. Femoral acetabular impingement may be corrected using an open surgical hip dislocation. Acetabular dysplasia may be corrected using a periacetabular osteotomy. Acetabular protrusio may require surgical hip dislocation with rim trimming and a possible valgus intertrochanteric osteotomy. Legg-Calve ́-Perthes disease produces complex deformities that may be better served with osteotomies of the proximal femur and/ or acetabulum. Chronic slipped capital femoral epiphysis (SCFE may also benefit from a surgical hip dislocation and/or proximal femoral osteotomy.

  6. Endoscopic low coherence interferometry in upper airways

    Science.gov (United States)

    Delacrétaz, Yves; Boss, Daniel; Lang, Florian; Depeursinge, Christian

    2009-07-01

    We introduce Endoscopic Low Coherence Interferometry to obtain topology of upper airways through commonly used rigid endoscopes. Quantitative dimensioning of upper airways pathologies is crucial to provide maximum health recovery chances, for example in order to choose the correct stent to treat endoluminal obstructing pathologies. Our device is fully compatible with procedures used in day-to-day examinations and can potentially be brought to bedside. Besides this, the approach described here can be almost straightforwardly adapted to other endoscopy-related field of interest, such as gastroscopy and arthroscopy. The principle of the method is first exposed, then filtering procedure used to extract the depth information is described. Finally, demonstration of the method ability to operate on biological samples is assessed through measurements on ex-vivo pork bronchi.

  7. Actinomyces meyeri Popliteal Cyst Infection and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Bharath Raj Palraj

    2017-01-01

    Full Text Available A 66-year-old, Caucasian male presented with pain and swelling involving the left knee of one-week duration. Arthrocentesis was negative for evidence of septic arthritis. Magnetic resonance imaging (MRI study of the left knee showed degenerative arthritis, partial tear of medial meniscus, and a complex fluid collection along the posteromedial aspect of the left knee suggestive of popliteal cyst. He underwent arthroscopy with partial medial meniscectomy. Intraoperative joint fluid was noted to be cloudy but cultures were negative. Arthroscopic procedure provided him with temporary relief but the pain and swelling in the posterior aspect of the left knee recurred in 6 weeks. Repeat MRI showed complex fluid collection in the posterolateral aspect of left knee. Ultrasound guided aspiration of the fluid collection revealed purulent material and cultures grew Actinomyces meyeri. He was treated with 6 weeks of intravenous penicillin regimen followed by 18 months of oral penicillin.

  8. [Scapholunate lesions and instabilities--how to recognize and treat them?].

    Science.gov (United States)

    Papaloïzos, Michaël

    2015-06-03

    The lesions of the scapholunate ligament are some of the most frequently encountered in the wrist. Left untreated, the complete rupture of the ligament is followed by degenerative arthritis according to a well-defined pattern of progression through the wrist, eventually leading to multifocal arthrosis, a condition described as scapholunate advanced collapse (SLAC wrist). The scapholunate lesions are classified in stages according to the degree of the lesion established by imaging studies or arthroscopy and to the chronicity of the lesion. Both together essentially determine the healing potential and the prognosis, which rapidly decrease after six weeks from the initial trauma, thus indicating the importance of recognizing the acute or subacute lesion and directing the patient to the hand surgeon early enough. The therapeutic options are notably reduced and often of palliative nature in case of chronic lesions with secondary changes in the wrist mechanics or cartilage damage.

  9. Comparison of an alcohol-based hand rub and water-based chlorhexidine gluconate scrub technique for hand antisepsis prior to elective surgery in horses

    Science.gov (United States)

    da Silveira, Eduardo Almeida; Bubeck, Kirstin A.; Batista, Edisleidy Rodriguez; Piat, Perrine; Laverty, Sheila; Beauchamp, Guy; Archambault, Marie; Elce, Yvonne

    2016-01-01

    This prospective clinical study evaluates the effectiveness of an alcohol-based hand rub (Avagard™) for pre-surgical hand antisepsis in an equine hospital and compares it with traditional scrubbing technique using 4% chlorhexidine gluconate sponges and water. Prior to elective surgery, 3 board-certified surgeons were randomly assigned to hand antisepsis with either technique. Culture samples of each hand were taken at 4 times: before and after neutral soap hand wash, after scrub or rubbing technique, and after surgery. There was no significant difference in mean bacterial colony forming units between scrub and rub techniques over the 3 time periods (P = 0.6), controlling for initial counts. One horse from the scrub group had a skin incision infection following stifle arthroscopy; this was resolved with medical treatment. The alcohol-based hand rub is equivalent in efficacy for pre-surgical hand antisepsis to traditional water-based scrubs in an equine hospital setting. PMID:26834268

  10. Comparative study between the Spin-echo and 3-D fast imaging techniques in the Knee evaluation with magnetic resonance. Estudio comparativo entre las tecnicas de Spin-Eco ecogradiente 3D, en la evaluacion de la rodilla con resonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Oleaga Zufiria, L.; Ibaez Zubiarrain, A.; Grande Icaran, J.; Vela Martin, A.C.; Cintora Leon, E.; Grau Garcia, M.; Grande Icaran, D. (Hospital Civil de Bilbao. Servicio de Radiodiagnostico. Bilbao (Spain))

    1993-01-01

    We have carried out a retrospective analysis of the results of magnetic resonance (MR) studies in 20 patients, comparing two different sequences. We compared a 2-D spin-echo (SE2D) sequence with a 3-D fast imaging with steady-state precession (FISP3D) sequence in the attempt to compare the reliability of each in the detection of knee injuries. Arthroscopy was employed as a control technique. Our study revealed no statistically significant difference between the two sequences, although the overall sensitivity for the detection of meniscal lesions was slightly greater with the FISP3D sequence; however, the reliability in the detection of ruptures of the posterior cruciate ligament is less with this sequence than with the SE2D sequence. Both sequences showed very low sensitivity in the detection of hyaline cartilage injuries. (Author) 14 refs.

  11. MR for assessing anterior cruciate ligament reconstructions by tendon grafts. Die Kernspintomographie zur Beurteilung des vorderen Kreuzbandersatzes mit Sehnentransplantaten

    Energy Technology Data Exchange (ETDEWEB)

    Allgayer, B.; Lehner, K.; Gewalt, Y. (Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Roentgendiagnostik); Gradinger, R.; Flock, K. (Klinikum rechts der Isar, Muenchen (Germany). Orthopaedische Klinik und Poliklinik)

    1991-10-01

    150 patients were examined via magnetic resonance (MR) after anterior cruciate (ACL) ligament reconstruction (76 patellar tendon grafts, 53 semitendinosous tendon grafts and 21 sutures). The results of MR were compared with clinical tests (Lachman, pivot-shift and anterior drawer test), in 2 cases with the operative findings, and in one case with arthroscopy findings. In 91% of patients with a clinically stable knee we found a continuous low-intensity ligamental structure. 10 patients were examined twice or more between 8 days and 6 months after surgery. Ligamental structures of low signal intensity did not significantly change their MR characteristics. MR is a valuable noninvasive method for evaluating ligament reconstructions. (orig./GDG).

  12. Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique

    Energy Technology Data Exchange (ETDEWEB)

    Autz, G.; Singson, R.D. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Radiology); Goodwin, C. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Orthopedics)

    1991-11-01

    The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well-defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. (orig.).

  13. [Idiopathic facial pain. Part 2: Treatment and prognosis].

    Science.gov (United States)

    Reher, P; Harris, M

    1998-01-01

    The present paper introduces a new concept in the physiopathology and treatment of the called "temporomandibular disfunction". This paper was divided into two parts, the first explained the definition, etiology and hypothesis of the idiopathic facial pain. In this second part, its treatment, prognosis and recommendations are explained. The treatment consists basically in counselling, and, in a second stage, the use of tricylic antidepressants or similar drugs is used. Occlusal devices are some times used, but have been of less value. Arthroscopy can be used in resistant patients, and surgery is usually not indicated. The present management is based on a working model developed in this department and in other world centres, and is revolutionising the clinical management of the patients with idiopathic facial pain.

