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1.
BMC Musculoskelet Disord ; 22(1): 845, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600519

RESUMO

BACKGROUND: Anterior shoulder dislocation remains a clinical challenge. This study aimed to assess the graft position and clinical outcomes of the arthroscopic Latarjet procedure and capsular repair for the treatment of recurrent anterior shoulder dislocation with significant glenoid bone loss in 37 patients. METHODS: Between 2017 and 2017, 37 patients underwent arthroscopic Latarjet plus capsular repair procedure for recurrent anterior shoulder dislocation combined with significant glenoid bone loss. In follow-up examinations, Walch-Duplay scores, subjective shoulder value (SSV) scores, Rowe scores, and active range of motion (AROM) were assessed. Three-dimensional computed tomography (CT) was used to evaluate coracoid graft position and bone resorption. A new method of evaluating the position of the coracoid bone block after Latarjet (H-Z method) was developed. RESULTS: Thirty-seven patients were included in this study. Follow-up ranged from 6 to 36 months postoperatively (with an average of 13 months). No recurrent dislocation occurred at the final follow-up, and there was no significant effect on the AROM (all p > 0.05). Rowe (from 42.2 ± 5.6 to 91.1 ± 3.3), Walch-Duplay (from 31.5 ± 8.0 to 92.6 ± 3.7), and SSV (from 63.9 ± 6.1 to 79.3% ± 5.0%) scores were improved significantly after surgery (all p < 0.001). CT showed that the 29 patients had varying degrees of bone resorption, and 23 recovered to the preinjury level of motional function within 6-12 months after surgery. CONCLUSIONS: In active patients with recurrent anterior shoulder dislocations and significant glenoid bone loss, the arthroscopic Latarjet procedure plus capsular repair could restore shoulder stability satisfactory.


Assuntos
Luxações Articulares , Instabilidade Articular , Articulação do Ombro , Artroscopia , Humanos , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Ombro , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia
2.
Ann Palliat Med ; 10(9): 9859-9869, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628912

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) causes joint pain and dysfunction that severely affects the patient's ability to walk. Arthroscopy combined with intraarticular injection of sodium hyaluronate can slow the development of knee osteoarthritis, but there is a lack of rigorous evidence-based medicine evaluation, and it has not been recognized by some scholars at home and abroad. This paper analyzed the clinical efficacy of arthroscopy combined with intraarticular injection of sodium hyaluronate in slowing knee osteoarthritis based on Lysholm score. METHODS: Randomized control trials of arthroscopy combined with intra-articular injection of sodium hyaluronate in the treatment of KOA on Chinese and English databases were retrieved using the following search terms: "knee osteoarthritis", "arthroscopic debridement of the joint", "articular cavity", and "sodium hyaluronate". The quality of the literature was evaluated using the Rev Man 5.3 software. RESULTS: Twelve literatures were included in the meta-analysis. Regarding Newcastle-Ottawa Scale (NOS) score, of the 12 literatures, 7 literatures (58.33%) scored 6-9 points, 3 literatures (25%) scored 3-5 points, and 2 literatures (16.67%) scored 0-2 points. With a random effects model used for analysis, the Lysholm score after 1 month of combined treatment was significantly higher than that before treatment [mean difference (MD) =30.65, 95% confidence interval (CI): 19.44, 41.86, P<0.01]. Further, after 3 months of combination treatment, the Lysholm score was significantly higher than that before treatment (MD =24.04, 95% CI: 13.75, 34.32, P<0.01), and the same trend was also observed after 6 months (MD =20.41, 95% CI: 14.43, 26.40, P<0.01) and after 12 months (MD =20.86, 95% CI: 8.99, 32.72, P<0.01) of combination treatment. Overall, the combined treatment achieved significantly better clinical therapeutic effects than the single treatments in the control group [odds ratio (OR) =7.51, 95% CI: 4.84, 11.65, P<0.01]. DISCUSSION: This meta-analysis has confirmed that arthroscopy combined with intra-articular injection of sodium hyaluronate demonstrates significant clinical therapeutic effects in the treatment of KOA. This combination treatment can significantly improve knee joint function, relieve clinical symptoms, and improve patients' quality of life.


