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Arthroskopie.00130003.eng.abstr | Arthroskopie.00130003.eng.abstr | [
{
"id": "Arthroskopie.00130003.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The posterior cruciate ligament ( PCL ) is the strongest ligament of the human knee joint . Its origin is at the lateral wall of the medial femoral condyle and the insertion is located in the posterior part of the intercondylar area . The posterior cruciate ligament consists of multiple small fiber bundles . From a functional point of view , one can differentiate fiber bundles with an anterior origin and fiber bundles with a posterior origin at the femur . The anterior fibers insert in the anterolateral part of the tibial insertion zone . These fibers become tense when the knee is flexed . The posterior fibers insert in the posteromedial part of the tibial insertion and become tense when the knee is extended . The main part of the posterior cruciate ligament consists of type I collagen positive dense connective tissue . The longitudinal fibrils of type I collagen are divided into small bundles by thin type III collagen positive fibrils . In the center of the middle third region , the structure of the tissue varies from the typical structure of a ligament . In this region , the structure of the tissue resembles fibrocartilage . Oval-shaped cells surrounded by a metachromatic extracellular matrix lie between the longitudinal collagen fibrils . The femoral origin and the tibial insertion have the structure of chondral apophyseal enthesis . Near the anchoring region at the femur and tibia there should be various mechanoreceptors which might have an important function for the kinematics of the knee joint . The blood supply of the PCL arises from the middle geniculate artery . The ligament is covered by a synovial fold where the terminal branches of the middle and the inferior geniculate artery form a periligamentous network . From the synovial sheath , the blood vessels penetrate the ligament in a transverse direction and anastomose with a longitudinally orientated intraligamentous network . The distribution of blood vessels within the PCL is not homogeneous . We detected three avascular areas within the ligament : Both fibrocartilaginous entheses of the PCL are devoid of blood vessels . A third avascular zone is located in the central zone of fibrocartilage of the middle third region ."
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Arthroskopie.00130011.eng.abstr | Arthroskopie.00130011.eng.abstr | [
{
"id": "Arthroskopie.00130011.eng.abstr-passage-0",
"type": "abstract",
"text": [
"An investigation of 122 knee joints was performed concerning the incidence and morphological characteristics of the meniscofemoral ligaments ( MFL ) Humphry and Wrisberg . Of the knees examined , 96% showed one or more ligaments , the incidence was independent of gender or age . The osseous parameters of the dorsal and ventral notch as well as the diacondylar width did not correlate with the incidence of MFL . The ventral notch width index ( NWI ) after Souryal was 0.22 in females and 0.24 in males . A dorsal notch width index ( dNWI ) , which has not been described so far , was 0.26 in females and 0.28 in males . The ligamentum meniscofemorale posterius ( Wrisberg ) showed distinct morphological variations . This resulted in a classification of type I-III . The results of the study underline the importance of the MFL for knee joint function including stabilization , proprioception , and meniscal positioning ."
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Arthroskopie.00130017.eng.abstr | Arthroskopie.00130017.eng.abstr | [
{
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"This article discusses the surgical treatment of chronic posterior knee instability . The treatment rationale includes osteotomy , posterior cruciate ligament ( PCL ) reconstruction , and posterolateral reconstruction . Exact evaluation of the osseous anatomy is mandatory to identify an eventual varus morphotype . This osseous variant in combination with posterior/posterolateral instability should be treated by an osteotomy . An additive osteotomy correcting varus and increasing the sagittal tilt of the proximal tibia is used . Patellar tendon grafts , quadriceps tendon grafts , or hamstrings can be used for posterior cruciate ligament replacement . Arthroscopic or mini-open techniques may be used for graft placement ; direct posterior fixation of the graft via a posterior incision is an option for patellar tendon grafts . Bousquet's biceps plasty or Clancy's biceps tenodesis are used for posterolateral stabilization , a biceps tendon strip can also be used for lateral collateral ligament reconstruction . Results of surgery are still moderate . Of the author's series with chronic posterior/posterolateral instability , 26 cases were treated with posterior cruciate ligament reconstruction and biceps tenodesis . Follow-up at 18 months demonstrated increased stability ( mean residual posterior drawer 8 mm at 70 ° and 20 lb force ) and improved knee function ( 33% IKDC B , 67% IKDC C ) . Presently , surgical treatment of chronic posterior knee instability should be restricted to centers devoted to this problem ."
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Arthroskopie.00130030.eng.abstr | Arthroskopie.00130030.eng.abstr | [
{
"id": "Arthroskopie.00130030.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The treatment of acute posterior instabilities can involve a reconstructive procedure as well as an antidislocation augmentation . Tibial bony avulsion ruptures must be reconstructed . For the treatment of chronic posterior instabilities we used the patella tendon graft , which can be implanted by an anterior or posterior approach . In cases of posterolateral instabilities , additional procedures are necessary ."
],
"offsets": [
[
0,
415
]
]
}
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Arthroskopie.00130035.eng.abstr | Arthroskopie.00130035.eng.abstr | [
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"Since 1989 , 99 people presenting with posterior knee instability were treated by a unique technique . Of these patients , 55 were available for long-term follow-up ( mean 8.2 years ) ; 85% were male , the mean age was 28 years and sport injuries predominated traffic accidents , 52.7% and 40% , respectively . Previous operations could be observed in 29 cases and in 5 patients a high tibial osteotomy and a biceps tenodesis was simultaneously performed with the PCL reconstruction . Clinical evaluation using the IKDC form showed 45 patients scoring in group C and 10 in group D preoperatively . Improvement was achieved in 72.7% of all cases , 63.6% had excellent or good results ( 3 A , 32 B , 17 C , and 3 D ) . The Tegner activity score before injury was 7 and was not found to be higher than 5.5 at follow-up . We think that PCL reconstruction with the middle third of the LAD-augmented patella tendon using an anterior and posterior approach is a good technique for surgical therapy of posterior knee instability ."
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Arthroskopie.00130041.eng.abstr | Arthroskopie.00130041.eng.abstr | [
{
"id": "Arthroskopie.00130041.eng.abstr-passage-0",
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"In a prospective study , 35 consecutive patients with an isolated posterior knee instability were stabilized arthroscopically in a new all-inside , double bundle technique using the autologous quadrupled semitendinosus and the doubled gracilis tendon . Femoral fixation of the grafts was performed with two Endobuttons . Out of 24 patients , 20 were evaluated with a follow-up of 25.4 months ( 12-47 ) on average ; in 15 cases the follow-up was less than 12 months . Only 18 patients could be evaluated because in two cases the grafts had to be removed ( one infection , one rupture ) . The Lysholm score improved from 67.6 points preoperatively to 88.5 points , the Tegner score from 3.9 to 4.9. The corrected posterior drawer measured with the KT-1000 arthrometer was reduced from 9.1 mm to 4.3 mm postoperatively . Preoperatively , 17 patients belonged to group D and one patient to group C in the IKDC overall evaluation form . After stabilization , eight patients were in group B , seven in group C , and three remained in group D. Damage to neurovascular structures in the popliteal area did not occur ."
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Arthroskopie.00130047.eng.abstr | Arthroskopie.00130047.eng.abstr | [
{
"id": "Arthroskopie.00130047.eng.abstr-passage-0",
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"text": [
"Transplant failure after anterior cruciate ligament plastic surgery is a typical complication . In larger collectives , the amount of revision operations is about 8-12% of the reconstructive anterior cruciate ligament operations . The number of revision operations is also growing in our clinic and is presently 11% . There are different reasons for transplant failure , including : technical faults during the operation , wrong fixation technique , or inadequate postoperative treatment . Rarely is a new \" adequate trauma \" the cause of a rerupture . The number of revision operations with low-fail positioned drill canals is growing with the improvement of target instruments and the refinement of operation techniques . The fixation method is also very important . Thus , we repeatedly see transplant insufficiencies after Endobutton fixation with enormous drill canal expansion and heavy canal sclerosis . Especially drill canal expansion with great tibial and femoral bone defects , caused by low-fail positioning , lead to serious problems for revision plastic surgery . Appropriate revision surgery is required for these defects , and in these cases , the TransFix technique , if necessary in conjunction with the OATS technique , is a reproducible alternative for immediate revision plastic surgery . Short-term results of the first seven patients operated this way justify this view ."
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Arthroskopie.00130054.eng.abstr | Arthroskopie.00130054.eng.abstr | [
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"We examined 223 patients who underwent arthrolysis after ACL reconstruction . An arthrofibrosis group ( n = 156 , 70% ) and a cyclops group ( n = 57 , 30% ) were formed . The mean time interval between arthrolysis and follow-up examination was 3.98 years . We recorded : timing of surgery ; additional injuries ; state of the knee before reconstruction ; range of motion during rehabilitation ; pain ; beginning , length and type of rehabilitation ; severeness and etiology of joint stiffness ; and the time between ACL reconstruction and revision . Furthermore , the present state of the knee was documented . A significant correlation between arthrofibrosis and preoperative irritation ( P = 0.001 ) , preoperative limited ROM ( P = 0.02 ) , perioperative pain ( P = 0.023 ) , and an early beginning of muscle training ( P = 0.024 ) was found . These correlations were not obvious in the cyclops group . The combination of a remaining loss of extension and development of degenerative joint disease proved to be significant ( P = 0.028 ) . The decrease of sports activity compared to the level before ACL injury was also highly significant ( P 0.001 ) ."
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"Magnetic resonance imaging ( MRI ) is used frequently in the diagnosis of knee injuries . The aim of this study was to compare the accruracy of MRI and clinical examination in diagnosing meniscal and cruciate ligament tears . Between January 1997 and June 1998 , a total of 883 patients had undergone knee joint arthroscopy , operated on by one orthopedic surgeon . Of these , 144 patients had a preoperative MRI ( group 1 ) . This group was compared with 309 patients who had undergone arthroscopy without MRI between January 1997 and June 1997 ( group 2 ) . Sensitivity , specificity and accuracy for tears of the medial meniscus were 80.6%/58.8%/72.9% in group 1 and 83.3%/78.5%/80.3% in group 2 , respectively , for tears of the lateral meniscus 44.4%/88.9%/83.3% in group 1 and 60.6%/98.8%/92.5% in group 2 and for tears of the anterior cruciate ligament 58.1%/92.0%/84.7% in group 1 and 80.1%/96.6%/89.6% in group 2. This study demonstrates that an experienced orthopedic surgeon can rely on the clinical diagnosis and decide whether arthroscopy is necessary in most cases without MRI . He will find intraarticular pathology in almost all cases if arthroscopy is performed . MRI should be reserved for special cases and should not be performed without first conducting a thorough clinical examination . The orthopedic surgeon should decide whether MRI is needed ."
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Arthroskopie.00130072.eng.abstr | Arthroskopie.00130072.eng.abstr | [
{
"id": "Arthroskopie.00130072.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This is a case report on arthroscopic removal of a glass splinter from the knee joint of a 56-year-old male . Recurrent hemarthrosis of the knee was the reason for differential diagnosis , as the patient could not remember any trauma . After performing MRI , a 12 x 5 mm signal-free zone showed up in the area of the lateral condylus femoris , which was identified through arthroscopy as a glass splinter and removed . The patient was discharged soon after without any complaints ."
],
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0,
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Arthroskopie.00130217.eng.abstr | Arthroskopie.00130217.eng.abstr | [
{
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"The present study describes a new anteroinferior portal for the arthroscopic repair of Bankart lesions . The portal was performed in an outside-to-inside fashion with the patient in the beach-chair position . The blunt guide rod was inserted 8-10 cm distal from the palpable coracoid tip lateral of the deltopectoral groove , directed to the inferior glenoid rim at an angle of about 135 to the glenoid . An 8.25-mm cannula was passed over the rod into the joint . The portal was established in 11 cadaver shoulders for anatomic evaluation . The average distance of the axillary nerve was 2.4 cm ( 1.5-5 cm ) . Close proximity to the circumflex artery and its accompanying veins ( three sisters ) was noted ( 0.5-2.5 cm ) . In each specimen , the portal was located lateral to the conjoined tendon without the possibility of damaging the musculocutaneous nerve . The described technique was applied in 200 patients who underwent arthroscopic Bankart repair by the senior author ( A. B. I. ) . We noted only one hematoma , but no neural complications . The new inferior portal can be applied safely and allows optimal arthroscopic repair of Bankart lesions . For treatment of bony Bankart fractures , this portal also allows placement of the screw perpendicular to the fracture site , which is more difficult during an open approach ."
