Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Sep 2012
The effect of local anesthetic and corticosteroid combinations on chondrocyte viability.
Local anesthetic and corticosteroid combination injections are often used in clinical practice, however research investigating the chondrotoxic properties of these combinations is minimal. The goal of this study was to evaluate the effect of single injection doses of 1% lidocaine or 0.25% bupivacaine in combination with single injection doses of dexamethasone sodium phosphate (Decadron), methylprednisolone acetate (Depo-Medrol), betamethasone sodium phosphate and betamethasone acetate (Celestone Soluspan), or triamcinolone acetonide (Kenalog) on human chondrocyte viability. ⋯ Clinicians should use caution when injecting 1% lidocaine or 0.25% bupivacaine in conjunction with betamethasone sodium phosphate and betamethasone acetate solution due to its pronounced chondrotoxic effect in this study. 1% lidocaine used in combination with methylprednisolone acetate or triamcinolone acetonide also led to significant chondrotoxicity.
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Corticosteroids are commonly injected into the joint space. However, studies have not examined the chondrotoxicity of one-time injection doses. The purpose of this study is to evaluate the effect of dexamethasone sodium phosphate (Decadron), methylprednisolone acetate (Depo-Medrol), betamethasone sodium phosphate and betamethasone acetate (Celestone Soluspan), and triamcinolone acetonide (Kenalog) on human chondrocyte viability in vitro. ⋯ A single-injection dose of betamethasone sodium phosphate and betamethasone acetate solution illustrated consistent and significant chondrotoxicity using a physiologically relevant in vitro model and should be used with caution. Given the observed chondrotoxicity of triamcinolone acetonide in a single trial, there may be some evidence that this medication is chondrotoxic. However, at 14 days, betamethasone sodium phosphate and betamethasone acetate was the only condition that caused significant cell death.
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Knee Surg Sports Traumatol Arthrosc · Aug 2012
Patellar dislocation in skeletally immature patients: semitendinosous and gracilis augmentation for combined medial patellofemoral and medial patellotibial ligament reconstruction.
Patellar instability is a frequent condition in children and adolescents. The problem can be associated with malalignment resulting from different anatomical abnormalities. Several surgical procedures have been suggested for recurrent patellar dislocation consequent to failed conservative treatment. ⋯ Expert opinion, Level V.
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Knee Surg Sports Traumatol Arthrosc · Aug 2012
Randomized Controlled Trial Comparative StudyBiomechanical comparison of three techniques for fixation of tibial avulsion fractures of the anterior cruciate ligament.
To evaluate the initial stability of a suture anchor fixation and to compare this with a screw fixation and pull-out suture fixation for anterior cruciate ligament tibial avulsion fracture. ⋯ These biomechanical results suggest that the initial fixation strength of suture anchor fixation was not less than that of screw fixation or pull-out suture fixation. And, the initial displacement of suture anchor fixation was lower than that of screw fixation or pull-out suture fixation. The suture anchor fixation appears to be a good alternative fixation technique for repair of anterior cruciate ligament tibial avulsion fracture.
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Knee Surg Sports Traumatol Arthrosc · Aug 2012
Patella baja after unicompartmental knee arthroplasty.
The literature data on patellar height following unicompartmental knee arthroplasty (UKA) are scarce. ⋯ Diagnostic study, Level III.