Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Nov 2004
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesic effect of intra-articular ketorolac in knee arthroscopy: comparison of morphine and bupivacaine.
This prospective study assessed the postoperative analgesic effect of intra-articular ketorolac, morphine, and bupivacaine during arthroscopic outpatient partial meniscectomy. Group 1 patients (n=20) received postoperative injection of 60 mg intra-articular ketorolac, group 2 patients (n=20) 10 cc intra-articular bupivacaine 0.25%, group 3 patients (n=20) 1 mg intra-articular morphine diluted in 10 cc saline, and group 4 patients (n=20, controls) only 10 cc saline. ⋯ No complications were found related to the intra-articular treatment. We conclude that 60 mg intra-articular ketorolac provides better analgesic effect than 10 cc intra-articular bupivacaine 0.25% or 1 mg intra-articular morphine.
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Knee Surg Sports Traumatol Arthrosc · Nov 2004
Open reconstruction of anterior glenoid rim fractures.
The present study evaluates the clinical and radiological results of patients with anterior glenoid rim fractures treated with two different open surgical techniques depending on the size of the bony fragment. In patients with displaced glenoid rim fractures involving less than 25% of the glenoid surface (Type I, II and IIIA fractures) suture anchor repair was performed. Patients with a bony defect involving more than 25% of the glenoid surface (Type IIIB fractures) underwent open reduction and internal fixation using cannulated screws. ⋯ Three patients in group one and one patient in group two had glenohumeral osteoarthritic changes. In cases of small glenoid-rim fractures (Type I, II and IIIA fractures), suture anchor repair resulted in an excellent clinical outcome; however, the radiological results of chronic Type I fractures revealed in many cases a non-anatomical glenoidal reconstruction. For Type IIIB fractures with significant loss of glenoid concavity, open reduction and internal fixation with cannulated screws gave good clinical and radiological results; however the early complication rate was higher.
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Knee Surg Sports Traumatol Arthrosc · Nov 2004
Comparative StudyComparison of anterior cruciate ligament reconstruction in male and female athletes using the patellar tendon and hamstring autografts.
Despite the higher incidence of anterior cruciate ligament (ACL) injuries in female than in male athletes few authors have studied the effects of gender on the outcome of ACL reconstruction. This prospective study compared the results of ACL reconstruction using the patellar tendon and hamstring techniques in men and women. We prospectively followed 80 comparable athletes (46 males, 32 females) from a population of 287 patients operated on at our institution for ACL reconstruction using either patellar tendon or hamstring graft. ⋯ Among patellar tendon patients there were no significant differences between males and females regarding knee evaluation form, laxity, or isokinetic and functional tests. Females in the hamstring group had significantly greater laxity, and isokinetic tests at 1 year revealed a significantly higher deficit of peak torque at 60 degrees /s in flexion and extension. We suggest further studies on the clinical significance of these findings particularly on their possible ramifications in the areas of return to sports and rehabilitation of female athletes.
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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.