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Arthroskopie.00130220.eng.abstr | Arthroskopie.00130220.eng.abstr | [
{
"id": "Arthroskopie.00130220.eng.abstr-passage-0",
"type": "abstract",
"text": [
"It is mandatory to differentiate between traumatic and atraumatic instability when treating shoulder instability . The traumatic instability is characterized by secondary lesions ( Bankart lesion , Hill-Sachs lesion , overstretching of the capsule ) , which are caused at the time of primary dislocation . The quality of the capsule has to be considered in close relationship to the appearance of the Bankart lesion . The stronger the capsule , the greater the external force has to be in order to surmount the resistance caused by the capsule . The damage to the glenoid rim makes it possible to draw conclusions about the condition of the capsule . In cases of atraumatic instability , secondary lesions are normally absent . These instabilities are often caused by laxity of the capsule . When stabilizing , a shoulder two criteria have to be taken into consideration : stability and function . Reattachment of the labrum alone will not guarantee stability . Additionally , the overstretched capsule has to be shortened or shifted . Both criteria are decisive for the success of the stabilizing operation ."
],
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Arthroskopie.00130226.eng.abstr | Arthroskopie.00130226.eng.abstr | [
{
"id": "Arthroskopie.00130226.eng.abstr-passage-0",
"type": "abstract",
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"Fixation of SLAP II lesions are often difficult because the posterior-superior part of the labrum does not allow good visualization of the glenoid . With our technique , we pass a suture through a needle which is placed in the supraspinous fossa . The suture is tied over the anterior-superior portal and drawn back through the fossa . Visualization of the posterior-superior glenoid is now allowed and the suture anchor can be placed precisely ."
],
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0,
446
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] | [] | [] | [
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Arthroskopie.00130229.eng.abstr | Arthroskopie.00130229.eng.abstr | [
{
"id": "Arthroskopie.00130229.eng.abstr-passage-0",
"type": "abstract",
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"Open treatment of shoulder instabilities is well accepted and still golden standard . But arthroscopic techniques show also good and comparable results . Arthroscopic procedures however are not accepted for treatment of failures and revision cases . Therefore we questioned whether a arthroscopic revision procedure is an option after failed first time open or arthroscopic stabilization . This prospective study was designed to assess the outcome of arthroscopic revision procedures after failed shoulder stabilization ."
],
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0,
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"id": "Arthroskopie.00130229.eng.abstr-s5-t2",
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"id": "Arthroskopie.00130229.eng.abstr-s5-t3",
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395,
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}
] | [] | [] | [
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{
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{
"id": "Arthroskopie.00130229.eng.abstr-s3-r1-t1.1-t2.1",
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{
"id": "Arthroskopie.00130229.eng.abstr-s3-r2-t1.1-t2.1",
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{
"id": "Arthroskopie.00130229.eng.abstr-s5-r1-t3.1-t1.1",
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},
{
"id": "Arthroskopie.00130229.eng.abstr-s5-r2-t3.1-t1.1",
"type": "measures",
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"arg2_id": "Arthroskopie.00130229.eng.abstr-s5-t1",
"normalized": []
}
] |
Arthroskopie.00130232.eng.abstr | Arthroskopie.00130232.eng.abstr | [
{
"id": "Arthroskopie.00130232.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Arthroscopic Bankart repair is performed via an inferior transmuscular approach to reattach the torn labrum-capsule complex with biodegradable extra-articular implants ( Suretac ) . An additional superior labrum or SLAP lesion is refixed with an intra-articular technique . Intra- and postoperative complications after arthroscopic stabilization of 170 patients with traumatic anterior instability or SLAP lesion were analyzed retrospectively . Intraoperative complications included breakage ( 1 ) and bending ( 3 ) of the guide wire , fracture ( 2 ) , and loss ( 2 ) of implants . In one case , the head of the Suretac cut through the refixed labrum , and in seven cases a bulging out of the glenoid cartilage after implant insertion was seen . Eight patients suffered from a frozen shoulder postoperatively , caused by a foreign body reaction and synovitis , and required revision surgery . No patient with neurologic complications or infections was recorded . Arthroscopic treatment of this pathology is technically demanding and requires an experienced surgical team , as well as the knowledge of all possible complications . The failure rate can be lowered by paying attention to some guidelines ( high flexible wires , 8-mm diameter Suretac , fixation steps under visualization ) . A higher incidence of adverse reactions with synovitis followed by adhesive capsulitis seems to be correlated to the biodegradable material , and isdifficult to avoid ."
],
"offsets": [
[
0,
1456
]
]
}
] | [
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21,
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s1-t2",
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96,
100
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]
},
{
"id": "Arthroskopie.00130232.eng.abstr-s1-t3",
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101,
115
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299,
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353,
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{
"id": "Arthroskopie.00130232.eng.abstr-s3-t4",
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377,
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s3-t5",
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285,
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"id": "Arthroskopie.00130232.eng.abstr-s4-t2",
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s4-t3",
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s4-t4",
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},
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"id": "Arthroskopie.00130232.eng.abstr-s5-t1",
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
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701,
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},
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},
{
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"synovitis"
],
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s6-t4",
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]
},
{
"id": "Arthroskopie.00130232.eng.abstr-s6-t5",
"type": "umlsterm",
"text": [
"foreign body"
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823,
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],
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"db_id": "C0016542"
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]
},
{
"id": "Arthroskopie.00130232.eng.abstr-s6-t6",
"type": "umlsterm",
"text": [
"foreign body reaction"
],
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823,
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],
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"db_id": "C0016549"
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},
{
"id": "Arthroskopie.00130232.eng.abstr-s7-t1",
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896,
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]
},
{
"id": "Arthroskopie.00130232.eng.abstr-s7-t2",
"type": "umlsterm",
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}
]
},
{
"id": "Arthroskopie.00130232.eng.abstr-s7-t3",
"type": "umlsterm",
"text": [
"infections"
],
"offsets": [
[
937,
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],
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Arthroskopie.00130241.eng.abstr | Arthroskopie.00130241.eng.abstr | [
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"id": "Arthroskopie.00130241.eng.abstr-passage-0",
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"Problem : In the present study , we evaluated the failure and revisions rates after arthroscopic subacromial decompression ( SAD ) . Method : We examined 70 patients who were treated with arthroscopic subacromial decompression for primary shoulder impingement stage II according to Neer at an average follow-up time of 30 months . Hereby , special attention was paid to the revision operations resulting from our treatment . Results : Revision operation had to be performed in nine patients ( 13% ) . Reasons for revisions were persisting or increasing pain as well as functional dissatisfaction . At the follow-up examination , six of these revised patients ( 66% ) were satisfied with the result . The mean follow-up CONSTANT score in the revised patients was 80.3 ( SD +/- 15.4 ) . In patients with impingement stage II , the mean follow-up CONSTANT score was 84.7 ( SD +/- 16.7 ) . In 60% of the revised patients , the necessity for revision operation was directly related to the technical problems of the primary operation , in 40% we found reasons not related to the primary SAD . Conclusions : Technical failures are the most common cause for the need of revision operations after SAD . This demonstrates how demanding this kind of operation procedure is . In case of revision operations , individual strategies should be developed in which the decision of whether to perform arthroscopic or open revision procedures is of special importance ."
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Arthroskopie.00130249.eng.abstr | Arthroskopie.00130249.eng.abstr | [
{
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"The AGA shoulder-dislocation study is a prospective multicenter study with many cases ( 371 stabilization operations ) , which has not terminated yet . One of the main aims of the study is the standardization of intraoperative findings within the unstable shoulder using a modified scheme from Habermeyer . Another aim is to judge the unstable shoulder by viewing the structure of IGHL , MGHL , and the incidence and extension of a Hill-Sachs lesion ."
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"As shown in acute adult knee trauma , not all injuries can be evaluated in the first clinical examination . Only through arthroscopy can the additional findings that were first overlooked become evident . In knee trauma in children , the clinical diagnosis is also often inaccurate . Nevertheless , arthroscopy is accepted only with hesitation , despite the fact that as early as in the 1980s the problem of accuracy in clinical knee examinations after acute trauma in children was addressed by several authors and arthroscopy advised to improve the diagnostic results . In two groups of children and adolescents with unclosed growth plates , a study comparing the years 1985 to 1988 and 1987 to 1996 was performed . The patients were selected from our hospital . The age was 6 to 15 years . In these patients the discrepancy between clinical examination and arthroscopical data could be demonstrated . Regarding the two groups , 45% and 36% , respectively , showed different findings in clinical and arthroscopic investigations . Isolated as well as combined lesions often could only be identified through arthroscopy . The main finding were interligamentary anterior cruciate ligament lesions , medial collateral ligament injuries and meniscal lesions . Patella luxations with retinaculum ruptures and osteochondral flakes not seen in clinical investigation were found through arthroscopy . Hemarthrosis was the most decisive predictor in severity of injury . Despite modern imaging techniques such as MRI , arthroscopy is exceptionally significant because it is simultaneously a diagnostic and therapeutic procedure . This more and more established conclusion should lead to further incorporation of arthroscopy in the managment of acute knee trauma in both children and adolescents ."
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Arthroskopie.80110016.eng.abstr | Arthroskopie.80110016.eng.abstr | [
{
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"On the basis of the results of 327 knee arthroscopies in children aged between 2 and 17 years in the period from 1985 to 1995 we attempt to evaluate the current status of this procedure . Arthroscopy as a diagnostic intervention in trauma with haemarthrosis or in any kind of knee effusion is progressively being replaced by sophisticated ultrasound techniques or MRI . This trend shows a predominant therapeutic use of knee arthroscopy . Taking our own \" incorrect \" clinical diagnoses as a starting point we look at common problems in the accurate clinical examination of the symptomatic knee in younger children . Rational utilization of all kinds of modern diagnostic measures will reduce purely diagnostic arthroscopies in favour of therapeutic endoscopic interventions thus reducing perioperative risks to a minimum ."
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] | [] | [] | [
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Arthroskopie.80110028.eng.abstr | Arthroskopie.80110028.eng.abstr | [
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Arthroskopie.80110034.eng.abstr | Arthroskopie.80110034.eng.abstr | [
{
"id": "Arthroskopie.80110034.eng.abstr-passage-0",
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"We report on 1952 arthroscopies of the knee in children aged up to 13 years and on 6464 arthroscopies in adolescents aged 14 to 17. At the same time operative arthroscopy was performed in 64% of the children and in 73% of the adolescents . The preoperative diagnosis was shown to be incorrect in 25% of the children and 24% of adolescents . Hemarthrosis was found in 35% of the children and in 29% of the adolescents . The most frequent pathology was in the patella ( 30% of the children and 41% of the adolescents ) . In the upper recessus , the distribution was 29% and 24% respectively , and 21% and 24% respectively , at the medial capsule and 16% and 14% at the medial femur condyle . A lesion of the ACL was obvious in 15% of the children and in 26% of the adolescents . A lesion of the medial meniscus was documented in 8% of the children and in 15% of the adolescents and in the lateral meniscus in 10% and 11% respectively . The most frequent operation was carried out on the synovia in 26% of the children and in 22% of the adolescents and on the plica in 23% and 24% respectively . A lateral release was performed in 19% of the children and in 18% of the adolescents , followed by operations on the joint space in 16% and 13% , respectively , on the patella in 16% and 19% respectively and on the medial condyle in 16% and 8% respectively . Operations on the medial meniscus were performed in 10% of the children in 18% of the adolescents , on the lateral meniscus in 10% and 12% respectively , and on the cruciate ligaments in 4% and 10% respectively . Diagnostic problems occurred in 1.4% of the children and in 1.2% of the adolescents and operative problems in 1.8% and 1.4% respectively . The intraoperative complication rate was found to be 2% in children and adolescents . Only rarely does diagnostic and operative arthroscopy in children and adolescents have problems and complications . Therefore , we conclude that either diagnostic or operative arthroscopy can be recommended under the following circumstances : In hemarthrosis , if ligament or meniscal lesions are suspected , after acute or recurrent patella dislocation , in knee joint effusion or pain for an unknown reason , for lavage of septic knee joints and if clinical examination or NMR is not possible because of pain or fear ."
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Arthroskopie.80110044.eng.abstr | Arthroskopie.80110044.eng.abstr | [
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"id": "Arthroskopie.80110044.eng.abstr-passage-0",
"type": "abstract",
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"Meniscal bucket-handle tears are common knee injuries , which cannot always be treated by meniscal sutures . Sometimes the bucket-handle resections can be difficult and require the skill of the arthroscopist to minimize iatrogenous chondral lesions and decrease operating time . We describe a simple trick for temporary fixation of the meniscus and its removal from the knee joint ."
