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At least 19 recordsLinked to original sources
PubMed1979

[Diagnostic arthroscopy and arthroscopic surgery: experiences with 500 knee arthroscopies].

A diagnosis by clinical examination and arthrography was not possible in 160 out of 500 arthroscopically examined patients, most of them with post-traumatic knee disorders. In 157 cases the clinical diagnosis was wrong, and in another 58 cases incomplete. Only in 89 patients (18%) arthroscopy proved the clinical diagnosis to be correct. At arthroscopy, a meniscal injury was found in 156 patients (medial meniscus 57, lateral meniscus 64, both menisci 8). With regard to the menisci a previous arthrography was found correct only in 103 out of 213 cases, i.e. in 48%. Lesions of the articular cartilage were present in 210 patients, although they were expected clinically in only one third of these cases. Normal intraarticular structures were found in 95 examinations. The arthroscopic examination was insufficient three times because of a protruding fat pad, and wrong in 2 patients in whom an arthroscopically diagnosed meniscal tear could not be found at arthrotomy. The morbidity of arthroscopy is small. Only complications: A local allergic reaction because of a wound spray in four cases, bronchial asthma following general anesthesia in two patients. No infection occurred. Several therapeutic procedures may be carried out through the arthroscope. So loose bodies were removed from the joint in 39 and partial meniscectomy performed in 13 patients, all of them being treated as out-patients.

Cartilage, Articular↗
PubMed2026

Hip Arthroscopy-Assisted Management of Pipkin Types I and II Femoral Head Fracture-Dislocations: Mid-Term Clinical and Radiographic Outcomes.

OBJECTIVES: Hip arthroscopy-assisted surgery has been proposed as a minimally invasive option for femoral head fractures; however, evidence with mid-term follow-up remains limited. This study aimed to evaluate the clinical and radiographic outcomes of arthroscopy-assisted management for Pipkin Types I and II femoral head fracture-dislocations with a minimum follow-up of 5 years. METHODS: This retrospective study included 23 consecutive adults (19 Pipkin I and 4 Pipkin II) treated with hip arthroscopy-assisted fragment excision or internal fixation between March 2013 and January 2020. Preoperative computed tomography was used for surgical planning, and fixation was placed with arthroscopic headless screws. Clinical outcomes were assessed using the Harris Hip Score (HHS) and Thompson-Epstein (T-E) criteria. Radiographic evaluation included avascular necrosis (AVN), heterotopic ossification (HO; Brooker), osteoarthritis (OA; Tönnis), and fracture reduction quality (Matta's criteria). Group comparisons were evaluated using independent samples t-tests, Mann-Whitney U tests, and Fisher's exact test. The mean follow-up was 86.2 ± 21.2 months. RESULTS: The cohort consisted of 19 males and 4 females with a mean age of 28.7 ± 9.9 years. Fifteen patients underwent fixation and eight underwent excision. The final mean HHS was 98.3 ± 1.9, with 21 patients (91%) achieving excellent and 2 (9%) good T-E criteria. There were no significant differences between the fixation and excision groups in demographic characteristics, operative time, or functional outcomes (all p > 0.05); however, hospital stay was significantly shorter in the excision group (2.9 ± 0.6 vs. 5.5 ± 4.6 days, p = 0.028). In the fixation group, mean maximal displacement improved from 7.6 mm preoperatively to 2.6 mm postoperatively, with anatomic reduction achieved in 6 cases (40%), imperfect in 6 (40%), and poor in 3 (20%). Patients with Pipkin Type I fractures had significantly higher HHS than those with Type II fractures (98.7 ± 1.7 vs. 96.0 ± 0.8, p = 0.018). Complications were rare, with one case of Brooker Grade I HO and one case of mild OA. No AVN or total hip arthroplasty occurred during the follow-up. CONCLUSIONS: Hip arthroscopy-assisted management of selected Pipkin Type I and II femoral head fractures yields excellent mid-term clinical outcomes with acceptable radiographic reduction and a low complication rate. This minimally invasive technique represents a viable alternative in appropriately selected patients when fragment characteristics and surgical expertise permit.

Humans↗
PubMed1979

Correlations of arthrography with arthroscopy.