  14. CLINICAL DIAGNOSIS OF SUBSCAPULARIS TENDON TEAR USING THE BEAR HUG SEMIOLOGICAL MANEUVER

    Science.gov (United States)

    Schiefer, Márcio; Júnior, Yonder Archanjo Ching-San; Silva, Sérgio Maurício; Fontenelle, César; Dias Carvalho, Marcos Genúncio; de Faria, Fabio Garcia; Franco, José Sérgio

    2015-01-01

    Objective: To evaluate the Bear Hug maneuver for clinically diagnosing subscapularis tendon tears, and compare this with other maneuvers described previously (Lift-off, Napoleon and Belly Press). Methods: Forty-nine patients with rotator cuff injuries who had undergone arthroscopy to repair the injury and had previously been assessed using the semiological maneuvers mentioned above were evaluated. Results: The diagnostic values obtained for the Bear Hug test were as follows: sensitivity 75%, specificity 56%, positive predictive value 62%, negative predictive value 70% and accuracy 65%. Conclusion: The highest sensitivity and negative predictive value values were obtained with the Bear Hug test. The highest specificity value was seen with the Lift-off test. The Belly press test gave the greatest specificity, positive predictive and accuracy values. PMID:27047870

  15. Diagnostic imaging of the hand. 3. rev. and enl. ed.; Bildgebende Diagnostik der Hand

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Rainer [Herz und Gefaessklinik GmbH, Bad Neustadt (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lanz, Ulrich

    2015-07-01

    The book on diagnostic imaging of the hand covers the following issues: projection radiography, cinematography, MRT and CR arthrography, arthroscopy, arteriography, skeleton scintiscanning, sonography, computerized tomography, magnetic resonance tomography, anatomy of forearm and carpus, anatomy of metacarpus and fingers, carpal function and morphometry, postoperative X-ray diagnostic, growing hand skeleton, normative variants, malformations and deformities, trauma of the distal forearm, lesions of the ulnocarpal complex (TFCC), scaphoid fractures, scaphoid arthrosis, fractures of other carpus bones, carpal luxations and luxation fractures, carpal instabilities, fractures of the metacarpalla, finger fractures, arthrosis deformans, enthesiopathies, sport induced soft tissue lesions, osteonecrosis, impingement syndromes, osteopenic skeletal diseases, metabolis diseases, crystal-induced osteoarthropaties, rheumatoid arthritis, spondyloarthritis, rheumatic fever, collagenoses, infective arthritis, osteomyelitis, soft tissue infections, cystoids bone lesions, skeletal tumors, soft tissue tumors, carpal tunnel syndrome, nerve compression syndrome, arterial perfusion disturbances, differential diagnostic tables on hand lesions.

  16. Anteriorly positioned ulnar nerve at the elbow: a rare anatomical event: case report.

    Science.gov (United States)

    Satteson, Ellen S; Li, Zhongyu

    2015-05-01

    Two patients with an anteriorly positioned ulnar nerve at the elbow, identified during cubital tunnel release, are presented. Upon encountering an empty cubital tunnel, additional dissection found the ulnar nerve to course posterior to and to penetrate through the intermuscular septum 3 to 5 cm proximal to the medial epicondyle. It then ran anterior to the pronator-flexor mass before entering the forearm between the ulnar and the humeral heads of the flexor carpi ulnaris. Although a rare anatomical anomaly, an anteriorly positioned ulnar nerve is potentially an underreported finding. In individuals with cubital tunnel syndrome, diagnosis and surgical treatment may be negatively affected if the surgeon fails to recognize the aberrant anatomy. Upper extremity surgeons should also be mindful of this rare anomaly when performing elbow arthroscopy or medial epicondyle release to prevent inadvertent injury to the nerve.

  17. 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.

  18. TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS BY MEANS OF THEARTHROSCOPY-ASSISTED MICROPERFORATION TECHNIQUE

    Science.gov (United States)

    de Lima, Everton; de Queiroz, Felipe; Lopes, Osmar Valadão; Spinelli, Leandro de Freitas

    2015-01-01

    Objective: To evaluate patients affected by osteochondral fractures of the talus who were treated surgically by means of arthroscopy-assisted microperforation. Methods: A retrospective study was carried out on 24 patients with osteochondral lesions of the talus who underwent microperforation assisted by videoarthroscopy of the ankle. They were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score system before and after the operation. Results: There were 19 men and 5 women, with a mean age of 35.3 years (minimum of 17 years and maximum of 54 years). The minimum follow-up was two years (maximum of 39 months). All the patients showed an improvement in AOFAS score after surgery, with an average improvement of around 22.5 points. Conclusion: Videoarthroscopy-assisted microperforation is a good option for treating osteochondral lesions of the talus and provides good functional results. PMID:27027076

  19. Hip Arthroscopic Osteochondral Autologous Transplantation for Treating Osteochondritis Dissecans of the Femoral Head.

    Science.gov (United States)

    Kubo, Takanori; Utsunomiya, Hajime; Watanuki, Makoto; Hayashi, Hidetoshi; Sakai, Akinori; Uchida, Soshi

    2015-12-01

    Osteochondritis dissecans (OCD) of the femoral head is not a common source of hip pain. Hip arthroscopy is becoming a more frequent indication for intra-articular pathologies of the hip. Osteochondral autologous transplantation is a promising technique that theoretically can reconstruct osteochondral lesions of the femoral head. We describe our technique for arthroscopic antegrade osteochondral autologous transplantation for the treatment of OCD of the femoral head. The advantages of this technique include that it is a less invasive method with the ability to assess and treat intra-articular pathologies associated with OCD of the femoral head at same time. Case series and outcomes after this technique are not currently reported in the literature; however, it could be a less invasive method and provide favorable clinical outcomes for patients with OCD lesions of the femoral head.

  20. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

    2005-07-01

    To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

  1. Comparison of an alcohol-based hand rub and water-based chlorhexidine gluconate scrub technique for hand antisepsis prior to elective surgery in horses.

    Science.gov (United States)

    da Silveira, Eduardo Almeida; Bubeck, Kirstin A; Batista, Edisleidy Rodriguez; Piat, Perrine; Laverty, Sheila; Beauchamp, Guy; Archambault, Marie; Elce, Yvonne

    2016-02-01

    This prospective clinical study evaluates the effectiveness of an alcohol-based hand rub (Avagard™) for pre-surgical hand antisepsis in an equine hospital and compares it with traditional scrubbing technique using 4% chlorhexidine gluconate sponges and water. Prior to elective surgery, 3 board-certified surgeons were randomly assigned to hand antisepsis with either technique. Culture samples of each hand were taken at 4 times: before and after neutral soap hand wash, after scrub or rubbing technique, and after surgery. There was no significant difference in mean bacterial colony forming units between scrub and rub techniques over the 3 time periods (P = 0.6), controlling for initial counts. One horse from the scrub group had a skin incision infection following stifle arthroscopy; this was resolved with medical treatment. The alcohol-based hand rub is equivalent in efficacy for pre-surgical hand antisepsis to traditional water-based scrubs in an equine hospital setting.

  2. 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...

