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Biomedical subjects

J M Strauss

Publications and source records attributed to J M Strauss.

At least 19 recordsLinked to original sources
PubMed2003

Mesophilic and thermophilic BTEX substrate interactions for a toluene-acclimatized biofilter.

Benzene, toluene, ethylbenzene and xylene (BTEX) substrate interactions for a mesophilic (25 degrees C) and thermophilic (50 degrees C) toluene-acclimatized composted pine bark biofilter were investigated. Toluene, benzene, ethylbenzene, o-xylene, m-xylene and p-xylene removal efficiencies, both individually and in paired mixtures with toluene (1:1 ratio), were determined at a total loading rate of 18.1 g m(-3) h(-1) and retention time ranges of 0.5-3.0 min and 0.6-3.8 min for mesophilic and thermophilic biofilters, respectively. Overall, toluene degradation rates under mesophilic conditions were superior to degradation rates of individual BEX compounds. With the exception of p-xylene, higher removal efficiencies were achieved for individual BEX compounds compared to toluene under thermophilic conditions. Overall BEX compound degradation under mesophilic conditions was ranked as ethylbenzene >benzene > o-xylene > m-xylene > p-xylene. Under thermophilic conditions overall BEX compound degradation was ranked as benzene > o-xylene >ethylbenzene > m-xylene > p-xylene. With the exception of o-xylene, the presence of toluene in paired mixtures with BEX compounds resulted in enhanced removal efficiencies of BEX compounds, under both mesophilic and thermophilic conditions. A substrate interaction index was calculated to compare removal efficiencies at a retention time of 0.8 min (50 s). A reduction in toluene removal efficiencies (negative interaction) in the presence of individual BEX compounds was observed under mesophilic conditions, while enhanced toluene removal efficiency was achieved in the presence of other BEX compounds, with the exception of p-xylene under thermophilic conditions.

Bacteria↗
PubMed2003

[Total intravenous anesthesia. On the way to standard practice in pediatrics].

Since venous cannulation in children has become easier and extensive experience has been gained with total intravenous anaesthesia (TIVA) in adults, the interest in TIVA for children has recently increased. An intensified sensitivity of the operating room atmosphere to contamination with volatile anaesthetic agents is another important reason to choose intravenous techniques for paediatric anaesthesia. One of the most interesting agents for TIVA in paediatric anaesthesia is propofol. The pharmacokinetic and pharmacodynamic data for modern intravenous drugs is poor. Because the interpatient variability is relatively large, pharmacokinetic data can only provide guidelines for the dosage of propofol. Propofol has a rapid and smooth onset of action and is as easy to titrate in children as in adults. Propofol can be excellently controlled. Severe haemodynamic side-effects are missing in healthy children and plasma is cleared rapidly of propofol by redistribution and metabolism. There is no evidence of significant accumulation, not even after prolonged infusion times. Because propofol has no analgetic properties it must be combined with analgetics or a regional block for all painful procedures. The combination with the ultra-short acting remifentanil is a major advantage, but requires effective analgetic concepts for painful procedures. In comparison the combination of propofol with long acting opioids abolishes some of the favourable properties of propofol. Further studies of the kinetics and dynamics of propofol and other intravenous agents are needed in paediatrics which should focus on age, maturity and severity of illness. The whole importance of the propofol-infusion syndrome has to be cleared up urgently. TIVA has an important significance in paediatric anaesthesia for diagnostic and therapeutic procedures, especially where these have to be repeated. In day-case anaesthesia TIVA has advantages for all short procedures and for ENT and ophthalmic surgery: even after prolonged infusion children have an short recovery time. There is no evidence of agitation or other behavioural disorders after TIVA with propofol in paediatric anaesthesia. Propofol has anti-emetic properties. TIVA with propofol can be combined with regional anaesthesia advantageously to provide long-lasting analgesia after surgery. TIVA with propofol has been used successfully for sedation of spontaneously breathing children for MRI and CT and other procedures with open airways like bronchoscopy or endoscopy. Propofol facilitates endotracheal intubation without the use of muscle relaxants. Of course, in malignant hyperthermia TIVA will continue to be the technique of choice. Nothing is known about awareness under TIVA in paediatric patients. TIVA must be considered by comparison with the volatile agents. The use of ultra-short acting agents may cause problems such as awareness, vagal response, involuntary movements and in some cases slow recovery after prolonged infusion of propofol. But it is not known exactly how often this happens during paediatric anaesthesia. With TIVA an effective postoperative analgesia must be provided. Newer administration techniques such as the target-controlled infusions or closed-loop control systems are under development and will help to minimise the potential risk of overdosage with TIVA in paediatrics. At the present TIVA is an interesting and practicable alternative to volatile anaesthesia for pre-school and school children. TIVA with propofol in infants younger than 1 year old requires extensive experience with TIVA in older children and with the handling of this special age group and should be undertaken with maximum precautionary measures.

