Treatment of an osteoporotic Hoffa fracture.

Two patients with Hoffa fracture of the knee, both suffering from poliomyelitis are reported. Both had unicondylar coronal plane fracture of the medial femoral condyle. The patients were treated with open reduction and screw fixation. Due to poor screw purchase, reoperation was necessary in one patient. The results were satisfactory in both patients.

Review of knee arthroscopy performed under local anesthesia.

Local anesthesia for knee arthroscopy is a well documented procedure with diagnostic and therapeutic role. Numerous therapeutic procedures including partial menisectomy, meniscus repair, abrasion chondroplasy, synovectomy, loose body removal can be performed safely and comfortably. Appropriate case selection, anesthetic strategy and technical expertise are the key to smooth and successful surgery.

The surgical outcome of immediate arthroscopic Bankart repair for first time anterior shoulder dislocation in young active patients.

This study evaluated the surgical outcomes of young active patients with arthroscopic Bankart repair within 1 month after first-time anterior shoulder dislocation. From July 2002-October 2004, patients presented with first-time traumatic anterior shoulder dislocation and treated with arthroscopic stabilization within 1 month of injury were retrospectively reviewed. Magnetic resonance imaging and computed tomography were performed before the operation in all cases. Cases with contralateral shoulder multidirectional instability or glenoid bone loss of more than 30% on preoperative computed tomography on the injury side were excluded. All patients were treated with arthroscopic Bankart repair, using metallic suture anchors or soft tissue bio-absorbable anchors by a same group of surgeons and followed the same rehabilitation protocol. Recurrence, instability signs, range of motion, WOSI score, Rowe score and complications were assessed. Thirty-eight patients were recruited: the average age was 21 (16-30). All patients had definite trauma history. Radiologically, all patients had Bankart/Hill-Sachs lesion. All the operations were done within 1 month after injury (6-25 days). The average hospital stay was 1.2 days (1-5 days). The average follow-up was 28 months (24-48 months). There were two cases of posttraumatic re-dislocation (5.2%). The average external rotation lag was 5 degrees (0-15) in 90 degrees shoulder abduction when compared with contralateral side. 95% of patients had excellent or good Rowe score. The average WOSI score was 83%. There was one case of transient ulnar nerve palsy and one case of superficial wound infection. This study concluded that immediate arthroscopic Bankart repair with an accelerated rehabilitation program is an effective and safe technique for treating young active patients with first-time traumatic anterior shoulder dislocation.