  3. Rotura em "alça de balde" simultânea dos meniscos no mesmo joelho Simultaneous "bucket-handle" tear of both menisci on the same knee

    Directory of Open Access Journals (Sweden)

    Andre Francisco Gomes

    2009-01-01

    Full Text Available Rotura em "alça de balde" de ambos os meniscos do mesmo joelho é um fenômeno raro. Apresentamos o caso de um paciente em que a ressonância magnética demonstrou rotura em "alça de balde" dos meniscos medial e lateral do mesmo joelho, associada a rotura do ligamento cruzado anterior, confirmado por videoartroscopia. A ressonância magnética demonstra sinais que permitem o diagnóstico preciso.Simultaneous "bucket-handle" tear of menisci on the same knee is a rare phenomenon. We describe a case of a bucket-handle tear of menisci and tear of anterior cruciate ligament of the same knee showed on magnetic resonance imaging and confirmed by arthroscopy. The magnetic resonance imaging can provide accurate diagnosis of this type of injury.

  4. Extra-articular hip impingement: a narrative review of the literature

    Science.gov (United States)

    Cheatham, Scott W.

    2016-01-01

    There is growing subgroup of patients with poor outcomes after hip arthroscopy for intra-articular pathology suggesting unrecognized cause(s) of impingement may exist. Extra-articular hip impingement (EHI) is an emerging group of conditions that have been associated with intra-articular causes of impingement and may be an unrecognized source of pain. EHI is caused by abnormal contact between the extra-articular regions of the proximal femur and pelvis. This review discusses the most common forms for EHI including: central iliopsoas impingement, subspine impingement, ischiofemoral impingement, and greater trochanteric-pelvic impingement. The clinical presentation of each pathology will be discussed since EHI conditions share similar clinical features as the intra-articular pathology but also contain some unique characteristics. PMID:27069266

  5. Acute phase response to surgery of varying intensity in horses

    DEFF Research Database (Denmark)

    Jacobsen, Stine; Nielsen, Jon Vedding; Kjelgaard-Hansen, Mads

    2009-01-01

    OBJECTIVE: To evaluate the postoperative inflammatory response of horses to elective surgery of varying intensity. STUDY DESIGN: Prospective longitudinal study. ANIMALS: Horses referred to 2 hospitals for either arthroscopic removal of a unilateral osteochondritic lesion in the tibiotarsal joint...... (minimal surgical trauma, n=11), correction of recurrent laryngeal neuropathy by laryngoplasty and ventriculectomy (intermediate surgical trauma, n=10) or removal of an ovarian tumor by laparotomy (major surgical trauma, n=5). METHODS: Horses had a thorough clinical examination every day. White blood cell....... RESULTS: Postoperative concentrations of SAA and fibrinogen were significantly higher in horses that had laparotomy and ovariectomy than in horses that had laryngoplasty and ventriculectomy, or arthroscopy. Iron concentrations decreased to lower levels after intermediate and major surgical trauma than...

  6. Health technology assessment of magnetic resonance imaging of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Huysse, W.C.J. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Wouter.huysse@ugent.be; Verstraete, K.L. [Department of Radiology, Ghent University, De Pintelaan 185, B-9000 Gent (Belgium)], E-mail: Koenraad.verstraete@ugent.be

    2008-02-15

    A search of the available literature was performed and the role of MR imaging of the knee is discussed. Based on this search the authors concluded that MR has a high sensitivity in detecting any abnormalities in the knee but it does not have the same diagnostic accuracy as a clinical investigation performed by a trained knee specialist when all knee injuries are taken together. It does lead to a decrease in the number of surgical interventions due to its high negative predictive value. For the detection of meniscal injury, MR has the same accuracy as arthroscopy and should be performed in order to avoid unnecessary surgical interventions. A negative MR also obviates further investigation in suspected cartilage damage. This is not true for anterior and posterior cruciate ligament problems where MRI is less accurate than clinical investigation.

  7. Imaging of superior labral anterior to posterior (SLAP) tears of the shoulder.

    Science.gov (United States)

    Simoni, P; Scarciolla, L; Kreutz, J; Meunier, B; Beomonte Zobel, B

    2012-12-01

    Superior labral anterior to posterior (SLAP) tears include a number of abnormal changes of the superior glenoid labrum. SLAP tears have been first reported in elite young atlete and are caused by repetitive overhead motion or by a fall on an outstretched arm. SLAP can lead to chronic pain and instability of shoulder. A diagnosis of SLAP may be difficult on the basis of clinical tests. Hence, modern imaging, including computed tomography arthrography (CTA), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) play a key role in the diagnosis of SLAP. The large number of normal anatomic variants of the superior labrum and the surrounding structures make the interpretation of SLAP challenging on imaging and at arthroscopy. In this article the imaging of SLAP are discussed in detail along with relevant anatomy, anatomic variants and biomechanics.

  8. The state of the vegetative nervous system in patients with gonarthrosis for surgical treatment before and after surgical treatment

    Directory of Open Access Journals (Sweden)

    Karaseva T.lu.

    2012-12-01

    Full Text Available Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I, tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II, treatment-and-diagnostic arthroscopy (Group III. Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered <1.0, its values were >10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion <10.0%, thereby reflecting organism»s energy deficiency state. Conclusion. Preoperative examination. When VLF proportion after orthotest is registered <10.0%, such patients should be referred to risk group and prescribed in-depth examination. The index of centralization (1С dynamics for orthotest (1С test/1С rest is one of the criteria of functional recovery level for the particular patient: its increase points to the positive dynamics of restorative rehabilitative process, and the values <1.0 —to the negative one.

  9. Are surgical scrubbing and pre-operative disinfection of the skin in orthopaedic surgery reliable?

    Science.gov (United States)

    Salvi, M; Chelo, C; Caputo, F; Conte, M; Fontana, C; Peddis, G; Velluti, C

    2006-01-01

    This study attempts to establish the actual effectiveness of pre-surgical disinfection of the patient and surgeon's hands. We evaluated bacterial density and composition on the skin of 15 patients undergoing knee arthroscopy and the left hand of two surgeons after standard disinfection with povidone-iodine. Three samples were taken after the first 6-min scrub in the first surgical operation from the periungual space of the 1 degrees finger, from the interdigital space between the 2 degrees and 3 degrees fingers and from the transverse palmar crest of the left hand of two surgeons for seven consecutive surgical sessions, for a total of 42 samples, and two samples from the pre-patellar skin and from the popliteal skin of 15 patients undergoing knee arthroscopy, for a total of 30 samples. Pre-surgical handwashing and disinfection procedures were identical in each case. Pre-surgical disinfection of the patient's skin with povidone-iodine was shown to be completely effective, with 100% of samples negative. Samples taken from the interdigital space and the palmar crest (100% of samples negative) demonstrated the efficacy of disinfection of the surgeon's hands with povidone-iodine, while the periungual space was contaminated in 50% of the samples. The bacterial strains isolated belong to the staphylococcus genus in 100% of the cases, with pathogenic strains in 29.6% of the cases. Standard pre-surgical disinfection of skin in areas easily accessible to the disinfectant is sufficient in itself to guarantee thorough sanitization. Standard scrubbing of the surgeon's hands is insufficient in eliminating bacterial contamination, including pathogenic germs, in the periungual space, where it is probably difficult for the disinfectant to come into contact with the skin.

