ABSTRACT
Background: Optimal relief of pain after knee arthroscopy is essential for early rehabilitation and mobilisation and to minimise postoperative morbidity. This study's aim was to assess dexmedetomidine as an additive to intra-articular (IA) bupivacaine in terms of analgesic duration and postoperative rescue analgesic consumption following arthroscopic knee surgery. Methods: A total of 70 patients, ASA physical status I and II, undergoing knee arthroscopy under general anaesthesia were enrolled in this double-blinded randomised controlled study, after Pan African Clinical Trial Registry (PACTR201507001048242) approval was obtained. Patients were randomly assigned into two groups; the bupivacaine group (B) received IA 19 ml bupivacaine 0.5% + 1 ml normal saline, bupivacaine dexmedetomidine group (BD) received IA injection of 19 ml bupivacaine 0.5% + dexmedetomidine 100 µg (1 ml). Postoperative visual analogue pain score (VAS), duration of analgesia and postoperative analgesic requirement were assessed. Results: VAS scores at rest and on mobilisation were significantly lower in the BD group at 4 h, 6 h and 8 h postoperatively in comparison with group B (p < 0.05). VAS scores were comparable between studied groups during the first 2 h, and at 12 h and 24 h postoperatively. Duration of analgesia was significantly longer in group BD (458.9 ± 93.5 min) than in the B group (229.1 ± 83.7 min) (p < 0.05). Postoperative analgesic consumption was lowered in the BD group compared with the B group (p < 0.05). Conclusions: Adding dexmedetomidine to IA bupivacaine after knee arthroscopy prolongs analgesic duration and decreases postoperative analgesic requirement
Subject(s)
Arthroscopy , Dexmedetomidine , Egypt , Intra-Articular Fractures , Pain, Postoperative , PatientsABSTRACT
Background: Many patients present to the orthopaedic surgeon with complaints of knee pain. In many such cases making a diagnosis based on clinical examination is often difficulty and frequently inaccurate. This study sought to document the common findings at knee arthroscopy and how they compare with clinical impressions. Methods: A cross-sectional study of 34 patients undergoing diagnostic knee arthroscopy with undetermined diagnosis was conducted at Mulago Hospital. The preoperative clinical provisional diagnosis and the findings at arthroscopy were documented; compared and analysed. Results: The commonest clinical diagnosis was medial meniscal tear (21); while the most frequentinding at arthroscopy was osteochondral lesions (27). The highest correlations between clinical impressions and arthroscopic findings were in ACL tears and osteoarthritis. The overall accuracy of clinical examination was 87.2.Conclusion: Clinical examination is a useful tool in diagnosing knee pathologies. In Mulago; the accuracy of the clinical impressions as proved at arthroscopy is high
Subject(s)
Arthroscopy , Bread , Knee , OrthopedicsABSTRACT
Purpose: To evaluate the results of early arthroscopic release in the patients of stiff shoulder Methods: Twenty patients of stiff shoulder; who had symptoms for at least three months and failed to improve with steroid injections and physical therapy of 6 weeks duration; underwent arthroscopic release. The average time between onset of symptoms and the time of surgery was 4 months and 2 weeks. The functional outcome was evaluated using ASES and Constant and Murley scoring systems. Results: All the patients showed significant improvement in the range of motion and relief of pain by end of three months following the procedure. At 12 months; mean improvement in ASES score is 38 points and Constant and Murley score is 4O.5 points. All patients returned to work by 3-5 months (average -4.5 months). Conclusion: Early arthroscopic release showed promising results with reliable increase in range of motion; early relief of symptoms and consequent early return to work. So it is highly recommended in properly selected patients. Level of evidence: Level IV
Subject(s)
Arthroscopy , Shoulder Pain/diagnosis , Shoulder Pain/surgeryABSTRACT
Partial thickness of rotator cuff tears is considered as a common cause of shoulder disability. Various techniques for arthroscopic repair of partial thickness tear of rotator cuff have been reported in the literature. These techniques have addressed the articular side partial thickness cuff tear. We present an arthroscopic repair of partial thickness tear of rotator cuff involving both articular and bursal surfaces without converting into a full thickness tear. Each side of the tear was repaired with suture anchors separately
Subject(s)
Arthroscopy , Case Reports , Rotator Cuff , ShoulderABSTRACT
Notre travail avait pour objectif d'analyser l'aspect diagnostic; therapeutique et l'evolution fonctionnelle post therapeutique des lesions meniscales par arthroscopie chez le footballeur. Il s'agit d'une etude retrospective qui a porte sur un effectif de 22 footballeurs des equipes de 1 ere et 2eme division de la FIF de janvier 1994 a decembre 2002; ayant eu une lesion meniscale. Au plan du diagnostic clinique; la douleur etait le signe le plus frequent (38;64pour cent) suivi des signes de la serie meniscale (20;45pour cent). La plupart des joueurs etaient vus apres un mois voire plus de six mois (72;75pour cent). Le genou droit est le genou le plus atteint (68;18pour cent). L'examen clinique a suffi pour poser le diagnostic. Le menisque interne est le menisque le plus atteint. Nous avons une dominante de lesions du cartilage articulaire a type de chondrite pour les lesions associees. L'hospitalisation a ete de 24 h au plus dans 86;36pour cent des cas. Il n'y a pas eu de complications per operatoire et post operatoire. Le resultat fonctionnel est satisfaisant confirmant ainsi les avantages indeniables de l'arthroscopie par rapport a l'arthrotomie