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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Treatment of ulnocarpal abutment (UAS) syndrome involves decompression of the pressure and impingement, or abutment of the ulnocarpal articulation. Debridement of triangular fibrocartilage complex (TFCC) tears alone in the patient with UAS may have a failure rate of as much as 25% to 30%. Ulnar shortening osteotomy (USO) can be an effective treatment of failed TFCC debridement. Good results have been reported with combined arthroscopic TFCC debridement and mechanical arthroscopic distal ulnar resection. Similar results have been reported with both ulnar shortening osteotomy and open wafer distal ulnar resections in the UAS patient. Because all of these treatment choices appear to yield similar relief of symptoms, determination of the optimal treatment protocol remains a point of debate. The purpose of this study was to evaluate 2 different surgical treatments for UAS. ⋯ Level III.
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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).