ABSTRACT
The management of avascular necrosis of the capitellum of the adolescent elbow continues to be a dilemma. This article is a critical retrospective analysis of 12 pediatric patients (mean age at surgery 14.5 years) who underwent arthroscopic debridement alone followed by early range of motion. Follow-up at a mean of 3.2 years (range, 2.0 to 5.7 years) indicated that the average flexion contracture improved from 23 degrees preoperatively to 10 degrees postoperatively. All patients had remodeling of the capitellum by plain radiographs; however, five patients had associated enlargement of the radial head. Eleven patients had minimal mechanical symptoms after the procedure and were highly satisfied. One patient had substantial enlargement of the radial head with continued loss of supination and mechanical symptoms requiring radial head resection 2 years after the index procedure. Five patients had a triangular avulsion fragment present off the lateral capsule. A statistically significant worse subjective outcome was associated with the presence of this fragment (P < .005). There were no complications.
Subject(s)
Debridement/methods , Elbow Joint , Endoscopy , Osteochondritis Dissecans/surgery , Adolescent , Arthroscopy , Child , Elbow Joint/physiopathology , Female , Humans , Joint Loose Bodies/physiopathology , Joint Loose Bodies/surgery , Male , Osteochondritis Dissecans/physiopathology , Range of Motion, Articular , Retrospective Studies , Treatment OutcomeABSTRACT
Hip arthroscopy is far less invasive than standard open arthrotomy and offers unparalleled visualization of the acetabulum and femoral head. Diagnostic arthroscopy is becoming increasingly accepted as therapeutic options are still evolving. We report the case of the arthroscopic removal of a .44 caliber bullet from the femoral head of a 45-year-old man. The procedure afforded the opportunity to thoroughly irrigate the joint, debride the articular surface, and remove several loose bodies.
Subject(s)
Endoscopy , Femur Head/surgery , Wounds, Gunshot/surgery , Arthroscopy , Humans , Male , Middle AgedABSTRACT
This case is a report of arthroscopically diagnosed synovial chondromatosis and pigmented villonodular synovitis in the same elbow. A literature review found no prior reports of an association of these entities. Arthroscopy appears to be effective in the management of pigmented villonodular synovitis and synovial chondromatosis in the elbow.
