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
Intra-articular ropivacaine 0.75% and bupivacaine 0.50% for analgesia after arthroscopic knee surgery: a randomized prospective study.
Intra-articular administration of local anesthetic solution provides analgesia after arthroscopic knee surgery. Bupivacaine is considered the gold standard local anesthetic in this indication, but ropivacaine, which is less toxic than bupivacaine, can consequently be administered in higher doses, potentially increasing the duration of analgesia. We compared the analgesic effect of intra-articular injection of ropivacaine 225 mg and bupivacaine 150 mg in patients undergoing arthroscopic surgery. ⋯ Level I.
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Randomized Controlled Trial Comparative Study
Short-term analgesic effects of intra-articular injections after knee arthroscopy.
To study the effects of 3 different intra-articular analgesic combinations on postoperative pain, and whether the timing of the injection, either preoperative or postoperative, had an effect on postoperative analgesia. ⋯ Level I, Randomized Controlled Trial.
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Hip arthroscopy has been shown to offer minimally invasive access to the hip joint compared with standard open arthrotomy. The use of arthroscopy for diagnosing and treating disorders about the hip continues to evolve. The authors describe an arthroscopically assisted technique for the removal of a bullet lodged in the acetabulum of a patient who sustained a gunshot wound that entered the abdomen and traversed the rectum before ending up in the weight-bearing dome of the acetabulum. ⋯ We considered the risks of potential bullet fragmentation and migration, as well as a possible abdominal compartment syndrome before proceeding. This surgical technique afforded a very satisfactory outcome for this patient and serves as a model for others when encountering a similar injury pattern in a trauma patient. It is a procedure that can be performed safely, quickly, and with minimal complications for surgeons who have experience with arthroscopy of the hip joint.
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Damage to the infrapatellar branch of the saphenous nerve (IPBSN) has been described for knee arthrotomy and arthroscopy. The true incidence of damage to this structure during anterior cruciate ligament (ACL) reconstruction has not been reported. Furthermore, the traditional vertical incision for central patellar tendon harvesting runs perpendicular to the course of this nerve. Therefore, a horizontal incision to avoid this potential complication was developed. ⋯ Level IV.
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Numerous surgical procedures have been described for the treatment of recurrent patellar dislocation. Studies have shown that the primary pathoanatomy associated with lateral patellar dislocation is injury to the medial patellofemoral ligament (MPFL), which is the major soft-tissue restraint to lateral patellar translation. Recently, various procedures have been described that address the medial ligamentous injury inherent to lateral patellar dislocation. We present a simple technique for MPFL reconstruction using a quadriceps tendon graft.