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Biomedical subjects

J S Parisien

Publications and source records attributed to J S Parisien.

At least 19 recordsLinked to original sources
PubMed1997

Impingement syndrome of the ankle caused by a medial meniscoid lesion.

Meniscoid lesion of the ankle is a well-described condition involving the anterolateral aspect of the ankle joint. To our knowledge, there are no reports of this condition involving the medial aspect of the ankle in the literature. We present the case of a 27-year-old man with a chronic deltoid ligament rupture who had developed anteromedial impingement syndrome of the ankle. The patient was treated with an arthroscopic debridement of the lesion and experienced a complete recovery.

Adult↗
PubMed1992

Arthroscopic management of pyarthrosis.

Sixteen patients (average age, 38 years; range, 20-63 years) with pyarthrosis were treated during a ten-year period by arthroscopic techniques consisting of joint debridement and application of suction drains, combined with appropriate antibiotics. There were 13 knees, two shoulders, and one ankle in the series. At the first visit to the authors' institution, patients typically had fever, leukocytosis, elevated sedimentation rate, and localized joint findings, such as generalized tenderness, swelling, effusion, and painful, limited range of motion in almost every joint involved. Most patients were seen two to five days after the onset of symptoms. After the initial culture and sensitivity were obtained and broad-spectrum antibiotics were administered, all patients were taken to the operating room on an emergency basis. At an average follow-up evaluation of 36 months (range, 14-48 months), the results have been excellent to good, without evidence of recurrence.

Adult↗
PubMed1991

Localized pigmented villonodular synovitis of the knee. Arthroscopic treatment.

Localized pigmented villonodular synovitis is a lesion that may affect any joint but is frequently found in the knee. Because of its rarity, diagnostic omissions are common. Definitive treatment usually involves resection of the lesions as well as a synovectomy. Nine patients were treated arthroscopically, thereby avoiding arthrotomy. There was no evidence of recurrence at the follow-up evaluation (range, 25-108 months; mean, 48 months). The patients with mechanical knee symptoms had small nodular lesions anteriorly related to the menisci; those with degenerative symptoms had slightly more prolific nodules in other sites. No recurrence occurred in either group.

Adolescent↗
PubMed1990

Arthroscopic excision of synovial hemangioma of the knee.

A synovial hemangioma in the knee joint of a 33-year old woman was diagnosed and removed arthroscopically. Preoperatively, this rare benign soft tissue lesion had caused recurrent swelling of the knee along with persistent pain and occasional buckling. Two years after surgery, the patient has a painless range of motion with no evidence of recurrence.

Adult↗
PubMed1990

Arthroscopic treatment of cysts of the menisci. A preliminary report.

A retrospective clinical study evaluated the results of arthroscopic management of cysts of the menisci. From 1979 to 1984, 24 patients with a diagnosis of meniscal cysts associated with tears of the semilunar cartilage were treated with partial meniscectomy and cyst decompression. The mean age was 29.9 years (range, 14-52 years). Each patient had tenderness over the joint line with a palpable mass. There were 25 cases of meniscal cysts, with one patient having a bilateral cyst. Twenty-two cysts involved the lateral meniscus, and three cysts were on the medial side of the knee. The follow-up period ranged from 16 to 48 months (mean, 33.5 months). All patients had a meniscal tear; most tears were either horizontal or transverse, with or without flap formation. The pathology was in the middle or anterior one-third of the meniscus. The arthroscopic surgery consisted of partial excision of the meniscal tear, leaving a peripheral rim at times, coupled with aspiration of the cyst material or manipulation of its contents into the joint cavity. No cyst recurred, and in every patient except one, preoperative symptoms disappeared. All patients but one were satisfied with the results. Two patients had a second arthroscopy, and no evidence of instability of the peripheral rim was found.

Adolescent↗
PubMed1988

Arthroscopic surgery of the elbow.

The author reviews his experience with a series of 25 cases treated over a period of 10 years. The technique is described and the most common indications for arthroscopic surgery of the elbow are given.

Adolescent↗
PubMed1988

Popliteus tendon rupture. Case report and review of the literature.