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

    Directory of Open Access Journals (Sweden)

    David Kovacevic

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

  11. Long head of the biceps brachii tendon: unenhanced MRI versus direct MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Tadros, Anthony S.; Huang, Brady K. [University of California, Department of Radiology, San Diego, CA (United States); Wymore, Lucas; Hoenecke, Heinz; Fronek, Jan [Scripps Clinic, Department of Orthopedic Surgery, La Jolla, CA (United States); Chang, Eric Y. [VA San Diego Healthcare System, Radiology Service, San Diego, CA (United States); University of California, Department of Radiology, San Diego, CA (United States)

    2015-09-15

    We sought to determine the diagnostic accuracy of unenhanced MRI and direct MR arthrography (MRA) for evaluation of the intra-articular long head of the biceps brachii tendon (LHBT) using arthroscopy as the gold standard. A retrospective review of patients who underwent shoulder MRI (n = 132) and MRA (n = 67) within 12 months prior to arthroscopy was performed. MR images were independently reviewed by two blinded musculoskeletal radiologists. Routinely recorded arthroscopic photos/videos were reviewed by an orthopedic surgeon. The LHBT was graded as normal, tendinosis, partial thickness tear less or greater than 50 %, and complete tear. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for tendinosis and tear detection were calculated. MRI correctly diagnosed fewer normal LHBTs compared to MRA (39-54 % versus 74-84 %, respectively; p < 0.005). MRI and MRA did not differ significantly in the diagnosis of tendinosis (18-36 % and 15-38 %, respectively; p > 0.05) and tears (75-83 % and 64-73 %, respectively; p > 0.05). For tendinosis, MRI versus MRA showed 18-36 % and 15-38 % sensitivity, 69-79 % and 83-91 % specificity, 22-28 % and 18-50 % PPV, 74-76 % and 80-86 % NPV, and 61-64 % and 70-81 % accuracy; respectively. For tears, MRI versus MRA showed 75-83 % and 64-73 % sensitivity, 73-75 % and 82-91 % specificity, 66-69 % and 41-62 % PPV, 82-87 % and 92-94 % NPV, and 74-78 % and 79-88 % accuracy; respectively. No significant difference was found between unenhanced MRI and direct MRA for the detection of tendinosis and tears of LHBTs. (orig.)

  12. Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation: comparison with single- and double-bundle reconstruction.

    Science.gov (United States)

    Nakamae, A; Ochi, M; Deie, M; Adachi, N; Shibuya, H; Ohkawa, S; Hirata, K

    2014-10-01

    We report the clinical outcome and findings at second-look arthroscopy of 216 patients (mean age 25 years (11 to 58)) who underwent anterior cruciate ligament (ACL) reconstruction or augmentation. There were 73 single-bundle ACL augmentations (44 female, 29 male), 82 double-bundle ACL reconstructions (35 female, 47 male), and 61 single-bundle ACL reconstructions (34 female, 27 male). In 94 of the 216 patients, proprioceptive function of the knee was evaluated before and 12 months after surgery using the threshold to detect passive motion test. Second-look arthroscopy showed significantly better synovial coverage of the graft in the augmentation group (good: 60 (82%), fair: 10 (14%), poor: 3 (4%)) than in the other groups (p = 0.039). The mean side-to-side difference measured with a KT-2000 arthrometer was 0.4 mm (-3.3 to 2.9) in the augmentation group, 0.9 mm (-3.2 to 3.5) in the double-bundle group, and 1.3 mm (-2.7 to 3.9) in the single-bundle group: the result differed significantly between the augmentation and single-bundle groups (p = 0 .013). No significant difference in the Lysholm score or pivot-shift test was seen between the three groups (p = 0.09 and 0.65, respectively). In patients with good synovial coverage, three of the four measurements used revealed significant improvement in proprioceptive function (p = 0.177, 0.020, 0.034, and 0.026). We conclude that ACL augmentation is a reasonable treatment option for patients with favourable ACL remnants.

  13. MR imaging characteristics and clinical symptoms related to displaced meniscal flap tears

    Energy Technology Data Exchange (ETDEWEB)

    Lance, Valentin; Heilmeier, Ursula R.; Joseph, Gabby B.; Steinbach, Lynne; Link, Thomas M. [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Ma, Benjamin [University of California, Department of Orthopedic Surgery and Sports Medicine, San Francisco (United States)

    2014-11-16

    The purpose of our study was (1) to analyze the flap tear location, direction of displacement and size on magnetic resonance (MR) imaging, (2) to describe associated knee abnormalities including presence of effusion, synovitis, bone marrow edema pattern or ligamentous tear, and (3) to assess clinical findings found with flap tears, including the pain score, and determine differences between operative and nonoperative groups. A retrospective radiology database search over the last 3 years identified 238 patients with flap tears, of which ultimately 58 with isolated flap tears were included after exclusion of patients with other significant knee internal derangement, severe degenerative change or prior surgery. MR studies of the knee were analyzed by two radiologists. Imaging characteristics were correlated with associated knee abnormalities and clinical findings. Statistical analysis employed linear and logistic regression models. Inter- and intrareader reliability was calculated. The medial meniscus was the most common site of flap tears (52/60, 87 %), with inferior displacement (47/60, 78 %). The degree of tibial cartilage loss had a positive correlation with the visual analog pain scale (p = 0.03). Patients who underwent arthroscopy were younger than those who did not (p = 0.01) and more likely to have a positive clinical McMurray test (p = 0.01). Medially and inferiorly displaced flap tears are the most common tear pattern. Those undergoing arthroscopy are more likely to have positive meniscal signs on clinical examination. A greater degree of cartilage loss involving the tibia on MR imaging was associated with increasing visual analog pain scores. (orig.)

  14. The role of extrinsic ligaments in maintaining carpal stability - A prospective statistical analysis of 85 arthroscopic cases.

    Science.gov (United States)

    Van Overstraeten, Luc; Camus, Emmanuel J

    2016-02-01

    Several biomechanical studies have shown that the scapholunate (SL) and lunotriquetral (LT) ligaments are not the only stabilizers of the proximal carpal row. However, no study has yet analyzed the range of ligament lesions leading to instability in vivo. Arthroscopy has been used to assess the condition of the wrist's extrinsic ligaments by palpating and tensioning the various ligament and capsule structures. In this prospective study, this arthroscopic method was used in 85 cases of wrist sprain without static instability to evaluate the correlation between lesions of the intrinsic and extrinsic carpal ligaments and carpal instability. In SL instability, a scapholunate interosseous ligament (SLIL) lesion was statistically correlated with lesions of the long radiolunate ligament (P<0.05). There also was a statistically significant correlation between lesions of the SLIL and the radioscaphocapitate, scaphotrapezial and dorsal intercarpal ligaments. There was a correlation between the stage of SL instability and the number of lax extrinsic ligaments (P<0.05) but not with the severity of the extrinsic ligament lesions. In LT instability, a LT interosseous ligament lesion was statistically correlated with lesions of the dorsal intercarpal ligament (P<0.05). There also was a correlation between the stage of LT instability and the number (P<0.005) and severity (P<0.001) of the extrinsic ligament lesions. Arthroscopy can reveal hidden radiographic instability and can also be used to define the number and severity of injured ligaments. In carpal instability, a lesion of one intrinsic carpal ligament was associated with a lesion of one or more extrinsic ligaments.

  15. Hip and Knee Osteoarthritis Affects Younger People, Too.

    Science.gov (United States)

    Ackerman, Ilana N; Kemp, Joanne L; Crossley, Kay M; Culvenor, Adam G; Hinman, Rana S

    2017-02-01

    Synopsis Although osteoarthritis (OA) has traditionally been considered a disease of older age, hip and knee OA can and does affect younger adults, with a profound impact on psychosocial well-being and work capacity. Obesity and a history of traumatic knee injury (eg, anterior cruciate ligament rupture and/or meniscal tear) are key risk factors for the accelerated development of knee OA, while structural hip deformities (including those contributing to femoroacetabular impingement syndrome) are strong predictors of early-onset hip OA. In view of these associations, rising rates of obesity and sports injuries are concerning, and may signal a future surge in OA incidence among younger people. Assessment of hip and knee OA in younger people should focus on a patient-centered history, comprehensive physical examination, performance-based measures, and patient-reported outcome measures to enable monitoring of symptoms and function over time. Referral for imaging should be reserved for people presenting with atypical signs or symptoms that may indicate diagnoses other than OA. Nonpharmacological approaches are core strategies for the management of hip and knee OA in younger people, and these include appropriate disease-related education, activity modification (including for work-related tasks), physical therapist- prescribed exercise programs to address identified physical impairments, and weight control or weight loss. High-quality evidence has shown no benefit of arthroscopy for knee OA, and there are no published clinical trials to support the use of hip arthroscopy for OA. Referral for joint-conserving or joint replacement surgery should be considered when nonpharmacological and pharmacological management strategies are no longer effective. J Orthop Sports Phys Ther 2017;47(2):67-79. doi:10.2519/jospt.2017.7286.

