Objective To evaluate an improving operative procedure and the cl inical results of arthroscopically assisted treatment for acute patellar dislocation. Methods Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, release of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The disease duration was 1-10 days with an average of 5.9 days. All patients had lateral dislocation; of them, 14 patients showed reduction without treatment, and 8 patients showed dislocation at admission and were given close manipulative reduction. The results were positive for apprehension test in all patients with the l imitation of passive motion and for Ballottable Patella Sign in 15 cases. Lysholm score, visual analogue scale (VAS) score, and Insall scale were adopted to evaluate the effect. Results All incisions healed by first intention. All the patients were followed up 12-36 months (17 months on average). During the first 3 months after operation, sunken skin in the puncture point medial to the patella was observed in 12 knees; 10 knees suffered pain of the soft tissue lateral to the patella; 15 knees felt tense in the soft tissue medial to the patella, however, all these problems disappeared or recovered gradually after rehabil itation and conservative treatment. No recurrence of dislocation was observed during the follow-up. Lysholm score was significantly improved from preoperative 67.3 ± 5.7 to postoperative 96.6 ± 4.5 (t=3.241, P=0.003) and VAS score from 6.5 ± 0.5 to 1.8 ± 0.4 (t=2.154, P=0.040). According to Insall scale, the results were excellent in 18 knees, good in 5 knees, and fair in 2 knees at 1 year after operation with an excellent and good rate of 92%. Conclusion The improving procedure of arthroscopically assisted treatment for acute patellar dislocation is a minimally invasive operation and has a number of benefits. Its short-term cl inical outcome was satisfactory.
ObjectiveTo investigate the early effectiveness of arthroscope for femoroacetabular impingement (FAI). MethodsBetween February 2012 and June 2014, 17 patients (17 hips) with FAI were treated under arthroscope. Of 17 patients, 12 were male and 5 were female, aged 18-60 years (mean, 37.2 years); 9 left hips and 8 right hips were involved. All patients had pain in groin for 12-24 months (mean, 15 months), no limited activity of the hip and obvious provocative pain in full flexion and internal rotation. The results of impingement test and the Faber test were all positive. According to X-ray examination, 8 cases were at early stage, 8 cases at middle stage, and 1 case at late stage; according to anatomical morphology, 6 cases were rated as cam-type impingement, 3 cases as pincer-type impingement, and 8 cases as mixed type. Based on impingement type, arthroscopic femoroplasty, arthroscopic acetabuloplasty, and a combination of arthroscopic femoroplasty and acetabuloplasty were performed on 6, 3, and 8 patients respectively. ResultsPrimary healing of incision was obtained. One patient had numbness in the lateral thigh, and symptom disappeared after 2 weeks. All cases were followed up 1-2 years (mean, 1.3 years). All patients obtained obvious hip pain relief. The postoperative Harris scores were significantly increased to 91.44±1.98 at 6 weeks, 95.83±0.53 at 3 months, and 95.33±2.43 at 1 year from preoperative 79.01±3.20(P＜0.05), and the scores at 3 months and at 1 year were significantly higher than that at 6 weeks (P＜0.05), but there was no significant difference between at 3 months and at 1 year (P>0.05). ConclusionArthroscope treatment of FAI can obviously relief hip pain. The key points for acquiring satisfactory early effectiveness are definite diagnosis, early detection, and minimally invasive treatment.
Objectives To compare the clinical therapeutic effect of arthroscope and mini-open in treating rotator cuff impairment with Meta-analysi. Methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (Jun 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2007), MEDLINE, EMBASE, and CBM, conference proceedings and reference lists of articles. Selection criteria: Randomized or comparative studies on all arthroscopic rotator cuff repairs and mini-open repairs. Results There were no randomized controlled trials (Level I) was found. Pooled results from all 12 trials showed that postoperative shoulder pain in all arthroscope group was statistically less than in the mini-open group (RR=0.94, 95%CI 0.28 to 1.60). Meanwhile, another evaluates outcomes such as ROM-Forward flexion (RR=0.17, 95%CI –0.10 to 0.45), patient’s satisfaction (RR=1.03, 95%CI 0.98 to 1.08), complication (RR=1.11, 95%CI 0.54 to 2.27), and shoulder functional score (RR=0.04, 95%CI –0.10 to 0.19) indicated no statistical difference in two groups. Conclusions According to Limited evidence, there are some findings as follows: comparing with mini-open treatment of rotator cuff impairment, all arthroscopic surgery can reduce the shoulder pain. Moreover, we found no statistical difference in shoulder functional score, ROM-Forward flexion, patient’s satisfaction and complication. Attention should be paid to outcome assessment in future trials.