Assuntos
Ácido Hialurônico , Osteoartrite do Joelho , Artroscopia , Humanos , Ácido Hialurônico/uso terapêutico , Injeções Intra-Articulares , Osteoartrite do Joelho/tratamento farmacológico , Qualidade de Vida
3.
J Am Acad Orthop Surg ; 29(20): 862-871, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34623341

RESUMO

Arthroscopy has become increasingly relevant to various subspecialties within the orthopaedic surgery. From a patient safety standpoint and surgical efficiency standpoint, it is critical to know the fundamental concepts of fluid management such as those related to the fluid, pressure, and flow. A satisfactory field of view during arthroscopy can be achieved with the use of gravity-dependent or automated fluid management systems. Fluid management parameters and their physiological impact on the patient should be continuously monitored to avoid morbidity or delayed recovery. Local and systemic complications can occur from careless use of techniques that improve visualization such as tourniquet, epinephrine-diluted irrigation, and controlled hypotensive anesthesia. The purpose of this article is to review the fundamental concepts of fluid management in arthroscopy and the techniques to safely improve arthroscopic visualization.


Assuntos
Artroscopia , Irrigação Terapêutica , Epinefrina , Humanos
4.
BMC Musculoskelet Disord ; 22(1): 838, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34592991

RESUMO

BACKGROUND: Although rotator cuff syndrome is common and extensively studied from the perspective of producing healed tendons, influence of gender on patient-reported outcomes is less well examined. As activity and role demands may vary widely between men and women, clarity on whether gender is an important factor in outcome would enhance patient education and expectation management. Our purpose was to determine if differences exist in patient-reported outcomes between men and women undergoing rotator cuff surgery. METHODS: One hundred forty-eight participants (76 W:72 M) aged 35-75 undergoing surgery for unilateral symptomatic rotator cuff syndrome were followed for 12 months after surgery. Demographics, surgical data, and the Western Ontario Rotator Cuff (WORC) scores were collected. Surgery was performed by two fellowship-trained shoulder surgeons at a single site. RESULTS: There were no gender-based differences in overall WORC score or subcategory scores by 12 months post-op. Pain scores were similar at all time points in men and women. Women were more likely to have dominant-arm surgery and had smaller rotator cuff tears than men. Complication rates were low, and satisfaction was high in both groups. CONCLUSION: Patient gender doesn't appear to exert an important effect on patient-reported rotator cuff outcomes in this prospective cohort. Further work examining other covariates as well as the qualitative experience of going through rotator cuff repair should provide greater insight into factors that influence patient-reported outcomes.


Assuntos
Lesões do Manguito Rotador , Manguito Rotador , Artroplastia , Artroscopia , Feminino , Humanos , Masculino , Estudos Prospectivos , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Ombro , Resultado do Tratamento
5.
BMC Musculoskelet Disord ; 22(1): 852, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610805

RESUMO

BACKGROUND: Post-arthroscopic osteonecrosis of the knee (PAONK) is a rare condition. No studies have analyzed the relationship between the meniscus extrusion and PAONK. The purpose of this retrospective study is to test a hypothesis that the degree of the medial meniscus (MM) extrusion might be significantly greater in the knees with PAONK than in the matched control knees both before and after the meniscectomy. METHODS: Ten knees with PAONK were detected out of a total of 876 knees which had undergone arthroscopic partial meniscectomy of the MM. Ten matched control knees were randomly selected out of the remaining 866 knees without PAONK. The clinical data of these 20 patients were retrospectively collected from the medical records. To evaluate the location of the menisci on the joint line, Extrusion width and Inner width were defined on a coronal section of magnetic resonance imaging (MRI). The intra- and inter-rater reliability was evaluated by calculating the intra- and inter-class coefficients. Statistical comparisons between the 2 groups were made using the 3 non-parametric tests. RESULTS: Before the meniscectomy, the Extrusion width of the MM (mean 4.7 ± 1.4 mm) was significantly greater than that (3.0 ± 1.3 mm) in the Control group (P = 0.0195). In the MRI taken in a range from 3 to 50 weeks after the meniscectomy, the Extrusion width of the MM (5.9 ± 1.1 mm) in the PAONK group was significantly greater than that (3.4 ± 1.4 mm) in the Control group (P = 0.0009), and the Inner width of the MM (0.6 ± 1.7 mm) in the PAONK group was significantly less than that (3.9 ± 1.0 mm) in the Control group (P = 0.0001). CONCLUSION: A significant relationship was found between the degree of the MM extrusion and the onset of PAONK. This study suggested that the extrusion of the MM is a potential predisposing factor for PAONK.