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Arthroskopie.80110052.eng.abstr | Arthroskopie.80110052.eng.abstr | [
{
"id": "Arthroskopie.80110052.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The purpose of this study was to determine the viscoplastic deformation in a quadrupled semitendinosus graft construct using a titanium button/ tape and screw post/suture fixation technique in response to cyclic loading . Eight quadrupled grafts for replacement of the anterior cruciate ligament ( ACL ) were prepared from human cadaveric semitendinosus tendons . For fixation , a polyester tape attached to a titanium button and four #2 nonresorbable sutures attached to each of the four tendon ends tied around a post screw were used . The graft construct was mounted on an INSTRON testing machine , with the titanium button and the post screw rigidly fixed at a constant distance of 120 mm . Cyclic creep tests ( with 100 cycles each ) were performed ( A ) between 20 and 100 N and ( B ) between 20 and 150 N ( Fig . 1 ) . The test sequence was A1-A2-B1-B2-A3 with a rest period of 1 h between single tests for graft recovery . The length of the graft construct after each rest period was used to determine the permanent elongation . Relative length changes along the graft construct ( proximal , central , distal ) were determined using a video tracking device . Finally , a load-to-failure test was performed . Under all test conditions the maximum elongation of the graft construct increased from the first to the 100th cycle , ranging from 1.0 mm to 3.1 mm . While these so-called creep patterns were almost identical in A1 and A2, elongations under A3 were 3-4 mm higher than under A1 and A2, probably as a result of higher loads at B1 and B2. The permanent elongation of the graft constructs after completion of the test series was 3.9 +/- 0.9 mm . Further analysis revealed that about 97% of this deformation occurred within the fixation materials and interfaces ( distal and proximal section ) and only about 3% within the tendon tissue ( central section ) . The load-to-failure test revealed an ultimate load of 416 +/- 36 N and a stiffness of 32.4 +/- 1.3 N/mm . All constructs failed at the polyester tape . Our results indicate that repetitive cyclic loading at relatively low loads can result in substantial , permanent elongation of a quadrupled semitendinosus graft construct with endobutton/tape and suture/post screw fixation method . Similar loads may be experienced by the graft construct during early postoperative activities and be a cause of gradual failure before graft incorporation is complete . We conclude that aggressive postoperative rehabilitation be applied with caution when using this graft construct . Better fixation materials and/ or techniques should be developed to improve biomechanical behavior of the graft construct ."
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Arthroskopie.80110061.eng.abstr | Arthroskopie.80110061.eng.abstr | [
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"Problem : The major problem when reconstructing the anterior cruciate ligament ( ACL ) with the semitendinous tendon ( STT ) is the low primary stability of the STT graft fixation techniques . Methods : From 1994 to 1996 , a surgical procedure for arthroscopic reconstruction of the ACL with the paired STT was performed on ten cadaveric knees , followed by operations on 26 patients ( average age , 25.1 years ; range , 16-43 years ) . The femoral attachment was achieved using a U-shaped tendon wrapped around a bone plug , which was then blocked in a steplike femoral channel . The tibial attachment was attained using a boneplug and applying a 7-mm interference screw . Results of the experimental trial : Anatomic studies were performed on the STT of the cadaveric knees . We carried out clinical tests ( anterior drawer sign , Lachmann ) and KT-1000 measurements preoperatively following artifical ACL rupture , and postoperatively . Isometrical estimations were performed for precise anatomical placement of the tendon and on the implaned STT transplant . The primary stability of the attachment methods in the tear-out testing amounted to 448.2 N for the femoral attachment and 440,0 N for the tibial attachment . Results of the clinical trial : The average postoperative surveillance period was 22.5 months ( 4-40 ) ( range , 4-40 months ) . Evaluation was undertaken using the Insall knee score ( average score preoperatively , 38.1 ; postoperatively , 95.7 ) , the Insall functional score ( average score preoperatively , 64.3 ; postoperatively , 96.2 ) , and the Lysholm score ( average score preoperatively , 53.6 ; postoperatively , 96.2 ) . The IKDC score showed very good results in 26.9% , good results in 65.4% , and moderate results in 7.7% of cases . The KT-1000 measurement carried out postoperatively showed equivalent stability of both knee joints in 92.3% of all patients ( anteroposterior transposition , 2 mm at 89 N ) . A total of 80.8% of all patients , including four athletes , regained their normal level of activity . Conclusion : The presented method makes it possible to achieve an economical and easy STT attachment using entirely autologous material with a high level of primary stability ."
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Arthroskopie.80110068.eng.abstr | Arthroskopie.80110068.eng.abstr | [
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"Biomechanically correct positioning of the replacement material is vital for a successful operation in anterior cruciate ligament ( ACL ) surgery . However , intra-articular fixation of the ACL to the anatomic origin and insertion has not yet been performed using any surgical technique . The transtibial canal is the principle underlying all previous ACL reconstruction operations . External fixation at such a distance exerts substantial strain on the graft in the tibial canal . This strain is due to a \" windshield-wiper motion \" occurring with each extension and flexion of the knee . Detrimental shearing forces at the graft's point of exit additionally weaken the replacement material . The all-inside technique is an innovative development in arthroscopic ACL surgery which obviates the need for a transtibial canal and fixes the graft anatomically correctly to the femoral origin and tibial insertion . The way in which the lateral third of the patellar tendon is excised is new . No patellar bone core is removed . Thus long-term post-operative patellar pain , which is otherwise frequent , does not occur . The chief advantages of the all-inside technique are as follows : anatomic graft fixation to the origin and insertion of the ACL ; no graft overloading in a transtibial canal , shear stresses and the windshield-wiper effect are eliminated ; a dorsally open , tibial fixation angle of the graft , which counteracts ventral translation forces of the tibia ; simplified revision possibilities ; and a lower morbidity rate ."
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Arthroskopie.80110078.eng.abstr | Arthroskopie.80110078.eng.abstr | [
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"The purpose of this study was to compare the midterm results of the conservative treatment of anterior cruciate ligament ( ACL ) ruptures in athletes . During 1989 and 1990 , 279 athletes with ACL ruptures were treated in our Sports Surgery Department , and 221 of them were suitable for inclusion in the study . The patients were divided into two groups based on management after the diagnosis of ACL rupture had been made . Group I ( n = 129 ) underwent ACL reconstruction using free bone-patellar tendon-bone autografts , while group II ( n = 92 ) received conservative treatment . We were able to evaluate 92 patients during follow-up ( 42 from group I and 50 from group II ) . The average follow-up period was 86 months . There were no significant differences between the two groups regarding the patients ' age , sex , or level of sports activity . Follow-up consisted of clinical and radiological examinations and recording of the subjective opinions of the patients . During follow-up , we used IKDC and OAK scores to evaluate the results . We found significantly better results in the group that was operated on if the patients took part in high-risk pivoting sports , but there was no difference if the patients were in the low-risk or no-risk pivoting group of athletes . Concerning reoperation and early arthrosis , the difference was significant between the two groups ."
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Arthroskopie.80110082.eng.abstr | Arthroskopie.80110082.eng.abstr | [
{
"id": "Arthroskopie.80110082.eng.abstr-passage-0",
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"text": [
"In this retrospective study , the meniscal status of 45 patients with conservatively treated complete anterior cruciate ligament ( ACL ) tears is reported . The ACL injury was initially documented by examination under anesthesia and arthroscopy . Treatment in all cases consisted of a standard protocol of early rehabilitation and bracing . The mean follow-up was 8 years . Twenty-nine ( 65% ) patients showed signs of meniscal pathology at an average of 3 years after the ACL injury during the follow-up period . Rearthroscopy was performed and showed a higher incidence of medial meniscus tears . The most common tear of the medial meniscus was the bucket-handle type , followed by the flap tear and the single longitudinal split of the posterior horn . Secondary reconstruction of the ACL was necessary in 24 patients complaining of the meniscus giving way . The remaining five patients had rearthroscopy 4 years after the ACL injury and a partial meniscectomy and ACL reconstruction was performed . Sixteen patients ( 35% of the overall sample ) had no instability complaints or meniscal pathology during the follow-up period , but discontinued their sporting activities . Results indicate the increasing incidence of meniscal tears during ACL insufficiency . We recommend that patients with ruptures of the ACL should be investigated for meniscal tears and that early ligament reconstruction of the knee and mensical repair or partial meniscectomy should be considered simultaneously ."
],
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Arthroskopie.80110086.eng.abstr | Arthroskopie.80110086.eng.abstr | [
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"Patients who were operated on because of an isolated trauma to the knee meniscus experienced instability of the knee joint concerned more frequently than age-matched controls . Patients who underwent knee surgery also experienced pain and swelling of the knee joint more frequently than controls Those patients who had arthroscopic procedures had fewer symptoms than patients undergoing open procedures . Both groups experienced increasing instability after 10 years . Early diagnosis and therapy is indicated in patients with persisting post-traumatic knee joint symptoms . Of the patients undergoing open meniscus operations , patients with bucket-handle tears complained more frequently about a feeling of instability than those with other lesions . This was not the case if the procedure was performed by arthroscopy . Patients who were noted to have chondropathy at the initial open procedure had more frequent symptoms of pain and were less satisfied with the procedure than patients without chondral disease . This was not evident after arthroscopic procedures . After nonarthroscopic procedures , a larger percentage of patients reduced their sporting activities ."
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Arthroskopie.80110098.eng.abstr | Arthroskopie.80110098.eng.abstr | [
{
"id": "Arthroskopie.80110098.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This study describes the approach that is necessary in outpatient surgery in order to carry out the operation safely . The particular procedure is discussed , and the necessity of strict postoperative management is shown . Between 1994 and 1997 , the author supervised 4588 outpatient operations , of which 3020 were arthroscopic . The observed complications are listed and evaluated . Overall , outpatient surgery is well accepted by the patients . The criteria for denying a patient surgery on an outpatient basis are laid out ."
],
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0,
530
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]
}
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] | [] | [] | [
{
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"type": "method_of",
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{
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}
] |
Arthroskopie.80110102.eng.abstr | Arthroskopie.80110102.eng.abstr | [
{
"id": "Arthroskopie.80110102.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Block of the sciatic and femoral nerves can be performed either by the surgeon or by the anaesthetist , allowing for numerous minimally invasive procedures in the knee and ankle joint . It also offers a certain flexibility with regard to the anaesthetist's schedule and provides a good and long anaesthesia and relaxation of the quadricep and hamstring muscles . Some contraindications - arrhythmia , severe conduction disturbance and heart failure - should be considered , as well as vegetative lability and oversensitivity to xylocaine , lidocaine or mepivacaine . There is no difficulty in finding the sciatic nerve and the femoral nerve as the topography is well described by Daniel C. Moore in his book about regional block . Though easy to perform , and even when wished for by the patient , the surgeon has to be aware of possible complications . In some cases we recommend that an anaesthesiologist stand by . In only 2 of 720 cases did the operation have to be interrupted because of severe pain or unexpected difficulty ."
],
"offsets": [
[
0,
1031
]
]
}
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"id": "Arthroskopie.80110102.eng.abstr-s1-t1",
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s1-t3",
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"knee"
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163,
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},
{
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"ankle"
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25,
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},
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},
{
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s2-t1",
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"flexibility"
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211,
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},
{
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},
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"schedule"
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]
},
{
"id": "Arthroskopie.80110102.eng.abstr-s2-t4",
"type": "umlsterm",
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"relaxation"
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311,
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
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353,
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s3-t1",
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"contraindications"
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"id": "Arthroskopie.80110102.eng.abstr-s3-t2",
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"arrhythmia"
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s3-t3",
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"heart"
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{
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"lidocaine"
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s3-t5",
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"mepivacaine"
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"db_id": "C0025384"
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"nerve"
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"nerve"
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},
{
"id": "Arthroskopie.80110102.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"book"
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"db_id": "C0006002"
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]
},
{
"id": "Arthroskopie.80110102.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"sciatic nerve"
],
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[
605,
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Arthroskopie.80110114.eng.abstr | Arthroskopie.80110114.eng.abstr | [
{
"id": "Arthroskopie.80110114.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Influenced by minimally invasive surgery , the endoscopic release of the carpal tunnel has become established in the therapy of carpal tunnel syndrome . However , due to of several intra- and postoperative complications , there is no standard endoscopic procedure . Reviewing 177 endoscopic operations using Agee's single portal technique ( operation and follow-up ) , we present the indication , limits , typical mistakes , and risks of this endoscopic technique . Excellent clinical and electrophysiological results 3 months postoperatively show that both intra- and postoperative problems and second-look operations are only rarely due to the endoscopic system . The most common reasons are too liberal an indication and insufficient training with respect to risks and possible mistakes . From our data , we conclude that Agee's carpal tunnel release system is a safe and convenient endoscopic surgical technique for median nerve decompression with short postoperative recovery and excellent cosmetic and functional results ."
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Arthroskopie.80110119.eng.abstr | Arthroskopie.80110119.eng.abstr | [
{
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"Endoscopic and open forms of surgical treatment of carpal tunnel syndrome have been the subject of controversy . The main arguments against endoscopy in spite of the advantages of the procedure , i.e. , small scars , low morbidity , are the reduced intraoperative overview of the anatomic site and the resulting risk of injury to the median nerve or flexor tendons . The most widely used endoscopic techniques were analyzed and the requirements for employing minimally invasive endoscopic procedures formulated . A newly developed technique which fulfills these requirements is presented . It incorporates a preparatory stage such that the structures which are to be protected or dissected can be viewed adequately . This surgical technique can even be employed in de Quervain's disease , whereby a very small skin incision can be used to dissect the first extensor tendon compartment ."