  16. 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.

  17. Septic arthritis in 15 standardbred racehorses after intra-articular injection.

    Science.gov (United States)

    Lapointe, J M; Laverty, S; Lavoie, J P

    1992-11-01

    Case histories, results of synovial fluid analyses, treatment regimens and outcome are described for 15 adult Standardbred horses with confirmed post-injection septic arthritis. Joint sepsis followed injection of corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anaesthetic. The median interval from injection to appearance of clinical signs was 2.5 days, and median interval from injection to referral was 9 days. The median initial synovial leucocyte count on admission was 57 x 10(9)/litre, but there was a wide range of values (18-258 x 10(9)/litre). The median synovial neutrophil percentage was 95% (77-99%). All bacterial isolates were Gram-positive cocci, 86% of which were staphylococci. All treated horses (12/15) initially received broad-spectrum parenteral antibiotic therapy, and the articulations of all horses except one were lavaged, either with non-surgical through-and-through techniques only (N = 3), or surgically with arthrotomy (N = 1) or arthroscopy (N = 7). The owners of all treated horses were contacted and racing records were consulted. Eleven of 12 horses returned to racing. Outcome was judged as either satisfactory (3/12) if the horse had returned to racing levels similar to or better than before treatment, or unsatisfactory (9/12) if the horse had poorer performance or could not return to racing. The 3 horses with satisfactory follow-up had been treated with arthroscopy and post-surgical closed suction drainage. The results of bacterial cultures suggest that the initial antimicrobial agents used should be effective against penicillin-resistant staphylococci.

  18. Influência do ligamento da cabeça do fêmur na mecânica do quadril Influence of the femoral head ligament on hip mechanical function

    Directory of Open Access Journals (Sweden)

    Marco Kawamura Demange

    2007-01-01

    Full Text Available Investigamos a influência do ligamento da cabeça do fêmur no arco de movimento de flexão-extensão e de adução-abdução do quadril. Para isso foram realizadas medidas em 7 quadris de cadáveres humanos, inicialmente com os ligamentos íntegros; posteriormente com a artroscopia e a seguir com os ligamentos seccionados também através de técnica artroscópica. Foi utilizado para isso um dispositivo elaborado para se medir o arco de movimento submetido a um torque de 2,5 N.m . Foi observado aumento com significância estatística no arco de abdução-adução às custas de adução. Concluímos que o ligamento da cabeça do fêmur influi limitando a adução do quadril.The authors investigated the femoral head ligament at hip flexion-extension and adduction-abduction ranges of motion. Seven human cadavers' hips were measured, initially with intact ligaments, and, subsequently, through arthroscopy, and then with sectioned ligaments also by means of arthroscopy. A specifically prepared device was used for measuring the range of motion which was submitted to a 2.5 N.m torque. An increased abduction-adduction range of motion was observed, which was statistically significant. We concluded that the femoral head ligament restricts hip adduction.

  19. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Waldt, S.; Bruegel, M.; Mueller, D.; Holzapfel, K.; Rummeny, E.J.; Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Imhoff, A.B. [Technische Universitaet Muenchen, Department of Sports Orthopedics, Munich (Germany)

    2007-02-15

    We assessed the diagnostic performance of magnetic resonance (MR) arthrography in the diagnosis of articular-sided partial-thickness and full-thickness rotator cuff tears in a large symptomatic population. MR arthrograms obtained in 275 patients including a study group of 139 patients with rotator cuff tears proved by arthroscopy and a control group of 136 patients with arthroscopically intact rotator cuff tendons were reviewed in random order. MR imaging was performed on a 1.0 T system (Magnetom Expert, Siemens). MR arthrograms were analyzed by two radiologists in consensus for articular-sided partial-thickness and full-thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. At arthroscopy, 197 rotator cuff tears were diagnosed, including 105 partial-thickness (93 supraspinatus, nine infraspinatus, three subscapularis) and 92 full-thickness (43 supraspinatus, 20 infraspinatus, 29 subscapularis) tendon tears. For full-thickness tears, sensitivity, specificity, and accuracy were 96%, 99%, and 98%, respectively, and for partial tears 80%, 97%, and 95%, respectively. False negative and positive assessments in the diagnosis of articular-sided partial-thickness tears were predominantly [78% (35/45)] observed with small articular-sided (Ellman grade1) tendon tears. MR arthrography is highly accurate in the diagnosis of full-thickness rotator cuff tears and is accurate in the diagnosis of articular-sided partial-thickness tears. Limitations in the diagnosis of partial-thickness tears are mainly restricted to small articular-sided tears (Ellman grade 1) due to difficulties in differentiation between fiber tearing, tendinitis, synovitic changes, and superficial fraying at tendon margins. (orig.)

  20. Hill-Sachs lesion location: does it play a role in engagement?

    Energy Technology Data Exchange (ETDEWEB)

    Gyftopoulos, Soterios; Wang, Annie; Babb, James [NYU Langone Medical Center, Department of Radiology, New York, NY (United States)

    2015-08-15

    To see if there is an association between engagement on physical examination (PE) and the location of the Hill-Sachs lesion (HSL) as assessed by the modified biceps angle. Sixty-two patients with a history of anterior shoulder dislocation, who underwent preoperative MRI and arthroscopy at our institution and were tested for engagement on PE, were collected. Two musculoskeletal radiologists reviewed the MR studies, noting the presence of an HSL and documenting the location of the HSL with the modified biceps angle. Statistical analysis included the Mann-Whitney (MW) test and ROC (receiver-operating characteristic) curve. Of 62 patients, there were 58 males and 4 females with a mean age of 30 (range 18-59 years). Twenty patients demonstrated engagement on PE, while 42 did not. All patients had evidence of an HSL on MRI and arthroscopy. The mean biceps angle for the engaging group was 151.5 ± 13.9 , and 142.4 ± 17.3 for the non-engaging group. The biceps angle was statistically significantly higher among patients who had engagement compared to those who did not (p = 0.027). Overall, diagnostic accuracy was highest for a biceps angle >149 , which resulted in a sensitivity of 70 % and specificity of 67 %. The modified biceps angle, as measured on MRI, was significantly higher in patients who demonstrated engagement on physical examination than in those who did not. This supports the theory that the location of the Hill-Sachs lesion may play a role in engagement and may be its most important characteristic when determining its significance. (orig.)

  1. Anterior cruciate ligament remnants nodule: potential factor causing extension loss

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; AO Ying-fang

    2013-01-01

    Background Extension loss caused by anterior cruciate ligament (ACL) remnants nodule was usually reported by case reports.There is no systematic report analyzing ACL remnants nodule.The purpose of this study was to investigate the characteristics of extension loss caused by remnants of ACL after injury.Methods From June 2008 to December 2011,ACL remnants were observed by atthroscopy in 1012 cases with ACL injuries at the time of primary reconstruction.ACL remnants nodules were recorded.The time of extension loss occurrence caused by ACL remnants nodule,associated symptom and sign,magnetic resonance imaging (MRI),and arthroscopic findings were observed.Histological examination was performed on the lesion resected.Results Twenty-four cases with ACL remnants nodules were found by arthroscopy.Among them extension loss caused by remnants of ACL happened in 19 cases (male 13; female 6).The average extension loss were 9.1° (range,5°-20°).The average time from injury to operation was 8.9 weeks (range,3-26 weeks).The remnants of ACL depressed in the inter-condylar notch were found on MRI in 15 cases with extension loss.The rupture locations of ACL were all close to the upper insertion of ACL.The microscopic examination of the resected remnants of ACL revealed disorganized fibrous connective tissue and tissue of ACL ligament.Conclusions Among 1012 ACL injury cases,24 ACL remnants nodules were found with arthroscopy and 19 nodules could cause knee extension loss.ACL remnants nodule should be paid attention to as a potential cause of extension loss.