Assuntos
Osteonecrose , Lesões do Menisco Tibial , Artroscopia , Causalidade , Humanos , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/cirurgia , Osteonecrose/diagnóstico por imagem , Osteonecrose/epidemiologia , Osteonecrose/etiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/cirurgia
6.
BMC Musculoskelet Disord ; 22(1): 847, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610812

RESUMO

BACKGROUND: The partial articular supraspinatus tendon avulsion (PASTA) lesion repair remains a topic of debate. We have performed in situ repair of PASTA lesions using a potentially viable threading lasso fixation technique. This retrospective case series aimed to evaluate the clinical outcomes of PASTA lesion repair using threading lasso fixation. To the best of our knowledge, this is the first study to review this technique and its outcomes in terms of pain and upper extremity function. METHODS: Twenty-five patients with PASTA lesions who were treated with threading lasso fixation were reviewed. All patients were followed up for at least 1 year. Preoperative and follow-up data were retrospectively collected and reviewed. Clinical outcomes were assessed to evaluate the efficacy of the surgery. RESULTS: There were no postoperative complications. The average follow-up period was 25.7 (22-27) months. At the last follow-up, all patients underwent follow-up magnetic resonance imaging; only two cases showed a partially healed tendon and no case converted to full-thickness tear. Furthermore, shoulder pain decreased and mobility was recovered, with statistically significant differences in all scoring measures. Specifically, the mean visual analog scale score decreased from 5.4 ± 1.2 before surgery to 1.1 ± 0.8 at the last follow-up (t = 14.908, P < 0.01), and the mean American Shoulder and Elbow Surgeons Shoulder Assessment Form score improved significantly from 51.6 ± 6.4 to 89.3 ± 5.2 (t = 22.859, P < 0.01). Additionally, the mean University of California Los Angeles score improved from 17.8 ± 3.5 preoperatively to 32.3 ± 1.4 (t = 19.233, P < 0.01). CONCLUSIONS: Arthroscopic repair using threading lasso fixation is a novel transtendinous technique for patients with partial articular supraspinatus tendon avulsion. Tendon integrity is preserved with this method, which may result in improved function. Overall, threading lasso fixation technique is an effective treatment.


Assuntos
Lesões do Manguito Rotador , Manguito Rotador , Artroscopia , Humanos , Estudos Retrospectivos , Lesões do Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/cirurgia , Tendões
7.
J Pak Med Assoc ; 71(Suppl 5)(8): S41-S44, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34634014

RESUMO

OBJECTIVE: To establish a relationship between sub acromial bursa and shoulder impingement by determining its presence or absence in sub acromial space. To determine the novel prospects and favourable outcome after surgery in shoulder impingement syndrome. Methods: Over 1000 patients with the diagnosis of shoulder impingement were studied from 2003 to 2020 at Manor Teaching Hospital, Walsall, UK. During Arthroscopy, the findings were noted and documented. The sub acromial bursa and its presence or absence was noted along with kissing lesion of supraspinatus confirmed at Arthroscopy. Functional outcome in all patients was assessed with q-Dash score and pain relief was documented with VAS (Visual Analogue Scale). RESULTS: Sub acromial decompression did not completely resolve symptoms in 649(64.9%) patients having adequate bursa and no kissing lesion. Therefore, a cause other than acromion impingement was considered. However, in 351(35.1%) patients without any bursal tissue, sub acromial decompression alone had better results. Mean post-operative q-DASH score in group A (Bursa present) was 49.21±41 and in group B (Empty Bursa) it was 35.73±23. Mean post-operative VAS (Visual Analogue Scale) score in group A was 6.5±2.3 and in group B, it was 4.1±2.1. CONCLUSIONS: We report that the presence of kissing lesion and an empty Bursal space under the acromion is a high predictor of successful outcome after arthroscopic decompression.