Analgesics↗
PubMed2001

[Endoprosthetic surface replacement of the head of the humerus].

The concept of an endoprosthetic surface replacement of the humeral head differs from that of stemmed endoprostheses. It is the replacement of the destroyed joint surface with reconstruction of the normal anatomy and minimal bone resection. The aim of this prospective study was to evaluate the short-term results of a newly developed cup arthroplasty (Durom-Cup) for the humeral head. In a prospective study, 39 patients with 46 Durom-Cups were evaluated preoperatively and every 3 months postoperatively. The average follow-up was 15 +/- 9 months. The group included 28 shoulders with rheumatoid arthritis, 15 joints with osteoarthritis, and 3 humeral head necroses. The Constant-score and SAS-function score were used. The Constant-score increased from 20.25 +/- 9.06 points preoperatively to 46.62 +/- 14.05 at 3 months, to 48.11 +/- 14.49 at 6 months, and to 55.25 +/- 11.6 at 9 months postoperatively. The Constant-score stayed at this level during further follow-up and was 55.81 +/- 16.31 at 12 months postoperatively. The best results were seen in the group of humeral head necroses with a Constant-score of 71.0 +/- 12.2 compared to 54.66 +/- 13.89 in the group of osteoarthritis and 56.78 +/- 13.33 in patients with rheumatoid arthritis at 12 months postoperatively. The results with the Durom-Cup are encouraging so that cup arthroplasty seems to be a good alternative to stemmed prostheses. The main advantages of the humeral head resurfacing are the bone-preserving fixation and the relatively simple surgical technique.

Aged↗
PubMed2001

BTEX catabolism interactions in a toluene-acclimatized biofilter.

BTEX substrate interactions for a toluene-acclimatized biofilter consortium were investigated. Benzene, ethylbenzene, o-xylene, m-xylene and p-xylene removal efficiencies were determined at a loading rate of 18.07 g m(-3) h(-1) and retention times of 0.5-3.0 min. This was also repeated for toluene in a 1:1 (m/m) ratio mixture (toluene: benzene, ethylbenzene, or xylene ) with each of the other compounds individually to obtain a final total loading of 18.07 g m(-3) h(-1). The results obtained were modelled using Michaelis-Menten kinetics and an explicit finite difference scheme to generate vmax and Km parameters. The Vmax/Km ratio (a measure of the catalytic efficiency, or biodegradation capacity, of the reactor) was used to quantify substrate interactions occurring within the biofilter reactor without the need for free-cell suspended and monoculture experimentation. Toluene was found to enhance the catalytic efficiency of the reactor for p-xylene, while catabolism of all the other compounds was inhibited competitively by the presence of toluene. The toluene-acclimatized biofilter was also able to degrade all of the other BTEX compounds, even in the absence of toluene. The catalytic efficiency of the reactor for compounds other than toluene was in the order: ethylbenzene > benzene > o-xylene > m-xylene>p-xylene. The catalytic efficiency for toluene was reduced by the presence of all other tested BTEX compounds, with the greatest inhibitory effect being caused by the presence of benzene, while o-xylene and p-xylene caused the least inhibitory effect. This work illustrated that substrate interactions can be determined directly from biofilter reactor results without the need for free-cell and monoculture experimentation.

Bacteria↗
PubMed1999

[Intraoperative changes in arterial end tidal CO2 partial pressure difference in interventions with constant ventilation-perfusion ratio].