  2. Glenoid labrum tears related to the long head of the biceps.

    Science.gov (United States)

    Andrews, J R; Carson, W G; McLeod, W D

    1985-01-01

    Tears of the glenoid labrum were observed in 73 baseball pitchers and other throwing athletes who underwent arthroscopic examination of the dominant shoulder. Most of the tears were located over the anterosuperior portion of the glenoid labrum near the origin of the tendon of the long head of the biceps muscle into the glenoid. At arthroscopy, the tendon of the long head of the biceps appeared to originate through and be continuous with the superior portion of the glenoid labrum. In many cases it appeared to have pulled the anterosuperior portion of the labrum off the glenoid. This observation was verified at arthroscopy by viewing the origin of the biceps tendon into the glenoid labrum as the muscle was electrically stimulated. With stimulation of the muscle, the tendinous portion became quite taut, particularly near its attachment to the glenoid labrum, and actually lifted the labrum off the glenoid. Three-dimensional high-speed cinematography with computer analysis revealed that the moment acting about the elbow joint to extend the joint through an arc of about 50 degrees was in excess of 600 inch-pounds. The extremely high velocity of elbow extension which is generated must be decelerated through the final 30 degrees of elbow extension. Of the muscles of the arm that provide the large deceleration forces in the follow-through phase of throwing, only the biceps brachii traverses both the elbow joint and the shoulder joint. Additional forces are generated in the biceps tendon in its function as a "shunt" muscle to stabilize the glenohumeral joint during the throwing act.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. 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.)

  4. Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears: A preliminary experience

    Directory of Open Access Journals (Sweden)

    Shivani Pahwa

    2014-01-01

    Full Text Available Aims: To compare conventional magnetic resonance imaging (MRI and direct magnetic resonance (MR arthrography in the evaluation of triangular fibrocartilage complex (TFCC and intrinsic wrist ligament tears. Materials and Methods: T1-weighted, fat suppressed (FS proton density plus T2-weighted (FS PD/T2, 3D multiple-echo data image combination (MEDIC sequences and direct MR arthrography were performed in 53 patients with wrist pain. Images were evaluated for the presence and location of TFCC, scapholunate ligament (SLL and lunatotriquetral ligament (LTL tears, and imaging findings were compared with operative findings in 16 patients who underwent arthroscopy or open surgery (gold standard. Results: Sixteen patients underwent arthroscopy/open surgery: 12 TFCC tears were detected arthroscopically out of which 9 were detected on FS PD/T2 sequence, 10 on MEDIC sequence, and all 12 were detected on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in the detection of TFCC tears were 75%, 83.3%, and 100%, respectively. Out of the eight arthroscopically confirmed SLL tears, three tears were detected on FS PD/T2 sequence, five on MEDIC sequence, and all eight were visualized on MR arthrography. The sensitivities of FS PD/T2, MEDIC sequences, and MR arthrography in detecting SLL tears were 37.5%, 62.5%, and 100%, respectively. One arthroscopically confirmed LTL tear was diagnosed on FS PD/T2 sequence, three on MEDIC sequence, and all five arthroscopically confirmed LTL tears were detected with MR arthrography. The sensitivities of PD, MEDIC sequences, and MR arthrography in detecting LTL tears were 20%, 40%, and 100%, respectively. Conclusions: MR arthrography is the most sensitive and specific imaging modality for the evaluation of wrist ligament tears.

  5. The Role of Wrist Magnetic Resonance Arthrography in Diagnosing Triangular Fibrocartilage Complex Tears; Experience at King Hussein Medical Center, Jordan

    Directory of Open Access Journals (Sweden)

    Asem A. Al-Hiari

    2013-05-01

    Full Text Available Objectives: The aims of the study were to evaluate the role of magnetic resonance arthrography (MRA of the wrist in detecting full-thickness tears of the triangular fibrocartilage complex (TFCC and to compare the results of the magnetic resonance arthrography (MRA with the gold standard arthroscopic findings. Methods:The study was performed at King Hussein Medical Center, Amman, Jordan, between January 2008 and December 2011. A total of 42 patients (35 males and 7 females who had ulnar-sided wrist pain and clinical suspicions of TFCC tears were included in the study. All patients underwent wrist magnetic resonance arthrography (MRA and then a wrist arthroscopy. The results of MRA were compared with the arthroscopic findings. Results: After comparison with the arthroscopic findings, the MRA had three false-negative results (sensitivity = 93% and no false-positive results. A total of 39 patients were able to return to work. Satisfaction was high in 38 of the patients and 33 had satisfactorypain relief. The sensitivity of the wrist MRA in detecting TFCC full-thickness tears was 93% (39, and specificity was 80% (16/20. The overall accuracy of wrist arthroscopy in detecting a full-thickness tear of the TFCC in our study was 85% (29/34. Conclusion: These results illustrate the role of wrist MRA in assessing the TFCC pathology and suggest its use as the first imaging technique, following a plain X-ray, in evaluating patients with chronic ulnar side wrist pain with suspected TFCC injuries.

  6. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Science.gov (United States)

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  7. Imaging of postarthroscopic complications after knee injuries; Bildgebung postarthroskopischer Komplikationen nach Knieverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, C. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und muskuloskelettale Radiologie, Klinik fuer Radiodiagnostik, Wien (Austria); Skrbensky, G. von [Medizinische Universitaet Wien, Klinik fuer Orthopaedie, Wien (Austria)

    2012-11-15

    The most common joint injuries in professional and recreational sports participants and also in the total population are knee injuries. Arthroscopy is indicated if this modality will improve the patient outcome and potential long-term complications can be avoided. Although uncommon, complications following arthroscopy are mostly evaluated by magnetic resonance imaging (MRI). For planning further therapy strategies following postarthroscopic complications, e.g. if anterior cruciate ligament (ACL) reconstruction is required, digital radiographs and computed tomography (CT) are helpful. This article provides an overview of the different procedures for surgical treatment which are a prerequisite for the analysis of postarthroscopic images. In addition typical complications after treatment of meniscal and chondral injuries as well as after ACL reconstruction are described and typical signs in MRI, radiography and CT are explained in detail. (orig.) [German] Kniegelenkverletzungen sind nicht nur bei Profisportlern, sondern auch in der Gesamtbevoelkerung die haeufigsten Gelenkverletzungen. Die Indikation zur arthroskopischen Operation wird gestellt, wenn im Vergleich zur konservativen Therapie ein besseres Ergebnis postarthroskopisch zu erwarten ist und potenzielle Spaetkomplikationen verhindert werden koennten. Die selten aber dennoch auftretenden postarthroskopischen Komplikationen werden zumeist mit der Magnetresonanztomographie (MRT) abgeklaert. Zur weiteren Therapieplanung nach Komplikationen, z. B. wenn eine Kreuzbandrevision notwendig ist, sind die digitale Projektionsradiographie und die Computertomographie (CT) hilfreich. Dieser Artikel bietet eine kurze Uebersicht ueber die unterschiedlichen Operationstechniken, die eine Voraussetzung fuer das Verstaendnis der bildgebenden postoperativen Veraenderungen sind. Weiter wird auf die haeufigsten Komplikationen nach Meniskus- und Knorpeloperationen sowie nach vorderer Kreuzbandrekonstruktion und den damit

  8. 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.