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] | [] | [] | [
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Arthroskopie.80110127.eng.abstr | Arthroskopie.80110127.eng.abstr | [
{
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"Epicondylitis humeri radialis unimproved by medical treatment may be caused by intra-articular pathology , especially in the radiohumeral part of the elbow . Both , the lateral plica and the hypertrophic dorsoradial synovial fringe have to be considered . Clinical examination , progress , magnetic resonance imaging ( MRI ) , and arthroscopy are the means of diagnosis . Arthroscopic treatment of the intra-articular pathology leads to prompt recovery . One surgeon treated 56 patients by arthroscopy of the elbow joint from January 1994 to December 1996. A total of 35 ( 63.6% ) patients were diagnosed to have radiohumeral joint impingement . We present our findings ( MRI , arthroscopic findings , and treatment ) in all patients and the results of our investigation by questionnaire in the first 24 patients ."
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] | [] | [] | [
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Arthroskopie.80110136.eng.abstr | Arthroskopie.80110136.eng.abstr | [
{
"id": "Arthroskopie.80110136.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The purpose of this study was to evaluate low-field magnetic resonance imaging ( MRI ) with an open system and to correlate results obtained with the experience of the radiologist . Between August 1995 and May 1997 , 75 patients at the Unfallchirurgische Universitaetsklinik , Mainz , Germany , with an acute trauma of the knee joint were operated on arthroscopically after clinical examination , X-ray and MRI imaging . MRI analysis was performed by two independent radiologists with varying MRI experience without knowledge of the patient's history . The sensitivity and specifity of the more [ U1] and the less experienced [ U2] radiologist ranged from 83 to 100% ( U1) and from 61 to 100% ( U2). Positive and negative predictive value ranged from 83 to 100% ( U1) and from 58 to 100% ( U2); accuracy ranged from 92 to 100% ( U1) and from 77 to 100% ( U1). We conclude that the results of low-field MRI are comparable with those of high-field MRI and that differences in the results of the experienced and less experienced radiologist can be established ."
],
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0,
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]
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Arthroskopie.80110142.eng.abstr | Arthroskopie.80110142.eng.abstr | [
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"Pigmented villonodular synovitis ( PVS ) occurs in a localized and a diffuse form . Most authors agree that local excision is the appropriate treatment for localized PVS due to low recurrence rates . The appropriate therapy for the diffuse form is still controversial because of the high recurrence rates . For these cases we recommend a differentiated therapy plan with an arthroscopic synovectomy followed by synovial irradiation with yttrium-90 and arthroscopic follow-up in order to recognize a recurrence at an early stage and , hence , to prevent further joint destruction ."
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] | [] | [] | [
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Arthroskopie.80110147.eng.abstr | Arthroskopie.80110147.eng.abstr | [
{
"id": "Arthroskopie.80110147.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We present the case of a 54-year-old male patient with a Syme amputation of his left leg following diabetic gangrene of the foot . A local infection of the stump was treated successfully with two endoscopic debridements and lavage . Additionally , the patient received local antibiotics by the application of antibiotic collagenous fleece and antibiotic chains . This therapeutic management combined with early weight bearing led to a stable stump ."
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] | [] | [] | [
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Arthroskopie.80110151.eng.abstr | Arthroskopie.80110151.eng.abstr | [
{
"id": "Arthroskopie.80110151.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Arthroscopy of the knee is only rarely helpful in determining the cause of patellar pain . This case report gives an example . A 12-year-old boy complained of patellar pain after a soccer match . The pain was misinterpreted as \" growing pains \" but induced muscular atrophy . A neurological disorder was taken into consideration . Arthroscopy revealed a fibrous , nodular hematoma , which was easy to remove using a Hol : YAG-Laser . The haematoma had developed subsequent to patellar contusion or subluxation . After treatment the boy recovered soon , and muscle atrophy was reversed ."
],
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Arthroskopie.80110177.eng.abstr | Arthroskopie.80110177.eng.abstr | [
{
"id": "Arthroskopie.80110177.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Is refixation of a osteochondritis dissecans ( OCD ) fragment of the knee an efficient method ? The series is composed of 43 patients operated on with a technique of fixation . There were 13 adolescents and 30 adults . 39 OCD were located in the medial condyle , and 4 in the lateral condyle , all were located in the weight bearing surface of the condyle ( zone 2 and 3 of the Cahill and Berg classification ) . We used either an arthroscopic technic or an open technique . The base of the fragment is cleared of all soft tissue , cancellous bone is impacted in the freshened bed and the fragment is stabilised with one or two cannulated compression screws . Average follow-up was 5,5 years ( 1 to 20 years ) . We used the Hughston rating scale for OCD . In Juvenile OCD , results are : excellent or good : 77% , fair or poor : 33% . In Adult OCD , results are : excellent or good : 47% , fair or poor : 50% , failure : 3% . Significant relationship exists between the results and the size of the fragment , the localisation , the quality of fixation , and the length of follow-up . There is also relationship between quality of cartilage , stability and size of the fragment . If healing does not occur with conservative treatment , fixation can be attempted if the fragment volume is bigger than 1 ccm , is in the weightbearing zone and is partially or totally detached in the weight bearing zone . Delay in treatment leads to preoperative degenerative changes which adversly affect the results ."
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Arthroskopie.80110182.eng.abstr | Arthroskopie.80110182.eng.abstr | [
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Arthroskopie.80110187.eng.abstr | Arthroskopie.80110187.eng.abstr | [
{
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"A total of 36 patients suffering from osteochondrosis dissecans or posttraumatic osteochondral defects of the talus were treated by arthroscopy in a prospective outpatient design . All of the patients were re-evaluated after 4 and 12 months in a standardized follow-up protocol . Of the patients two thirds reported a traumatic event in their medical history , this ratio being significantly higher in laterally located osteochondral lesions . Conventional radiographic examination turned out to give reliable predictions of stage and localization of osteochondrosis . Although more than 50% of the lesions were located in the dorsal part of the talus , all of them could be arthroscopically accessed without need of malleolar osteotomy , tibial drilling or joint distraction . Furthermore , arthroscopy enables synovectomy in cases of reactive synovitis as well as the removal of osteophytes at the anterior tibia . Owing to the low rat of complication , the short rehabilitation time and the good postoperative results , arthroscopic debridement and drilling are considered to be the treatments of choice for osteochondral defects of the talus ."
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Arthroskopie.80110193.eng.abstr | Arthroskopie.80110193.eng.abstr | [
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"In this study the course of osteochondritis dissecans at two often affected areas , the femoral condyles of the knee joint and the talus at the upper ankle joint , is evaluated by studying and comparing the medium-term outcome in 40 patients treated conservatively and 72 patients treated surgically by arthroscopy . The criterion of assessment was magnetic resonance imaging ( MRI ) , which shows a close correlation to the arthroscopic stages of osteochondritis . The stages on MRI follow the morphology of the interface , i.e. , the zone between the osteochondral fragment and the parent bone , on T1- and T2-weighted images . After 18 and 24 months there were no substantial differences visible on MRI between the two different treatment groups . In fact , in the majority of cases ( > 60% ) the MRI result was the same in spite of the treatment that had been carried out . Arthroscopic treatment compared to conservative treatment resulted in a small percentage in a reintegration in the sense of upgrading on the MRI ( 36% to 30% ) ; nevertheless , a disintegration could not be avoided in all cases ( 4% ) . In both treatment groups the age of the patient seems to play an important role in the course of osteochondritis , juvenile forms following a milder course than adult forms ."
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Arthroskopie.80110203.eng.abstr | Arthroskopie.80110203.eng.abstr | [
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"In arthroscopy of the ankle a number of sports-specific alterations can be found in soccer players . These comprise exostoses of the anterior tibia , a corresponding lesion of the talar neck and anterior soft tissue impingement . Those lesions can be summarized in one symptom complex . In the Traumatology Department at the Nuremberg-South Clinic 27 patients were treated for this symptom complex from January 1992 to December 1996. Twenty-five patients were followed up for an average of 21/2 years . The functional results were assessed using a score published by Pfoerringer and Stolz in 1991. Our 25 patients achieved an average of 42 of 50 possible points , whereas 5 patients remained below 35 points . The average time interval between arthroscopy and reliefe of symptoms was 7 months among the 25 patients examined and was therefore relatively long . The range of movement in the tibiotalar joint clearly improved . Seventeen patients regained their previous sports activity level again . In the presence of concomitant ligamentous instabilities , additional stabilizing treatment is necessary , which should be performed in one session . In the case of impingement exostosis and soft tissue impingement , we suggest that this symptom complex be characterized with the German term `Fussballergelenk' ( soccer player's ankle ) ."
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"Arthroscopic assisted treatment of intraarticular fractures of the knee was first reported in 1982 for fractures of the tibial eminence and in 1985 for fractures of the tibial plateau . Since then , publications on this subject deal only with occasional cases or with small series of less than 50 patients . In the meantime , arthroscopic treatment has proved to be ideally suited for several specific types of intraarticular fractures , including dislocated fractures of the intercondylar eminence , and unicondylar fractures of the tibial condyles with or without impression of the plateau . In fractures of the tibial eminence and in simple fractures of the tibial condyle , internal fixation with cannulated screws is recommended , possibly with washers , for pure impression elevation of the tibial plateau and filling of the defect with cancellous bone , and for impression combined with split fracture of the condyle bone grafting and additional screw fixation . Even more complicated fractures may be treated with arthroscopic assistance . The indication for this kind of treatment relies on the type of fracture and the experience of the surgeon . Additional internal fixation , i.e. with a butress plate , is necessary as a rule . In specific cases , osteochondral fractures of the femoral condyles and fractures of the patella can be treated arthroscopically . Arthroscopic fracture fixation has distinct advantages compared with the open procedure : Arthroscopy allows reliable diagnosis and therapy of concomitant intraarticular lesions , provides a better view of the joint surfaces and therefore enables a better reduction of the fracture . The minimal soft tissue injury results in a markedly decreased morbidity . Following intraarticular fractures , the removal of metallic implants as well as debridement in loose or broken-up joint cartilage and the resection of bony irregularities can be performed arthroscopically . Loss of extension in non-united or in healed but displaced fractures of the tibial eminence is an ideal indication for arthroscopic notch plasty . All published studies report good results . However , there is just one study with a control group treated by open operation , reporting only a small number of patients [ 25 ] . In this study , arthroscopic treatment is superior to open internal fixation . Up to now the proof is still missing that results of the arthroscopic procedure are better . This is especially true for the treatment of fractures of the tibial plateau . to minimise posttraumatic osteoarthritis ."
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Arthroskopie.80110235.eng.abstr | Arthroskopie.80110235.eng.abstr | [
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"Surgery of tibial plateau fractures with joint involvement ( AO classification 41 A1, B1-B3 and C1- C3) makes high demands on traumatological management . By using modern , minimally invasive operative techniques for juxta-articular fractures , it is possible to prevent soft tissue injuries that might affect the functional result . The aim of this technique is to achieve the exercise stability obtained with standard procedures . Arthroscopically assisted osteosynthesis not only minimizes the surgical soft tissue trauma , but also enables a precise assessment of the articular surfaces under the operation , as well as the simultaneous treatment of concomitant intra-articular injuries , a particular advantage as compared to conventional operative methods . From a total of 54 patients with tibial plateau fractures , arthroscopically assisted osteosynthesis was performed in 34 patients at our clinic from September 1994 to January 1998. The follow-up of a total of 17 patients revealed good recoveries when assayed by means of the Lysholm and Delamarter score . We suggest that arthroscopically assisted , minimally invasive osteosynthesis can also be used in selected patients for the treatment of AO classification 41 C1-C3 fractures ."
