Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jan 1997
Randomized Controlled Trial Clinical TrialPre- and postoperative intra-articular analgesia for arthroscopic surgery of the knee and arthroscopy-assisted anterior cruciate ligament reconstruction. A double-blind randomized, prospective study.
We tested the effectiveness of different intra-articular analgesics and of pre-emptive intra-articular analgesia for arthroscopy-assisted anterior cruciate ligament reconstruction (ACLR) and for operative knee arthroscopy. Eighty-two patients underwent operative knee arthroscopy under selective subarachnoid anaesthesia (group A), and 60 patients underwent arthroscopy-assisted ACLR under general anaesthesia (group B). Patients were randomly assigned to intra-articular analgesic treatment as follows. ⋯ Morphine provides a better pain control both in operative knee arthroscopy patients and in ACLR. A 2 mg dose is adequate for operative knee arthroscopy but not for ACLR, where higher dosages are required (5 mg). Pre-emptive intra-articular morphine provides better analgesia than postoperative administration.
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Knee Surg Sports Traumatol Arthrosc · Jan 1997
Case ReportsSignificance of corrective growth of opposite physes in the surgical correction of deformity following epiphyseal injury around the knee joint.
Deformation due to growth disturbance after epiphyseal fractures around the knee may involve more than the primarily injured epiphysis, as spontaneous corrective growth of the opposite epiphyseal plate can take place in an attempt to maintain overall alignment of the leg. As a result, there will be an inclination in the knee joint line if corrective osteotomy is only performed for the primary angulation. We report two cases of this complex deformity in which corrective osteotomies of both the distal femur and the proximal tibia were performed, resulting in correct alignment of the overall leg axis and knee joint axis.
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Knee Surg Sports Traumatol Arthrosc · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialPullout strength of tibial graft fixation in anterior cruciate ligament replacement with a patellar tendon graft: interference screw versus staple fixation in human knees.
The endoscopic single incision technique for anterior cruciate ligament (ACL) reconstruction with a femoral half-tunnel may lead to a graft/tunnel mismatch and subsequent protrusion of the block from the tibial tunnel. The typical tibial fixation with an interference screw is not possible in these cases. Fixation with staples in a bony groove inferior to the tunnel outlet can be used as an alternative technique. ⋯ Stiffness calculated at 175 N load was significantly higher in staple fixation. With either fixation technique, the recorded failure loads were sufficient to withstand the graft loads which are to be expected during the rehabilitation period. Staple fixation of the bone block outside of the tunnel resulted in a fixation strength comparable to interference screw fixation.
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Knee Surg Sports Traumatol Arthrosc · Jan 1997
Editorial CommentArthroscopic surgery and local anaesthesia.