This study compares the endoscopic carpal tunnel release with the conventional open technique with respect to short and long-term improvements of functional and clinical outcomes.

We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Thirty-seven patients underwent the endoscopic method according to Chow and 35 were assigned to the open method. Improvement in symptoms, severity and functionality were evaluated shortly preoperatively (at two days, one week and two weeks) and one year after using the Symptom Severity Scale, Symptom Severity Status and DASH questionnaire. Changes in clinical outcomes (grip strength, key pinch and two-point discrimination test) were evaluated one year postoperatively. Complications were also assessed.

Both groups showed similar improvement in all but one outcome one year after the release; increase in grip strength was significantly higher for the endoscopic group. The endoscopic method was also associated with a significantly faster short-term improvement. Separate analysis of the questionnaire components referring to pain reveals that the delay of improvement in the open group is due to the persistence of pain for a longer period. Paresthesias and numbness decrease shortly after the operation with comparable rates for both groups.

Objective: The aim of this study was to present a review of intraarticular ganglia of the knee. Materials: Cases of intraarticular ganglia of the knee were isolated from a group of 1405 consecutive patients referred for MR imaging examinations of the knee. Diagnoses were conþrmed by means of a histological study after arthroscopic or surgical excision. Results: 14 pts (10 men and four women) had intraarticular ganglia of the knee. 3 ganglia were found in Hoffañs fat pad, 5 were associated with the anterior cruciate ligament, 5 were associated with the posterior cruciate ligament, and one was associated with the ligament of Humphrey. Pain was the most common complaint. Symptoms grew worse with activity in 9 pts. There was associated limited knee extension in 4 cases and limited knee ßexion in 3 cases. One of the three pts with ganglia in Hoffañs fat pad had a palpable mass on physical examination. The cysts were ßuidþlled, with low T1-w and high T2-w signal intensity. 10 cases demonstrated peripheral thin rim enhancement on fat-suppressed contrast-enhanced T1-w SE images. Grad echo sequences were useful in excluding areas of hemosiderin. Conclusion: Intraarticular ganglia of the knee have been found to occur commonly, with a prevalence of 1.% in the present series. The clinical presentation of intra-articular ganglion cyst is varied according to its intra-articular location. Radiologists should be aware of this entity and its defferential diagnoses. The contrast-enhanced sequences allow intraarticular ganglia to be distinguished from PVNS, synovial hemangioma and synovial sarcoma.

Introduction: Osteochondral lesions of the talus may cause persistent joint pain requiring surgical treatment, which today can be performed arthroscopically. The purpose of this study is to evaluate the effectiveness of arthroscopic treatment of these lesions.

Material and Method: Seventeen patients (7 males and 10 females) underwent ankle arthroscopy from 1998 through June 2002 for treatment of osteochondral lesions of the talus. Their age ranged from 11 – 68 years. The right talus was affected in 12 and the left in 5 patients. All but one had a history of previous trauma, for which they had been treated conservatively for at least 6 months.

Bone scanning, CT and MRI were performed for lesion staging according to Brent and Harty. One patient was stage I, 2 were stage II, 7 were stage III, and 7 were stage IV.

The patients underwent ankle arthroscopy without use of a distractor. Inspection of the joint was followed by shaving and debridement of the lesion with or without drilling.

Results: Follow-up had a mean duration of 15 months (range 8 – 24 months). Outcome was evaluated with the Ogilvie-Harris score for pain, swelling, stiffness, limp and patient activity level. All patients had excellent or good results. In all cases there was a reduction in lesion size.

Conclusions: Arthroscopy is effective for treatment of osteochondral lesions of the talus. It causes less morbidity than open surgery and patients are able to follow an early mobilization and rehabilitation protocol. However, specialized surgical tools, as well as an in-depth knowledge of joint anatomy are required to avoid iatrogenic damage.