Postoperative analgesic efficacy of fascia iliaca block versus periarticular injection for total knee arthroplasty.

Study Objective: This study evaluated the postoperative analgesic efficacies of fascia iliaca block and periarticular drug injection techniques after TKA (total knee arthroplasty) surgeries.

Design: Prospective, randomized clinical trial.

Setting: University Teaching and Research Center.

Restoration of pull-out strength of the failed pedicle screw: biomechanical comparison of calcium sulfate vs polymethylmethacrylate augmentation.

Objective: The aim of the present study was to compare calcium sulfate (CAS) and polymethylmethacrylate (PMMA) bone cements used for the augmentation of a failed pedicle screw with biomechanical pull-out strength (POS) testing.

Methods: Thirty lumbar vertebrae were harvested from 6 calves and bone mineral densities (BMD) were measured. Primary polyaxial pedicle screws were randomly inserted and pulled out and the POSs of the specimen were recorded.

Prospective evaluation of the functional and anatomical results of arthroscopic repair in small and medium-sized full-thickness tears of the supraspinatus tendon.

Objective: The purpose of this study was to analyze the relation between tendon integrity and functional results following the arthroscopic treatment of small- and medium-sized rotator cuff tears.

Methods: Arthroscopic repair was performed on 26 consecutive patients (21 women, 5 men;mean age: 55.9 years; range: 33-72 years) with small- and medium-sized tears of the supraspinatus tendon.

Extracorporeal shock waves in articular cartilage defects in the rats.

Thirty adult Sprague-Dawley rats were used to assess the nature of healing tissues in hyaline cartilage defects and to compare the healing in defects treated with shock waves, with those in defects without treatment. A 2 × 2 mm cartilage defect with exposed cancellous bone was created in a nonweight-bearing area of each medial femoral condyle. Each right knee defect was received extracorporeal shock waves (Swiss Dolorclast) of 500 impulses in 5 min at 2 bar (comparative to 0.

[Unicondylar knee arthroplasty in medial unicompartmental osteoarthritis: technical faults and difficulties].

Objectives: The aim of this study is to evaluate both the technical problems of surgery and the clinical and radiologic outcomes of patients treated with unicondylar knee arthroplasty.

Patients And Methods: Forty-one unicondylar knee prosthesis were performed in 40 patients (3 males, 37 females; mean age 58.2 years; range 44 to 76 years) diagnosed with unicompartmental knee osteoarthritis.

[The effects of two different fixation methods on femoral bone tunnel enlargement and clinical results in anterior cruciate ligament reconstruction with hamstring tendon graft].

Objectives: We investigated the effects of anatomic and non-anatomic tunnel fixations on femoral tunnel widening and clinical results in anterior cruciate ligament (ACL) reconstructions.

Methods: We retrospectively evaluated 35 patients who underwent arthroscopic ACL reconstruction with quadrupled hamstring tendon graft. Fixation was performed in the tunnel using the transcondylar RigidFix pin (group 1) in 18 patients (mean age 32 years), and from outside the tunnel using the EndoButton-CL device (group 2) in 17 patients (mean age 30 years).

The correlation of correction magnitude and tibial slope changes following open wedge high tibial osteotomy.

We investigated whether there is a correlation between coronal plane correction magnitude and tibial slope in patients treated with medial open wedge high tibial osteotomy (OWHTO) and also measured changes in patellar height. Thirty-four knees treated with for varus deformities were retrospectively reviewed and the follow-up period of the patients was averaged 24.1 months.

Knee joint synovial cyst following total knee arthroplasty with bone allograft.

Allograft has been shown to be highly successful for managing large osseous defects in total knee arthroplasty. We report a 68-year-old woman in whom a bone allograft had been used during total knee arthroplasty owing to a massive segmental medial tibia plateau defect 4 years earlier. Eighteen months after surgery, a 10x10 cm knee synovial cyst was detected by computed tomography scanning on the anteromedial side of the tibial plateau, and an en-bloc surgical excision was performed.

Plating after lengthening (PAL): technical notes and preliminary clinical experiences.

Introduction: Shortening the period of time for the external fixator after limb lengthening decreases the complication rate and increases the patient satisfaction.

Material And Method: We describe the plating after lengthening (PAL) as a new technique on five patients with limb length discrepancy (1 femoral, 4 tibial) who had lengthening procedure with Ilizarov technique. The mean amount of lengthening was 50 mm.

Combined ulnar and carpal tunnel syndrome caused by pigmented villo-nodular tenosynovitis: a rare case.

Pigmented villo-nodular synovitis/tenosynovitis (PVNS) is a rare cause of combined ulnar and median nerve compression neuropathy at the wrist. In our case, a 53-year-old house-wife had sensorial and motor complaints at her left hand. In clinical examination, painless soft tissue mass was palpated at her wrist and both the tenar and hypotenar muscles were atrophic.

Necrotizing soft-tissue infection of a limb: clinical presentation and factors related to mortality.

Background: Necrotizing fasciitis is a rare and often fatal soft-tissue infection. Prompt diagnosis and immediate aggressive surgical debridement of all compromised tissues are critical to reducing morbidity and mortality in these rapidly progressive infections. The purpose of this study was to analyze the clinical presentation and evaluate factors that determine mortality associated with this uncommon surgical emergency.

Arthroscopic debridement and grafting of an intraosseous talar ganglion.

We report the case of a 41-year-old man with right ankle pain and swelling who had an intraosseous talar ganglion in the medial part of talar dome. A surgical procedure was performed using the 3-portal arthroscopic approach. The softened chondral surface was removed and the content of the cyst was discharged arthroscopically.