Assuntos
Acrômio , Síndrome de Colisão do Ombro , Acrômio/diagnóstico por imagem , Acrômio/cirurgia , Artroscopia , Descompressão , Humanos , Manguito Rotador , Síndrome de Colisão do Ombro/cirurgia
8.
BMC Musculoskelet Disord ; 22(1): 869, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641837

RESUMO

BACKGROUND: Interosseous ligament vertical segment (IOLV) and calcaneofibular ligament (CFL) have been reported to be important in stabilizing the subtalar joint. Unlike CFL, there is not much information regarding the comparison of MRI results with surgical evaluation of IOLV and the comparison between 2D and 3D MRI on IOLV evaluation. The feasibility of MRI in IOLV evaluation has yet to be reported. The purpose of this study was to evaluate the validity and reliability of MRI in IOLV tear detection via correlation with arthroscopic results. We also compared the diagnostic performance of 2D and 3D MR images. METHODS: In this retrospective study, 52 patients who underwent subtalar arthroscopy after ankle MRI were enrolled. Arthroscopic results confirmed IOLV tear in 25 cases and intact IOLV in 27 cases. Two radiologists independently evaluated the IOLV tears using only conventional 2D images, followed by isotropic 3D images, and comparison with arthroscopic results. RESULTS: Only the 2D sequences interpreted by two readers showed a sensitivity of 64.0-96.0%, a specificity of 29.6-44.4%, a positive predictive value of 51.6-56.4%, and a negative predictive value of 57.1-88.9%. Addition of isotropic 3D sequences changed the sensitivity to 60.0-80.0%, specificity to 63.0-77.8%, positive predictive value to 64.3-76.9%, and negative predictive value to 66.7-80.8%. The overall diagnostic performance of isotropic 3D sequences (AUC values: 0.679-0.816) was higher than that of 2D sequences (AUC values: 0.568-0.647). Inter-observer and intra-observer agreement between the two readers was moderate-to-good for both 2D and 3D sequences. The diagnostic accuracy in 19 patients with tarsal sinus fat obliteration tended to increase from 26.3-42.1% to 57.9-73.7% with isotropic 3D sequences compared with 2D sequences. CONCLUSIONS: Isotropic 3D MRI was feasible for the assessment of IOLV tear prior to subtalar arthroscopy. Additional 3D sequences showed higher diagnostic accuracy compared with conventional 2D sequences in IOLV evaluation. Isotropic 3D sequences may be more valuable in detecting IOLV tear in case of tarsal sinus fat obliteration.


Assuntos
Artroscopia , Imageamento por Ressonância Magnética , Estudos de Viabilidade , Humanos , Ligamentos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
9.
J Am Podiatr Med Assoc ; 111(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34478532

RESUMO

BACKGROUND: The aim of the present study was to contribute new and updated information to the literature by comparing the clinical and radiologic results of arthroscopic microfracture, platelet-rich plasma (PRP) after arthroscopic microfracture, and BST-Cargel scaffold application after arthroscopic microfracture in the treatment of talar osteochondral lesions. METHODS: Sixty-two talar osteochondral lesion patients (31 women and 31 men) who underwent ankle arthroscopy in two different centers were randomized into three groups. The first group consisted of patients who underwent only arthroscopic microfracture (MF) (n = 22); the second group consisted of patients who underwent the PRP procedure after arthroscopic MF (PRP; n = 19); and the third group consisted of patients who underwent the BST-Cargel procedure after arthroscopic MF was (BST-Cargel; n = 21). The talar osteochondral lesions in the three groups were classified according to magnetic resonance and arthroscopic images. American Orthopedic Foot and Ankle Society, Foot and Ankle Ability Measurement (overall pain, 15-minute walking, running function), and visual analog scale scores were evaluated preoperatively and postoperatively, and postoperative return time to sports activities was performed. RESULTS: Compared to the preoperative score, postoperative American Orthopedic Foot and Ankle Society score increased 48.80 ± 9.60 in the BST-Cargel group, whereas there was an increase of 46.68 ± 3.65 in the PRP group and 29.63 ± 3.69 in the MF group, which were statistically significant (P < .05).There was a statistically significant postoperative change in the visual analog scale scores of the patients in all three groups compared to the preoperative scores (P < .05). At the end of the follow-up, the Foot and Ankle Ability Measurement overall pain, 15-minute walking, and running function results of all three groups increased significantly postoperatively compared to the preoperative values (P < .005). CONCLUSIONS: BST-Cargel application with microfracture is a method that can be applied easily and safely with arthroscopy to lesions larger than 1.5 cm2 regardless of the size of the cartilage defect, and it has been found to be superior to the other two methods in terms of pain, functional score, radiologic recovery, and return to sports activities.