During general anaesthesia, the endtidal CO2 pressure serves as an estimate of the arterial CO2 pressure to regulate the ventilator setting. Important arterial to end-tidal carbon dioxide tension differences (P(a-et)CO2) have been observed among patients undergoing procedures which have substantial impact on the ventilation-perfusion ratio (V/Q). Data on the P(a-et)CO2 for procedures in which the V/Q-ratio remains constant are lacking. Repeated measurements of P(a-et)CO2 in twelve patients with chronic obstructive lung disease (COLD) and nine pulmonary healthy patients undergoing jaw surgery were performed. The P(a-et)CO2 in the pulmonary healthy subjects (5.96 +/- 1.68 mmHg) was lower than in the COLD patients (9.05 +/- 3.49 mmHg) (p < 0.01). A clinically significant P(a-et)CO2 > or = 8 mmHg was observed in 52% of the measurements in patients with COLD compared with 11% in the pulmonary healthy subjects (p < 0.01). Both patient groups showed only minimal intraoperative changes of P(a-et)CO2. The deviation of all subsequent P(a-et)CO2 values from the initial P(a-et)CO2 was 2.17 +/- 1.52 mmHg in the pulmonary healthy patients and 2.02 +/- 1.49 mmHg in the patients with COLD (p = 0.76). Intraoperative changes of the P(a-et)CO2 are small during procedures with no major alterations of the V/Q ratio. For these procedures an initial measurement of the P(a-et)CO2 in patients with lung disease should be sufficient. In pulmonary healthy subjects the P(a-et)CO2 seems to be negligible.

Adult↗
PubMed1997

Comparison of surgical procedures for degenerative lumbar spinal stenosis: a meta-analysis of the literature from 1975 to 1995.

Therapy for spinal stenosis remains difficult. The possibilities for conservative management are limited and not satisfactory in the more severe cases. Various surgical procedures are possible, such as decompression, decompression and fusion without instrumentation and decompression and fusion with instrumentation. The aim of our meta-analysis was to compare the postoperative results of these three surgical techniques in the literature and, thus, to establish a treatment of choice for degenerative lumbar spinal stenosis. Via Medline, 30 articles met the inclusion criteria for our study, leading to a total number of 1668 cases being included in the meta-analysis. The evaluation was made according to our own definition of outcomes, based on criteria most commonly used in the studies reviewed. We found that in patients suffering degenerative spinal stenosis for up to 8 years, decompression without fusion showed the best results. For a duration of symptoms of 15 years or more, decompression with instrumented fusion had the best results. Analysing all postoperative outcomes, decompression is the surgical procedure with the highest rate of success and the fewest complications, followed by decompression with instrumented fusion. In surgery for degenerative lumbar spinal stenosis, decompression and fusion without instrumentation was the least successful procedure. As patients suffering from a degenerative spinal stenosis often are elderly, operations are risky and place a strain on them. This review of the literature shows that the least invasive surgical procedure can obtain the best results if the correct diagnosis is made and if the operation is carried out within the first years of the disease.

Adult↗
PubMed1997

[How relevant are calculations of mean intracompartmental pressure in functional compartment syndrome?].

The intracompartmental pressure in the anterior tibial compartment was documented under standardized conditions in 29 patients walking at a speed of 4.5 km/h, as well as heel-and-toe running at a speed of 8 km/h. All pressure curves were integrated and the resulting mean pressure was compared with the arithmetic mean pressure indicated in the literature. During walking, the difference between calculated and integrated pressures was between 80 and 140%. In the case of heel-and-toe running, the difference was between 80 and 165%. On the basis of these results, the calculation of the mean intracompartmental pressure recommended in the literature does not appear to be of any clinical relevance.

Adolescent↗
PubMed1996

[Patient-controlled analgesia with clonidine and piritramide].