Hallucal sesamoid osteonecrosis: an overlooked cause of forefoot pain.

Four cases of osteonecrosis of hallucal sesamoids are reported here. Surgical excision of necrotic sesamoid tissue yielded satisfactory results, with the patients reporting no residual pain. Although it has not been frequently addressed in the literature, avascular necrosis of the sesamoid bones should be considered in the differential diagnosis of persistent forefoot pain.

Time dependent changes in patellar tracking with medial parapatellar and midvastus approaches.

The aim of this study was to compare the alteration of patellar tracking by time, which was performed through two different approaches: midvastus and medial parapatellar. Twenty-one patients undergoing simultaneous bilateral primary total knee replacements were randomized prospectively to perform the surgery via a medial parapatellar approach on one knee and midvastus approach on the other knee. All of the patellae were resurfaced.

Arthroscopic treatment of solitary benign intra-articular lesions of the knee that cause mechanical symptoms.

Purpose: Most cases of knee locking and giving-way are caused by meniscal tears, loose bodies, or chondral lesions. Intra-articular benign tumors or tumor-like lesions can present with symptoms that resemble acute mechanical derangement. From a database of 2,200 arthroscopic interventions, 19 cases of intra-articular masses that presented with catching and locking symptoms in the knee were retrospectively analyzed.

[A comparison between single- and two-staged bilateral total knee arthroplasty operations in terms of the amount of blood loss and transfusion, perioperative complications, hospital stay, and cost-effectiveness].

Objectives: We compared bilateral total knee arthroplasty (TKA) operations performed at a single session or at two separate sessions with respect to perioperative complications, the amount of blood loss and transfusion, the length of hospital stay, and the overall cost.

Methods: The study included 39 patients (34 females, 5 males; mean age 68.1 years; range 52 to 88 years) and 16 patients (13 females, 3 males; mean age 66.

Primary clear cell sarcoma of rib.

Clear cell sarcoma (malignant melanoma of soft tissues) is a very rare soft tissue neoplasm. It generally arises in tendons and aponeuroses. Although metastasis of malignant melanoma to bone is not uncommon, primary clear cell sarcoma of bone is an extremely rare neoplasm.

Iatrogenic medial dislocation of hallucal sesamoids with hallux varus in an adolescent.

Background: Iatrogenic hallux varus is a rare deformity linked to bunion surgery at late adult age. Here reported is the first adolescent case of acquired hallux varus and medial dislocation of both sesamoid bones.

Case Report: The patient had had a surgical intervention under his first metatarsophalangeal joint when he was 10 years old.

Tunnel enlargement after arthroscopic anterior cruciate ligament reconstruction: comparison of bone-patellar tendon-bone and hamstring autografts.

Bone tunnel enlargement associated with anterior cruciate ligament (ACL) reconstruction has recently become a topic of interest in the literature. This association was examined, along with the effect of femoral and tibial tunnel enlargement on the clinical results of ACL reconstruction performed with either bone-patellar tendon-bone (BPTB) or hamstring (HST) autografts. Forty-six patients underwent arthroscopic ACL reconstruction (23 receiving BPTB autograft and 23 HST) between March 1999 and July 2001.

Synovial cysts of proximal tibiofibular joint causing peroneal nerve palsy: report of three cases and review of the literature.

Introduction: Synovial cyst of the proximal tibiofibular joint is a very rare condition, for which there is no consensus regarding treatment.

Case Presentation: We present three patients who had synovial cysts of proximal tibiofibular joint that caused peroneal nerve palsy. We discuss the special features of synovial cysts and review the literature.

The timing of tourniquet release and its influence on blood loss after total knee arthroplasty.

We performed a prospective, randomized study on 76 patients (82 knees) scheduled for total knee arthroplasty to determine the effect of tourniquet release and hemostasis on the peri- and postoperative blood loss. Patients were randomly divided in two groups. Posterior cruciate retaining tricompartmental total knee prostheses were used in all.

Benign noninfectious subcutaneous emphysema of the hand.

A 17-year-old girl presented pain and subcutaneous crepitation in the left hand. Because of lack of systemic symptoms, non-infectious cause was considered. Radiographic and magnetic resonance imaging revealed subcutaneous emphysema.

Type 4 median nerve entrapment in a child after elbow dislocation.

Unlabelled: CASE STUDIED: Median nerve entrapment is a rare, serious complication of elbow dislocation. We report a Type 4 median nerve entrapment after elbow dislocation in a 10-year-old boy. Radiologically Matev's sign and a new radiological finding-a sclerotic tunnel at the lateral side of the olecranon-were seen.

[Arthroscopic capsular release for frozen shoulder].

Objectives: This study was designed to evaluate the results and technical considerations of arthroscopic capsular release of the glenohumeral joint in frozen shoulder disease.

Methods: Arthroscopic capsular release was performed in 16 patients (11 women, 5 men; mean age 51 years; range 40 to 60 years) unresponsive to physical therapy. The affected shoulder was on the right in 10 patients, and on the left in six, being on the dominant side in 12 patients.

Primary hydatid disease of the quadriceps muscle: a rare localization.

Background: Hydatidosis is a protozoal infestation which generally involves the liver and the lungs. Primary skeletal muscle hydatidosis without involving the thoracic and abdominal organs is extremely rare.

Methods: A 48-year-old farmer presented with a mass in the quadriceps muscle that had persisted for 10 years.