  9. Evaluation of chondromalacia of the patella with axial inversion recovery-fast spin-echo imaging.

    Science.gov (United States)

    Lee, S H; Suh, J S; Cho, J; Kim, S J; Kim, S J

    2001-03-01

    The purpose of our study was to assess the accuracy of inversion recovery-fast spin-echo (IR-FSE) imaging for the evaluation of chondromalacia of the patella. Eighty-six patients were included, they underwent magnetic resonance (MR) examination and subsequent knee arthroscopy. Medial and lateral facets of the patella were evaluated separately. Axial images were obtained by using IR-FSE (TR/TE/TI = 3000/25/150 msec; echo train length, 8; 4-mm thickness; 12-cm field of view; 512 x 256 matrix; two, number of excitations) with a 1.5-T MR machine. MR interpretation of chondromalacia was made on the basis of the arthroscopic grading system. Of a total of 172 facets graded, arthroscopy revealed chondromalacia in 14 facets with various grades (G0, 158; G1, 1; G2, 3; G3, 6; G4, 4). Sensitivity, specificity, and accuracy in the chondromalacia grades were 57.1%, 93.0%, and 90.1%, respectively. There was one false-negative case (G4) and 11 false-positive cases (G1, eight; G2, two; G3, one). Sensitivity and specificity corrected by one grade difference were improved to 85.7% and 98.1%, respectively. When cartilage changes were grouped into early (corresponding to grade 1 and 2) and advanced (grade 3 and 4) diseases, sensitivity and specificity of the early and advanced diseases were 75% and 94% and 80% and 99%, respectively. IR-FSE imaging of the knee revealed high specificity but low sensitivity for the evaluation of chondromalacia of the patella.

  10. Posterior horn lateral meniscal tears simulating meniscofemoral ligament attachment in the setting of ACL tear: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Lawrence S.; Jacobson, Jon A.; Jamadar, David A.; Caoili, Elaine; Kalume-Brigido, Monica [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Wojtys, Edward [University of Michigan, Department of Orthopaedic Surgery, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States); University of Michigan Sports Medicine Program, Department of MedSport, 24 Frank Lloyd Wright Drive, Box 391, Ann Arbor, MI (United States)

    2007-05-15

    We have noted apparent far lateral meniscal attachment of the meniscofemoral ligament (MFL) with an anterior cruciate ligament (ACL) tear. This study evaluates MFL attachment and association with posterior horn lateral meniscus (PHLM) tear. Nine months of knee arthroscopy reports were reviewed to classify the PHLM and ACL as torn or normal. After excluding those with prior knee surgery, MR images were reviewed by two radiologists to determine the number of images lateral to PCL, which showed the ligaments of Humphrey and Wrisberg visible as structures separate from the PHLM. Any patient with abnormal PHLM surface signal not continuous with the MFL was excluded. MRI findings were compared with arthroscopy using Student's t test and Fisher's exact test. Of the 54 participants, 5 had PHLM tears and 49 were normal. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The ligament of Humphrey inserted on average 0.9 consecutive images lateral to the PCL without an PHLM tear and 4.7 with an PHLM tear; the ligament of Wrisberg inserted on average 3.0 consecutive images without an PHLM tear and 4.5 with an PHLM tear (slice thickness/gap = 3 mm/0.5 mm). There was a significant association between PHLM tear and number of images (p = 0.0028), and between ACL tear and this type of PHLM tear (p = 0.0064). Apparent far lateral meniscal extension of a meniscofemoral ligament (greater than or equal to four images lateral to the PCL) should be considered as a possible PHLM tear, especially in the setting of an ACL tear. (orig.)

  11. Which oblique plane is more helpful in diagnosing an anterior cruciate ligament tear?

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, J.W. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Yoon, Y.C. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)], E-mail: ycyoon@skku.edu; Kim, Y.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Ahn, J.H. [Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Choe, B.K. [Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2009-03-15

    Aim: To evaluate the diagnostic role of additional oblique coronal and oblique sagittal magnetic resonance imaging (MRI) for an anterior cruciate ligament (ACL) tear. Materials and methods: A total of 101 patients who had undergone preoperative knee MRI examinations with orthogonal and two sets of oblique images were enrolled in the study. Two radiologists evaluated the MRI images by the use of four methods: orthogonal images only (method A); orthogonal and additional oblique coronal images (method B); orthogonal and oblique sagittal images (method C); and orthogonal images with oblique coronal and sagittal images (method D). The status of the ACL (normal or tear) was determined by consensus. The sensitivity, specificity, and accuracy for an ACL tear with the use of each method were calculated in comparison with arthroscopy as the reference standard, and values were statistically analysed using the McNemar test. The diagnostic accuracies were compared using receiver operating characteristic (ROC) analysis. Results: Arthroscopy identified 10 partial ACL tears and 30 complete ACL tears. The specificities and accuracies for methods B, C, and D were significantly higher than the specificities and accuracies for method A (p < 0.05). There was no significant difference in the sensitivity, specificity, and accuracy for methods B, C, and D. Diagnostic ability was not significantly different for each method, as determined by ROC analysis (p > 0.05). Conclusions: Additional oblique imaging for an ACL tear improved the specificity. Either of the oblique imaging methods is sufficient, and no further improvement in the diagnostic efficacy was achieved by simultaneous use.

  12. MR imaging of the anterior intermeniscal ligament: classification according to insertion sites

    Energy Technology Data Exchange (ETDEWEB)

    Aydingoez, Uestuen; Kaya, Ayten [Department of Radiology, Hacettepe University Medical Center, Ankara (Turkey); Atay, Ahmet Oe.; Doral, Nedim M. [Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, Ankara (Turkey); Oeztuerk, Halil M. [Department of Radiology, SSK Ankara Hospital, Ankara (Turkey)

    2002-04-01

    Our objective was to study the frequency of anterior intermeniscal ligament on MR imaging and to make a classification according to its insertion sites on MR images. Sagittal T1-weighted and thin-section transverse T2*-weighted MR images of the knee were prospectively evaluated in 229 subjects without significant synovial effusion or total rupture of the anterior cruciate ligament. By using thin-section transverse images, the ligament was classified into three types according to its insertion sites (type A: between anterior horns of medial and lateral menisci; type B: between anterior horn of medial meniscus and anterior margin of lateral meniscus; type C: between anterior margins of medial and lateral menisci). On sagittal images location of the ligament was determined with respect to a line drawn between anterior of the tibial epiphysis and posterior of the intercondylar notch to look for a relation between its type on transverse images and location on sagittal images. Separately, arthroscopy was made in 36 patients to verify the MR assessment of the presence of the ligament. Anterior intermeniscal ligament was found in 53% of the subjects. Type B was the most common group (58%). Magnetic resonance imaging has a sensitivity and a specificity of 67 and 100%, respectively, in the detection of the ligament. Types A and C had a statistically significant location posterior and anterior, respectively, to the master line on sagittal images. In arthroscopy, the ligament was either cord-like (67%) or flat (33%) in appearance. Routine sagittal MR images can help identify anterior intermeniscal ligament. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-03-01

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

  14. Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology

    Energy Technology Data Exchange (ETDEWEB)

    Fallahi, Farshid [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom); North Cumbria University Hospitals, Department of Radiology, Carlisle (United Kingdom); Green, Nick; Gadde, Sarat; Jeavons, Lisa; Armstrong, Patrick; Jonker, Leon [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom)

    2013-09-15

    Indirect magnetic resonance arthrography (I-MRA) confers significant logistical advantages over direct MRA and does not require articular injection. In this study, we determined the diagnostic performance of I-MRA in relation to conventional MRI and arthroscopy or surgery in detecting tears of the glenoid labrum, including Bankart lesions and superior labral antero-posterior (SLAP) tears in a standard clinical setting. Ninety-one symptomatic patients underwent conventional MRI and I-MRA of the affected shoulder, followed by either arthroscopy or open surgery. The scans were interpreted independently by two experienced radiology consultants with a special interest in musculoskeletal radiology. Using the surgical findings as the standard of reference, sensitivity, specificity, and diagnostic accuracy of conventional non-contrast MRI and I-MRA in the detection of labral tears were calculated. The sensitivity of I-MRA was 95 and 97 %, respectively, for two radiologists as opposed to 79 and 83 % for conventional MRI. For both radiologists, the specificity of I-MRA, as well as MRI, was 91 % for detection of labral tears of all types. Accuracy of diagnosis was 93 and 95 %, respectively, for two radiologists with indirect MRA, compared to 84 and 86 % with non-contrast MRI. This retrospective study shows that I-MRA is a highly accurate and sensitive method for the detection of labral tears. The data obtained supports the use of I-MRA as standard practice in patients with shoulder instability due to suspected labral pathology where further investigative imaging is indicated. (orig.)