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"Certain intra-articular fractures of the knee can be managed by arthroscopically assisted reduction and fixation . The known benefits of arthroscopy include better visualization of the entire joint , limited dissection , and thorough irrigation . The purpose of this paper is to present our experience with arthroscopically assisted reduction and fixation of certain intra-articular fractures of the knee . From May 1995 to November 1997 , 34 patients with intra-articular fractures of the knee were treated by arthroscopic reduction and fixation . We treated 11 patients with tibial plateau fracture type I , II and III ( according to J. Schatzker classification ) , 20 patients with avulsion fracture of the tibial insertion of the anterior cruciate ligament ( intercondylar eminence ) type II , III and IV ( according to Meyers , McKeever and Zariczny classification ) , two patients with completely dislocated osteochondral flake fractures of the femoral condyle , and one patient with a minimally displaced fracture of the patella . Postoperatively they were all allowed passive motion exercises . Patients with avulsion fractures of the ACL and the patient with fracture of the patella were allowed immediate weight bearing , while patients with tibial plateau fractures and osteochondral fractures were allowed weight bearing only after 12 weeks . Results : Of the 11 tibial plateau fractures , 8 were anatomically reduced , and in 2 the dislocation was less than 2 mm . No further dislocation of the fragment followed . All patients but one reported stable knees and they all had a full range of motion at follow-up . Of the 20 patients with avulsion fracture of the anterior cruciate ligament , 19 were anatomically reduced . Except in one patient , functional results were excellent ( KT1000 was 1.3 mm , average loss of flexion was 2.5 ° , loss of extension was 1.3 ° ) . In two cases of osteochondral fractures of the femoral condyle , reduction was anatomical . The fractures healed , the patients were free of pain and had full ROM at the follow-up . The fracture of the patella healed in 4 weeks with full ROM of the knee . There was one case of aseptic synovitis and no other major complications . Conclusions : Arthroscopic reduction and fixation are technically possible in certain types of intra-articular fractures of the knee . Provided indications are good , results of arthroscopic treatment are better than in classical surgical treatment through arthrotomy . There is less postoperative morbidity , and hospitalization and total rehabilitation times are shorter . Some technical hints are presented ."
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Arthroskopie.80110252.eng.abstr | Arthroskopie.80110252.eng.abstr | [
{
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"Although arthroscopy of the ankle joint has been well established , there are only very few reports about arthroscopy in ankle fracture treatment . In order to sytematically analyze the intraarticular lesions of ankle fractures , we assessed 196 consecutive ankle fractures immediately before ORIF . There were 94 male and 101 female patients with an average age of 47.8 years ( 16-88 years ) . There were more cartilage lesions found than expected , and cartilage lesions were not noted more frequently in type C-fractures than in type B-fractures . In both fracture types , an increasing amount of cartilage lesions was found from group 1 to 3. In addition , more ligament injuries were found than expected , especially in the B. 1- and B. 2-fractures . Successful arthroscopic surgery was performed in 26 cases : internal fixation , 9 ; loose body removal , 7 ; ligament reposition , 5 ; cartilage smoothening , 4 ; and cartilage fracture repair , 1. In one case , a periostal flap could not be reduced , and in another case , the internal fixation of the medial malleolus was not stable . In summary , arthroscopy was shown to be a very helpful diagnostic tool in ankle fractures . As long-term results are not yet available , it remains , however , unclear as to whether arthroscopy may improve the success of the following ORIF . Arthroscopy was also shown to be a successful tool for several closed surgical procedures . Of these , percutaneous internal fixation of the medial malleolus under arthroscopic view may be an excellent indication ."
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Arthroskopie.80110259.eng.abstr | Arthroskopie.80110259.eng.abstr | [
{
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"Since 1993 , 30 patients with acute distal intraarticular radius fractures have been treated under arthroscopic assistance . According to the AO classification there were 3 B- and 27 C-fractures , most of them Frykman VIII fractures . Of 30 fractures 23 showed additional lesions which could only be diagnosed under arthroscopic view . In particular , 12 partial or complete tears of the intracarpal ligaments were found . Of 25 fractures 23 which were treated at least 12 months previously could be followed up radiologically and clinically . X-rays included postero anterior and lateral views to evaluate the radial angles and the radial length and stress tests to check for instability , especially of the scapholunate ligaments . Clinical examination included range of motion and objective grip strength measured with a Jamar ( Cedaron ) tester . Each test was performed on both wrists for comparison . Subjective data included pain and function for daily activities . Data were evaluated by the Jakim and the Cooney scoring system and the demerit point system by Gartland and Werley as modified by Sarmiento et al. About 70% of our patients showed an excellent or good result ; about 15% had a poor result . However , we must mention that we were not able to reduce one C3-fracture under arthroscopic view and had to switch to a semi-open procedure with additional external fixateurs . Arthroscopically assisted treatment of distal intraarticular fractures is not only useful to detect and manage additional carpal lesions , but seems to give good midterm results as well ."
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Arthroskopie.80110276.eng.abstr | Arthroskopie.80110276.eng.abstr | [
{
"id": "Arthroskopie.80110276.eng.abstr-passage-0",
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"In a cadaver study on 10 human formalin-fixed hands we identified 3 different portals ( palmar , radial and dorsal ) for arthroscopy of the trapeziometacarpal joint and 1 portal ( palmar ) for the scaphotrapezial joint . In 8 cryoconserved human hands we performed standardized arthroscopy of these joints using the portals described above and arthroscopic resection of the cartilage of the trapezium and the first metacarpal . After marking the portals with needles , we made anatomical preparations of all the important structures of this region . We found slight lesions of the ligaments in 2 cases ( oblique posterior ligament and trapeziometacarpal ligament ) . We did not see any lesion of the radial nerve or the radial artery , but in one case an injury of a branch of the cephalic vein . To get the full orientation in the trapeziometacarpal joint , it is sufficient to use two of these portals . To prevent any lesion of nerves and vessels , we recommend the palmar and the radial portal . The preparation showed that 65-85% of the cartilage of the trapezium was removed and 60-75% of the cartilage in the first metacarpal . Hence , we were able to prove experimentally that arthroscopically assisted removal of the cartilage of the trapeziometacarpal joint is possible ."
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Arthroskopie.80110283.eng.abstr | Arthroskopie.80110283.eng.abstr | [
{
"id": "Arthroskopie.80110283.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the medical care of a professional dance group we were often confronted with problems of the first metatarsophalangeal joint ( MTP I ) . A painful , limited dorsiflexion of the great toe makes classical ballet performance virtually impossible . After anatomical cadaver studies we introduced arthroscopy of MTP I at the Orthopaedic Department of the Academic Medical Centre of the University of Amsterdam in 1990. By 1992 arthroscopic procedures had been performed in 23 patients . The indications for the operations were : ( 1 ) hallux rigidus ( n = 4 ) , ( 2 ) impingement syndrome ( painful joint with slightly limited dorsiflexion ; n = 11 ) , ( 3 ) osteochondrosis dissecans/loose bodies ( n = 3 ) , and ( 4 ) pathological conditions in sesamoid bone ( n = 5 ) . The result of this prospective study were analysed in respect of function , pain , swelling , ability to work and sport performance . The best results of arthroscopic surgery were seen in patients with impingement syndromes and in osteochondrosis dissecans or loose bodies . The results of arthroscopic surgery of the hallux rigidus and the sesamoid bone pathology were less favourable . The results of our new arthroscopic procedure on MTP I are encouraging . Arthroscopy of the MTP I can be advised for suitable indications ."
],
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Arthroskopie.80110291.eng.abstr | Arthroskopie.80110291.eng.abstr | [
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"The purpose of the present investigation is a comparative study between conventional mechanical therapy methods and laser-supported techniques in the arthroscopic treatment of chondropathy of the knee joint . A total of 102 patients could be classified in two groups . In the first group ( n = 52 patients ) , a Holmium-YAG-laser was used . In the second group ( n = 50 patients ) , conventional mechanical instruments ( milling cutter , rigid cut and branching instruments ) were utilized . Determining criteria were degenerative or post-traumatic lesions of the cartilage . With regard to the severity of the lesion , the localization , the distribution of age and sex , the duration of the operation and the perioperative treatment , there was no difference between the two patient groups . After an average follow-up period of 21 months , all patients answered a standardized questionnaire , which included measurements of the Lysholm score and pain determination with the help of a visual analog scale . In group 1 , 49 patients and in group 2 , 45 patients could be examined clinically . With regard to the objective findings , there were no significant differences between the groups . A significant positive result was found in the laser-treated group with regard to pain perception , as measured by the visual analog scale . The subjective data , determined by the Lysholm scores collected through individual questionnaires , showed statistically significant improvements in results from the laser-treated group for a number of criteria ( total value of the Lysholm score , climbing a staircase without pain , subjective sense of pain , willingness to repeat the operation ) ."
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Arthroskopie.80110297.eng.abstr | Arthroskopie.80110297.eng.abstr | [
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"Analysis of 147 repeat arthroscopies of the knee performed at the Department of Surgery at the Herz-Jesu Krankenhaus , Fulda , from 1990 to 1995 , showed that meniscal lesions were the most common ( n = 89 , 60.5% ) . The majority of meniscal lesions ( n = 45 , 50.6% ) occurred in menisci that had already been partially resected . The most common localization was the posterior third of the medial meniscus in ipsilateral lesions . Conversely , contralateral meniscal injuries were only documented in 18 cases ( 20.2% ) , while de-novo lesions occurred in 29 cases ( 29.2% ) . A coincidence of meniscal injury with first- or second-grade cartilage damage was documented in 35 patients ( 39.3% ) , whereas 54 patients ( 60.7% ) had normal intra-articular cartilage . Cartilage damage was most frequent in patients who had previously undergone partial meniscectomy . The most common therapeutic consequences were partial meniscectomy and cartilage-shaving . Concerning patients ' postoperative satisfaction and evaluation of the results by OAK score , the majority of patients attained significant improvement in function ( 65.2% ) and showed good or excellent outcome in the OAK score ( 88.8% ) . Patients without accompanying cartilage damage had better results in comparison to patients with cartilage damage in the affected area ( p 0.05 ) . In conclusion , in patients with positive meniscal signs and a history of previous meniscal surgery , repeat arthroscopy is generally and early indicated and can be recommended as a valid method to assess cartilage damage objectively . However , patients with cartilage damage do not have the same benefit ."
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Arthroskopie.80110304.eng.abstr | Arthroskopie.80110304.eng.abstr | [
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"The aim of this retrospective study was to compare operative and nonoperative medial collateral ligament ( MCL ) treatment in patients who underwent arthroscopic anterior cruciate ligament ( ACL ) reconstruction . In 38 patients we performed operative MCL repair by adaptive sutures ; in 27 patients the MCL injury was treated conservatively . The postoperative rehabilitation protocol includes brace treatment for all patients over a 6-week period . Group II patients ( conservative MCL treatment ) had significantly better mean quadriceps muscle strength at 4 months postoperatively . In group I ( operative MCL treatment ) we performed a rearthroscopy due to postoperative loss of extension in nine patients . In group II postoperative loss of extension was removed arthroscopically in four patients . After a mean interval of 23 months we saw no difference in the prevalence of anterior or medial instabilities . Four patients of group I had a loss of extension ( -5 ° in comparison with the uninjured leg ) . In group II two patients had a loss of extension . The Lysholm scores of the two groups were similar ( group I : 85.05 ; group II . 85.3 ) . The position on the Tegner activity scale was 5.4 ( preoperatively : 6.1 ) in group I ; group II reached a level of 5.5 ( preoperatively : 6.0 ) . The results of our study demonstrate that 2 years after arthroscopic ACL reconstruction there is no difference between patients who have had conservative or operative MCL treatment . With regard to the higher operative risk , we conclude that there is no need for operative MCL repair ."
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Arthroskopie.80110316.eng.abstr | Arthroskopie.80110316.eng.abstr | [
{
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"Three case reports of a pseudomeniscus and an angiomatoid vascular proliferation of the synovial membrane as rare aseptic complications of unicompartmental knee arthroplasty are presented . Neither complication can be confirmed by clinical examination , laboratory findings or diagnostic imaging techniques . Arthroscopy of the knee joint permits both diagnostic evaluation and low-risk surgical treatment ."
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Arthroskopie.90120003.eng.abstr | Arthroskopie.90120003.eng.abstr | [
{
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"The biochemical properties of articular cartilage rely on the biochemical composition and integrity of its extracellular matrix . This matrix consists mainly of a collagen network and the proteoglycan-rich ground substance . In osteoarthritis , ongoing cartilage matrix destruction takes place , which leads to a progressive loss in joint function . Besides the degradation of molecular matrix components also the destabilization of supramolecular structures such as the collagen network takes place . These processes as well as the cellular reaction pattern explain the histomorphology of osteoarthritic cartilage degeneration : the loss of histochemical proteogylcan staining reflects the damage on the molecular level , whereas the supramolecular matrix destruction leads to fissuring and finally to the loss of the cartilage . The chondrocytes react by increasing matrix synthesis , and also by proliferation and changing their cellular phenotype . For the management of osteoarthrits , early and prognostically relevant diagnostic criteria are desired , but new analytical tools are needed in order to supplement conventional histopathological evaluation ."
],
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Arthroskopie.90120009.eng.abstr | Arthroskopie.90120009.eng.abstr | [
{
"id": "Arthroskopie.90120009.eng.abstr-passage-0",
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"Treatment of degenerative gonarthritis is one of the main fields of arthroscopy . Different treatment possibilities are discussed considering recent literature , especially concerning dependence of indication on degree of chondromalacia , success and structural changes . Experimental stability testing shows increased translation in gonarthritis as a sign of instability . Partial resection of the posterior meniscal horns lead to considerable loss of stability , causing cartilage defects if no muscular compensation takes place . Finally , treatment methods for cartilage restoration are compared ."