UNLABELLED: Following parenteral administration, clonidine has analgesic effects at both cerebral and spinal levels. Patient-controlled analgesia (PCA) makes it possible to determine equipotent dosages of analgesics by relating analgesic consumption per time to the levels of analgesia obtained in comparable patient populations. Therefore, we studied the equipotency ratios of clonidine and piritramide and the incidence of undesired side effects in the treatment of postoperative pain in patients undergoing maxillo-facial surgery. METHODS: After approval of the local ethics committee and informed consent 40 patients (age > 18 year, ASA I-III) were studied. Following randomization, the patients each received a PCA device containing either clonidine (bolus 30 micrograms), or piritramide (bolus 1.5 mg) for treatment of postoperative pain (lockout interval 5 min in both groups). During the postoperative period, pain was determined using a visual analogue scale, while analgesic consumption, sedation, haemodynamic parameters, respiration rate, and the occurrence of undesired side effects were documented additionally. RESULTS: The groups had comparable distributions of biometric data, duration of anaesthesia, and ASA classification. Pain level decreased significantly (P < 0.0001) in both groups during the first 2 h of PCA. Mean arterial pressure and heart rate were lower (P < 0.05) in the clonidine group 4 and 6 h after PCA onset, while the degree of sedation after 2 (P < 0.01) and 6 (P < 0.05) h was higher than in the piritramide group. Nausea and vomiting were more frequent (P < 0.05) in the piritramide group. Both groups showed a wide interpatient variation in analgesic requirement. The equipotency ratio clonidine/piritramid was 1:63.7. CONCLUSION: Intravenous clonidine is a potent analgesic and is suitable or the treatment of postoperative pain following maxillo-facial surgery. The analgesic potency of 150 micrograms clonidine i.v. was equivalent to that of 9.56 mg piritramide i.v. Nausea and vomiting occurred more rarely in the clonidine group, while deeper sedation was observed more frequently than in the piritramide group. Owing to the wide interindividual variation of analgesic consumption, clonidine dosages have to be adjusted to the actual requirements.

Adolescent↗
PubMed1996

[Degradation of halothane, enflurane, and isoflurane by dry soda lime to give carbon monoxide].

In the presence of completely dry soda lime volatile anaesthetics will decompose to carbon monoxide (CO). In an in vitro study, the absorbent (soda lime, ICI) was dried with a constant gas flow of 11/min oxygen for 120 h. The weight loss during the drying was 17.1%. Two vol% of halothane, enflurane or isoflurane in oxygen was administered with a constant flow of 0.51/min oxygen through the completely dry absorbent. Concentrations of gases were measured before and after the absorbent using mass spectrometry (MGA 1100, Perkin-Elmer) and an electrochemical NO monitor (Mini PAC CO, Dräger). The temperature inside the soda lime was monitored continuously. Shortly after adding the anaesthetic to the oxygen passing through the absorbent, carbon monoxide appeared in the outlet of the soda lime container. The measured peak concentrations varied around 450 ppm (halothane), 3500 ppm (enflurane) and 3800 ppm (isoflurane). The temperature inside the absorbent rose from the ambient temperature (19.8 degrees C) to a maximum of 52.1 degrees C during CO production and decreased when the CO production lowered after approximately 1 h (all anaesthetics). During CO production no measurable concentration of halothane left the absorber. After passing through the absorbent the concentrations of isoflurane and enflurane were slightly lower than the corresponding concentrations in the fresh gas measured before absorption.

Absorption↗
PubMed1996

[Arthroscopic therapy of tendinitis calcarea--acromioplasty or removal of calcium?].

In a retrospective analysis we evaluated 48 patients who had been arthroscopically treated for tendinitis calcarea. The calcific deposit was removed whenever possible and all patients were treated by arthroscopic subacromial decompression. In subjects who showed subacromial stenosis by X-ray or by intraoperative findings, an arthroscopic acromioplasty was performed. At follow-up all patients were evaluated according to the Constant score. Additionally all pre- and postoperative X-rays were reviewed. After surgery the Constant score significantly improved. In all cases where acromioplasty was performed, a flattening of the bony configuration was achieved. The X-ray analysis showed that no calcific deposit with blurred borders converted to sharp borders. There was also no deposit that converted from a transparent appearance to a dense structure. Patients with disappearance of the calcific deposit post-operatively had significantly better outcome than patients with no change in the X-ray. An additional acromioplasty did not improve the results. The aim of arthroscopic treatment of calcific tendinitis has to be the removal of the calcific deposit. Acromioplasty does not lead to further improvement to the result.

Acromioclavicular Joint↗
PubMed1996

Osteoneogenesis and its influencing factors during treatment with the Ilizarov method.