Arthrography and arthroscopy were compared on a prospective basis in 100 consecutive and unselected knees, all in patients who underwent arthrography, arthroscopy, and surgery. Arthroscopy was found to be more accurate than arthrography in the diagnosis of medial and lateral meniscus and anterior cruciate ligament lesions. Because of its easy availability and relatively low cost, arthrography continues to be a useful extension of the physical examination of the knee, serving as a further diagnostic screening technique. However, arthroscopy is recommended in all patients prior to surgery because it provides more complete and more accurate delineation of intra-articular lesions.

Cartilage, Articular↗
PubMed2026

Hip Arthroscopy During Female Menstruation: A Retrospective Analysis of Safety and Clinical Outcomes With 24-Month Follow-Up.

OBJECTIVES: To investigate the safety and clinical outcomes of hip arthroscopy performed during menstruation in reproductive-age female patients, and to determine whether surgery during menstruation increases intraoperative risks or adversely affects postoperative recovery. Currently, clear clinical guidelines regarding the timing of elective orthopedic surgeries relative to the menstrual cycle are lacking, often leading to unnecessary surgical rescheduling. Therefore, this study aimed to provide evidence-based guidance for perioperative management and optimal surgical scheduling, thereby addressing a critical clinical need. METHODS: This retrospective cohort study included reproductive-age female patients who underwent hip arthroscopy at the First Medical Center of Chinese PLA General Hospital, the Fourth Medical Center of Chinese PLA General Hospital, and the Department of Sports Medicine at the Second Hospital of Shandong University from December 2018 to September 2023. Patients were categorized into the menstruation group (MP) and the non-menstruation group (NMP) based on whether they were menstruating on the day of surgery. The NMP group consisted of equally sized ovulatory (OP) and luteal (LP) phases. Perioperative outcomes included: intraoperative blood loss, anesthetic dosage, operative time, hemoglobin (Hb) change (within 24&#x2009;h postoperatively), prothrombin time (PT), and activated partial thromboplastin time (APTT). Postoperative outcomes included analgesic consumption, duration of analgesic use, time to first unassisted weight-bearing ambulation, complications, and urinary tract infections. Functional outcomes were assessed at 24-month follow-up using the Visual Analog Scale (VAS), Modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS). RESULTS: Of 884 eligible patients, 28 were included in the MP group and 56 matched patients in the NMP group. Operative time, anesthetic use, Hb change, PT, and APTT were comparable between the two groups (all p&#x2009;>&#x2009;0.05). No serious complications or urinary tract infections occurred in either group. At the 24-month follow-up, both groups demonstrated significant improvements in VAS, mHHS, iHOT-12, HOS-ADL, and HOS-SSS (all p&#x2009;<&#x2009;0.001), with no statistically significant differences observed between the groups. CONCLUSIONS: Hip arthroscopy during menstruation does not increase intraoperative bleeding, impair coagulation, or delay functional recovery for female patients. Menstruation should not be considered a contraindication when appropriate perioperative management is applied.

Humans↗
PubMedDate not supplied

Operative arthroscopy.

In a period of 20 months, over 200 patients (age ranged from high school students to middle-aged persons) with knee injuries were treated by operative arthroscopy. The majority of the injuries were incurred while the patients had been participating in athletic events, either competitive or recreational. Operative arthroscopy offers the advantage of shortened hospital stay, rapid rehabilitation, lack of disfiguring scar, and reduced costs. Patients are followed yearly after the first postoperative year. Improved long-term results from diagnostic and operative arthroscopy, as compared to conventional surgical procedures, are expected. The proof of those expectations will be determined in the next several years as this group of patients requiring partial meniscectomies or procedures for pathologic and degenerative conditions is reevaluated.

Adolescent↗
PubMed1979

Arthroscopy in spontaneous osteonecrosis of the knee.

