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Arthroscopy-assisted reduction versus open reduction in the fixation of medial malleolar fractures

Turhan E. | Doral M.N. | Demirel M. | Atay A.O. | Bozkurt M. | Bilge O. | Huri G.

Article | 2013 | European Journal of Orthopaedic Surgery and Traumatology23 ( 8 ) , pp.953 - 959

Purpose: Purpose of this case-control study was to evaluate the feasibility and advantages of arthroscopically assisted reduction and internal fixation of isolated medial malleolar fractures and compare the outcomes with conventional open reduction and internal fixation. Methods: Forty-seven patients with medial malleolar fractures were grouped into two: arthroscopy-assisted group, and conventional open reduction and internal fixation group. Arthroscopic treatment group consisted of 21 patients. The mean age was 34 years (range: 22-49 years). Conventional open reduction and internal fixation group included 26 patients. The mean age . . .was 42 years (range: 22-58 years). According to Herscovici system, 6 fractures in the arthroscopy group were classified as type-B, 13 fractures as type-C, and 2 fractures were classified as type-D. In both groups, fractures were classified according to Herscovici system. Radiological and clinical outcomes were evaluated according to van Dijk classification and Olerud-Molander scoring system, respectively. Results: The mean follow-up period was 26 months (18-52 months) for arthroscopically assisted group and 38 months (24-58 months) for the conventional group. According to van Dijk classification, there was only one patient with Grade 1 osteoarthritic changes in arthroscopically assisted group compared with the conventional group where two patients had Grade 2 and one patient had Grade 1 osteoarthritic changes. Median Olerud Scores were 92.3 (75-100) and 86.3 (70-100) for the arthroscopically assisted group and for the conventional group, respectively. The difference was statistically significant (p = 0.015). Conclusions: With the use of arthroscopically assisted techniques in fixation of isolated medial malleolar fractures, surgeon can evaluate intra-articular surface and reduction that may be of value in the improvement in clinical outcomes over conventional surgical treatment. Level of evidence: Case-control study, Level III. © 2012 Springer-Verlag France Daha fazlası Daha az

The fate of patellar tendon and infrapatellar fat pad after arthroscopy via central portal

Bayar A. | Turhan E. | Özer T. | Keser S. | Ege A. | Erdem Z.

Article | 2008 | Knee Surgery, Sports Traumatology, Arthroscopy16 ( 12 ) , pp.1114 - 1120

Central patellar (CP) portal is an accessory portal in arthroscopic knee surgery, which generally is considered to be safe. In this cross sectional study, we aimed to delineate the clinical and radiological outcome of patellar tendon (PT) and Hoffa's fat pad after the use of this approach. From our hospital records, patients who underwent arthroscopy via CP portal were identified and were invited for the study. There were16 men and 4 women with a mean age of 32 years. Mean follow-up time was 28 months. Meniscectomy had been performed for irreparable bucket-handle type medial meniscal tears in all patients. At the latest follow-up, n . . .o patients had anterior knee pain and physical examination was normal. Mean PT thickness of operated knees measured with Ultrasonography was 5.63 ± 1.56, while it was 3.76 ± 0.46 mm in contralateral knees and the difference was significant. Contour irregularity of PT and focal hypoechoic areas were found in 17 patients, two of which also had hyperechogenic calcification focuses. Abnormal signal intensity of PT was also found in 17 patients with Magnetic Resonance Imaging (MRI). Eleven of these had decreased signal intensity within the tendon which was interpreted as fibrosis. In six patients, increased signal intensity, radiologically similar to chronic tendinitis, was detected. Four patients had decreased signal intensity in the Hoffa's fat pad. Local fibrous tissues in patellar tendon might cause weakness in the tendon. This study showed that although CP portal did not cause any clinical problems in a low demand group of patients, it leads to a significant radiological sequela in the tendon, biomechanical significance of which needs to be clarified. © 2008 Springer-Verlag Daha fazlası Daha az

The effect of watching live arthroscopic views on postoperative anxiety of patients

Bayar A. | Tuncay I. | Atasoy N. | Ayoglu H. | Keser S. | Ege A.

Article | 2008 | Knee Surgery, Sports Traumatology, Arthroscopy16 ( 11 ) , pp.982 - 987

Surgery is a stressful experience. Many minor interventions have been shown to cause considerable anxiety in patients, but whether arthroscopy leads to such anxiety is not well-known. Methods for lowering perioperative anxiety have been sought and listening to music or watching a movie have been recommended. The method of permitting patients to watch their own endoscopy has been studied infrequently. Our aim in this study was to find out the effect of watching simultaneous arthroscopic views on postoperative anxiety. A total of 63 patients were randomly divided into two groups: those watching their own arthroscopy formed group W, wh . . .ile patients that were only verbally informed formed group NW. The mean age of patients in both groups were 33 and 34, respectively. Meniscal surgery was the most commonly performed procedure (49/63 patients). The patients filled in state scale of State-trait anxiety inventory (STAI) forms and the study questionnaire (SQ) prepared for this study, just before and after the arthroscopy. Group W had significantly lower postoperative scores of STAI-S, whole questionnaire (Q-score) and all but one of individual statements in SQ. Having a previous operation history did not affect STAI scores. Age and level of education was not correlated with any of the studied parameters either. The ratio of patients that were pleased with the arthroscopy experience in group W and NW were 94 and 63%, respectively. Watching live arthroscopic views has led to a significant decrease in postoperative anxiety and worries about the surgery and the postoperative period, while increasing overall understanding and satisfaction of the patient. © 2008 Springer-Verlag Daha fazlası Daha az

An unusual cause for anterior knee pain: Strangulated intra-articular lipoma

Keser, Selçuk | Bayar, Ahmet | Numanoğlu, Gamze

Article | 2005 | Knee Surgery, Sports Traumatology, Arthroscopy13 ( 7 ) , pp.585 - 588

Lipoma is the most frequently encountered benign soft tissue tumor. However, intra-articular lipomas are rarely seen. Anterior knee pain is a frequent complaint of adults and is of diverse etiology. This 42-year-old female patient had severe anterior knee pain, unresponsive to medical treatment. Magnetic resonance imaging revealed an intra-articular tumor of the knee joint. Arthroscopic intervention and subsequent histological examination resulted in the diagnosis of strangulated lipoma originating from infrapatellar fat pad. We present clinical, radiological and operative features of this rare case of intra-articular lipoma. © Spri . . .nger-Verlag 2005 Daha fazlası Daha az

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