The radiographs of 57 patients who had undergone 58 callus distractions and 13 epiphyseal distractions were evaluated. During the course of treatment, the density of the distraction areas on radiographs was measured in total and along the medial, lateral, ventral, and dorsal margins using a digital radiograph processing system. The densities of the whole distraction length were correlated to the following parameters: age of patient, start of distraction after corticotomy, mean distraction speed, mean amount of weight load during the period of distraction and consolidation, location of corticotomy (distal femoral metaphysis versus the proximal tibial one), and diclofenac medication. Except for the location of corticotomy and the diclofenac medication, the density was influenced by all these parameters. Age of the patient and weight load were the most important parameters. Patients with leg shortening caused by poliomyelitis and a patient with a shortened leg after amniotic strangulation showed a slower rise of the density trend curve on radiographs than the other patients. When comparing the different regional density curves, a significant gradual density decrease could be observed from the medial to the lateral side in the femur, from lateral to medial in the tibia, and from the dorsal to the ventral side in both bones. The respective differences between lateral and medial density, and between dorsal and ventral density, were significantly higher in cases of callus distraction than in cases in which epiphyseal distraction had been used. The amount of bone regeneration varied regionally primarily because of the inhomogeneous soft tissue covering of the bone and the impairment of its local blood supply by the surgical exposure for the corticotomy. The clinical relevancy of the various parameters for osteoneogenesis is discussed in this article.

Adolescent↗
PubMed1996

Evaluation of two electrochemical monitors for measurement of inhaled nitric oxide.

Inhaled in low concentrations, nitric oxide (NO) acts as a potent pulmonary vasodilator, but when inhaled in high concentrations NO and its metabolite NO2 are potentially toxic molecules. Thus, an accurate and reproducible measurement of both NO and NO2 is necessary, and changes in NO concentration need to be detected instantly to avoid lung damage (high concentrations) or failure of NO therapy (low concentrations; unnoticed interruption of NO supply). We investigated two electrochemical NO monitors (Sensor Stik 4586 and Dräger PAC II) for accuracy and time constants. Both provided accurate and reproducible results at different NO concentrations. Known NO concentrations (standards: 10, 50, 75 ppm) were detected within a 3% tolerance, and acceptable time constants were seen when NO concentration was abruptly increased from zero to 50 ppm. The display read the final value within 60 s with the Sensor Stik and 11 s with the Dräger PAC II. Significant differences were seen when the NO concentration was rapidly reduced from 50 ppm to zero. The Sensor Stik took more than 2 h to reach zero, whereas the PAC II took 60 s.

Administration, Inhalation↗
PubMed1995

[Intraoperative thrombosis of the inferior vena cava].

A pre-term infant weighing 900 g, gestational age 25 weeks, developed an acute abdomen. Intravenous lines had been inserted previously in the left (silastic catheter) and right (24 G cannula) saphenous veins in the neonatal intensive care unit. During surgical exploration, a perforation of the terminal ileum was found. The operation consisted in partial resection of the perforated ileum with an end-to-end anastomosis and a double-lumen colostomy. Major blood loss during the procedure caused serious haemodynamic problems. Despite transfusion of erythrocyte (100 ml), thrombocytes (75 ml), and albumin (50 ml), the patient developed bradycardia and hypotension. Administration of atropine, adrenaline, and calcium i.v. had no effect. The operation could be finished only with extrathoracic resuscitation. When the drapes were removed, livid, swollen lower limbs raised the suspicion of an acute thrombosis of the inferior vena cava. After insertion of a 24 G i.v. cannula into a vein of the right upper arm, the circulation stabilised after rapid transfusion of 40 ml blood and 25 ml thrombocytes and resuscitation was successful. Paediatricians and anaesthesiologists must consider the risk of thrombosis of the vena cava. If venous lines in the lower limbs are not visible to the anaesthesiologist during the operation, venipuncture of veins of an upper limb is recommended before starting the surgical procedure. Due to the high incidence of vena cava thrombosis caused by central venous lines and the difficulty of peripheral venipuncture in pre-termintanty, a safe venous line should be inserted if necessary by pre-operative venesection.

Blood Transfusion↗
PubMed1995

[Nitric oxide in therapy of pulmonary hypertension after correction of congenital single atrium].

