Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
-
We describe two patients who had pain of unknown cause in the right hip for many years. Plain roentgenograms results were normal, and arthrography did not reveal any abnormal findings. Because clinical examinations strongly suggested internal derangement of the hip, arthroscopies of the hips were performed. ⋯ Partial limbectomies were performed by the posterior approach, and the patients showed marked decrease in hip pain postoperatively. This report shows that a solitary lesion of fibrocartilaginous tissue of the hip can cause hip pain. These conditions can be easily misdiagnosed as sciatica.
-
The course of the suprascapular nerve and its distance from fixed scapular landmarks were measured in 90 cadaveric shoulders. In an additional 15 cadavers, three pins were passed at various angles in a general anterior-posterior direction through the middle of the glenoid neck just inferior and lateral to the base of the coracoid process. The distance between the exit site on the posterior glenoid neck and the suprascapular nerve at the base of the scapular spine was recorded for each pin. ⋯ On the basis of these data, a relative safe zone is described in the posterior glenoid neck. Knowledge of the anatomic course of the suprascapular nerve may aid the physician in the diagnosis and treatment of suprascapular neuropathies. Appreciation of the safe zone may help the shoulder surgeon avoid iatrogenic injury to the suprascapular nerve during arthroscopic Bankart procedures and other open surgical procedures requiring dissection of the posterior glenoid neck.
-
Since the development of the nail gun in the 1950s, various reports cite injuries to the head, chest, abdomen, and extremities. Few of these reports mention any nail gun injuries to the knee joint. A total of 33 patients with penetrating injuries to the knee was identified. ⋯ None developed an infection or needed additional surgery. Based on this series, power nail gun knee joint wounds should have tetanus prophylaxis, arthroscopic evaluation, and irrigation of the knee joint in conjunction with nail removal, i.v. antibiotics for 12-48 h, followed by a 10-day course of oral antibiotics. Unless cultures indicate differently, a first-generation cephalosporin is recommended.
-
A retrospective review with a mean follow-up time of 60 months was performed on 126 patients who had treatment of unicompartmental gonarthrosis with either abrasion arthroplasty plus arthroscopic debridement or arthroscopic debridement alone. Fifty-nine patients had abrasion arthroplasty and arthroscopic debridement, and 67 patients had arthroscopic debridement alone. All patient had stage II Ahlbäck changes roentgenographically, as well as Outerbridge stage IV changes arthroscopically in the involved compartment. ⋯ The conditions of ten of the patients who had poor results actually became worse subsequent to their abrasion arthroplasty. In the group that had arthroscopic debridement, 66% had good to excellent results, 13% had fair results, and 21% had poor results. The conditions of 12 of the patients who had poor results actually became worse subsequent to the arthroscopic debridement.
-
We evaluated the use of the beach-chair, or sitting, position for arthroscopic shoulder surgery in 50 consecutive patients. Routine arthroscopy, arthroscopic subacromial decompression, and arthroscopic shoulder stabilizations were performed, with no complications. The advantages of this position include ease of setup, lack of brachial plexus strain because no traction is used, excellent intraarticular visualization for all types of arthroscopic shoulder procedures, and ease of conversion to the open approach if needed. The positioning technique is described.