Search

Objective: We aimed to identify factors that affect pain, complications, and function following elbow arthroscopy for elbow synovial chondromatosis., Methods: We retrospectively reviewed the cases of all patients with elbow synovial chondromatosis treated by arthroscopic synovectomy and loose body removal between January 2000 and January 2016 at our institution. Eleven patients were enrolled (8 male; mean age, 41.7 years). The mean duration of symptoms was 13.7 months, and all patients had a decreased range of motion (ROM) in the affected elbow. By Milgram criteria, there was 1 phase II case, and 10 cases were phase III., Results: All patients were followed postoperatively (mean follow-up, 65 months). The preoperatively restricted ROM of 100° flexion (range, 78°-120°) and extension of 30° (range, 15°-40°) were improved to 130° flexion (range, 120°-140°) and -5° hyperextension (range, -10°-0°). Pain, recorded as the pain subscore of the American Shoulder and Elbow Surgeons questionnaire for elbows, was significantly improved from 32 points (range, 20-50) preoperatively to 85 (range, 70-100) postoperatively (on a scale ranging from 0 [worst pain] to 100 [pain-free]). Recurrence occurred in 2 patients (18.2%) who then received arthroscopic synovectomy and loose body removal again. There were no fractures or neurovascular complications, and no patient developed an infection., Conclusion: Arthroscopic management of synovial chondromatosis of the elbow was an effective and safe therapeutic method. After the intervention, immediate and durable improvement of elbow function can be expected.

Objective: To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.
 Methods: Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January, 2013 to December, 2014. All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle. All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day, 4th week and 12th week. Visual Analogue Scales (VAS), Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st, 3th, 6th month follow-up, then follow-up every 6 months.
 Results: The mean follow-up was 28 (24-36) months. All cases were negative in valgus stress test. MCL rupture, femoral fracture, articular cartilage lesion and neurovascular injury were not found at the last follow-up. The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P<0.05) at the 1st day, 5.5 mm and 4.2 mm 
(P<0.05) in the 4th week and 4.8 mm and 4.3 mm (P>0.05) at the 12th week, respectively. VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561, P<0.05). Lysholm scores was changed from 52.3±5.8 preoperatively to 93.2±6.3 at the final follow-up (t=-41.353, P<0.05). Tegner scores was changed from 4.1±1.1 preoperatively to 5.5±0.6 at the final follow-up (t=-18.792, P<0.05). IKDC scores was changed from 54.5±6.2 preoperative to 93.8±4.5 at the final follow-up (t=-38.253, P<0.05).
 Conclusion: Pie-crusting the medial collateral ligament release is a safe, minimal invasive and effective surgical option for posterior horn of medial meniscus tear in tight medial tibiofemoral compartment of knee joint.

Objective: To explore the therapeutic efficacy of arthroscopic reconstruction of anterior cruciate ligament (ACL) with autologous multi-stranded semitendinous tendon (ST)., Methods: From September 2000 to December 2004, 50 cases of ruptures of ACLs were diagnosed by clinical and arthroscopic examinations. There were 32 males and 18 females with an average age of 26.3 years (18-51 years). The locations were left knee in 31 cases and right knee in 19 cases. All patients had the history of knee joint injury. Arthroscopy showed 26 cases of rupture, 14 cases of defect, 4 cases of avulsion and 6 cases of laceration. All patients were operated upon arthroscopically by using autologous multi-stranded ST. Plaster splints were used for 4 weeks after operation. The result was estimated by AO Yingfang's standards and Lysholm knee scores., Results: All patients achieved healing by the first intention. The extension and flexion function was restored normal at 8-10 weeks. The patients were followed up averagely 1 year and 8 months (6-48 months). The results of drawer test and Lachman test were positive in 3 cases and suspiciously positive in 8 cases. The results were excellent in 23 patients, good in 18 and fair in 9. Lysholm knee scores were 40.57+/-10.68 preoperatively and 86.43+/-9.33 postoperatively, showing significant difference (P < 0.01)., Conclusion: Arthroscopy reconstruction of ACL with autologous multi-stranded ST may be one of the excellent methods bringing less injury.

