J Bone Joint Surg Br
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The menisci of the knee have an important role in load-bearing and shock absorption within the joint. They may also function as secondary stabilisers, have a proprioceptive role, and aid the lubrication and nutrition of the articular cartilage. Complete or partial loss of a meniscus can have damaging effects on a knee, leading to serious long-term sequelae. This paper reviews the consequences of meniscectomy and summarises the body of evidence in the literature regarding those factors most relevant to long-term outcome.
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J Bone Joint Surg Br · Dec 2006
Case ReportsFracture of the stem of the femoral component after resurfacing arthroplasty of the hip.
Resurfacing arthroplasties of the hip are being undertaken with increasing frequency and the complications associated with this procedure are well documented. We have encountered a further problem with a fracture of the centralising peg of the femoral component in a prosthesis which had been in situ for three years.
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J Bone Joint Surg Br · Dec 2006
Neurolysis is not required for young patients with a spontaneous palsy of the anterior interosseous nerve: retrospective analysis of cases managed non-operatively.
We studied 21 patients with a spontaneous palsy of the anterior interosseous nerve. There were 11 men and 10 women with a mean age at onset of 39 years (17 to 65). Pain around the elbow or another region (forearm, shoulder, upper arm, systemic arthralgia) was present in 17 patients and typically lasted for two to three weeks. ⋯ Prolonged pain was not always associated with a poor outcome but the age of the patient when the palsy developed was strongly correlated. Recovery occurred within 12 months in patients under the age of 40 years who achieved a final British Medical Research Council grade of 4 or better. Surgical decompression does not appear to be indicated for young patients with this condition.
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J Bone Joint Surg Br · Dec 2006
Randomized Controlled TrialThe efficacy of intra-articular bupivacaine for relief of pain following arthroscopy of the ankle.
The intra-articular injection of local anaesthetic is frequently used for pain relief after arthroscopy. There is, however, no published evidence of the analgesic effect of bupivacaine in the ankle. ⋯ Intra-articular bupivacaine had a significant analgesic effect in the immediate post-operative period, reducing pain scores and the need for additional analgesics. We recommend the use of intra-articular bupivacaine for post-operative analgesia in ankle surgery.
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J Bone Joint Surg Br · Dec 2006
Case ReportsDelayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures.
The use of volar locking compression plates for the treatment of fractures of the distal radius is becoming increasingly popular because of the stable biomechanical construct, less soft-tissue disturbance and early mobilisation of the wrist. A few studies have reported complications such as rupture of flexor tendons. We describe three cases of rupture of extensor tendons after the use of volar locking compression plates. We recommend extreme care when drilling and placing the distal radial screws to prevent damaging the extensor tendons.