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Arthroskopie.90120017.eng.abstr | Arthroskopie.90120017.eng.abstr | [
{
"id": "Arthroskopie.90120017.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Long term results after arthroscopic débridement of the knee for evaluating the operative outcome in arthritis of grade III or IV are still missing . In the present retrospective study , patients who met specific criteria were evaluated for examination . Of 452 patients , 182 treated by arthroscopic débridement of the knee joint were reviewed . The average age was 63.2 years and follow-up had a minimum of 10 years . All patients were monitored using a subjective rating scale , a standardized scoring scale , and radiographs of the knee . Criteria for the study were a medial and lateral gonarthrosis of grade III or IV without meniscal tears . Only 10 patients ( 5.5% ) were still satisfied with the operative result ( subjective analog scale ) , whereas 54 patients ( 29.7% ) reported a good result up to 5 years after arthroscopy . 131 cases ( 72% ) rated their results as good for up to one year . Almost one third of patients ( 28% ) reported no relief of pain at all . Generally , the mean scoring scale decreased from preoperatively 44 points ( max . 100 ) to 23 points postoperatively . The radiographic outcome showed that in nearly all cases the preoperative arthrosis had increased at time of follow-up . In comparing the results there was no significant age difference and no significant difference in the frequency of severe articular surface degeneration or duration of complaints ( p > 0.05 ) . Results of arthroscopic therapies reported in literature are different due to the fact that studies contain patients of different osteoarthritic conditions mixed with additional meniscal tears and a follow-up ranging from 1-2 years . With the following study we report on patients with an isolated grade II or IV arthritis who underwent arthroscopic débridement of the knee . With a follow-up of 10 years it is possible for the surgeon and the patient to estimate the success rate of an arthroscopic débridement individually , which might end up in a total replacement of the knee ."
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Arthroskopie.90120022.eng.abstr | Arthroskopie.90120022.eng.abstr | [
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"Extra-articular interventions by osteotomies to correct the axial malpositioning of the joint ( genu varum or valgum ) are treatments proven over many years . The middle and long term results shows many patients are very satisfied . Unfortunately a uniform critical examination is lacking because the investigators used no scores . The good results by infra- and supracondylar osteotomies - some of them for 15 years and more - have to be achieved by prosthesis first . The important facts for gonarthrosis of the knee joint are the axial malpositioning , the miss load , and the instability of the joint ; these facts are the cause for the complaints and for the restriction of functional efficiency . Therefore , indication of infra- or supracondylar osteotomies is not limited by the age of the patient . The most important fact is the condition of the joint , especially the quality of bone , the instability of the joint , and the loss of bone . Given the right indication , the treatment of genu varum and valgum by osteotomies is an important factor in preserving the joint . Also , there are still chances to do another operation , such a prothesis . A prothesis can be implanted if the osteotomy has no chance to preserve the joint ."
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Arthroskopie.90120029.eng.abstr | Arthroskopie.90120029.eng.abstr | [
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"The \" knee school \" concept combines guidelines for knee-friendly behavior in everyday conditions and a comprehensive program of muscle strengthening exercises that gonarthrosis patients can perform at home . Groups of patients are instructed on the basics of relevant anatomy , the development of arthrosis , and knee-friendly conduct . They train easy-to-grasp patterns of movement that help them to improve coordination and relieve their knee joints of unphysiological strain . A prospective randomized study proved the \" knee school \" concept to be successful in treating gonarthrosis after arthroscopy ."
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Arthroskopie.90120043.eng.abstr | Arthroskopie.90120043.eng.abstr | [
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"Autologous chondrocyte transplantation ( ACT ) is a cell based therapy for treatment of full thickness cartilage defects . ACT induces chondroneogenesis at defect sites leading to formation of tissue that duplicates the structure , composition , mechanical properties and durability of articular hyaline cartilage . The newly formed tissue is fully integrated with the surrounding cartilage . The arthroscopical and histological evaluation of the repaired cartilage tissue showed no arthritic changes . ACT treatment results in normal , symptom-free joint function without deterioration over years . The ACT-induced repair of hyaline cartilage is dependent on the proliferative capacity and differentiation stage of the cultured autologous chondrocytes . Quality management of manufacturing , testing , packaging and shipment of autologous chondrocyte transplantates is required for their approval as biological . Quality assurance of approved chondrocyte transplantates and standardized surgical procedure are essential for the long-term success and safety of ACT treatment ."
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"The principle of photodynamic therapy ( PDT ) for rheumatoid arthritis consists in specifically concentrating a drug ( photosensitizer ) in the synovium . Subsequent activation of the photosensitizer by means of a laser leads to a cytotoxic effect . The practicability of PDT was tested in an animal model of IgG-induced arthritis in rabbits . Photosan-3, 5-aminolevulinic acid and BPD-MA were administered intraarticularly or intravenously . In this model , concentration of the photosensitizer in the synovial lining cells , the lymphoid infiltrate , and the skin was seen . After laser irradiation a selective demarcation and destruction of the synovium by prior administration of Photosan-3, not constant by BPD-MA and without therapeutic effect by 5-aminolevulinic acid , was observed . In contrast , bradytrophic tissues such as cartilage , meniscus , and ligament structures were changed neither macroscopically nor microscopically in all series . PDT thus offers ideal preconditions for minimal invasive treatment of chronic inflammatory joint diseases because of its selectivity and efficacy . Photodynamic laser therapy can be considered a new method in the surgical treatment of inflammatory disease of the synovial membrane ."
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Arthroskopie.90120062.eng.abstr | Arthroskopie.90120062.eng.abstr | [
{
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"Aware-state surgery has been used in this unit to identify the source of spinal pain in over 2500 patients as part of a process termed \" viviprudence \" . This process consists of clinical analysis , dynamic radiology and scanning tested by differential discography , endoscopy and patient feedback . This replaces guesswork with sighted diagnosis and allows keyhole tissue-preserving techniques to be used not only for the treatment of compressive radiculopathy but also for back pain , failed back syndrome , perineural scarring , multilevel degenerative disc disease , lateral recess stenosis and dynamic listhesis . This has led to the identification of new pathology and the refinement of the inclusion criteria for laser disc decompression and endoscopic laser foraminoplasty . Since 1994 , an endoscopic system has been developed to explore the intervertebral foramen and epidural space via the postero-lateral route . The system has been used to address lateral recess stenosis , epidural scarring , osteophytosis , settlement , listhesis , disc extrusion and sequestration and failed back syndrome . The objective has been the endoscopic aware-state definition of the source of pain with decompression of the foramen , mobilisation and neurolysis of the exiting and transiting nerves and ablation of osteophytes and other causes of failed back syndrome confirmed endoscopically . This prospective study involved day-case endoscopic laser foraminoplasty performed on 101 men , and 99 women with an average age of 56 years ( range , 22-83 years ) . They were followed for an average period of 34 months ( range , 26-43 months ) . The average preoperative duration of symptoms was 5.6 years ( range , 5-11 years ) . A total of 46 patients had had one to four previous open operations , and 14 patients were on narcotic analgesics prior to surgery . At other centres , 106 of these patients were evaluated and open surgical procedures were not deemed appropriate or likely to benefit . A cohort integrity of 96% was maintained at the final follow-up . Back , buttock and leg pain were separately compared and analysed using the Oswestry Disability Index , a patient satisfaction scoring scale , a visual analogue pain scale and a patient target achievement score . Using an Oswestry Disability Index of 50 or more to determine good and excellent outcomes , 55% of patients exceeded this score for back pain , 52% for buttock pain and 53% for leg pain . In patients with one prior operation , the corresponding figures were 51% , 33% and 29% . These results indicate that endoscopic laser foraminoplasty provides a minimalist means of exploring the extraforaminal zone , the foramen and the epidural space and performing discectomy , osteophytectomy and neurolysis . It incorporates the prophylactic advantage of foraminal undercutting and provides a promising means of identifying and treating the pain of failed back surgery and back pain and sciatica of indeterminate origin . It serves to identify and localise the source of pain generation . Endoscopic laser foraminoplasty avoids the morbidity associated with open spinal surgery and serves as a useful means of effecting keyhole neurolysis without extensive exploration and fusion . Current improvements in equipment promise wider application and more encouraging results in the future ."
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"This study was carried out from 1986 to 1996 to evaluate the technique of translaminal epidural endoscopic discectomy in lumbar hernias occupying over 50% of the radicular canal , foraminal hernias , and hernias invading it entirely . This minimally invasive arthroscopic technique was applied in patients suffering from degenerative lumbar stenosis between L3 and S1. The first part of the study dealt with lumbar hernias . Of a total of 222 patients , 175 ( 78.82% ) showed radicular canal invasion ranging between 50 and 90% . The disc level was L4-L5 in 59% , L5-S1 in 39% , and L3-L4 in 4% . Most of these hernias were lateral extrusions . However , the study also included protrusions and foraminal hernias , since they were large and technically difficult to operate on . In terms of distribution , 25 patients ( 14.28% ) had protrusions and 120 ( 68.57% ) extrusions , and in 30 patients ( 17.14% ) hernias had migrated . Surgery was carried out by the biportal posterior approach through the flaval ligament . An irrigation pump was used and the structures were under permanent accurate arthroscopic visualization . Good results were obtained in 96% , fair in 3% , and poor in 1% . The second part of the study dealt with lateral stenosis . Drawing from the experience gained by experiments performed in 1993 on five cadavers and by translaminar epidural endoscopy since 1986 , this surgical technique was designed to provide decompression by resection of the ventral zone of the articular facet and , in some cases , foramenostomy . Of the 19 patients treated , nine presented with pathology in one segment , nine in two segments , and one in three segments . All had lumbar and sciatic complaints , intermittent neurological claudication and predominantly lateral sensory motor deficit . The general results were good in 84% and fair in 16% ."
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Arthroskopie.90120085.eng.abstr | Arthroskopie.90120085.eng.abstr | [
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"Endoscopic techniques in the spine have become possible with improvements in instrumentation . Other minimally invasive techniques are limited to intradiscal surgery , not at the site of the pathology . With the transforaminal approach , treatment in the epidural space has become possible . In a pilot study we investigated the pitfalls , risks , and complications of transforaminal surgery . Patient satisfaction and acceptance of the method were documented . Some 27 patients with disk pathologies at the level of the disk space , excluding extremely medially situated herniations , were treated . We used a standard posterolateral approach under local anesthesia combined with spinal morphine anesthesia . The treated levels were L5/S1 ( 11 ) , L4/5 ( 12 ) , L3/4 ( 3 ) , and L2/3 ( 1 ) . All areas could be reached by this approach . One procedure had to be abandoned because of instrumentation problems . One patient had recurrent disk herniation and had an open procedure . Two patients were reoperated because of persistent pain . No signs of reherniation could be found in these cases , but there was swelling of the nerve root and minimal scarring . One patient developed spondylodiscitis . Minor complications were trancient root paresthesia and headache postoperatively . Postoperative MRI or CT scans revealed only little scar tissue . This impression was supported in the open revisions we performed . Clinical acceptance of the procedure was excellent and the patients recovered very quickly . Endoscopic transforaminal surgery has a considerable learning curve , even when surgeons are acquainted with the posterolateral approach and arthroskopic surgery . However , it offers a good alternative to other minimally invasive procedures and has to be seen as a good alternative to open disk surgery , too ."
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Arthroskopie.90120092.eng.abstr | Arthroskopie.90120092.eng.abstr | [
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"The goal of surgery using a thoracoscopic approach for the anterior reconstruction of fractures of the thoracic and lumbar spine is the reduction of postoperative pain and morbidity . Fusion of the injured segment was performed by partial corporectomy and the vertebral body reconstructed using a tricortical autogenous bone graft . A plate and screw assembly was inserted to stabilize the surgical correction . This technique was used between May 1996 on May 1998 in 100 patients with 103 fractures of the thoracic and lumbar spine . Fractures from T4 to L3 were stabilized ; most fractures occurred at the thoracolumbar junction . A monosegmental short fusion was given preference in 51 patients . A dorsoventral approach was necessary in 68 patients on account of the fracture type . Comparing a group of 30 patients who had undergone an open procedure and a similar group treated under thoracoscopic assistance , we found a marked reduction of the postoperative need for analgesics and the duration of postoperative ventilation ."
