Hip arthroscopy a report of the early work of Assiut University Hospital

Hip arthroscopy is relatively a new advancement in the field of arthroscopy in Egypt. The purpose of this work is to report our early work on diagnostic and therapeutic hip arthroscopy. Hip arthroscopy was performed in six patients. Four were males, and two females. The age ranged from 15 - 56 years. Four cases had chronic unexplained hip pain after exhausting the non-invasive investigations, one had chronic pain with a previous history ofpyogenic arthritis, and one case had a loose body. The procedure was performed on traction table under the control of fluoroscopy, using the regular 4 mm. scope, and instruments that are used in Knee arthroscopy. in the case with a loose body it was extracted, and the case with previous history of pyogenie arthritis intra-articular adhesions was found and excised. In the other four cases arthroscopic partial synovectomy was done and the histological examination of the synovial membrane biopsy revealed early tuberculous arthritis in two cases, mono-articular rheumatoid arthritis in one case, and chronic non-specific arthritis in the last case. The adverse events were a pudendal nerve injury in one case, and entrapment of the suction tube in another case. Hip arthroscopy proved to be a useful procedure for diagnosis of hip problems, and for therapeutic procedures as loose body removal, and partial synovectomy

Comparative study between patellar tendon, and hamstring autografts in arthroscopic anterior cruciate ligament reconstruction

The patellar tendon [PT] and the semitendinosus and gracilis [STG] currently are the most common types of grafts used for anterior cruciate [ACL] reconstruction. The aim of this work is to compare the results of reconstruction using the two graft types. Between April 2000,and March 2003, fifty six cases with ACL injury were diagnosed and treated in the arthroscopy and sport injuries unit in Assiut University hospital using Quardrupled semitendinosus and gracilis tendon [STG]. All patients were men with average age 28.4 years: ranged 18-42 years''. Out of these 56 cases, the results of 11 case were deducted because of loss of follow up in 6 cases and due to combined posterolateral corner instability in the other 5 cases. The follow up for this group ranged from 19 months to 35 months [average 23.3 months]. The remaining 45 cases in this group were compared to a group of the same number [45], operated in the same unit between March 1997 and October 2000 but using the patellar tendon autograft arthroscopically with average follow up 24 months [range 9-42 months], and they were all men except one . The rehabilitation program was standard and accelerated in both groups. Both groups were evaluated using the Lysholm Knee score and the International Knee Documentation Committee [IKDC] scores. The Lysholm evaluation showed excellent or good result in 89% of PT group and in 91.2% of the STG group with no statistically significant difference. The IKDC evaluation showed normal or nearly normal results in 89.3% of PT group and in 95.7% of the STG group. No difference was found between the two groups concerning the activity level and return to moderate or strenuous activity. Patello- Femoral crepitus, anterior knee pain and harvest site tenderness were more among the PT group. The extension loss and thigh atrophy were also more frequent in the PT group but the difference was not statistically significant [P-value]. Radiological enlargement of the bone tunnels was more prominent with the STG group although not affecting the final IKDC evaluation and has no clinical impact on the objective or subjective stability. In ACL reconstruction both the autogenous PT and STG grafts provide biomechanically excellent graft material but the STG with recent improvement in the fixation technique has several advantages over the PT graft