Arthroscopic bullet extraction from the hip in the lateral decubitus position.

Hip arthroscopy was first described in 1931 by Burman, and in recent years the applications have extended to labral surgery, osteochondroplasty, and a variety of other procedures. Hip arthroscopy may also be employed to extract loose or foreign bodies from the hip, and may be associated with more rapid recovery than an open procedure. We present a case of arthroscopic bullet removal from the hip in a 24-year-old man.

Discoid lateral meniscus: diagnosis and results of arthroscopic treatment.

We evaluated the results of arthroscopic meniscectomy in patients with discoid lateral menisci of the knee. Discoid lateral menisci were detected in 308 patients, of whom 197 (124 males, 73 females; mean age 34.5 years, range 6-67) were clinically, radiologically, and arthroscopically found to be symptomatic and underwent partial meniscectomy. The average period between injury and operation was 13.2 months (range 6-52). The results were evaluated according to the Ikeuchi and Lysholm criteria. The mean follow-up was 57.8 months (range 24-138). The most common complaints were pain (66%) and joint line tenderness (61%). Widening of lateral joint space was the most common radiological finding (25%). The confirmation of diagnosis by magnetic resonance imaging was not congruent with arthroscopic results for some patients (31%). According to the Ikeuchi criteria, the results were excellent in 110 patients (56%), good in 53 (27%), fair in 26 (13%), and poor in 8 (4%). On the other hand, according to the Lysholm scale, the results were excellent in 119 patients (60%), good in 57 patients (29%), fair in 16 (8%), and poor in five (3%) patients. Clinical and radiological findings were not congruent with arthroscopic results for all patients. Therefore arthroscopic evaluation has more value for discoid lateral meniscus. Moreover, tear pattern and degenerative changes in lateral compartment may effect outcomes without relation to the type of surgery. We concluded that arthroscopic partial meniscectomy should be the preferred method for the surgical treatment for discoid lateral menisci, due to it's minimal traumatic effects, possibilities of early mobilization, a lower complication rate, and easy and short rehabilitation period.

Arthroscopy-assisted operative management of tibial plateau fractures.

This retrospective review evaluated the results of arthroscopy-assisted surgery for tibial plateau fractures in 45 patients with closed tibial plateau fractures. The fracture involved articular depression in 27 patients in whom lifting and bone grafting with autogenous corticocancellous iliac bone graft was required. In 23 patients there were also meniscal lesions, which were treated by partial resection in 16 and repaired in 7. Internal fixation was performed using screws in 36 knees and plate in 10 knees. Radiological results were evaluated according to the Resnic-Niwoyama criteria; mean follow-up was 36 months (range 14-72). There was no intraoperative complication in the series, but postoperatively there were one infection and one loss of correction. Results were satisfactory in 89% of cases, according the Rasmussen criteria. Arthroscopy is thus an excellent and minimally invasive method for assessment and treatment of tibial plateau fractures. The advantages are complete and anatomical reduction in the fractured articular surface and evaluation of other concomitant intra-articular pathology and entails only little additional morbidity, especially compared to arthrotomy.

[Arthroscopic meniscal repair with the use of conventional suturing materials]. / Konvansiyonel sütür materyalleri ile yapilan artroskopik menisküs tamirleri.

OBJECTIVES: We evaluated the mid-term clinical results of patients who underwent arthroscopic meniscal repair. METHODS: Sixty-one patients (43 males, 18 females; mean age 26.9 years; range 17 to 42 years) underwent meniscal repair using conventional suture techniques for unstable vertical longitudinal meniscal tears in the peripheral vascular zone, measuring more than 1 cm. All patients had an adequate follow-up. The involved side was right in 34 patients, and left in 27 patients. The localization was medial in 36 tears, and lateral in 25 tears. Arthroscopic meniscal repair technique was inside-out in 47 cases, and outside-in in 14 cases. Associated lesions were anterior cruciate ligament tears in 24 patients, and tibial plateau fractures in five patients, all of which were treated simultaneously. The patients were evaluated with the use of a modified Marshall knee scoring system. The mean follow-up was 44 months (range 12 to 72 months). RESULTS: The results were excellent in 41 patients, good in 14 patients, fair in three patients, and poor in three patients. Limited range of motion seen in four knees postoperatively was successfully treated by arthroscopic release and an intense rehabilitation program. All patients returned to sports activities within a mean of six months. Second-look arthroscopy performed in 20 patients after a mean of six months postoperatively showed complete healing of the involved menisci in 17 patients. CONCLUSION: Meniscal tears occurring in the peripheral vascular zone without any injury to the meniscal body can be successfully repaired using conventional suture techniques.