PURPOSE: This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures. METHODS: The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imaging of the suprascapular notch was captured by a handheld digital microscope (Q-scope). The supraspinatus and subscapularis muscles were traced as they course at the suprascapular notch vicinity. The omohyoid muscle attachment onto the suprascapular ligament was measured. A scoping review and meta-analysis were done to investigate the observed rare muscular variants. RESULTS: In 3.48%, the suprascapular notch anterior surface was fully covered by the subscapularis muscle. The omohyoid muscle inserted onto the suprascapular ligament in 31.25% and extended up to 3/4th of the suprascapular ligament length in 2.61%. Two rare variant muscles were encountered: subclavius posticus muscle and a newly reported "coracoscapularis muscle". CONCLUSIONS: Four categories of muscles with topographical relationship to the suprascapular notch and its arthroscopic feasibility have been classified: (1) constant muscles not intervening with the suprascapular notch space - supraspinatus muscle; (2) constant muscles with variable positions that can intervene with the suprascapular notch space - subscapularis muscle; (3) constant muscles with variable positions that can intervene with the surgical approach - omohyoid muscle; (4) variable muscles intervening with the suprascapular notch space and surgical approach - subclavius posticus and coracoscapularis muscles. This study elucidates the necessity to assess/secure the omohyoid muscle attachment onto the suprascapular ligament in suprascapular nerve decompression ligamentectomy. LEVEL OF EVIDENCE: V Basic Science Research.
- MeSH
- anatomická variace * MeSH
- artroskopie * metody MeSH
- chirurgická dekomprese metody MeSH
- kosterní svaly * inervace anatomie a histologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lopatka inervace anatomie a histologie MeSH
- mrtvola * MeSH
- ramenní kloub inervace chirurgie anatomie a histologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- ambulantní chirurgické výkony metody MeSH
- artroskopie * metody MeSH
- autologní transplantace metody MeSH
- kloubní chrupavka chirurgie zranění MeSH
- lidé MeSH
- nanomedicína metody MeSH
- poranění kolena chirurgie MeSH
- poranění rotátorové manžety chirurgie MeSH
- regenerace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
PURPOSE OF THE STUDY: In our study, it was aimed to evaluate the efficacy of microfracture and retrograde subchondral drilling on clinical outcomes in patients who underwent ankle arthroscopy due to osteochondral lesion of medial talus. MATERIAL AND METHODS: Twenty eight patients with osteochondral lesion of talus less than 1.5 cm2 treated with ankle arthroscopy were evaluated retrospectively. Microfracture was performed in 16 patients and retrograde subchondral drilling was performed in 12 patients that there was no loss of integrity in the cartilage layer or cartilage layer is partially preserved during ankle arthroscopy. Postoperative evaluations of the patients were done with Foot and Ankle Ability Measure (FAAM) and results of both group were compared statistically. RESULTS: The mean activities of daily living scale was 93.4±3.2 and sportive activity scale was 90.1±5.7 in the retrograde drilling group. In the micro-fracture group, mean activities of daily living scale was 93.8±4.1 and mean sportive activity scale was 88.9±9.5. No significant difference was found as a result of statistical comparisons of both groups results. DISCUSSION: It has been determined that the size and preservation of the integrity of talar osteochondral lesions are important factors on clinical results. Results of arthroscopic debridement, microfracture and drilization are not good in lesions larger than 1.5 cm2 and lesions with impaired integrity. In our study, depending on the general literature, osteochondral lesions in talus were less than 1.5 cm2 in patients who underwent arthroscopic micro fracture and retrograde drilling. CONCLUSIONS: Both microfracture and retrograde subchondral drilling are effective treatment methods with good clinical results for talar osteochondral lesions less than 1,5cm2 . Retrograde subchondral drilling can be an alternative treatment method with the reliability of clinical results in patients with no loss of the integrity of the cartilage layer or cartilage layer is partially preserved. KEY WORDS: talus, osteochondral lesion, microfracture, subchondral drilling.
