Biomedical subjects

A Gassen

Publications and source records attributed to A Gassen.

3 recordsLinked to original sources

PubMed1994

Arthroscopic management of postoperative arthrofibrosis of the knee joint: indication, technique, and results.

From October 1987 through March 1991, 58 patients with postoperative joint stiffness underwent arthroscopic fibroarthrolysis. Forty-six knees in 46 patients were followed. The indication for arthroscopic management was decreased range of motion after surgery. Eighty-seven percent had been treated by arthrotomy. Thirteen percent had been managed by arthroscopic surgery. The indication for primary surgery was a torn anterior cruciate ligament in 74%. The mean interval between arthroscopic fibroarthrolysis and follow-up was 22.1 months. The average age was 32.7 years. A modified Blauth and Jäger score was used for classification of fibroarthrosis: grade I (mild 17.4%), grade II (moderate 63%), grade III (severe 15.2%), and grade IV (bad 4.3%). The gain in range of motion was evaluated by the Cauchoix index: the results were excellent in 54.5%, good in 21.7%, and fair and poor in 23.8%. Pain was evaluated according to a modification of the Lysholm score: 80.4% of the patients experienced a reduction in pain. The sports activity level in the Tegner activity scale increased from 2.3 to 4.8. Patient satisfaction was excellent or good in 56.5% (n = 26), fair in 39.1% (n = 18), and poor in 4.3% (n = 2). On the basis of our retrospective study, we feel that arthroscopic fibroarthrolysis is of benefit to the patients with postoperative joint stiffness even after a prolonged period.

Adult↗

PubMed1994

[Arthroscopic partial double meniscectomy].

Arthroscopic treatment of meniscal pathology has become a routine procedure within the last 10 years. In our patients who underwent arthroscopic surgery for multiple reasons we found 226 cases with combined lesions of the medial and lateral menisci. Eliminating the patients with instabilities, chondral lesions grade IV and general diseases like rheumatoid arthritis and those who had had surgery previously, 71 patients were left. Forty-four (62%) were male and 27 (38%) female. The average age was 52 years. The lesion was located in the right knee in 41 cases (58%) and in 31 cases (42%) in the left one. The duration of symptoms was more than 3 months in most cases. Eleven patients (15%) had a trauma in their history. A standardized interview according to the Tapper and Hoover score was carried out in each patient. Out of the 77 patients with partial double meniscectomy we were able to examine 55 patients. According to the Tapper and Hoover score the following results were evaluated: 17 patients (31%) rated excellent. In 28 cases (51%) the result was good. 8 patients (15%) showed fair results. The main cause in this group was a slight feeling of instability and a mild loss of function (lack of flexion < 5 degrees, lack of extension < 10 degrees). Two patients (3.6%) were rated poor. Of the patients 89% were satisfied with this surgical procedure and would choose it again. Only 11% (n = 6) were not satisfied with the outcome of the procedure and would prefer arthrotomy. Our follow-up study indicates that arthroscopic double partial meniscectomy gives good results.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗

PubMed1992

[Diagnostic arthroscopy and arthroscopic surgery of the upper ankle joint].

Arthroscopy of the ankle joint was limited to the anterior compartments for a long time. The key to the entire diagnostic and therapeutic arthroscopy procedure on the ankle joint was the distension of the joint space through modern distraction techniques. The distraction devices available make arthroscopic surgery of the ankle joint as effective as in other joints like the knee and shoulder. Distension of the joint space allows visualization of all compartments, including the posterior ankle. In the case of hidden cartilage pathology of the posterior talus, an osteotomy linked with hardware removal through a second operation can be avoided today. The indications for arthroscopy of the ankle are pain, swelling, instability, hemarthrosis and joint locking. Generally, arthroscopy of the ankle joint is performed utilizing three general portals: anterolateral, anteromedial and posterolateral. Arthroscopic standard equipment, including the small joint set, is sufficient to treat the major part of ankle pathology through the standard portals. Arthroscopic ankle joint debridement in degenerative arthritis, removal of osteophytes, elimination of loose bodies and the management of soft tissue and bony impingement are possible. A complete synovectomy can be performed, including the posterior compartments. The treatment of osteochondritis dissecans is facilitated through the transmalleolar approach in combination with the distraction device. Arthroscopic ankle arthrodesis is possible and induces less trauma because an arthrotomy can be avoided. In our opinion diagnostic arthroscopy and arthroscopic surgery of the ankle joint is a procedure of great benefit for the patients if the indications are strictly adherred to.

Ankle Injuries↗