Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Comparative Study
Radiographic analysis of femoral tunnel position in postoperative posterior cruciate ligament reconstruction.
The purpose of this study was to test the hypothesis that plain radiographs are accurate in assessing femoral tunnel positions in posterior cruciate ligament (PCL) reconstruction. ⋯ Three radiographs; the AP, lateral, and internally rotated lateral, can be used to detect a significant difference in the majority of tunnel locations. The tunnel positions that could not be differentiated with these measurements were posterior and may not be clinically important. We concluded that a plain radiograph is an accurate indicator of PCL tunnel position.
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This study presents the 2- to 10-year results of 35 arthroscopically assisted combined anterior cruciate ligament and posterior cruciate ligament (ACL/PCL) reconstructions evaluated preoperative and postoperatively using Lysholm, Tegner, and Hospital for Special Surgery knee ligament rating scales, KT-1000 arthrometer testing, stress radiography, and physical examination. ⋯ Combined ACL/PCL instabilities can be successfully treated with arthroscopic reconstruction and the appropriate collateral ligament surgery. Statistically significant improvement is noted from the preoperative condition at 2- to 10-year follow-up using objective parameters of knee ligament rating scales, arthrometer testing, stress radiography, and physical examination. Postoperatively, these knees are not normal, but they are functionally stable. Continuing technical improvements will probably improve future results.
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The purpose of this study was to evaluate chondrocyte viability and surface contouring of articular cartilage using confocal laser microscopy (CLM) and scanning electron microscopy (SEM), respectively, during different treatment time intervals with monopolar and bipolar radiofrequency energy (RFE). ⋯ When applying thermal chondroplasty, a broad treatment time range could result in variable degrees of cartilage smoothness and significant chondrocyte death.
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The goal of this study was to evaluate the opinion of sports medicine fellowship directors and orthopaedic surgery department chairpersons on how many repetitions the average resident needs to become proficient in several common arthroscopic procedures. ⋯ These results indicate that, in the opinion of physicians involved in the education of residents and fellows, it may take a substantial number of repetitions to become proficient in arthroscopy. Physicians who perform little or no arthroscopy themselves may underestimate its difficulty. Interestingly, there was substantial variability in the number of repetitions estimated to achieve proficiency in all procedures. The results of this study may be helpful in designing arthroscopic training programs for orthopaedic residents or sports medicine fellows; however, the wide variability in opinions may indicate difficulty in reaching a consensus.
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We describe a technique that uses the Vac Pac (Olympic Medical, Seattle, WA) for patient positioning in shoulder surgery. This technique is well-liked by anesthesiologists, nurses, and operating room staff because of its ease and simplicity. If careful attention is given to detail during positioning, problems with encroachment on the operative field can be avoided. We believe this technique allows for safe and effective patient positioning for shoulder surgery using the readily available and inexpensive Vac Pac.