- MeSH
- artroplastika subchondrální metody MeSH
- artroskopie * metody MeSH
- činnosti denního života MeSH
- dospělí MeSH
- hlezenní kloub chirurgie MeSH
- kloubní chrupavka * chirurgie zranění MeSH
- lidé MeSH
- retrospektivní studie MeSH
- talus * chirurgie zranění MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- MeSH
- artroskopie metody přístrojové vybavení MeSH
- hallux valgus chirurgie MeSH
- lidé MeSH
- miniinvazivní chirurgické výkony * trendy MeSH
- osteotomie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
PURPOSE OF THE STUDY The aim of this study is to confirm that the involvement of arthroscopy in the surgical treatment of painful elbow syndrome, when proper and long enough conservative treatment failed, has better results than open radial epicondylitis surgery alone. MATERIAL AND METHODS A total of 144 patients included 65 men and 79 women, with the mean age of 45.3 years, namely 44.4 years (range 18-61 years) in men and 45.8 years (range 18-60 years) in women. Each patient was clinically examined, an anteroposterior and lateral X-ray of the elbow were performed, and proper therapy was chosen - either primary diagnostic and therapeutic arthroscopy followed by open epicondylitis surgery or primary open epicondylitis surgery alone. The treatment effect was evaluated by using the QuickDASH (Disabilities of the Arm, Shoulder and Hand) scoring system at 6 months after surgery. RESULTS Out of the total group of 144 patients, 114 (79%) patients completed the questionnaire. All the results of the QuickDASH score in our group of patients are in the better half (0-5 very good, 6-15 good, 16-35 satisfactory, over 35 poor), with the mean value 5.63 (in men the mean value was 2.95-2.27 for the combination of arthroscopic and open procedure of LE, 4.55 for open procedure of LE, while in women the mean value was 7.50-6.82 for the combination of arthroscopic and open procedure of LE, 9.09 for open procedure of LE only). Altogether 96 patients (72%) experienced full pain relief. In patients treated with a combination of arthroscopic and open surgery, a higher percentage of patients reported full relief (53 patients, 85%) compared to the patients treated with the open method alone (21 patients, 62%). DISCUSSION By involving arthroscopy in the surgical treatment of patients with lateral elbow pain syndrome after unsuccessful conservative treatment, a successful and early solution to the problem was achieved in 72% of patients. The advantage of elbow arthroscopy over the conventional approach to the treatment of lateral epicondylitis consists mainly in the opportunity to observe intraarticular structures, thus provide a detailed view of the entire joint without the need for direct extensive joint opening, which makes it possible to exclude other causes of problems (e. g. chondromalacia of the radial head, loose body and other intraarticular abnormalities). At the same time, we can treat this source of problems with minimum burden placed on the patient. CONCLUSIONS Arthroscopic examination of the elbow joint makes it possible to diagnose all potential intraarticular sources of difficulties. Simultaneous elbow arthroscopy and open treatment of radial epicondylitis (release of ECRB or EDC, ECU, necrotic tissue excision, deperiostation and radial epicondyle microfractures) is a safe method with low morbidity, faster rehabilitation and return to the original activities based on subjective evaluation of patients and objective scoring. Key words: lateral epicondylitis, radiohumeral plica, elbow arthroscopy.
- MeSH
- artralgie MeSH
- artroskopie metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- loketní kloub * chirurgie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- radius MeSH
- tenisový loket * chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- artroskopie metody MeSH
- bolest ramene diagnóza etiologie MeSH
- burzitida chirurgie diagnóza farmakoterapie MeSH
- diferenciální diagnóza MeSH
- luxace ramenního kloubu chirurgie diagnóza etiologie MeSH
- pooperační péče metody rehabilitace MeSH
- poranění ramene chirurgie etiologie MeSH
- poranění rotátorové manžety chirurgie diagnóza MeSH
- ramenní kloub * chirurgie patofyziologie MeSH
- syndrom zhmožděného ramene chirurgie diagnóza farmakoterapie MeSH
- techniky fyzikální terapie * MeSH
- věkové faktory MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- artroskopie metody rehabilitace MeSH
- lidé MeSH
- muskuloskeletální manipulace metody MeSH
- obnova funkce MeSH
- pooperační komplikace prevence a kontrola MeSH
- pooperační péče MeSH
- ramenní kloub chirurgie patofyziologie MeSH
- rotátorová manžeta patofyziologie MeSH
- rozsah kloubních pohybů fyziologie MeSH
- syndrom zhmožděného ramene * chirurgie diagnóza rehabilitace MeSH
- techniky fyzikální terapie * MeSH
- terapie cvičením MeSH
- urychlená pooperační rehabilitace MeSH
- Check Tag
- lidé MeSH