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Arthroskopie.90120117.eng.abstr | Arthroskopie.90120117.eng.abstr | [
{
"id": "Arthroskopie.90120117.eng.abstr-passage-0",
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"text": [
"Arthrofibrosis is a severe complication of trauma and surgery around joints with loss of motion due to an excessive fibrotic response in the repair process . Both the cause and mechanism of arthrofibrosis remain unclear . We investigated fibrotic tissue samples taken from 18 patients ( average age : 32.5 years ; range : 18-64 years ) , who underwent arthrolysis of the knee joint because of symptomatic arthrofibrosis following ligament injuries , fractures , or corrective soft tissue surgery . The mean interval between trauma and arthrolysis was 16 months . All samples were stained with HE . Monoclonal antibodies ( Ki-67, anti-PCNA , anti-factor VIII ) were applied for immunohistological localization of proliferating cells and of small vessels . Synovial tissue samples from knee joints without any detectable pathology served as controls . Arthrofibrotic tissue from the anterior joint compartment revealed synovial hyperplasia and a chronic inflammatory reaction with lymphocytes and plasma cells as well as a perivascular fibrotic enlargement . Immunostaining showed hypervascularity and an increase in proliferating cells . The stratum fibrosum of the joint capsule was enlarged by hypocellular fibrosis . Samples taken from the posterior capsule showed less cellularity and vascularity than samples from the anterior compartment . The histological findings indicate that arthrofibrosis is a fibroproliferative disorder . The chronic inflammatory process may play a crucial role in the mechanism of arthrofibrosis . A strong immune response may lead to attraction and activation of inflammatory cells and may stimulate resident cells in the synovial tissue to proliferate . Thus , arthrofibrosis may be similar to other systemic or local fibrotic disorders . However , the stimuli which triggers the fibrotic response remains unknown . Further studies are necessary to define the cause and mechanism of arthrofibrosis in order to make progress in preventing and treating this disorder ."
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Arthroskopie.90120125.eng.abstr | Arthroskopie.90120125.eng.abstr | [
{
"id": "Arthroskopie.90120125.eng.abstr-passage-0",
"type": "abstract",
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"Arthroscopically assisted treatment of distal radial fractures combines a closed procedure with conventional techniques . Lower morbidity is the only difference in comparison with open surgery . The main advantage is the possibility of recognizing concomitant injuries and of visualizing the joint surface to be reduced ."
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Arthroskopie.90120137.eng.abstr | Arthroskopie.90120137.eng.abstr | [
{
"id": "Arthroskopie.90120137.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Arthroscopy , joint lavage and suction drainage , and open surgery are used in the treatment of knee joint empyema . Between February 1991 and December 1997 , we treated 97 cases arthroscopically . In most cases , the cause of infection was intra-articular injection . Infections after surgical procedures were found in 39 patients . In spite of a clear macroscopical findings , in about one third of the cases the infecting organism could not be found in the synovial fluid culture . During the first operations , the arthroscopy was performed according to the stage of infection : for stage I , only lavage of the knee joint was performed ; for stages II and III , synovectomy was also done . The lavages were performed using separate inflow cannula at least 15 l fluid . At the end of the operations , a collagen-fleece ( Sulmycin Implant ) containing antibiotica was brought into the joint . Systemically , a first generation cephalosporin was given before culture and changed when necessary . The further course was carefully observed postoperatively . Depending on the course and laboratory findings such as WBC , ESR , and CRP , the indication and timing for further revisions were made . In most cases , second-look operations 5-7 days after the first ones were planned . Depending on the course , further operations were also performed . If necessary , partial synovectomy , removal of fibrin clots and adhesions , and additional lavage were performed during the second examination . After that , intra-articular instillation of 160-320 mg gentamycin ( Refobacin ) was performed . Also during the second examination , synovial fluid cultures were taken to find the infecting organism ."
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"id": "Arthroskopie.90120137.eng.abstr-s1-t9",
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"id": "Arthroskopie.90120137.eng.abstr-s6-t6",
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Arthroskopie.90120144.eng.abstr | Arthroskopie.90120144.eng.abstr | [
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"We report on ten patients with idiopathic non-traumatic hemarthrosis of the knee . Arthroscopic evaluation showed various bleeding sources . Besides vascular abnormalities ( e.g. , hemangioma ) or meniscus lesions we found signs of bleeding from severe degenerative osteochondral lesions . Surgical therapy , mostly with arthroscopy , led to good results ."
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Arthroskopie.90120148.eng.abstr | Arthroskopie.90120148.eng.abstr | [
{
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"Popliteal arteriovenous fistula following knee surgery is a very rare complication . Reviewing the literature , only few such cases are mentioned following tibial head osteotomy , total knee arthroplasty or arthroscopy . We report the case of a 31-year-old man suffering from a pulsatile mass in the poplitea fossa 1 week after arthroscopic resection of the posterior horn of the medial meniscus . Colour-Doppler sonography and angiography revealed a popliteal arteriovenous fistula about 4 months after arthroscopy . After dissection of the fistula and reconstruction of the popliteal artery and vein , the patient's complaints were promptly relieved . The literature covering vascular complications and their incidence in arthroscopy is reviewed"
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] | [] | [] | [
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Arthroskopie.90120161.eng.abstr | Arthroskopie.90120161.eng.abstr | [
{
"id": "Arthroskopie.90120161.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In cases of anterior shoulder instability it is mandatory to differentiate between traumatic and atraumatic instability . The traumatic instability is characterized by three lesions which are caused at the time of the primary dislocation : ( 1 ) Bankart lesion , ( 2 ) Hill-Sachs lesion , and ( 3 ) overstretching of the capsule . The capsule has to be considered in close relationship to the appearance of the Bankart lesion . The stronger the capsule the greater the external force has to be to surmount the resistance caused by the capsule . The greater the external force , the greater the shearing forces are on the glenoid rim and the greater the damage is to the glenoid rim . Damage to the glenoid rim makes it possible to draw conclusions about the condition of the capsule . The Bankart lesion can be classified into five types : ( 1 ) minimal or no Bankart lesion , ( 2 ) Broca-Hartmann lesion , ( 3 ) step-like , detached labrum lesion , ( 4 ) avulsion fracture , and ( 5 ) chisel fracture . According to the investigation of 100 shoulders with recurrent anterior shoulder dislocation , in 8% the Bankart lesion extended from 6 to 8 o ' clock ( left shoulder ) , in 34% from 6 to 9 o ' clock , in 40% from 6 to 11 o ' clock and in 15% from 6 to 12 o ' clock or beyond these marks . Only in 3% was there no Bankart lesion . When stabilizing a shoulder two criteria have to be taken into consideration : stability and function . A balance has to be found between the two criteria . Reattachment of the labrum alone will not guarantee stability ; the overstreched capsule also has to be shortened or shifted . Two criteria are decisive for the success of the stabilizing operation : ( 1 ) The capsule has to be reattached firmly and watertight all over the anterior glenoid rim ; and ( 2 ) the overstreched capsule has to be shifted or shortened . A comparison between 100 shoulders operated on arthroscopically and 110 operated on according to open Bankart repair has shown that good results concerning stability and function can be obtained with both techniques . The recurrence rate was slightly lower in the open group compared to the arthroscopic group . This study has also shown that excellent function increases the recurrence rate slightly independently of open or closed technique ."
],
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"Baker , Norlin , Hintermann and Arciero have described the arthroscopic findings in first-time traumatic anterior shoulder dislocation ( FTASD ) in a homogeneously aged population . There is no report of arthroscopic findings in other age groups , taking into consideration the time elapsed from the initial traumatic episode . A prospective study of 48 patients suffering a complete FTASD have been arthroscopically examined and documented . Arthroscopy was performed within 6 weeks of the traumatic episode ( group 1 ) or subacutely after 6 weeks in case of persistent pain and apprehension ( group 2 ) . To study the effect of age , patients were divided between those under and those over 32 years of age . All groups demonstrated high numbers of laberal detachments . Group 1 shows no instances of labral destruction and the lowest rate of labral substance lesions ( 40% ) . However , this group revealed the highest rate of IGHL detachment ( insertion site ) , Hill-Sachs-Lesions and glenoid rim defects . There was a significant difference in IGHL substance lesion between acute ( group 1 ) and subacute ( group 2 ) cases ( P = 0.0485 ) as well as in IGHL scar formation ( P = 0.0052 ) . Group 2 also showed a statistical higher rate of labrum destruction ( P = 0.078 ) . Patients older than 32 years showed the highest percentage of partial and complete rotator cuff tears and rotator interval biceps pully lesions . To the best of our knowledge this is the first study which documents the arthroscopic intraarticular pathology in cases of FTASD , also taking into account patient age and time interval from injury . Although patient numbers were small , certain trends appear to emerge . Young patients with FTASD show high percentages of labrum and IGHL detachment , whereas substance defects in these structures were low . Persistent pain and apprehension after initial dislocation appears to be related to substance lesions of the labrum and of IGHL ( group 2 ) . As anticipated , more and marked rotator cuff lesions were found in patients > 32 than in patients = 32 years . An unexpectedly high rate of partial rotator cuff lesions ( 25% ) was detected in patients = 32 years ."
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"The application of laser energy to joint capsular tissues resulted in the reduction of the joint capsule . Primary clinical results of combined laser-assisted capsular shrinkage ( LACS ) and multiple suture repair ( Caspari ) for arthroscopic stabilization procedure of anterior shoulder instability are presented . From July 1997 to October 1998 , 18 patients ( 2 female , 16 male ; mean age 27.9 years ; range 16-42 years ) with anterior instability and recurrent dislocations of the shoulder received a combined arthroscopic stabilization procedure . The operative technique involved the use of transglenoid sutures to repair the labrum and shift the capsule ( Caspari ) and LACS . Laser energy was applied using a Ho : YAG laser ( 10 W , 1 J , 10 pulses/s , total energy : 1500-2000 J ) . The patients were followed for an average of 9 months ( range 4-20 months ) . From June 1992 to Februrary 1996 , arthroscopic suture stabilization without laser shrinkage was performed on 17 patients ( 2 female , 15 male ; age 25.9 years/range 18-37 years ) . The average follow-up in this group was 4.5 years ( range 2-5 . 5 years ) , and we found 41.2% ( 7/17 ) recurrent dislocations . After combined arthroscopic procedure of multiple suture repair ( Caspari ) and LACS , a significantly ( chi-squared test , P = 0.05 ) lower recurrence rate was obtained . Only in one patient ( 5.6% , 1/18 ) did we find this failure . No complications occurred in either group . The combination of arthroscopic LACS and Caspari's technique of multiple suture repair in cases of posttraumatic anterior shoulder instability and recurrent dislocations is promising . Although , no long-term results are available , the method seems to be suitable for associating low recurrence rates with the advantages of arthroscopic surgery ."
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Arthroskopie.90120194.eng.abstr | Arthroskopie.90120194.eng.abstr | [
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"Bioabsorbable implants have been advocated for use in arthroscopic repair of unstable shoulders . These implants have been thought to be safe and to have few adverse effects . However , similar implants have been shown to cause nonspecific granulomatous reactions when implanted into bone or soft tissues in studies in both animals and human beings . This retrospective study reports the adverse effects of these implants in five patients who had arthroscopic repair of unstable shoulder . All patients reported increasing pain and loss of shoulder motion , following a symptom-free interval of an average of 2 weeks after insertion of these devices . Two of them required a further arthroscopic lavage and de-bridement to reduce the intracapsular synovitis . Granulomatous reactions were identified histologically in all cases . Three patients were treated conservatively . In all cases an open Bankart repair was required after recurrent dislocation within 1 year ."
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Arthroskopie.90120198.eng.abstr | Arthroskopie.90120198.eng.abstr | [
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"Insufficiency after anterior cruciate ligament ( ACL ) reconstruction is a typical complication . Between 1 January 1992 and 31 December 1997 a total of 604 operations at the ACL were performed in the traumatology department of Nuremberg hospital . During the same period 48 \" transplant failures \" were treated . There were various reasons for the failure of the transplant , some of them technical , occurring during the operation or during aftercare . Another reason for a re-rupture of the transplant was by trauma . The different reasons for the failure of the transplant were analysed in our patient population . The 48 patients were classified into five groups depending on the primary operation and the means of treatment ( I = ACL sutures , II = artificial ligament , III = semitendinosus tendon , IV and V = ipsi- or contralateral bone-patellar-bone graft harvest after ACL reconstruction ) , so that the different ways of treatment were better comparable . Of the 48 patients 36 were followed up over an average of 2 1/2 years using the Lysholm scores and the OAK scores . The total score of the 36 patients was 81 points and can be valued as good using the evaluation scale of Lysholm and Gillquist . Using the OAK score we found an average of 71 to 81 points in the different groups ; results in the group with the ipsilateral bone-tendon-bone graft harvest after ACL reconstruction were the worst . The totalscore using the OAK score was 74 points and was considered \" moderate \" . The score results were discussed and compared with the current literature ."
