Arthroscopic Surgery of the Knee Through Ambulatory Care Unit Under General Anesthesia

PURPOSE: Though many patients who visit ambulatory care unit are performed arthroscopic surgery under local anesthesia, it is difficult to do it in some patients. By selecting the anesthetic agents, educating the patients preoperatively and controlling the pain carefully, we gained the good results in arthroscopic surgery of knee through ambulatory care unit under general anesthesia without complications. MATERIALS AND METHODS: From May 1998 to December 1999, arthroscapic surgery of the knee(menis-cectomy, synovectomy, debridement, loose body removal, bursa excision) was carried out under general anesthesia in 91 patients through ambulatory care unit. The anesthetic agents used in operation were propofol(52 cases) and ethrane(39 cases), 10cc of 0,25% bupivacaine with 1% lidocaine was injected in1o knee joint after arthroscopic surgery for pain control. RESULTS: The pain scores were improved from 12.5 points to 14.7 points at rest, from 9.5 points to 13 point at walking. Postoperatively, there were nausea(2 cases), chest pain(1 case), elevated blood pressure(2 case), redness(3 cases), pain(18 cases), effusion(27 cases). But these symptoms were improved without other complications. CONCLUSION: It is considered one of the comfortable, safe end reliable methods to perform arthroscopic surgery of knee through ambulatory care unit under general anesthesia.

Solitary Osteochondroma of the Clavicle associated with Congenital Muscular Torticollis: A Case Report / 대한정형외과학회잡지

Congenital torticollis, or wryneck, is caused by fibromatosis within the sternocleidomastoid muscle. It may invlove the muscle diffusely, but more often it is localized near the clavicular attachment of the muscle. An osteochondroma is a benign lesion that is often considered to be the most common type of bone tumor and this lesion rarely occurs in the clavicle. We report a case who had congenital muscular torticollis with solitary osteochondroma on the clavicular attachment site of sternocleidomastoid muscle of medial clavicle.

Arthroscopic Debridement in Osteoarthritis of the Knee

A retrospective review was performed in 33 knees of 30 patients who had undergone arthroscopic debridement for degenerative osteoarthritis of the knee. The mean age of the patients at operation was 55 years and the mean follow-up after operation was 15 months. We divided the knec:s into 2 groups; meniscectomy group (23 knees) and non-meniscectomy group (10 knees). The preoperative radiographic findings were divided into 3 groups according to the classification systern by Lotke et al. The postoperative results were evaluated using the nine-point scale by Baumgaertner et al. Our study was conducted to: 1) assess the overall efficacy of arthroscopic debridement, 2) compare the results between the. Meniscectomy group and nonmeniscectomy group, and 3) identify the relationship between the preoperative radiographic findings and out- come at the final follow-up time. Overall excellent or good results were ac.hieved in 22 knees (67%) and the preoperative radiographic findings correlated with the outcome at the final follow-up time. But the results in the meniscectomy and non-meniscectomy poups showed no significant differences statistically. We believe that arthroscopic debridement is an effective option of treatments for mild I:o moderate degenerative arthritis of the knee after failure of conservative measures.

Surgical Treatment of Intraarticular Calcaneal Fractures / 대한정형외과학회잡지

The management of fractures of os calcis remains highly controversial. The fractures involving subtalar joint may cause serious and persistent disabilities. Recently, the computed tomography (CT) scan has been shown to he superior in evaluating the intraarticular fractures of calcaneus and the most widely used classification is based on the number of fragments especially seen on. Although the classification of calcaneal fractures hy CT, tongue type and joint depression type fractures hy plain radiographic views have been commonly used. Generally, closed reduction and axial fixation with metallic pin for tongue type fractures and open reduction and internal fixation for joint depression type fractures have been performed. The authors did so. The 13 fractures were tongue types and 17 fractures were joint depression types. The intraarticular calcaneal fractures of 30 feet in 26 patients who were treated at Our Lady of Mercy Hospital were analyzed in clinical and radiological aspects from Mar.1991 to Apr.1996. The results were as follows: 1. Of 30 cases, 16 fractures were treated with closed reduction and pinning, and 14 fractures were treated with open reduction and internal fixation. 2. The preoperative, postoperative and the last follow-up average Bohlers angle were 6.0, 21.0 and 20.5 respectively. 3. The preoperative, postoperative and the last follow-up average Gissanes angle was 106, 129 and 126 respectively. 4. Based on assessment of the criteria of Salama et al 19), excellent results were 5, good results were 14, fair results were 6 and poor results were 5. 5. All the five cases of poor results were tongue type fractures and they were treated with closed reduction and axial pinning. 6. Of 7 fractures using autogenous iliac bone graft, 6 fractures were good, I fracture was fair and there was no poor results. Therefore, open reduction and internal fixation for joint depression type calcaneal fractures was thought to be a good method of treatment. But we must consider whether axial fixation with metallic pin for tongue type calcaneal fractures will be a good method of treatment.

Radial styloid process fractures associated with scapholunate dissociation / 대한정형외과학회잡지

No abstract available.