Eight knees with spontaneous osteonecrosis were investigated through arthroscopy, and in seven the intra-articular findings were rechecked at arthrotomy performed one to two weeks later. Anbormalities in the articular cartilage were observed in detail under arthroscopy that could not be seen in roentgenograms. In the early stage of osteonecrosis, flattening and fissures in the articular surfaces, with and without formation of a cartilage flap, were useful findings in choosing intra-articular surgical procedures. In the late stage, free bodies such as cartilage plates in the joint and regeneration with fibro-cartilaginous tissue over the necrotic lesion were also important in selecting surgical treatment. In addition to roentgenographic classification of developmental stages in osteonecrosis, arthroscopy is necessary in differentiating osteoarthroses, in observing the articular surface of the femoral condyles, and in determining the stage of disease when roentgenography provided insufficient information to justify intra-articular procedures such as drilling and bone grafting.

Aged↗
PubMed1979

Precision in the diagnosis of meniscal lesions: a comparison of clinical evaluation, arthrography, and arthroscopy.

We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in fifty knees in which arthrotomy was performed for disabling symptoms after evaluation by these three methods. At surgery, forty-seven menisci were removed, of which forty-four were abnormal and three were normal. In three patients with normal menisci, loose bodies were found in two and the exploration was negative in one. In the forty-four knees with a meniscal lesion, a correct diagnosis was made clinically forty time, arthrographically thirty-nine times, and arthroscopically thirty-two times. Most errors occurred in the knees with posterior horn lesions of the medial meniscus. Clinical diagnosis was least accurate for lesions of the lateral meniscus (four missed) and arthroscopy was least accurate for lesions of the posterior horn of the medial meniscus (ten missed). Arthrography appeared to provide collateral evidence of lesions not seen directly. Based on this study it was concluded that even with negative findings by arthroscopy and arthrography it still may be necessary occasionally to remove a meniscus on the basis of the clinical evaluation.

Adult↗
PubMed1978

Therapeutic arthroscopy of the knee.

This paper describes transcutaneous therapeutic procedures performed during arthroscopy. Sixty-six patients were treated. Small loose bodies were flushed out through the arthroscope in 7 cases. In 19 of 24 knees a loose body 0.5-2 cm in size was extracted either with a Dormia stone-dislodger or a pituitary rongeur. In 5 patients we failed to remove the loose body transcutaneously and arthrotomy was performed. A meniscus was resected in 17 patients using a pituitary rongeur alone or in combination with some other instrument. The late result was good in 14, but 3 subsequently underwent arthrotomy. Various procedures such as lateral release of the patella by a special technique, removal of intra-articular sutures and other measures were also undertaken. No complications occurred and the duration of sick leave was usually short. Before arthrotomy for removal of loose bodies or resection of ruptured menisci is performed, we feel that an attempt at transcutaneous therapy under arthroscopy should be made.

Adolescent↗
PubMed1979

Indications for arthroscopy in mon- and polyarticular arthritis.

In many cases clinical and laboratory data and x-rays are insufficient to diagnose the aetiology of synovitis in gonarthritis and to plan adequate treatment. The efficacy of arthroscopy in the management of the knee lesion was studied in mon- and polyarthritis. A classification of 'very useful', 'useful' and 'not useful' was used. On the basis of results reported here we outline the indications for arthroscopy in mon- and polyarthritis.

Adolescent↗
PubMed1979

Arthroscopy of the wrist and finger joints.

Ninety arthroscopies of the wrist and finger joints in 34 clinical cases and two amputated arms were carried out with the number 24 arthroscope. Eighty-four wrist and finger joints of four cadavers and two amputated arms were also dissected for macroscopic observation. Most portions of the interior structures of the wrist and finger joints can be observed by the dorsal approaches. Color photography and punch biopsy are also possible. Some arthroscopic photographs taken with the number 24 arthroscope are illustrated. From these experiences it is concluded that the number 24 arthroscope is a useful diagnostic tool in arthroscopy of the small joints, even though there are still many problems.

Adult↗
PubMed1978

Arthroscopy of the knee.

Fiberoptics permit a minimally invasive direct inspection of the knee joint. Arthroscopy is indicated when no definitive clinical diagnosis can be made. An organized approach includes inspection of the suprapatellar pouch, the articular surfaces of the patella, the medial and lateral compartments of the knee and the intercondylar area. Common afflictions diagnosed by arthroscopy include chondromalacia, meniscal lesions, osteoarthritis, cruciate ligament injuries, chronic synovitis and loose bodies. Complications and morbidity are minimal.

