RESUMEN
The aim of this study was to investigate the outcomes and complications after posterior ankle arthroscopy for the treatment of posterior ankle impingement syndrome, in a local population with a single surgeon series. Two-portal posterior ankle or hindfoot arthroscopy is an alternative option to open surgery in cases of posterior ankle impingement, that showed similar results but with less morbidity and faster recovery. There has been increasing interest in minimally invasive surgical techniques. Indications include extra- and intra-articular conditions and range from bony, cartilaginous to soft tissue pathology. Posterior ankle arthroscopy has been shown to be a good option in cases that are refractory to a period of conservative therapy. Posterior ankle arthroscopy also has known complications of sural nerve damage laterally and neurovascular bundle injury medially and also a steep learning curve that has been studied in the context of os trigonum excision. There have been few or no studies on the local Singaporean population and this article seeks to describe the various indications, results, and complications in the local Singaporean population by a single surgeon.Levels of Evidence: Level IV: Case series.
Asunto(s)
Traumatismos del Tobillo , Artropatías , Astrágalo , Humanos , Artroscopía/métodos , Tobillo/cirugía , Articulación del Tobillo/cirugía , Traumatismos del Tobillo/cirugía , Astrágalo/cirugía , Artropatías/cirugíaRESUMEN
BACKGROUND: To date, there is no study comparing outcomes between post-total knee replacement genu recurvatum and fixed flexion. This study aims to provide data that will help in deciding which side to err on when neutral extension is not achieved. METHODS: A prospective cohort study of primary total knee arthroplasties was performed, which compared the 6-month and 2-year clinical outcomes between fixed flexion and genu recurvatum deformities at 6 months. RESULTS: At 6 months, knees in genu recurvatum did better than knees in fixed flexion deformity in terms of knee flexion. However, at 2 years, knees in fixed flexion deformity did better in terms of knee scores and showed better improvement in the degree of deformity. CONCLUSIONS: We conclude that it is better to err on the side of fixed flexion deformity if neutral alignment cannot be achieved.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Artroplastia de Reemplazo de Rodilla/efectos adversos , Articulación de la Rodilla/fisiopatología , Estudios Prospectivos , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
<p><b>INTRODUCTION</b>We conducted a biomechanical study comparing cerclage wiring using a power tool with the traditional manual method.</p><p><b>MATERIALS AND METHODS</b>Our study consisted of 4 experimental arms based on the method of fixation and diameter of wires. The 4 arms were: 1) power tool method using 0.8 mm cerclage wires, 2) power tool method using 1.0 mm cerclage wires, 3) conventional manual method using 0.8 mm cerclage wires, and 4) conventional manual method using 1.0 mm cerclage wires. Synthetic femur bones were employed in our study. Six specimens were prepared for each arm. Each specimen was cut lengthwise and pressure sensors were placed in between. For the power tool method, while maintaining tension, wires were coiled using the Colibri power tool until just before secondary coiling occurred. For the conventional manual method, each specimen was compressed by plier twisting for 10 rounds, while maintaining tension. Cerclaging and data recording was done thrice for each specimen, giving a total of 18 readings per arm. Peak and steady-state forces were recorded.</p><p><b>RESULTS</b>There was no significant difference between the peak forces recorded between the power drill and manual methods. The steady-state forces achieved using the power tool method were significantly higher than that achieved in the manual fixation method (0.8 mm wires: 54.89N vs 27.26N, P = 0.037; 1.0 mm wires: 71.59N vs 39.66N, P = 0.025).</p><p><b>CONCLUSION</b>The power tool method achieved a superior steady-state force of compression across the fracture site for both 0.8 mm and 1 mm wires.</p>