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Aim: The purpose of this study was to evaluate the success and complication rate of endoscopic carpal tunnel release (ECTR) using the Chow technique in a large series of patients. Methods: Between September 1897 and February 2001, 2402 hands in 1698 patients underwent ECTRusing the Chow technique. The mean age of the patients was 51 years (14–96). The diagnosis of CTS was based on clinical symptoms and nerve conduction velocity test. Patients were evaluated by physical examination or interviewed by telephone for the current status of their hands. Patients were asked to report about any symptoms following surgery, including numbness, tingling, night pain, weakness and if present the severity of them. The return to work status was followed in 1156 patients. Results: The average follow-up was 6 years and 10 months (range 4 to 161 months). The average operating time was 8 minutes (ranged 5 to 27). A total of 2284 (95%) hands were completely asymptomatic or had very minor problems after ECTR. There were 26 complications, including perioperative (neurapraxias) and late (failed cases, recurrences, infections) complications. The overall complication rate was 1.1% but no serious complications were occurred in this series. Ninety percent of non-workerñs compensation patients and 60% of workerñs compensation patients return to work within 4 weeks. Conclusions: This study suggests that ECTR for carpal tunnel syndrome is a reliable procedure with a high success rate. Furthermore, the technique was found to be safe and iatrogenic complications can be avoided with meticulous surgical technique.
Aim: The purpose of this study was to evaluate the results of arthroscopic capsular release in patients with primary adhesive capsulitis of the glenohumeral joint. Methods: Twenty-eight shoulders in 27 patients with adhesive capsulitis of the glenohumeral joint were treated with manipulation and arthroscopic capsular release. Their average age was 54.5 years (range, 39–67). During surgery, synovectomy and a combined anterior, posterior and inferior arthroscopic release using electrocautery or laser was performed. Range of motion and evaluation with the Constant score before and after surgery was performed in all patients. Results: The mean follow-up was 32 months (24–63). The mean Constant score significantly improved from 44.6 (28–52) preoperatively to 86.3 (73–52) postoperatively (p<
0.001, paired t-test). Range of motion for all planes significantly improved. Abduction improved from 72° preoperatively to 165° postoperatively; Internal rotation improved from 13° to 60° and external rotation from 10° to 75°. Subjectively all patients had remarkably less pain, and there were no complications. Conclusions: Our study suggest that arthroscopic treatment of primary adhesive capsulitis with capsular release is an effective and reliable method for restoring a painless motion of the glenohumeral joint.
Aim: The aim of this prospective study was to evaluate the results of arthroscopic treatment of chondral and osteochondral lesions of the knee with osteochondral autogenous transplantation (OAT). Methods: Thirty patients with symtomatic cartilage lesions of the femoral condyles were treated with OAT. Inclusion criteria were full thickness femoral condyle defects between 1 and 3 cm in diameter. Grafts were harvested from the superior intercondylar notch and press þt into holes drilled into the defect starting adjacent to the articular cartilage margin. All patients were evaluated both pre and postop with the Lysholm score, IKDC Form and radiological assessment. Second look arthroscopy was offered to all patients independently of their symptoms. Results: The mean follow-up was 44.7 months. The mean Lysholm score signiþcantly improved from 43.6 pre-operatively to 87.5 postoperatively (p<
0.001, paired t-test) with excellent and good results in 25 (83.3%) patients. Using the IKDC assessment 26 (86.6%) of the patients reported their knee as being normal or nearly normal. Repeat arthroscopies have been done in 9 (30%) patients. Seven of these demonstrated complete healing and two partial healing. The histological examination ascertained the presence of viable chondrocytes and normal hyaline cartilage in the completely healed cases. Conclusions: Our study suggest that arthroscopic OAT is an effective method for treating chondral defects of the femoral condyles in selected cases. However, further studies with long-term follow-up are needed to determine if the transplanted area will maintain functional and structural integrity over time.