Arthroscopic chronic tennis elbow surgery preserves elbow proprioception.

STUDY DESIGN: Retrospective cohort study. INTRODUCTION: A new method of accurately assessing the compromised elbow's proprioception was developed for this postsurgical population using information from previous neurophysiologic proprioception studies of healthy elbows. HYPOTHESIS: This retrospective cohort study investigated the patterns and the degree of proprioceptive impairment and recovery following arthroscopic surgery for chronic lateral epicondylitis. MATERIAL AND METHODS: Participants had undergone arthroscopic elbow surgery two years prior to this study (n=15). Healthy, non-injured volunteers with similar demographics (n=15) served as controls. Both groups were evaluated using quantitative measures of joint position sense for proprioceptive functioning. In order to obtain the most accurate proprioceptive measurements, interindividual interaction and visual input biases were eliminated. Retrospective chart reviews were performed to compare qualitative self-reported measures of proprioceptive function in arthroscopic surgery patients before surgery and two years post-surgery. RESULTS: Active and passive joint repositioning outcome measurements were similar between groups (p>0.05). No significant differences were found among any angles except one: passive joint position sense at 120° of flexion (p<0.05). At this angle, the arthroscopy group showed greater deviation from target angles than the control group. The novel proprioceptive testing method we developed was found to be accurate and reliable. DISCUSSION: Outcomes of arthroscopic treatment of chronic lateral epicondylitis with no decortication yielded outcomes measure similar to those of healthy controls. The sole significant difference was at 120° flexion passive joint repositioning, with a higher negative angular deviation from the target point. We propose that our study results and specific proprioception method may have implications for improving accuracy of future elbow arthroscopy and proprioceptive recovery in this population. LEVEL OF EVIDENCE: II, low-powered prospective randomized trial.

Behçet's disease: treatment of popliteal pseudoaneurysm by an endovascular stent graft implantation.

Behçet's disease is a multisystemic chronic autoimmune process that can be responsible for some vascular lesions, in addition to its typical dermatologic lesions. Arterial pseudoaneurysm formation can be diagnosed in this group of patients and generally surgery is indicated. In this report, we discuss an alternative endovascular intervention and its advantages. An endovascular stent graft was placed in the popliteal artery pseudoaneurysm of a 37-year-old male with Behçet's disease. Early results of this procedure are good thus far. Implantation of an endovascular stent graft, an alternative modality in the treatment of pseudoaneurysms, can result in a shorter hospital stay and a significantly shorter period before returning to normal life. General anesthesia and surgical dissection are avoided, thus diminishing morbidity.

Platelet scintigraphy results of heparin versus streptokinase treatment in acute deep vein thrombosis.

OBJECTIVE: The aim of the study was to document the therapeutic effects and primary recanalization ratios of either streptokinase or heparin in the therapeutic process of deep vein thrombosis (DVT). The results are obtained with the help of platelet scintigraphy. DESIGN: The investigation was planned as a randomized, controlled and prospective study, including 20 patients within two groups. Group I contained 10 patients undergoing IV infusion therapy of unfractionated heparin while Group II contained 10 patients undergoing thrombolytic therapy using streptokinase. After 8 weeks, scintigraphies using Tc-99m HMPAO-labeled thrombocytes were made, and interpreted by two blinded nuclear medicine physicians. The results are compared using Mann-Whitney U- and chi2-tests. RESULTS: No complication leading to interruption of therapy took place. Significantly smaller pathologic thrombocyte accumulations were detected in the streptokinase group. The difference was statistically significant (p = 0.019). CONCLUSION: Although a general clinical improvement had been observed in all patients, the scintigraphic investigation showed that the thrombolytic therapy maintained a better deep vein luminous patency.