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

  17. 肩关节前方盂唇损伤的MRI和MR关节造影诊断%Diagnostic value of MRI and MR arthrography in the detection of injuries of anterior labrum in shoulder

    Institute of Scientific and Technical Information of China (English)

    李海峰; 刘玉杰; 程流泉; 李众利; 王俊良; 齐玮; 王宁; 朱娟丽; 刘洋

    2012-01-01

    Objective:To investigate the diagnostic value of MRI and MR arthrography in the detection of injuries of anterior labrum in shoulder and to evaluate the accuracy of MR arthrography in the classification of anterior labrum lesion. Methods: Seventy-eight patients with arthroscopically proved anterior labrum lesions(study group) and 75 patients with arthroscopi-cally proved intact anterior labrum (control group) from January 2007 to December 2010 were included to the study. All patients underwent MRI and MR arthrography at our institution prior to shoulder arthroscopy. All MRI and MR arthrography were analyzed by one musculoskeletal radiologists and one sports medicine surgeon who had no knowledge of the clinical histories and arthroscopic results. The same classification system of labrum lesions based on arthroscopy was used in image analysis. Imaging findings and arthroscopic findings were compared in all patients. With arthroscopy used as the standard of reference, the sensitivities, specificities and accuracies of MRI and MR arthrography in the detection of anterior labrum lesions were compared , and the sensitivities, specificities and accuracies of M R arthrography in the correct classification of anterior labrum lesions were calculated. Results: In arthroscopy,78 anterior labrum lesions,67 rotator cuff lesions and 8 SLAP lesions were diagnosed,for the detection of anterior labrum lesions,the sensitivity of MRI and MR arthrography was 80.8% and 92.3% ,the specificity was 89.3% and 97.3%,the accuracy was 85.0% and 94.8% respectively. Seventy-eight patients with arthroscopically proved anterior labrum lesions included 39 Bankart lesions,32 ALPSA lesions and 7 Perthes lesions,with MR arthrography, Bankart.ALPSA.and Perthes lesions were correctly classified in 84.6% ,84.4% ,and 57.1% of cases,respectively. Conclusion: MR arthrography has a higher sensitivity, specificity and accuracy than MRI in the detection of anterior labrum injuries. MR arthrography was useful

  18. 三维MR影像对前交叉韧带损伤诊断价值的研究%Evaluation of anterior cruciate ligament ruptures by three dimension MR imaging

    Institute of Scientific and Technical Information of China (English)

    程瑾; 刘霞; 杜湘珂

    2012-01-01

    Objective To compare the diagnosic performance of conventional 2D and 3D Cube MR imaging to identify complete and partial tears of anterior cruciate ligament(ACL).Methods Farty patients suspected of having tears of anterior cruciate ligament were prospectively studied by 3.0 T conventional 2D and 3D Cube MR imaging and arthroscopy.MR images were interpreted in consensus by two experienced radiologists,and the ACL was diagnosed as being normal,partially torn,or completely torn.Diagnostic accuracy of 2D and 3D Cube MR for the detection of both complete and partial tears of ACL was calculated using arthroscopy as the standard of reference.Area under curve (AUC) of both methods were calculated using ROC curves and were compared using Hanley& McNeil curve comparisions.Results Sixteen patients had intact ACL,12 had complete tear,and 12 had partial tear of the ACL at arthroscopy.For complete ACL tear,AUC of 2D MR and 3D Cube was 0.839 and 0.923 respectively,and there was no significant difference on ROC curves (Z =1.245,P =0.213).For partial ACL tears,AUC of 2D and 3D Cube MR were 0.643 and 0.881 respectively,and there was significant difference on ROC curves (Z =2.384,P =0.017).Conclusions Both 2D MR and 3D Cube MR have high sensitivity and specificity for identifying the complete ruptures of ACL.3D Cube MRI appears to be superior inidentifying partial rupture of ACL.%目的 比较常规2D及3D超长回波链采集FSE序列(3D Cube T2WI) MRI对前交叉韧带(ACL)损伤的诊断价值.方法 40例膝关节外伤患者先后行常规2D MR及3D Cube T2WI MR检查并分别作出ACL损伤的诊断,包括ACL完整、部分撕裂及完全撕裂.以关节镜检查结果作为ACL损伤的金标准.应用ROC法计算2种影像检查对ACL部分撕裂及完全撕裂诊断的曲线下面积(AUC)值并应用Hanley&McNeil检验比较两者在统计学上的差异.结果 40例经关节镜证实的膝关节损伤患者中,ACL完整者16例,双束完全撕裂为12

  19. 规范化疼痛管理在肩关节镜手术患者应用中效果观察%The Research of Standard Pain Management on Patients with Arthroscopic Shoulder Surgery

    Institute of Scientific and Technical Information of China (English)

    李伦兰; 汪亚兵; 倪秀梅

    2014-01-01

    Objective To explore the effect of standard pain management on patients with operation of the shoulder joint by arthroscopy .Methods 60 patients with operation of the shoulder joint by arthroscopy were selected from October 2011 to December 2013 and divided into two groups randomly .Patients of experiment group received standard pain manage-ment such as pain assessment-pain education-preemptive analgesia-multimodal analgesia-individualized analgesia while pa-tients of control group received conventional pain management .And observed the pain score three days after operation and satisfaction of pain control .Results The score of the experimental group were lower than the control group at 6hours 、1day、2days and 3days after operation(P<0 .05) ,and the satisfaction were higher than the control group at 3days after opera-tion(P<0 .05) .Conclusion standard pain management could relieve the pain of patients with operation of the shoulder joint by arthroscopy and improve quality of care .%目的:探讨规范化疼痛管理在肩关节镜手术患者围手术期应用的效果。方法将2011年10月~2013年12月行肩关节镜手术的60例患者,通过计算机随机法分为对照组和实验组,各30例。实验组采用围手术期规范化疼痛管理。对照组采取传统按需镇痛处理方法,即患者疼痛时给予镇痛处理。观察两组术后3天内疼痛评分、患者对疼痛控制的满意度。结果实验组疼痛评分在手术后6h、术后第1、2、3天低于对照组(P<0.05);术后3天镇痛满意度评分高于对照组,有显著性差异(P<0.05)。结论肩关节镜手术患者实施规范化疼痛管理,可以使患者以无痛或最低的疼痛状态度过围手术期,提高患者的舒适度,使其能尽早进行康复功能锻炼,促进疾病早日康复,提高了护理质量。

  20. 急性滑脱性髌股关节撞击症的影像学表现%The imaging performance and mechanism of acute slipped patellofemoral joint impingent syndrome

    Institute of Sci