Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesic effects of intra-articular bupivacaine and morphine after arthroscopic cruciate ligament surgery.
Intra-articular administration of local anaesthetics such as bupivacaine can produce short-term postoperative analgesia in patients undergoing diagnostic arthroscopy or arthroscopic meniscectomy. A peripheral anti-nociceptive effect may also be induced by the administration of intra-articular opiates interacting with local opioid receptors in inflamed peripheral tissue. In the present study we aimed to study the analgesic effects of intra-articularly given bupivacaine and morphine sulphate (as well as the combination of both drugs) on postoperative pain. ⋯ In the group that received a combination of both bupivacaine and morphine, the pain scores were significantly reduced throughout the whole postoperative observation period. No side-effects or complications from therapy were seen in any of the groups. The conclusion of this study is that intra-articular morphine is effective in the postoperative period after arthroscopic ACL reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
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Knee Surg Sports Traumatol Arthrosc · Jan 1995
Case ReportsTibial-talar dislocation without fracture: treatment principles and outcome.
The incidence of tibial-talar dislocations without fracture is unknown and has been sparsely reported in the literature. The diagnosis of the injury is straightforward with the appropriate examination and roentgenograms. ⋯ Although open dislocations require irrigation, debridement, and possibly delayed closure, controversy exists with regard to acute ligament repair. Because good to excellent results are possible without acute ligament repair, and delayed repair on reconstruction can be accomplished with good outcomes, we recommend treating these injuries without ligament repair.
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Knee Surg Sports Traumatol Arthrosc · Jan 1995
Osteoid osteoma in the differential diagnosis of persistent joint pain.
We report 20 cases (13 male and 7 female), mean age 21 years) of juxta-articular osteoid osteoma. The distribution of affected joints was as follows: hip joint (7 cases), knee joint (2 cases), ankle joint (2 cases); iliosacral joint (2 cases), lumbar spine (2 cases), carpus (2 cases), shoulder (1 case), second metacarpal (MCP; 1 case) and first metatarsal (MTP; 1 case). The duration between the onset of symptoms and diagnosis varied from 8 months to approximately 4 years. ⋯ When the clinical picture is suggestive but radiological findings are negative, we must proceed to further investigation with bone scintigraphy and computed tomography. These examinations should be repeated 1 year after the onset of symptoms because initially negative findings may become positive at a later date. When the diagnosis of an osteoid osteoma is confirmed, surgical excision leads to complete relief of the symptoms.