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"Arthrofibrosis represents a severe complication of trauma and surgery around joints with loss of motion due to an excessive fibrotic response in the repair process . Patients with primary arthrofibrosis suffer from a general fibrotic healing response after injury or surgery , while patients with secondary arthrofibrosis exhibit loss of motion due to a local fibrotic healing response . Nonisometric positioning of cruciate ligament grafts , notch impingement or hardware problems may lead to secondary arthrofibrosis . In contrast , the etiology of primary arthrofibrosis is still unknown . There are alterations of the extracellular matrix with an increase in collagen type VI expression similar to other local or systemic fibrotic disorders . A chronic inflammatory process may play a crucial role in the mechanism of primary arthrofibrosis and may indicate an immune response . This immune response may activate inflammatory cells and stimulate resident cells to proliferate and to form extracellular matrix . We still do not know which stimuli trigger the fibrotic response . It may be reasonable to assume that primary arthrofibrosis is an independent disease while secondary arthrofibrosis represents a true complication of trauma and surgery around joints ."
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Arthroskopie.90120233.eng.abstr | Arthroskopie.90120233.eng.abstr | [
{
"id": "Arthroskopie.90120233.eng.abstr-passage-0",
"type": "abstract",
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"In most cases total knee arthroplasty is a powerful tool in the treatment of final stage diseases of this joint . However , some patients complain of postoperative pain , swelling , and loss of range of motion . Noninvasive diagnosis often does not reveal an appropriate cause and is insufficient in terms of treatment . Magentic resonance imaging is not available for technical reasons . Thus , invasive procedures are required . In these cases arthroscopy has proved to be of value . The common causes of postoperative dysfunction are arthrofibrosis , impingement due to soft tissue , patellar instability , infection , loosening and wear , and breakdown of implants . The authors demonstrate and discuss diagnostic and therapeutic possibilities by arthroscopy in respect of the literature ."
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Arthroskopie.90120246.eng.abstr | Arthroskopie.90120246.eng.abstr | [
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Arthroskopie.90120252.eng.abstr | Arthroskopie.90120252.eng.abstr | [
{
"id": "Arthroskopie.90120252.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Arthrofibrosis of the knee may be a localized or generalized condition . The localized forms are cylops tumors , hypertrophic cruciate grafts due to notch-impingement , and intra- or extraarticular adhaesions . These problems can usually be managed by limited , arthroscopic procedures . Generalized arthrofibrosis is caused by a diffuse inflammatory reaction of the knee with fibrosis of the anterior fat pad and the parapatellar retinaculae and contracture of the posterior capsule . Treatment should include open resection of the dense fibrotic tissue , replacing the fat pad and parts of the anterior retinaculae . In addition , open posterior capsulotomy allows for complete extension of the knee . A total of 115 cases have been treated by the authors , and the results of 53 are reported ."
],
"offsets": [
[
0,
796
]
]
}
] | [
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Arthroskopie.90120260.eng.abstr | Arthroskopie.90120260.eng.abstr | [
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"Most reports in the literature on the timing of anterior cruciate ligament ( ACL ) reconstruction are retrospective . The majority of the authors propose delayed surgery of 4-6 weeks postinjury . In the present study , 45 consecutive ACL reconstructions performed within 2 weeks after injury are documented prospectively . The objective was to evaluate the rate of arthrofibrosis and to detect whether there is a difference between very early ( 3 days after injury ) and early ( 4-14 days after injury ) reconstructed knees . In group A ( \" very early \" ) , 88% of the patients were available for final clinical examination after a mean follow up of 12.6 months . In group B ( \" early \" ) , 90% of the patients were seen after a mean follow-up of 11.6 months . The overall ( n = 40 ) rate of arthrofibrosis was 7.5% ; for group A ( n = 22 ) the rate was 4.5% and for group B ( n = 18 ) 11% . There was no statistically significant difference between the groups comparing the following parameters : Duration of physical therapy and sick leave , manual Lachman testing , KT-1000 measurements , Lysholm score , and IKDC score . Although the difference was not statistically significant , the results regarding the activity level at follow-up are medically important : In group A , 77% of the patients had the same activity level compared to the preoperative status and 23% were less active . In group B , 61% showed the same activity level at follow-up and 39% a lower one . We conclude that in group A the late results in activity level are better and the incidence of arthrofibrosis is lower ( 4.5% ) than for the patients operated on between 4 and 14 days after injury ( arthrofibrosis rate 11% ) . We therefore suggest that early ACL surgery should be performed within 3 days after injury . In all other cases we recommend delayed ACL reconstruction after an interval of over 4-6 weeks , since the incidence of arthrofibrosis in group B was higher ( 11% ) than in the existing literature on delayed ACL reconstruction ."
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Arthroskopie.90120294.eng.abstr | Arthroskopie.90120294.eng.abstr | [
{
"id": "Arthroskopie.90120294.eng.abstr-passage-0",
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"The clinical application of cartilage repair procedures is currently being discussion . To define cartilage lesions with respect to localization , degree of cartilage damage , size , and etiology we retrospectively reviewed data from 4408 patients who had knee arthroscopies . Chondral lesions were divided into traumatic ( n = 572 , mean age 30.2 years ; 13.2-52.7 years ) and degenerative ( n = 976 , mean age 51.4 years ; 27.1-79.9 years ) lesions . All traumatic cartilage lesions were associated with isolated anterior cruciuate tear . The time interval between injury and arthroscopy was subdivided in patients with acute anterior cruciate ligament tear ( 6 weeks ) or with chronic joint instability ( > 6 weeks ) . Isolated degenerative cartilage lesions were subdivided in patients aged = 40 years and > 40 years . Patients with other associated lesions were excluded . Because we believe that patients with grade III cartilage lesions under the age of 40 years represent the ideal type of patient to receive cartilage or osteochondral transplantation , the data set was analyzed further to characterize these patients . In both groups ( traumatic and degenerative ) the medial femoral condyle and the medial tibial plateau were most affected . Grade III lesions increased in number and size in all compartments with age by about 2-3 . 5-fold . The medial tibial plateau showed a significantly higher alteration of about 13-fold in patients aged > 40 years . The two subgroups comprising acute and chronic anterior cruciate ligament tears did not demonstrate any statistically significant differences in any parameter . Potential candidates for cartilage grafting accounted for 82 patients ( 5.3% ) on the medial femoral condyle and for 33 patients ( 2.1% ) on the medial tibial plateau of all cartilage lesions ( n = 1548 in this data set . In conclusion , we found no relationship between time of surgery and degree of traumatic cartilage lesions after anterior cruciate ligament tear . The development of grade III cartilage lesions in patients older than 40 years was significantly higher on the medial tibia plateau than in the other compartments . That means that extrinsic factors have more influence on the cartilage damage than genetically determined factors . In respect to the observation that most of the patients achieve a total knee arthroplasty because of osteoarthritis on the medial compartment , all cartilage reconstructive procedures should be focused on the medial compartment ."
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Arthroskopie.90120305.eng.abstr | Arthroskopie.90120305.eng.abstr | [
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"In recent years ACL reconsruction with the midpatellar tendon has been being called into question more and more because of high morbidity at the harvest site and problems with fixation near the joint . The \" wiper effect \" or \" bungee-effect \" may be mentioned as an example . In this paper , ACL reconstruction using the hamstrings is presented , which , in contrast to fixation with the Endobutton , has a very high pull out strength and also tibial fixation near the joint with a biodegradable interference screw . This surgical method has been carefully developed and is technically sophisticated . The technique can be used mainly in younger women with small patellae , athletically inactive persons with a high level of instability , all patients with parapatellar problems or pain , and patients whose occupation involves kneeling . The short-term results are excellent ; long-term results with this new method are not yet available . This method should be seen as an alternative to ACL reconstruction with the midpatellar tendon and , in our view , the security of fixation is at least as good as with the Endobutton ."
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Arthroskopie.90120313.eng.abstr | Arthroskopie.90120313.eng.abstr | [
{
"id": "Arthroskopie.90120313.eng.abstr-passage-0",
"type": "abstract",
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"Since 1993 , 30 patients with acute intraarticular distal radius fractures have been treated under arthroscopic assistance . In 12 patients ( 40% ) concomitant lesions of the intrinsic scapholunate ligaments were diagnosed . According to Geissler we found grade I-tear in one patient , grade II in three , grade III in six and grade IV in two patients . The eight individuals with grade III-and IV-lesions additionally revealed marked instablity intraoperatively . Therefore , operative stabilization was subsequently performed by temporary scapholunate and scaphocapitate arthrodesis . Seven patients out of this group ( 87.5% ) were followed up clinically and radiologically 3 years postoperatively , on average . Clinical examination included range of motion tests and a subjective questionnaire concerning pain and working ability . Objective grip strength was measured using a Jamar tester and compared to the contralateral wrist . Radiological evaluation consisted of the posteroanterior and lateral view as well as stress views in radial and ulnar deviation . Data were evaluated by the Jakim and Cooney scoring system as well as the demerit point system by Gartland and Werley as modified by Sarmiento et al. According to Gartland , 100% of our patients showed an excellent result ; these rates were 86% using the Jakim score and 60% using the Cooney scoring system . According to the subjective questionnaire all of the patients revealed an excellent or good result ."
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] | [] | [] | [
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Arthroskopie.90120318.eng.abstr | Arthroskopie.90120318.eng.abstr | [
{
"id": "Arthroskopie.90120318.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Displacement of the discus articularis with and without repositioning represents a common pathological alteration of the temporomandibular joint ( tmj ) . The primary clinical symptoms are pain and reduced jaw movement . Particularly in cases of long-term complaints , conservative treatment methods such as splint and physiotherapy often do not produce the desired results . For these patients , arthroscopy combined with lysis and lavage is the treatment of choice for diagnostic as well as therapeutic purposes . In our department we performed this surgery on a total of 23 patients with discus displacement . With this low-risk procedure we achieved a definite improvement in symptoms in 20 patients ; 11 of those patients were eventually complaint-free . Additionally , we can report a general improvement in opening the mouth . Except for a slight postoperative soft-tissue swelling , no complications developed . Thus , we can conclude that arthroscopic lysis and lavage , a low-risk and minimally invasive procedure , should be preferred to open arthrotomy in the primary treatment of tmj-displacements ."
],
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Bundesgesundheitsblatt.00430011.eng.abstr | Bundesgesundheitsblatt.00430011.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.00430011.eng.abstr-passage-0",
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"The laboratory surveillance of measles in Germany contributes to an objective estimation of the situation . Compared to data of the pre-vaccination era , the incidence of measles has been reduced , while a shift in age towards the group of 15-year-olds is observed . Germany will have considerable difficulties to reach the aim of eradicating measles in the European region by the year 2007. Apart from the fact that systematic surveillance is lacking , the immunity gaps in small children represent a particularly weak spot . In order to effectively control measles , high vaccination rates of at least 90% are necessary by the end of the second year of life . In addition , laboratory surveillance has to be included to measure successful vaccination . Main focusses are the laboratory confirmation of suspected measles cases , seroprevalence studies of population immunity as well as the control of the circulation of measles viruses . The Working Group Measles ( \" Arbeitsgemeinschaft Masern \" - AGM ) as well as the amended law on infection prevention are important instruments to make measurable progress towards measles eradication also in Germany . We report on the activities of the National Reference Centre for Measles , Mumps and Rubella since 1991. The German data are compared to those of selected other European countries ."
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Bundesgesundheitsblatt.00430190.eng.abstr | Bundesgesundheitsblatt.00430190.eng.abstr | [
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"The assessment of health related quality of life is increasingly accepted in medicine . Health related quality of life can be viewed as self-report relating to psychological , social , physical and every day life components of well-being and function as perceived by the person . To measure health related quality of life several assessment instruments have been developed and psychometrically tested , are available internationally . One of those instruments is the originally American SF-36 which assesses with 36 items eigth dimensions of subjective health as well as two summary scores ( a short form with 12 items , the SF-12, exists , too ) . The instrument was translated into several languages , psychometrically tested and normed in more than ten countries , also in Germany . Translating and psychometric testing of the German SF-36 complied with the international guidelines ( IQOLA-Group ) . In several healthy and ill population excellent psychometric properties concerning reliability , validity and sensitivity were found . In the meantime international work with the SF-36 has proceeded , also in Germany the instrument is frequently used . Currently a health economical derivate of the SF-36, the SF-6D, originally developed in England , as well as computerized applications , computer adaptive testing and evaluation of the item relevance in comparison to other health related quality of life instruments are being performed . The SF-36 is one of the most prominent instrument to assess health related quality of life , even though it has been criticised for focussing on functional conceptualizations of quality of life . The coming years will show which role the SF-36 plays in comparison to other instruments in assessing health related quality of life in medicine ."
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Bundesgesundheitsblatt.00430198.eng.abstr | Bundesgesundheitsblatt.00430198.eng.abstr | [
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