Assuntos
Cartilagem Articular , Fraturas de Estresse , Fraturas Intra-Articulares , Tálus , Artroscopia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/cirurgia , Feminino , Humanos , Masculino , Estudos Prospectivos , Tálus/diagnóstico por imagem , Tálus/cirurgia , Resultado do Tratamento
10.
Acta Ortop Mex ; 35(1): 28-32, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34480436

RESUMO

INTRODUCTION: Diagnosis and management of congenital and traumatic articular ailments carry an additional problem in young people. Arthroscopy has improved treatment of these injuries, which are more frequent. OBJECTIVE: To describe the experience of arthroscopic handling in pediatric patients affected with knee disease, managed at a third level hospital in Puebla, Mexico. MATERIAL AND METHODS: Descriptive, retrospective, cross sectional study performed in patients having knee disease, admitted at Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia Puebla, from March first, 2015 to February 28th, 2018. Lysholm and IKDC functional scales and Tegner functional satisfaction scale were applied at zero, six and twelve months. Student's t and Wilcoxon tests were used. RESULTS: 29 young ones of five to 17 years of age became recruited, slightly more women (62.06%). The most frequently affected limb was the left one, with 55.17%. The disorders found are: discoid meniscus, harm of the anterior cruciate ligament, idiopathic inflammatory synovitis, tumor, meniscal injury, chondral damage, patellar hyperlaxity. Lysholm and IKDC registered improvement from the first semester. Tegner registered their ability to go back to previous daily occupations. On the Lysholm scale, there was improvement at six months. On the Tegner scale there was complete incorporation to their activities (previous to the presentation and surgical intervention). At six months subsequent to treatment, the IKDC evidenced improvement and recovery, and reintegration to their activities. Statistically significant differences (p 0.01) resulted, in measurements at zero, six and 12 months. CONCLUSIONS: Congenital and traumatic illnesses were found, the latter ones sports related. Arthroscopic approach registered positive functional results in these children.


Assuntos
Artroscopia , Hospitais , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , México , Estudos Retrospectivos , Resultado do Tratamento
11.
Acta Ortop Mex ; 35(1): 46-50, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34480439

RESUMO

INTRODUCTION: Posterior ankle arthroscopy allows the diagnosis and treatment of multiple pathologies through minimal trauma. The use of posterior portals associated or not to mechanical distraction, allows a good vision of the posterior ankle, tendons of the region, and subtalar joint. OBJECTIVES: We evaluated intra- and postoperative complications of posterior ankle arthroscopy without joint distraction, and compared them with those described in international literature. MATERIAL AND METHODS: A retrospective study that evaluated 49 patients undergoing posterior ankle arthroscopy for several pathologies. All of them operated by a single surgeon, in two health institutions, for seven years. RESULTS: were analyzed using the visual analog scale and the AOFAS score. Intra- and postoperative complications were recorded. The average follow-up was 28 months. RESULTS: 33 men and 16 women. The average age was 38.6 years old. There were seven complications (14.3%): paresthesia and - or hypoesthesia of the sural nerve (four cases), residual pain in the portal (two cases), and portal scar dehiscence (one patient). The average improvement of VAS was 5.53 points, and the improved AOFAS score was an average of 35.78 points. CONCLUSIONS: Posterior ankle arthroscopy without distraction through the classic postero-lateral and posteromedial portals is a safe technique, with a low rate of complications.


Assuntos
Tornozelo , Artroscopia , Adulto , Articulação do Tornozelo/cirurgia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Tendões
12.
BMC Musculoskelet Disord ; 22(1): 760, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488703

RESUMO

BACKGROUND: Acromial anatomy has been found to be correlated with degenerative full-thickness rotator cuff tears in current studies. However, research on the relationship between acromial anatomy and articular-sided partial thickness of rotator cuff tears (PTRCTs) is still lacking. The purpose of this study was to evaluate whether these imaging graphic parameters exhibit any association between acromial anatomy and degenerative articular-sided PTRCTs. METHODS: Between January 2016 and December 2018, a total of 91 patients without a history of trauma underwent arthroscopy as an articular-sided PTRCT group. In the control group, with age- and sex-matched patients, we selected 91 consecutive outpatient patients who underwent shoulder magnetic resonance imaging (MRI) because of shoulder pain and an MRI diagnosis of only synovial hyperplasia and effusion. MRI was used to measure the acromial type, acromiohumeral distance (AHD), lateral acromial angle (LAA), acromion index (AI), and critical shoulder angle (CSA) by 2 independent observers. RESULTS: The acromion type, AHD and LAA showed no difference between degenerative articular-sided PTRCTs and controls (P = 0.532, 0.277, and 0.108, respectively). AI and CSA were significantly higher in degenerative articular-sided PTRCTs (P = 0.002 and 0.003, respectively). A good correlation was found between AI and CSA to measurement(Pearson correlation coefficient = 0.631). CONCLUSIONS: Our study revealed that higher AI and CSA were found in degenerative articular-sided PTRCTs. Acromial anatomy with a large acromial extension was associated with the occurrence of degenerative articular-sided PTRCTs.


