Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialKnee arthroscopy with different anesthesia methods: a comparison of efficacy and cost.
To evaluate the cost and time effectiveness for different anesthesia methods when performing knee arthroscopy, this study compared three different anesthesia methods. Four hundred healthy patients scheduled for knee arthroscopy were randomized to either local anesthesia (LA) (n=200), spinal anesthesia (SA) (n=100) or general anesthesia (GA) (n=100). The LA arthroscopies were performed in a facility set up in our outpatient department without anesthesia service. ⋯ The time from start of anesthesia to start of surgery was significantly longer in the LA group, 39.2 min (SD 13.13, range 17-87), compared to 20.1 min (SD 4.93, range 11-35) in the SA group and to 17.6 min (SD 4.64, range 9-44) in the GA group. There were no differences in the surgery time for the three groups. The use of LA was shown to save SEK 1011 (Swedish Crowns) per patient compared to SA and GA.
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Knee Surg Sports Traumatol Arthrosc · Sep 2004
Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound.
The aim of the study is to develop a clinically useful and reproducible method for evaluating lateral meniscal extrusion in normal and transplanted knees under different axial loading conditions. Magnetic resonance imaging (MRI) and ultrasound (US) were used to assess meniscal extrusion. Both types of imaging were performed at least 6 months postoperatively (mean 23.5 months). ⋯ The anterior horn of both normal and transplanted menisci is extruded more laterally than the posterior horn. Both methods are adequate to measure laterally-directed extrusion of the normal and transplanted lateral meniscus, but have distinctive advantages and disadvantages: MRI in this series visualizes the complete-from posterior to anterior-meniscal body, but only in the supine, non-weight-bearing position. Using ultrasound one can evaluate the meniscal extrusion in different conditions of axial loading, but only from a single examination point.
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Knee Surg Sports Traumatol Arthrosc · Sep 2004
Distribution of substance-P nerve fibers in intact and ruptured human anterior cruciate ligament: a semi-quantitative immunohistochemical assessment.
Numerous studies have reported qualitative and quantitative analysis of nerve supply in the anterior cruciate ligament; however, as yet relatively little is known about the distribution of substance-P nerve endings in the human anterior cruciate ligament. The objective of this work was to evaluate the distribution of substance-P nerve fibers in intact human anterior cruciate ligament, and determine if rupture of the ligament has any influence on occurrence of these receptors. The intact anterior cruciate ligament group (group 1) of osteoarthritis knee, undergoing total knee arthroplasty, consisted of nine patients (eight females) with a mean age of 65.3 years at surgery. ⋯ This study showed that distribution of the nociceptive nerve supply, positively stained for substance-P, is equal among the intact anterior cruciate ligament. The substance-P nerve ending density was significantly affected by the injury as well as by the time since rupture. The results of this study provide immunohistochemical evidence suggesting that between 1 to 4 months after rupture the site of the injury undergoes neurogenic inflammation, which could have an influence on the healing course of the torn ligament.