MyMedR

Fulltext Peroneus quartus and peroneal tendoscopy

Yong CK

Med J Malaysia, 2006 Dec;61 Suppl B:45-7.

This is a report of a case of peroneal subluxation caused by peroneus quartus, a supernumerary muscle in the peroneal muscle group. Peroneus quartus' anatomy and its clinical relevance in lateral ankle pain, swelling and peroneal subluxation are described. It may be accurately diagnosed by peroneal tendoscopy. The technical note of this procedure is also described.

Matched MeSH terms: Arthroscopy/methods*

Fulltext Chronic posterolateral rotatory instability of the knee

Yong CK

Med J Malaysia, 2006 Dec;61 Suppl B:27-31.

PMID: 17605179

Posterolateral corner (PLC) laxity of the knee results in rotatory instability, in association with posterior cruciate ligament (PCL) laxity led to a grossly unstable knee. This is a series of eight patients with chronic PLC and PCL laxity treated with arthroscopic quadriceps tendon PCL reconstruction and extraarticular hamstring PLC reconstruction. Seven cases had high tibial osteotomy to address associated genu varus deformity. With prospective pre- and post-operative assessments, there was a significant improvement in the 2000 International Knee Documentation Committee (IKDC) subjective assessment and knee examination, Lysholm-Gillquist and Tegner activity scores, as well as KT-1000 arthrometry measurement after one year in all knees. Surgical treatment of PLC laxity must address coexisting problems of the PCL and mechanical alignment for a successful outcome.

Matched MeSH terms: Arthroscopy*

Fulltext The incidence of deep venous thrombosis following arthroscopic knee surgery

Ng WM, Chan KY, Lim ABK, Gan EC

Med J Malaysia, 2005 Jul;60 Suppl C:14-6.

PMID: 16381276

A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.

Matched MeSH terms: Arthroscopy/adverse effects*

Fulltext Comparison of intra-articular analgesics for analgesia after arthroscopic knee surgery

Rao SK, Rao PS

Med J Malaysia, 2005 Dec;60(5):560-2.

PMID: 16515105

Post Arthroscopic intra-articular analgesia is a better method to avoid post-operative pain after arthroscopic surgery, thus avoiding the adverse effects of systemic analgesics. In this prospective randomized double blind study conducted on 90 patients, 30 patients in group A received 20 ml of intra-articular saline, 30 patients in Group B received 10 ml of intra-articular saline and 10 ml of 0.25% bupivacaine and 30 patients in Group C received 10 ml of 0.25% bupivacaine, 1 ml (30 mg) of ketorolac and 9 ml of saline intra-articularly. Ambulatory status, duration of analgesia and requirement for supplemented analgesia were compared in these three groups. Patients receiving this intra-articular analgesic combination of bupivacaine and ketorolac required significantly less supplemental postoperative analgesics. This combination significantly prolonged the duration of analgesia. Patients receiving this combination of drugs for intra-articular analgesia ambulated earlier.

Matched MeSH terms: Arthroscopy/adverse effects*

Fulltext Symptomatic intra-articular ganglion cyst of the knee

Aminudin CA, Samsudin OC, Hyzan MY, Hamzaini AH, Zahiah M

Med J Malaysia, 2004 Dec;59 Suppl F:57-9.

PMID: 15941165

We are reporting a case of a patient with a symptomatic intra-articular ganglion of the knee arising from infrapatellar fat pad. Plain radiograph and Magnetic Resonance (MR) images were correlated with arthroscopic examination and histological findings. The cyst was removed and post operatively patient regained full extension.

Matched MeSH terms: Arthroscopy

Fulltext The rusty knee--pigmented villonodular synovitis

Samsudin O, Leong KK, Shukur MH, Tan KK, Ismail S

Med J Malaysia, 2004 Dec;59 Suppl F:54-6.

PMID: 15941164

Pigmented villonodular synovitis (PVNS) is a distinct but rare clinical entity often presents late with a diagnostic difficulty. Its non-specific manifestations require exclusion of several chronic inflammatory disorders and other humorous lesions but all investigations including highly predictive magnetic resonance imaging (MRI) and arthroscopic examination are non-diagnostic demanding confirmatory tissue biopsy. A typical case of such lesion is presented to highlight some potential difficulties.

Matched MeSH terms: Arthroscopy/methods

Fulltext An unusual radiographic presentation of posterior cruciate ligament avulsion fracture

Nizlan MNM, Suhail A, Samsudin OC, Masbah O

Med J Malaysia, 2004 Dec;59 Suppl F:65-8.

PMID: 15941168

A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.

Matched MeSH terms: Arthroscopy

Fulltext Is arthoscopy of the shoulder safe - a study/perspective on arthroscopic subracromial decompression

Loh YC, Trail IA

Med J Malaysia, 2002 Jun;57(2):205-8.

PMID: 24326652

Fourteen fit and healthy patients underwent arthroscopic subacromial decompression (ASD) of shoulder for rotator cuff impingement. Their blood chemistry was analysed pre-operatively, 24 hours post-operatively and 2-3 weeks post-operatively. Levels of haematocrit, sodium, potassium, creatinine and urea were measured. The blood chemistry returned almost to the pre-operative level at 2-3 weeks post-operatively. There was no statistically significant differences found. This study concludes that arthroscopic subacromial decompression is a safe technique when considering the blood parameters despite the haemodilution seen in all patients.

