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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Randomized Controlled Trial Comparative Study Clinical Trial
The efficacy of intra-articular ketamine for postoperative analgesia in outpatient arthroscopic surgery.
The purpose of this study was to compare the postoperative analgesic effects of intra-articularly administered ketamine, neostigmine, and bupivacaine after outpatient arthroscopic surgery. ⋯ Our basic finding was reduction in postoperative pain and consumption of adequate analgesic drugs with intra-articular ketamine, bupivacaine, or neostigmine use. We have not seen any psychomimetic side effects, particularly as seen with higher doses or systemic use. This study may conclude that intra-articular administration of ketamine provides long-lasting and effective analgesia, similar to neostigmine but less effective than bupivacaine after knee arthroscopy without any adverse effects. LEVEL OF EVEIDENCE: Level I.
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Comparative Study
Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures.
Although arthroscopy offers an unparalleled view of intra-articular pathology, its use in the treatment of intra-articular distal radius fractures remains controversial. This study was designed to compare functional and radiologic outcomes of arthroscopically assisted (AA) versus fluoroscopically assisted (FA) reduction and external fixation of distal radius fractures. ⋯ Level II prospective cohort study.
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Surgical procedures for treatment of acromioclavicular (AC) joint dislocation replace the coracoclavicular (CC) ligaments to minimize motion, allow scarring, and increase the subsequent stability of the joint. The purpose of this study was to evaluate the biomechanical function of the surgically repaired or reconstructed (CC Sling, Rockwood Screw [DePuy Orthopaedics, Warsaw, IN], and Coracoacromial [CA] Ligament Transfer Construct) AC joint after AC joint dislocation. ⋯ Current surgical procedures do not have the appropriate stiffness to restore the stability of the intact joint before healing. Therefore, our results may lead to the design and development of new repairs, reconstructions, and rehabilitation protocols for AC joint dislocation.
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The purpose of this study was to explore and describe reasons for variation in diagnostic accuracy of clinical tests using Yergason's and Speed's tests in predicting biceps tendon pathology and SLAP lesions. Shoulder arthroscopy was used as the gold standard. ⋯ Level I diagnostic study: testing of previously developed criteria in a series of consecutive patients (using surgery as gold standard).
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Comparative Study
Manual punch versus power harvesting of osteochondral grafts.
The purpose of the study was to analyze the effect on chondrocyte viability of 2 existing methods of harvesting osteochondral grafts used for articular cartilage resurfacing. ⋯ This study shows that the original method (power trephine) of harvesting osteochondral grafts results in great loss of chondrocyte viability versus manual punch harvesting and should no longer be used.