A 23-year-old man sustained an isolated popliteus tendon rupture while pushing a car. The diagnosis was established with the use of arthroscopy, electromyography, and Cybex testing. After the patient failed to respond to conservative therapy, the tendon rupture was surgically repaired. The patient had an uneventful recovery and returned to his preinjury level of athletic activity. Although popliteus tendon tenosynovitis as well as injury to the popliteus in association with other ligamentous knee injuries has been described, neither an isolated popliteus tendon rupture nor an arthroscopic evaluation of a popliteus tendon rupture has been reported.

Adult↗
PubMed1988

The role of arthroscopy in the treatment of postoperative fibroarthrosis of the knee joint.

Twenty-one patients with significantly limited range of motion of the knee secondary to open surgical procedures were treated by arthroscopic resection of the adhesions and gentle manipulation. The surgical procedures consisted of realignment procedures for patellar dislocation, arthrotomy for meniscectomy and synovectomy, ligamentous reconstruction, open reduction of intraarticular fractures, and prosthetic replacement. The interval between the arthroscopic treatment and the open procedures was from four months to two years. All patients had the arthroscopic releases performed with general or spinal anesthesia, were kept in the hospital for a minimum of three days, and were placed on a continuous passive motion machine. After discharge, an intensive rehabilitation program was instituted under the supervision of a physical therapist. With a follow-up period ranging from six months to two years, marked improvement of range of motion was obtained in most patients. Preoperative flexion was between 40 degrees and 50 degrees in 13 patients, 30 degrees in two patients, 60 degrees in four patients, 80 degrees in one patient, and 10 degrees in only one patient. The final flexion was between 120 degrees and 140 degrees in 12 patients. The remaining patients had postoperative flexion between 85 degrees and 100 degrees. One patient with 10 degrees of range of motion did not improve. Six of the eight patients with an extension lag preoperatively regained full or almost full extension after arthroscopic debridement. Morbidity was low and no serious complications were encountered. This study suggests that arthroscopic intraarticular release of adhesions is efficacious in the management of arthrofibrosis of the knee subsequent to previous open operative procedures.

Adolescent↗
PubMed1987

Arthroscopic management of pyarthrosis. An overview.

The author evaluates the place of arthroscopic techniques in the treatment of bacterial infection of joints. Based on a review of the pertinent literature and an analysis of clinical material consisting of 11 cases, he concludes that pyarthrosis can be managed successfully by arthroscopic debridement combined with appropriate antibiotics and early institution of a program of range-of-motion exercises.

Ankle Joint↗
PubMed1987

Diagnostic and operative arthroscopy of the ankle. An experimental approach.

To determine safe and effective placements of the arthroscope, 14 freshly amputated ankle joint specimens were used for experimental diagnostic and operative procedures. Preoperatively, chondral and osteochondral lesions, articular defects, and loose bodies were created within the ankle joint. The following arthroscopic portals were investigated: anteromedial, anterocentral, anterolateral, posteromedial, and posterolateral. Overlapping of vision fields was noted with the three anterior portals. Optimum visualization of a lesion was obtained when the arthroscope was placed on the same side as the lesion. Lesions on the posterior aspect of the talar dome and within the posterior talar pouch required the posterior placement of the arthroscope for optimum visualization. The use of the anterocentral approach, with a 2.7-mm arthroscope yields good visualization of the anterior aspect of the joint, and very often, of the posterior compartment. Anatomic guidelines for the avoidance of neurovascular structures and the exact placement of the arthroscope in both anterior and posterior portals are presented and were specifically defined in two additional fresh ankle specimens.

Ankle Joint↗
PubMed1986

Arthroscopy of the posterior subtalar joint: a preliminary report.

The technique of arthroscopy is, at the present time, available for the investigation of the subtalar joint. In this preliminary report, the relevant anatomy and technique are reviewed. Illustrative cases are presented to review some of its applications. It is the conclusion of the author that arthroscopy of the subtalar joint may be of value in the following situations: assessment of the articular cartilage in suspected cases of degenerative, rheumatoid, or infectious arthritis; evaluation of chronic pain syndrome in the hindfoot after injuries; and biopsy of the synovial lining, breakage of adhesions, joint lavage, and removal of loose bodies.

