Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Apr 2007
Randomized Controlled TrialArthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial.
In this prospective randomised study two treatments after non-traumatic medial meniscal tear diagnosed with radiological examination and magnetic resonance imaging were compared; arthroscopic partial meniscectomy followed by supervised exercise or supervised exercise alone. The aim was to evaluate knee function and physical activity. Ninety patients (mean age 56 years) were evaluated using the Knee Injury and Osteoarthritis Outcome Score, the Lysholm Knee Scoring Scale, the Tegner Activity Scale and a Visual Analogue Scale for knee pain prior to the intervention, after 8 weeks of exercise and after 6 months. ⋯ After the intervention both groups reported decreased knee pain, improved knee function and a high satisfaction (P<0.0001). Forty-one per cent of the patients returned to their pre-injury activity level after 6 months. In conclusion, when evaluated with outcome scores, arthroscopic partial medial meniscectomy followed by supervised exercise was not superior to supervised exercise alone in terms of reduced knee pain, improved knee function and improved quality of life.
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Knee Surg Sports Traumatol Arthrosc · Apr 2007
Results of treatment of septic knee arthritis: a retrospective series of 40 cases.
We studied a consecutive series of 40 patients presenting a septic knee arthritis, with a mean age of 49 +/- 20 (range 19-81) years. The aetiologies were: 18 postoperative arthritis, 12 haematogenous infections, 7 arthritis following aspiration or infiltration, and 3 articular wounds. The most common organisms were Staphylococcus aureus and epidermidis (23 cases). ⋯ Needle aspiration should be only performed at the very early stages. Arthroscopic debridement should be the routine treatment. Synovectomy should be considered even as a primary procedure when significant synovial hypertrophy is present (Gächter stage III and IV) or when a more conservative treatment did not lead to a fast improvement.
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Knee Surg Sports Traumatol Arthrosc · Apr 2007
Randomized Controlled TrialEarly versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study.
The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either patellar tendon or hamstring grafts. Sixty-eight patients, 36 males and 32 females, with either patellar tendon graft (34 patients) or hamstring graft (34 patients) were enrolled in this study. All patients were randomly allocated to either early (the 4th postoperative week) or late (the 12th postoperative week) start of OKC exercises for the quadriceps, resulting in four subgroups: patellar tendon reconstruction, early start (P4) or late start (P12) of OKC quadriceps exercises, hamstring tendon reconstruction, early start (H4) or late start (H12) of quadriceps OKC exercises. ⋯ On the contrary, it appears as if the choice of graft affected the strength of the specific muscle more than the type of exercises performed. Our results could not determine the appropriate time for starting OKC quadriceps exercises for patients who have undergone ACL reconstruction with hamstring tendon graft. Future studies of long-term results of anterior knee laxity and functional outcome are needed.
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Knee Surg Sports Traumatol Arthrosc · Apr 2007
The Oxford phase III unicompartmental knee replacement in patients less than 60 years of age.
Treatment of younger patients with medial unicompartmental disease of the knee joint remains a challenging therapeutic dilemma. With the refinement of implant design, fixation and the minimally invasive techniques employed with unicompartmental knee replacement, indications have expanded to include its use in young patients. ⋯ We conclude that the unicompartmental knee arthroplasty is an important option for the treatment of medial compartment disease for patients 60 years or younger. Obesity can cause technical difficulties, increased risk of complications and early failure of this prosthesis.