Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Mar 2004
A clinical case and anatomical study of the innervation supply of the vastus medialis muscle.
The innervation supply to the vastus medialis (VM) muscle, a component of quadriceps femoris (QF), is provided by a branch of the femoral nerve (FN) running along the muscle. The course of the nerve from lumbar roots to the muscle has been described by many researchers. It is known to ride along the femoral vein, artery and saphenous nerve and enter the adductor canal (Hunter's canal), and then to divide into branches that supply vastus medialis and the knee joint. ⋯ Isolated vastus lateralis (VL) atrophies have been reported by a few authors, suggesting that compression of the nerve and direct violation of the nerve with injections might be the reason for mononeuropathy. Isolated VM atrophy has not been previously reported. The purpose of the study was to identify the anatomical structures around the FN branch which innervates the VM muscle.
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Knee Surg Sports Traumatol Arthrosc · Mar 2004
Comparative StudyTunnel enlargement and changes in synovial fluid cytokine profile following anterior cruciate ligament reconstruction with patellar tendon and hamstring tendon autografts.
There is growing evidence that cytokines such as tumor necrosis factor (TNF) alpha, interleukin (IL) 1beta, IL-6, bone morphogenetic proteins (BMP), and nitric oxide (NO) play an important role in the pathogenesis of bone tunnel enlargement following anterior cruciate ligament (ACL) reconstruction. Furthermore, the release of these mediators has been considered a possible reason for the higher incidence of bone tunnel enlargement following hamstring tendon (HST) than following patellar tendon (PT) ACL reconstruction observed in several studies. In this investigation synovial fluid samples from 13 patients were collected immediately before (24+/-7 days after ACL rupture) and 7 days after ACL surgery and values of TNF-alpha, IL-1beta, IL-6, NO, and BMP-2 were analyzed. ⋯ There were no significant differences in concentrations between HST and PT groups. In conclusion, we observed an association between tibial bone tunnel enlargement and elevated synovial fluid concentrations of IL-6, TNF-alpha, and NO 7 days after ACL surgery indicating the potential involvement of these biological mediators in the pathogenesis of bone tunnel enlargement. However, there was no difference between HST and PT ACL reconstructions regarding synovial fluid contents of IL-6, TNF-alpha, IL-1beta, NO, and BMP-2, suggesting a comparable biological response between these autografts following their use in ACL reconstruction.
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Knee Surg Sports Traumatol Arthrosc · Mar 2004
Randomized Controlled Trial Clinical TrialBilateral vs. unilateral spinal anesthesia for outpatient knee arthroscopies.
This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to intraoperative and postoperative complications, and time to discharge from hospital for knee arthroscopies in outpatients. We studied 70 ASA I patients scheduled for elective outpatient knee arthroscopy. The patients were randomly allocated into two groups to receive either 3 ml (15 mg) 0.5% hyperbaric bupivacaine (bilateral group) or 1.5 ml (7.5 mg) 0.5% hyperbaric bupivacaine (unilateral group). ⋯ Nine patients in the bilateral group and six patients in the unilateral group developed postspinal headache. Backache occurred in five patients in the bilateral group and in six patients in the unilateral group. Our data indicate that the use of unilateral spinal block is a suitable technique for knee arthroscopies in outpatients.
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Knee Surg Sports Traumatol Arthrosc · Mar 2004
Case ReportsRehabilitation of avulsion fracture of the tibial tuberosity following Osgood-Schlatter disease.
A sixteen-year-old boy suffered from sharp pain in the knee during a jump while playing basketball. He had a positive history of Osgood Schlatter disease. Radiographic evaluation demonstrated an avulsion fracture of the tibial tuberosity Type III according to the classification of Watson-Jones. ⋯ In such avulsion fractures, landing on the ground with the knee fully extended after a jump is the most likely cause. This case report reviews the rehabilitation program, and selected functional outcome measures after rehabilitation are reported. The patient returned to sporting activity after 12 months.