Endoscopes↗
PubMed2026

Effect of different liposomal bupivacaine concentrations in ultrasound-guided superior trunk block on postoperative analgesia and mobility: a randomized double-blind controlled trial protocol for shoulder arthroscopy.

BACKGROUND: Shoulder arthroscopy frequently causes severe postoperative pain that may impede recovery. Liposomal bupivacaine provides prolonged analgesia, and ultrasound-guided superior trunk block (STB) offers comparable analgesia to interscalene block with a lower risk of hemidiaphragmatic paralysis. However, the optimal concentration of liposomal bupivacaine for STB remains unknown. METHODS: This randomized, double-blind, controlled trial will enrol 282 adult patients scheduled for elective arthroscopic rotator cuff repair. Patients will be randomly allocated (1:1:1) to receive ultrasound-guided STB with liposomal bupivacaine 66&#x2009;mg (Group A), 44&#x2009;mg (Group B) or 33&#x2009;mg (Group C), each diluted to 10&#x2009;mL. The co-primary outcomes are (1) rest pain Numeric Rating Scale (NRS) score at 48&#x2009;h post-surgery and (2) cumulative oral morphine milligram equivalents (MME) consumption within 0-48&#x2009;h after surgery. Secondary outcomes include rest pain NRS scores at 6, 24 and 72&#x2009;h; motor function assessed by Muscle Balance Scale, Bromage score and American Shoulder and Elbow Surgeons (ASES) score at 6, 24, 48 and 72&#x2009;h; and Quality of Recovery-15 (QoR-15) score at 24 and 48&#x2009;h. DISCUSSION: This study will provide evidence on the optimal concentration of liposomal bupivacaine for STB in arthroscopic shoulder surgery, aiming to achieve effective and prolonged analgesia without compromising shoulder mobility.

Humans↗
PubMed1978

Arthroscopy of the knee.

Arthroscopy of the knee is an essential diagnostic aid for difficult knee problems. It is safe and is indicated especially in the problem knee of adolescents, where it is most undesirable to remove a normal cartilage; in litigation cases; in the post-surgery knee problem; in planning surgical procedures; and in surgery on professional sportsmen.

Adolescent↗
PubMed1978

Therapeutic value of arthroscopy.

Thermography before and after joint irrigation at arthroscopy showed no significant improvement of inflammation in 14 patients. Subjectively, those with chondrocalcinosis did best.

Arthritis↗
PubMed1979

Correlation of arthroscopy with other diagnostic modalities.

In our experience arthroscopy proved to be the most reliable method of evaluating internal derangement of the knee. Among 96 patients who underwent arthrotomy, the arthroscopic diagnosis was confirmed in 96 per cent. The combined anteromedial, anterolateral, and posteromedial approaches consistently demonstrated all intraarticular disorders. We found the posterolateral approach of little benefit.

Adolescent↗
PubMed1979

Arthroscopy in the evaluation of operative treatment of osteochondrosis dissecans.

In an early stage of postoperative evaluation of intra-articular surgery, as in osteochondrosis dissecans, arthroscopic examination is indispensable. In order to compare the results of different cases, a classification is necessary. The arthroscopic grading system presented is valuable for assessing degeneration of the three knee compartments. Early arthroscopic evaluation for follow-up can be used to classify postoperative complications that are not visable radiologically and are not severe enough to justify re-exploration. After follow-up examination with arthroscopy, advice to the patient may halt the progression of deterioration. Further study of the different treatments can help in formulating a plan of management of osteochondrosis dissecans.

Adolescent↗
PubMed1979

Problems in recording arthroscopy.

Several good combinations of photographic equipment are available today for recording arthroscopies. Some of them are so simple to use that everyone can obtain good still pictures through the arthroscope. It is usually preferable to enlarge the arthroscopic pictures in order to get better slides for presentations during lectures and at scientific meetings. Movie film and video tape offer a more dynamic recording but are both fairly expensive. The use of video tape can cause problems during presentations to larger audiences. Video tape, however, can be transferred to 16 mm. movie film, which is the international standard in the teaching world. Color TV has three different standards in different parts of the world and there are at least four different video casette systems available today.

Documentation↗