Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
-
We describe an articular talar dome fracture treated with the use of an arthroscopically assisted placement of a transfibular Acutrak screw (Accumed, Hillsboro, OR). This minimally invasive technique can be used to avoid the large incision used in the traditional open reduction and internal fixation of these fractures. Accurate reduction and stable fixation of fractures of the articular surface of the talus is a must, and this technique allows this while avoiding the morbidity of the open approach.
-
The purpose of this study was to evaluate the effect of various local anesthetics on chondrocyte viability in articular cartilage by use of a bovine disk model. ⋯ After arthroscopic surgery, it has been common practice to inject various local anesthetics into the joint for pain relief. Because adult chondrocytes have little or no capacity to regenerate, these results suggest that high-dose, long-term intra-articular administration of local anesthetics should be performed with caution.
-
Shoulder arthroscopy has become a routine outpatient surgery. Pain control is a limiting factor for patient discharge after surgery, and several modalities are used to provide continued analgesia postoperatively. Regional anesthetic blocks and shoulder pain pumps are common methods to provide short-term pain control. ⋯ Several clinical studies suggested--which was confirmed by a bovine and rabbit cartilage study--that there is significant chondrotoxicity from bupivacaine, a local anesthetic commonly used in pain pumps. Postarthroscopic glenohumeral chondrolysis is a noninfectious entity associated with factors including use of radiofrequency thermal instruments and intra-articular pain pumps that administer bupivacaine, but there have been no cases reported with subacromial pain pump placement. Treatment options are difficult in a young patient with postarthroscopic glenohumeral chondrolysis, and understanding the literature with regard to risk factors is paramount to counseling patients and preventing this devastating complication.
-
Randomized Controlled Trial Comparative Study
The effect of forced-air warming during arthroscopic shoulder surgery with general anesthesia.
The aim of this study was to compare the change in body temperature between the cotton blanket group and forced-air warming blanket group during arthroscopic shoulder surgery. In both groups irrigation fluid at room temperature (22 degrees C) was used. ⋯ Level I, randomized controlled trial.
-
The purpose of this systematic review was to address the treatment of multiligament knee injuries, specifically (1) surgical versus nonoperative treatment, (2) repair versus reconstruction of injured ligamentous structures, and (3) early versus late surgery of damaged ligaments. ⋯ Our review suggests that early operative treatment of the multiligament-injured knee yields improved functional and clinical outcomes compared with nonoperative management or delayed surgery. Repair of the posterolateral corner may yield higher revision rates compared with reconstruction.