Assuntos
Lesões do Manguito Rotador , Articulação do Ombro , Acrômio/diagnóstico por imagem , Artroscopia , Humanos , Imageamento por Ressonância Magnética , Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/diagnóstico por imagem
13.
Zhongguo Zhen Jiu ; 41(9): 1010-4, 2021 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-34491651

RESUMO

OBJECTIVE: To compare the effect between acupoint application of Zhanjin Huoxue formula combined with local cold compress and simple local cold compress on swelling and pain after knee arthroscopy in patients with knee osteoarthritis (KOA). METHODS: A total of 62 KOA patients with knee swelling after knee arthroscopy were randomly divided into an observation group and a control group, 31 cases in each group. In the control group, cold compress was adopted after surgery, 3 times a day. On the basis of the treatment as the control group, acupoint application of Zhanjin Huoxue formula (angelicae sinensis radix, chuanxiong rhizome, cinnamon twig, poria, etc.) was applied at Liangqiu (ST 34), Xuehai (SP 10), Zusanli (ST 36), Fenglong (ST 40), Sanyinjiao (SP 6), Yinlingquan (SP 9), Yanglingquan (GB 34), Xuanzhong (GB 39) on the affected side in the observation group, 4 h each time, 2 times a day. The treatment was given 7 days in both groups. Before treatment and 1,3,5 and 7 days into treatment, the pain visual analogue scale (VAS) score and swelling value of knee joint (2 cm above the patella upper pole, patella midline, 5 cm below the patella lower pole) were compared in the two groups. RESULTS: The VAS scores 3, 5 and 7 days into treatment were lower than those before treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). The swelling values of 2 cm above the patella upper pole 3, 5 and 7 days into treatment were lower those before treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). The swelling values of patella midline 1, 3, 5 and 7 days into treatment were lower than those before treatment in the two groups (P<0.05), and except for 1 day into treatment, those in the observation group were lower than the control group (P<0.05). The swelling values of 5 cm below the patella lower pole 1 day into treatment in the observation group and 3, 5 and 7 days into treatment in the two groups were lower those before treatment (P<0.05), and except for 1 day into treatment, those in the observation group were lower than the control group (P<0.05). The total effective rate in the observation group was 93.5% (29/31), which was higher than 74.2% (23/31) in the control group (P<0.05). CONCLUSION: Acupoint application of Zhanjin Huoxue formula combined with cold compress could effectively improve the knee joint swelling and pain after arthroscopy in KOA patients, and the curative effect is better than simple cold compress.


Assuntos
Osteoartrite do Joelho , Pontos de Acupuntura , Artroscopia , Humanos , Articulação do Joelho , Osteoartrite do Joelho/terapia , Dor , Resultado do Tratamento
14.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(9): 1141-1146, 2021 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-34523279

