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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The purpose of this study was to investigate the intermediate-term postoperative results of arthroscopic surgery for lateral compartment osteoarthritis (OA) of the knee in a case series study. ⋯ Level IV, therapeutic case series.
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Case Reports
Be aware of bone marrow edema syndrome in ankle arthroscopy: a case successfully treated with iloprost.
Bone marrow edema syndrome (BMES) is a nontraumatic syndrome characterized by disabling joint pain. The disease occurs especially in the hip joint, and the ankle joint has been reported in the English-language literature to be affected only rarely. We describe here the case of an adult with BMES in both ankle joints. ⋯ This case report suggests the need for orthopaedic surgeons to know about BMES. Before all-arthroscopic interventions are performed, MRI views should be evaluated carefully. Iloprost infusion therapy seems to be effective and safe in the management of BMES.
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Arthrotomy is considered standard treatment for septic arthritis of the hip; the procedure may be complicated by avascular necrosis or postoperative hip instability. Arthroscopic treatment of patients with this condition is still not an established technique, despite its minimally invasive nature and the fact that it is associated with low morbidity. A 3-portal arthroscopic technique by Byrd with the patient in the supine position was used for drainage, debridement, and irrigation in 6 patients with septic coxarthrosis. ⋯ No complications occurred with this group of patients. Thus, 3-directional arthroscopic surgery combined with large-volume irrigation is an effective treatment modality in cases of septic arthritis of the hip. It is less invasive than arthrotomy and offers low rates of postsurgical morbidity.
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Postoperative pain pumps are increasingly used to deliver a continuous infusion of local anesthetic into the surgical wound or the joint. Recently, there have been concerns that the use of such devices may be associated with chondrotoxicity and even cases of chondrolysis in the shoulder. An experimental model is presented that investigates potential chondrotoxic effects of a continuous intra-articular infusion of bupivacaine in the rabbit shoulder. ⋯ Bupivacaine showed profound chondrotoxic effects in an experimental model that closely followed the current clinical application of postoperative pain pumps. The results caution against the use of such devices in applications for smaller joints with minimal clearance or dilution as a result of hematoma, where continuous exposure of cartilage to bupivacaine is expected.