Objective: To introduce the surgical technique and clinical outcomes of arthroscopic anterior talofibular ligament (ATFL) repair using the Internal Brace and lasso-loop technique for chronic ankle lateral instability.Methods: A retrospective study was performed on 29 patients who underwent all-arthroscopic ATFL repair with the Internal Brace and lasso-loop technique from January to August 2020. The patients included 24 males and five females, with a mean age of 30.17 years. Through the accessory anterolateral (AAL) portal, we drilled the bone tunnels and fixed the tape with 4.75 mm and 3.5 mm "SwiveLock" anchors and reattached the torn ligament by the lasso-loop technique.Results: All 29 patients underwent all-arthroscopic procedures smoothly without serious complications, such as infection and important nerve or vessel injuries. There were eight cases of lateral malleolar avulsion fractures and ten cases of talus cartilage injury. The visual analog scale (VAS), Karlsson-Peterson, Tegner, and American Orthopedic Foot and Ankle Society (AOFAS) scores were used to evaluate the clinical consequences. All the patients were followed up for 18.66 ± 4.85 months on average. The average pre-operative VAS score was 4.69 ± 1.04, which was significantly higher than the average post-operative VAS score of 1.14 ± 1.56. At the final follow-up appointments, the averages of Karlsson-Peterson, AOFAS, and Tenger scores were 75.83 ± 9.44, 88.31 ± 6.81, and 6.93 ± 1.79, respectively, which was significantly higher than that before the operation.Conclusion: This arthroscopic anterior talofibular ligament repair with the Internal Brace and lasso-loop technique achieves satisfactory clinical outcomes with the benefits of high safety and reliability for chronic ankle lateral instability. [ABSTRACT FROM AUTHOR]

Objective: To describe an arthroscopic technique for giant meniscal cyst excision with preservation of the functional meniscus, report the short‐ and medium‐term outcomes, and assess magnetic resonance imaging (MRI) for follow‐up imaging evaluations. Methods: A total of 54 consecutive patients with symptomatic meniscal cysts were admitted to the Second Xiangya Hospital of Central South University between 2014 and 2019. Nine patients with giant meniscus cysts (six females and three males) were included in this study. The age range of the patients was 6–34 years. All patients underwent a complete physical examination, X‐ray, Doppler ultrasound, and MRI of the knee preoperatively. After an arthroscopic diagnosis of a meniscal rupture with a giant meniscal cyst, partial meniscectomy, ablation of the cyst, and suturing of the retainable meniscus were performed. Lysholm and International Knee Documentation Committee (IKDC) scores were used preoperatively and at the most recent follow‐up. Clinical outcomes were classified into four categories: excellent, good, fair, and poor. During the last visit, all patients underwent MRI to assess the recurrence of the cyst and meniscal suture healing. Results: Preoperative MRI and arthroscopic examination revealed giant meniscal cysts combined with meniscal tears and congenital discoid meniscus, and all giant meniscal cysts occurred in the lateral meniscus. The main types of meniscal tears were horizontal and complex tears. The cysts were unicystic in one case and multicystic in eight cases. The mean size of the cysts on the MRI was 5.86 cm × 2.24 cm × 2.48 cm. The mean follow‐up periods were 37.5 (19–60) months. Clinical outcomes were excellent in six patients and good in three patients. The postoperative scores were significantly improved compared to the preoperative scores (Lysholm: 90.78 ± 4.60 vs. 54.56 ± 7.25; IKDC: 96.2 ± 3.46 vs. 61.69 ± 3.36; p <0.01). No recurrence of the cyst was indicated on the MRI, and there was good healing of the torn meniscus. Conclusions: Arthroscopic cystectomy combined with the meniscus suture technique was effective to eradicate residual cyst cavities, and traffic orifices be highly recommended. [ABSTRACT FROM AUTHOR]