RESUMO

Objective: To investigate the effectiveness of arthroscopic 360° capsular release for frozen shoulder. Methods: Between April 2018 and April 2019, 42 patients with frozen shoulders were treated with arthroscopic 360° capsular release. There were 13 males and 29 females, with an average age of 52.3 years (range, 45-56 years). There were 14 left shoulders and 28 right shoulders. The disease duration ranged from 5 to 18 months (mean, 11.1 months). The main clinical symptoms were limited active and passive movement of the shoulder joint with severe pain. All patients excluded impingement syndrome and shoulder osteoarthritis. Preoperative range of motion was as follows: forward flexion (93.2±15.4)°, external rotation at side (15.9±6.0)°, external rotation at 90° abduction (18.4±9.9)°, and internal rotation reaching the greater trochanter in 5 cases, buttocks in 20 cases, S 1 level in 17 cases. The visual analogue scale (VAS) score was 6.7±1.7 and the American Society of Shoulder and Elbow Surgery (ASES) score was 41.6±9.3. The active range of motion of shoulder joint, VAS score, and ASES score were recorded during follow-up. Results: All incisions healed by first intention, and no early complications occurred. Patients were followed up 12-24 months (mean, 15.6 months). After operation, forward flexion, external rotation at side, and external rotation at 90° abduction significantly improved when compared with preoperatively ( P<0.05). The range of internal rotation restored to the level of T 6-12 at 3 weeks, which was equivalent to that of the normal side at 12 months after operation ( Z=-0.943, P=0.346). VAS scores decreased and ASES scores increased after operation, and the differences between pre- and post-operation were significant ( P<0.05); and with time, the VAS scores and ASES scores improved further ( P<0.05). Conclusion: Arthroscopic 360° capsular release can significantly increase the range of motion of the shoulder joint, release pain, and improve function. It is an effective method for the treatment of frozen shoulders.


Assuntos
Bursite , Articulação do Ombro , Artroscopia , Bursite/cirurgia , Feminino , Humanos , Liberação da Cápsula Articular , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Rotação , Ombro , Articulação do Ombro/cirurgia , Resultado do Tratamento
17.
Arthroscopy ; 37(9): 2743-2744, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34481616

RESUMO

Overtension repair of rotator cuff tear may predispose to the failure of postoperative integrity of the rotator cuff tendon. Surgeons should consider the size of the rotator cuff tear and maintain adequate tension for successful rotator cuff repair. Feel the tension on the tendon: too much can poison the outcome.


Assuntos
Lesões do Manguito Rotador , Manguito Rotador , Artroscopia , Humanos , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Tendões , Resultado do Tratamento
18.
Arthroscopy ; 37(9): 2817-2819, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34481622

RESUMO

Femoroacetabular impingement is a recognized source of hip pain and cause of labral and articular cartilage injury. Persistent femoroacetabular impingement has been recognized as a source of inferior patient-reported outcomes, and attempts to define a "normal" α-angle has resulted in more aggressive resection of cam lesions. An overzealous femoroplasty may result in iatrogenic hip instability. A dynamic intraoperative examination may be the best way to truly recognize this problem, in particular, by visualizing the loss of the suction seal, as the cam resection engages the acetabulum, resulting in subluxation. A soft tissue "remplissage" salvage procedure may offer an option to correct cam overresection and improve patient outcomes during revision arthroscopy, as we continue to search for the "right" amount of cam correction to perform.


Assuntos
Cartilagem Articular , Impacto Femoroacetabular , Acetábulo/cirurgia , Artroscopia , Cartilagem Articular/cirurgia , Impacto Femoroacetabular/cirurgia , Humanos , Resultado do Tratamento
19.
Arthroscopy ; 37(9): 2838-2839, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34481624

RESUMO

Thermal pie-crusting of the capsule can increase hip arthroscopy surgical exposure in the peripheral compartment. Recent time-zero biomechanical research suggests that repairing the capsule after pie-crusting yields similar strength and increased stiffness when compared to a T-capsulotomy. However, the risks of thermal damage to the capsule should be weighed against the biomechanical advantages of repairing a pie-crusted capsule versus a T-capsulotomized capsule. In addition, if a surgeon wants to inject an intra-articular orthobiologic such as platelet-rich plasma (PRP), I would not recommend pie-crusting because the full-thickness slits in the capsule could allow the PRP to escape, even after capsular repair. I will still use traction sutures for 100% of my hip arthroscopy procedures. However, in the very rare setting when traction sutures alone yield inadequate exposure, I will perform pie-crusting instead of a T-capsulotomy.


Assuntos
Artroscopia , Cadáver , Humanos
20.
Arthroscopy ; 37(9): 2846-2847, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34481625

RESUMO

Post-free hip arthroscopy has garnered much attention over the past several years. The attraction of eliminating groin complications is at the forefront of this technique. Recent studies have shown improved blood flow, safe techniques, but other benefits, if any, are yet to be discovered. For now, those adopting post-free distraction do so to eliminate a source of groin complication, improved access to the cam, and a perceived decrease in pain. Several options exist to achieve post-free distraction, and, as we continue to perfect this technique, continued studies may reveal other advantages or disadvantages to post removal.


Assuntos
Artroscopia , Dor , Virilha , Humanos
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