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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 82 - 82
1 Mar 2010
Azcárate AV Morandé SC Gasque GM Nin JV
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Introduction and Objectives: We present the final results of a prospective study using a platelet enriched gel in ACL surgery with a bone-tendon-bone allograft. It was our aim to assess whether the use of a platelet enriched gel had beneficial effects in ACL surgery using a bone-tendon-bone allograft with respect to pain, inflammation and clinical results.

Materials and Methods: This was a prospective, randomized, study with alternate selection in 100 patients. There was a control group without gel (50 patients) and a gel group (50 patients) with platelet gel; both groups were homogeneous in both age and sex. The same anesthesia, surgery and analgesia protocol was used in all cases and hospital discharge was 24–48 hours postoperatively. Pain was assessed using a Visual Analog Scale (VAS) and inflammation with two patellar perimeters measured preoperatively and postoperatively (24 hours) and blood analysis with PCR was performed at 24 hours and 7 days. Clinical results were assessed with IKDC and a radiological double-blind study was performed by an independent radiologist using simple X-rays and Magnetic Resonance Imaging at 6 months.

Results: The groups were homogeneous as far as surgical techniques used. No significant differences were found between both groups (p> 0.05) either in inflammation or pain scale.

Discussion and Conclusions: With the platelet harvesting technique we used, the use of platelet enriched gel in ACL surgery with bone-tendon-bone allograft does not seem to have a beneficial effect on inflammatory or analytical parameters, nor on clinical results.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 86 - 86
1 Mar 2010
Morandé SC Garayoa SA Azcarate AV
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Introduction and Objectives: Carpal tunnel syndrome (CTS) is the most frequent compressive neuropathy, it is seen in 1% of the general population. It mainly affects women between 40 and 60 years of age, and it is frequently bilateral. There are a variety of surgical techniques for its treatment, both open and endoscopic. The aim of this study is to compare the efficacy of the mini-incision and endoscopic techniques in the relief of symptoms and resumption of daily living activities; to assess risks and complications; and to determine the efficiency of each technique.

Materials and Methods: We compared 2 groups of 58 individuals, with idiopathic CTS, with a minimum 2 year follow-up The patients in group 1 were operated endoscopically, those in group 2 were operated using a minimally invasive technique; in both cases the median nerve was anesthetized. We described both surgical techniques. We applied a modified DASH test.

Results: There were no immediate or late complications or reoperations in any of the patients in either group. In group II 20% of the patients reported discomfort at the site of the scar on their first follow-up exam, this was not present 1 year after surgery. There was a slight subjective loss of force in 5% of the patients, with no differences between groups. The mean time of return to work was 21 days in both groups. All patients reported that they were satisfied with the results.

Discussion and Conclusions: Both techniques leave a minimal scar and have little morbidity. Endoscopic surgery requires a greater learning curve and has greater potential risks. The greater economic cost of this technique and the operating room time it requires lead us to prefer the use of the mini-incision technique for the treatment of TCS.