We report on a 19-month-old boy with congenital single atrium. Cardiac catheterization preceding the surgical repair revealed an elevated pulmonary artery pressure of 60/15 mmHg (mean pressure 40 mmHg). Pulmonary flow was 8.4 l/min.m2 and systemic flow was 5.5 l/min.m2. Pulmonary arteriolar resistance was elevated to 4.2 U.m2 with 64% left-right shunt and 25% right-left shunt. Arterial O2-saturation varied around 90%. After surgical repair (insertion of a Goretex patch), the patient required mechanical ventilation with 100% oxygen for adequate oxygenation. Cardiac catheterization was repeated on the first postoperative day. No residual shunts were found. The pulmonary artery pressure was 66/40 mmHg (mean pressure 50 mmHg), systemic arterial pressure was 85/62 mmHg (mean pressure 68 mmHg). Cardiac index was 2.8 l/min.m2, pulmonary vascular resistance was 12 U.m2. After administration of prostacyclin a significant decrease of pulmonary artery pressure was observed, but without changing the ratio between pulmonary and systemic pressure. The AaDO2 varied between 400 and 580 mmHg and the oxygenation-index (PaO2/FiO2) was less than 1.0. In this situation, an attempt with inhaled nitric oxide (NO) was performed. After adding 20 ppm NO to the inspired gas, the AaDO2 decreased significantly from 580 to 270 mmHg and the oxygenation-index (OI) rose from 0.9 to 1.5. The inspired fraction of oxygen could be reduced quickly to 60%. During the next days, the concentration of NO was reduced stepwise to 1 ppm. Finally, the AaDO2 was within the normal range (25-65 mmHg) and the OI rose to a level about 4.0. The FiO2 could be reduced to 30% and nitric oxide therapy could be stopped and the child could be extubated.

Administration, Inhalation↗
PubMed1994

Shoulder joint stability after arthroscopic subacromial decompression.

In 55 patients with type I or type II impingement lesions we performed arthroscopic subacromial decompression. Fifty-two patients are followed up 1 year postoperatively. In all patients the condition of the affected shoulder before and after decompression was documented using a 100-point shoulder score (pain on activity, 15 points; pain without activity, 15 points; function, 20 points; weight lifting, 10 points; muscle strength, 15 points; range of motion, 25 points). At follow-up we also documented the extent of passive inferior shift of the humeral head by ultrasound. The mean score preoperatively was 60.9 (+/- 13.8). Postoperatively there was a significant increase to 84.7 (+/- 12.5). The average postoperative hospital stay was 8.8 days (+/- 2.1). In 12 patients (23%) the postoperative score was less than 85 points, and in these the treatment was considered to have failed. Comparison of these patients as a group with those in whom the treatment was successful revealed no difference in age, a small but not significant difference in the preoperative duration of shoulder complaints, and no difference in the postoperative length of stay in hospital. However, there was a significant difference in the extent of passive inferior shift of the humeral head: in the failure group the mean inferior shift was 4.6 +/- 1.9 mm, while in the other patients the shift was only 2.7 +/- 1.0 mm. This difference was statistically highly significant. There was a statistical highly significant negative Pearson correlation coefficient of -5.56 between postoperative score and inferior shift of the humeral head. We conclude that patients with subacromial pathology and hypermobile glenohumeral joints may not be good candidates for subacromial decompression.

Acromion↗
PubMed1994

[Arthroscopic treatment of anterior synovitis of the upper ankle joint in the athlete].

UNLABELLED: In a retrospective study we analyzed the results of arthroscopic treatment of anterior synovitis of the ankle in 35 athletes. 5 athletes suffered additionally from anterior osteophytes and 3 presented with an anterolateral plica. Average age was 25 years (SD: 8.3) and follow-up interval was 32.4 months (SD: 19.4). 8 patients suffered from additional hyperlaxity of the ankle joint. At time of follow-up the patients were examined clinically as well as radiologically. The results were scored according to an ankle score containing the criteria pain, function, athletic activity, walking aids, range of motion, and swelling. During surgery a partial synovectomy was performed as well as removal of anterior osteophytes or anterolateral plica if necessary. The overall score increased non-significantly from 66.2 preoperatively to 78.7 postoperatively (p > 0.05). Comparing the different criteria the score parameter pain significantly increased after arthroscopy. All other parameters (function, athletic activity, walking aids, range of motion, swelling) showed only slight changes in this patient group. Athletes with hypermobile joint showed worse results compared to the others. Even after surgery we documented severe restriction in athletic activity. Only 9 patients performed their activities on their previous level, 19 reduced their activity level and 7 discontinued their athletic activity. In 6 cases we found iatrogenic temporary neurologic damage. CLINICAL RELEVANCE: Due to the uncertain clinical outcome and the documented high risk of neurovascular complications, patient selection for arthroscopic partial synovectomy in the athletic population should be performed extremely carefully. Prior to surgery, all other conservative options including changes of running shows as well as modifications in exercise program and athletic activity should be considered.

Adolescent↗