Adult↗
PubMed1985

Arthroscopy of the subtalar joint: an experimental approach.

Talocalcaneal articulations are relatively complex and functionally very important because they play a major role in the movements of inversion and eversion of the foot. Few reports on arthrography of the subtalar joints are available in the literature, and, similarly, little attention has been paid by arthroscopists to these joints. This preliminary study briefly defines the normal anatomy of the subtalar joints and describes a new technique of arthroscopic examination of the posterior subtalar joint. The distal lower extremities of six fresh cadavers were used in these experiments. All the subtalar joints were supple. A 2.7-mm arthroscope was used to carry out arthroscopic and anatomic examinations. A technique of examination with one anterior portal and one posterior portal is described in detail. When the anterior portal was used, the egress needle was placed posteriorly; when the posterior portal was used, the converse was true. By using the two portals, the following intraarticular structures could be visualized: a major part of the convex posterior calcaneal facet of the talus and the posterior talar facet of the calcaneus; the synovial lining laterally and posteriorly; the posterior aspect of the interosseous talocalcaneal ligament; and the posterior recess of the joint. The results of this experimental study indicate that arthroscopy of the posterior subtalar joint is technically feasible. Clinically, the possible indications for arthroscopy would include state of the articular cartilage in suspected cases of degenerative arthritis, rheumatoid arthritis, and infection; visualization of the joint after intraarticular fracture to evaluate chronic pain syndrome in the hindfoot; biopsy; management of sinus tarsi syndrome; loose body removal.

Adult↗
PubMed1985

Diagnostic and operative arthroscopy of the ankle technique and indications.

The technique of ankle arthroscopy is outlined and cases are presented illustrating some of its current applications. The author believes that ankle arthroscopy can play a valuable role in both the evaluation and treatment of traumatic, degenerative, and inflammatory disorders of the synovial and articular linings of the joint.

Adult↗
PubMed1985

Operative arthroscopy of the ankle. Three years' experience.

This is a preliminary report on 15 cases of surgical arthroscopy of the ankle performed between 1979 and 1983. Age range of the patients was from 14 to 35 years. Follow-up examinations were performed between six months and two and one-half years after surgery, with an average of 14 months. The indications were pain or clicking sensations accompanied by painful limitation of motion for an average of three months. Chondral and osteochondral fracture of the talar dome were observed in nine cases; chondral and osteochondral lesions of the tibial plafond in two cases; osteochondral loose bodies in two cases and; posttraumatic adhesions or arthritis was found in three cases. Treatment consisted of debridement of osteochondral lesions, removal of loose bodies, curettage, drilling, synovectomy, and abrasion of the subchondral bone. The results were assessed subjectively and objectively. Satisfactory overall results were obtained in 85% of the cases. There were no major complications. This study suggests that arthroscopic surgery has a definite role in the management of intra-articular lesions of the ankle. The results are reproducible if the arthroscopic surgeon pays proper attention to the anatomy of the area and is familiar with the use of different arthroscopic portals.

Adolescent↗
PubMed1984

The role of arthroscopy in the management of low-velocity gunshot wounds of the knee joint.

Eight patients with low-velocity civilian gunshot wounds of the knee were examined and evaluated by arthroscopy. Three of these patients were also treated by surgical arthroscopy and underwent limited arthrotomy for bullet removal. In two patients small arthrotomy incisions were made following arthroscopic exploration for removal of bullets. Two patients underwent diagnostic arthroscopy. One underwent internal fixation for a chondral fracture of the femoral condyle. The majority of patients sustained intra-articular damage and retained foreign materials (denim flecks and metallic shards) and osteochondral fragments. There were no postoperative infections after a minimum follow-up period of one year. Arthroscopy is highly effective in the diagnosis and surgical management of low-velocity gunshot wounds of the knee both alone and in combination with limited arthrotomy depending on the severity of the condylar damage. The length of the hospital stay is reduced (length of stay exceeded 3-4 days only as a result of intravenous antibiotic coverage). Physical therapy requirements are minimal. Active mobility and a full range of motion are regained more rapidly with arthroscopy than with surgical exposure of multiple exploratory incisions or conventional standard arthrotomy.

Adult↗