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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This study aimed to review the isometric point of the posterior cruciate ligament (PCL) based on insertional locations identified in recent anatomic studies by use of a 3-dimensional knee model. ⋯ Reproducing normal tibial and femoral anatomy underpins PCL surgical reconstruction. These findings suggest that to perform an isometrically accurate PCL reconstruction, particular attention should be paid to the location of the femoral attachment site, once the tibial footprint has been established. There were no isometric points in any virtual PCL bundle in the fully flexed knee because of excessive lengthening. Therefore, to avoid lengthening of the reconstructed graft, we recommend that fixation is performed at knee flexion angles between 0° and 90° and that patients avoid high flexion during postoperative rehabilitation.
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Clinical Trial
Endoscopic plantar fascia release by hooked soft-tissue electrode after failed shock wave therapy.
The purpose of this study was to assess the outcome of endoscopic plantar fascia release (EPFR) after failed extracorporeal shock wave therapy (ESWT). ⋯ Level IV, therapeutic case series.
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Randomized Controlled Trial Comparative Study
Can gabapentin help reduce postoperative pain in arthroscopic rotator cuff repair? A prospective, randomized, double-blind study.
The aim of the study was to determine the effect of low-dose gabapentin on postoperative pain management in patients undergoing arthroscopic rotator cuff repair. ⋯ Level I, randomized controlled trial.
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During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease in frontal lobe oxygenation to below the level that causes presyncopal symptoms in the awake subject. In the healthy middle-aged patient, cerebral oxygenation decreased by approximately 40%, indicating that cerebral blood flow was markedly reduced, and intravenous administration of ephedrine rapidly restored cerebral oxygenation. During surgery in the beach-chair position, hypotension must be avoided, and in all patients regional, cerebral oxygenation should be monitored and optimized.