Ultrasound-assisted calcaneoplasty.

PURPOSE: The endoscopic technique for resection of a postero-superior part of calcaneus served as a golden standard during the last 10 years, and it has mostly replaced the open techniques. In an effort to reduce the morbidity and the recovery time, we had introduced the ultrasound-assisted technique. METHODS: In the period of 1 year, 15 patients with the prominent postero-superior part of calcaneus and retrocalcaneal bursitis were operated through the single skin incision using the ultrasound-assisted technique. The prominent part of calcaneus was resected with a bone abrader under the ultrasound control to the point when there was no impingement between Achilles tendon and calcaneus in maximal dorsal flexion. The patients were evaluated preoperatively and postoperatively with the AOFAS score and Ogilvie-Harris score. The strength test of the muscle triceps surae, as well as the proprioceptive test, was also undertaken. RESULTS: Initially, the follow-up was meant to last 6 months, but there were no differences in results between 6 weeks and 3 months postoperatively, so it was concluded that the 3-month follow-up is sufficient and relevant. All 15 patients were available for follow-up. All measured variables significantly improved (AOFAS, Ogilvie-Harris), and all the patients were satisfied with the postoperative result. Only one minor complication occurred: superficial infection. CONCLUSION: The ultrasound-assisted calcaneoplasty enables a precise resection of the postero-superior part of calcaneus and removal of the retrocalcaneal impingement. This method could become clinically relevant as it enables effective treatment of Haglund deformity, and results of this study presented rapid functional recovery. LEVEL OF EVIDENCE: Case series with no comparison group, Level IV.

Influence of arthroscopic lateral release on functional recovery in adolescents with recurrent patellar dislocation.

INTRODUCTION: The aim of this study is to prove the influence of the arthroscopic lateral release on functional recovery in adolescents with recurrent lateral dislocation of patella. MATERIALS AND METHODS: From 2006 to 2009, arthroscopic release of the lateral retinaculum was done on 27 adolescent patients (24 women, 3 men) and 33 knees (in 6 patients on both knees). All of them were active in different sports. The severity of patellar subluxation and dislocation was analysed on X-ray; the Q angle, congruence angle, sulcus angle, patellofemoral angle and height ratio were measured. Functional scores (Lysholm, Kujala, Tegner) were measured preoperatively and postoperatively. The average duration of clinical and X-ray follow-up was 4.5 years (range 3-6 years). RESULTS: The mean age of the patients was 14.56 years (range 11-18 years). There was an average of 4.16 dislocations (range 2-28 dislocations) before surgery. The mean Lysholm score improved from 64 to 95 (p = 0.0002), and the mean Kujala score improved from 66 to 94 (p < 0.0001). Congruence angle and lateral patellofemoral angle improved but without any significant differences. CONCLUSION: Arthroscopic lateral release successfully treats recurrent patellar dislocations in adolescents, influences functional recovery and improves knee function.