PURPOSE OF THE STUDY To present the technique, learning curve, complications, postoperative pain levels and cost-effectiveness analysis of 24 patients with symptomatic rotator cuff tear operated with Drillbone Tunneler - a novel transosseous suture-passing device designed for arthroscopic use. MATERIAL AND METHODS Between February and May 2021, 24 patients underwent arthroscopic transosseous rotator cuff repair. During the study, the time spent preparing the tunnels was recorded along with the occurrence of complications during the operation. Price calculation of the delivered transosseous cuff repair and an alternative procedure with suture anchors was made. During the postoperative period, the patients rated their pain (on the VAS scale) twice a day, in the morning and in the evening, for 4 weeks, based on which the average values per each week were calculated. RESULTS The average time it took to prepare the tunnels and pull through the sutures was 6.2 minutes. In one case it was impossible to pull the shuttle loop through and that is why during the surgery arthroscopic transosseous-equivalent repair using suture anchors was performed instead. Apart from this, no other complications occurred. The patients reported rapid reduction of postoperative pain during the second and third week after surgery. The cost price analysis proved an average saving of CZK 9.463 per procedure. DISCUSSION There is a growing body of evidence that arthroscopic transosseous rotator cuff repairs achieve equivalent clinical outcomes as suture anchor repairs or even better clinical outcomes. These techniques are safe and effective; there is an earlier reduction of postoperative pain. Healing is more biological due to better vascularity, larger footprint coverage and clinically optimal biomechanical strength. Moreover, these techniques significantly save costs and meet requirements of the upcoming era of value-based surgery. CONCLUSIONS In our cohort, a favourable learning curve and minimum occurrence of complications were established. The study confirmed the data published so far on early relief of postoperative pain. We also proved that significant saving of costs of the materials used was achieved. Key words: arthroscopic transosseous rotator cuff repair, suture anchor, postoperative pain, cost-benefit analysis, Drillbone Tunneler.
- MeSH
- artroskopie škodlivé účinky metody MeSH
- lidé MeSH
- pooperační bolest chirurgie MeSH
- poranění rotátorové manžety * chirurgie MeSH
- rotátorová manžeta * chirurgie MeSH
- šicí techniky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Osteoarthritis is the most common type of degenerative joint disease and affects millions of people. In this paper, we propose a non-obtrusive and straightforward method to assess the progression of osteoarthritis. In standard medicine praxis, osteoarthritis is observed with X-rays. In this study, we use widely available wearable sensors with gyroscopes to make the observation. Two novel methods are proposed for gyroscope data processing. A small-scale study has shown that these methods can be used to monitor osteoarthritis's progression, and to differentiate between healthy subjects and subjects with femoroacetabular impingement syndrome.
Introduction: The plica is a residual septum that divides the knee into three compartments: supra, medial, and lateral. Although anatomically suprapatellar plica of the knee is common, it rarely causes symptoms. Thickening of suprapatellar plica may present as anterior knee pain with or without mechanical symptoms. The suprapatellar plica may be a cause to be missed as a cause to look for anterior knee pain. Case Presentation: 33-years-old woman presented with recurring anterior knee pain. A non-specific patellofemoral pain was concluded as initial diagnosis, but conservative treatment failed to relieve the pain. During exploratory arthroscopic examination, a shallow suprapatellar cavity with folded synovium with central perforation was found. Plica excision was done with no complication. After 10 days, the patient has significant improvement and after one month the patient walked uneventfully. Conclusion: Suprapatellar plica is the most common arthroscopic findings compared to other type of plica. Because the presence of suprapatellar plica does not always depict suprapatellar plica syndrome, it is a cause to be looked for during arthroscopy on anterior knee pain. The complete type of it, especially without perforation, appears only as shallow suprapatellar cavity, that the surgeon should be aware of.
- MeSH
- artroskopie metody MeSH
- dospělí MeSH
- koleno patologie MeSH
- lidé MeSH
- muskuloskeletální bolest etiologie MeSH
- neúspěšná terapie MeSH
- patela patologie MeSH
- patelofemorální syndrom * diagnóza patologie MeSH
- synovitida * chirurgie diagnostické zobrazování patofyziologie patologie terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
