Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jul 2007
Adult tibial eminence fracture fixation: arthroscopic procedure using K-wire folded fixation.
The purpose of this article is to describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fractures using folded surgical pin. This technique allows reduction and fixation of the bone fragment without using special equipment. After standard arthroscopic procedure to explore the knee and to remove fracture debris and blood clot, the bone block is reduced and advanced with the spike of the anterior cruciate ligament tibial drill guide. ⋯ Next, the other side is bent on the anterior tibial cortex and cut. This arthroscopic fixation allows elastic compression fragment stabilization that authorizes early weight bearing and rehabilitation programs. The material is extracted by traction after 6 months.
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Knee Surg Sports Traumatol Arthrosc · Jun 2007
Second-look arthroscopy after arthroscopy-assisted treatment of tibial plateau fractures.
The only way to show the healing potential in hyaline cartilage after the treatment of tibial plateau fractures in humans is the second-look arthroscopy. Our aim is to examine the healing potential of the hyaline cartilage in tibial plateau fractures treated with arthroscopy-assisted surgery. We applied second-look arthroscopy to the 12 patients out of 52 who had tibial plateau fractures treated by arthroscopy-assisted surgery. ⋯ Moreover, if there is step-off, insufficient healing potential appears. Although we did not have enough cases, we can say that in tibial plateau fractures anatomic reduction is mandatory. Contrary to the common idea, step-off is not tolerated by hyaline cartilage.
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Knee Surg Sports Traumatol Arthrosc · Jun 2007
Case ReportsAn unusual case of foreign body knee that spontaneously migrated inside and out of the joint: arthroscopic removal.
Cause of acute knee pain and locking episodes in a young sports person can be due to foreign bodies which penetrated unnoticed into the joint cavity. Here we report an unusual injury of this kind where a glass foreign body remained in the subcutaneous tissue for many years and then migrated late into the knee joint cavity. Complaints occurred for the first time in adult age. ⋯ The late and episodic migration of the glass piece into the joint from its extracapsular location produced symptoms of acute pain and locking. There is no reported case of such spontaneous and episodic migration of a glass foreign body inside and out of the knee joint resulting in acute episodes of pain and locking during sporting activity mimicking a torn meniscus or a chondral lesion. This report highlights the importance of accurate history taking, thorough physical examination, besides describing this unusual extra capsular location of the glass foreign body during arthroscopic surgery.
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Knee Surg Sports Traumatol Arthrosc · May 2007
Randomized Controlled TrialIntraarticular tramadol plus pericapsular incisional bupivacaine provides better analgesia than intraarticular plus pericapsular incisional bupivacaine after outpatient arthroscopic partial meniscectomy.
Postoperative analgesic effects of intraarticular tramadol plus periarticular bupivacaine, and intraarticular plus periarticular bupivacaine injections after day-case arthroscopic partial meniscectomy were compared. Seventy-four ASA I/II patients undergoing arthroscopic partial meniscectomy, performed by a single surgeon under general anesthesia were assigned in a randomized, double-blinded manner into two groups: Group TB (n = 41) received intraarticular 100 mg of tramadol in 20 ml normal saline and periarticular incisional injection of 10 ml bupivacaine 0.5%. Group BB (n = 33) received intraarticular 20 ml 0.25% and periarticular incisional 10 ml 0.5% bupivacaine injections. ⋯ VAS scores at rest at 15, 30 min and at movement at 0, 15, 30 min were lower in group TB (P < 0.05). First time requiring additional analgesia was lower in group TB (17.1 +/- 21.9, 33.8 +/- 26.6) (P < 0.05) and total paracetamol dose at the end of 24 h was 1.2 +/- 1.5 g in group BB and 0.9 +/- 1.3 g in group TB (P < 0.05). Intraarticular tramadol plus periarticular bupivacaine combination provides better pain relief and less analgesic requirement following arthroscopic outpatient partial meniscectomy surgery.
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Knee Surg Sports Traumatol Arthrosc · May 2007
Comparative StudySurgical treatment of type II floating knee: comparisons of the results of type IIA and type IIB floating knee.
The prognosis of type II floating knee injuries was not as good as that of type I. Our purpose is to clarify the factors affecting the outcome of type II floating knee injuries. Thirty-five patients (36 limbs) with type II floating knee injury were studied with a mean follow-up of 52 months (26-96). ⋯ Intra-articular knee involvement is the most important factor contributing to poor outcome of type II floating knee. The treatment of floating knee injuries with intra-articular knee involvement is still difficult. Further efforts to search better methods of treatment are required for these complex injuries in the future.