Matched MeSH terms: Arthroscopy

Fulltext Arthroscopy under local anaesthesia

Ramanathan R

Med J Malaysia, 1998 Sep;53 Suppl A:99-101.

PMID: 10968190

We studied 95 patients who underwent knee Arthroscopy under local anaesthesia between JANUARY 1995 till 1997. Materials used were 1% Xylocaine and 0.25% Bupivacaine of 20 mls each combined with midazolam 2 mg and IV pethidine 30 mgm for sedation. The patients were attached to monitors (pulse Oxymeter, ECG and BP and pulse recorders) and blood less field was created using a tornquet. The procedures lasted about 45 minutes. 90 out of 95 patients completed the procedures successfully without any complications. 2 developed respiratory embarrassments and were intubated and ventilated. 3 procedures abandoned and converted to general anaesthesia. The range of procedures done include meniscectomy, meniscal repair, synovial biopsy, debridement for osteoarthrosis, shaving of osteophytes, drilling of cartilage and bones and removal of loose bodies. This study is to show that knee arthroscopy under LA is a safe alternative in hospitals where GA time is limited.

Matched MeSH terms: Arthroscopy*

Fulltext The role of preoperative magnetic resonance imaging in internal derangement of the knee

Zairul-Nizam ZF, Hyzan MY, Gobinder S, Razak MA

Med J Malaysia, 2000 Dec;55(4):433-8.

PMID: 11221154

We attempted to compare the accuracy of our clinical examination and the usage of magnetic resonance imaging (MRI) in evaluating patients suspected of having internal derangement of the knee who were seen in our Orthopaedic clinic. This was done using the findings of arthroscopy as the 'gold standard'. The accuracy of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to 48-65% for clinical examination. We thus propose that MRI examination is an effective first-line investigation for patients with suspected internal knee derangement, especially menisci injuries; allowing arthroscopy to be reserved for patients in whom surgery is truly indicated.

Study site: Orthopedic clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Arthroscopy/standards

Fulltext Diagnostic and operative arthroscopy of the knee: report of 51 consecutive arthroscopies

Rajaram TJ

Med J Malaysia, 1986 Sep;41(3):269-72.

PMID: 3670145

Fifty-one consecutive arthroscopies of the knee were reviewed after an average of eight months follow-up. Thirty-eight patients underwent arthroscopic surgical procedures as well. A meniscus tear was the commonest (68%) primary pathology noted, followed by isolated anterior eructate tears (16%). Excellent/good results were obtained in 80% of arthroscopic partial meniscectomies. Synovial biopsies and loose body removal were all successfully achieved arthroscopically: Arthroscopic knee surgery is a useful and less traumatic technique of obtaining a diagnosis and treating amenable knee lesions compared to open arthrotomy.

Matched MeSH terms: Arthroscopy

Fulltext Diagnosis of meniscal lesions of the knee

Dhillon KS, Doraisamy S, Raveendran K

Med J Malaysia, 1985 Mar;40(1):24-7.

PMID: 3841686

In a prospective study of 50 patients with suspected tear of the meniscus of the knee, the clinical diagnosis, arthrographic and arthroscopic findings were compared at arthro-tomy. The clinical diagnosis was correct in 85%, arthrographic in 54%, and arthroscopy in 91%of the patients.

Matched MeSH terms: Arthroscopy

Unusual case of lipoma arborescens in the subacromial-subdeltoid bursa

Lim MC, See PL, Wang SY, Wee AT, Tee UL

Med J Malaysia, 2018 12;73(6):400-402.

PMID: 30647212

A 38-year-old female presented with a 10-month history of right shoulder pain with impingement symptoms. She was diagnosed on magnetic resonance (MR) imaging to have supraspinatus tendon tear and degenerative changes contributing to subacromial impingement. She also had lipoma arborescens of the subacromial-subdeltoid bursa, an uncommon condition in a particularly rare location. Lipoma arborescens is a benign intra-articular condition characterized by lipomatous proliferation of synovium with replacement of subsynovial tissue by mature adipocytes. It is typically a monoarticular process affecting the knee. Due to the presence of pathognomonic fat, diagnosis is usually straightforward with MR as the preferred imaging modality.

Matched MeSH terms: Arthroscopy

How does geometric change after open-wedge high tibial osteotomy affect anterior cruciate ligament status?

Kim JE, Won S, Jaffar MSA, Lee JI, Kim TW, Lee YS

Knee, 2020 Jun;27(3):940-948.

PMID: 32331827 DOI: 10.1016/j.knee.2020.04.008

BACKGROUND: Open-wedge high tibial osteotomy (OWHTO) produces three- dimensional (3D) geometric changes. Among them, increased posterior tibial slope (PTS), and altered coronal inclination that induces unintended tibial translation may affect anterior cruciate ligament (ACL) status. The purpose of current study was to evaluate the geometric changes following OWHTO, such as increasing PTS and decreasing tibial subluxation, which may affect the status of ACL.

METHODS: From April 2014 to December 2015, a total of 72 knees in 64 patients that underwent OWHTO, second-look arthroscopy, and magnetic resonance imaging (MRI) assessment, were enrolled. Preoperative and postoperative coronal and sagittal translation, joint line orientation angle, the distance between medial femoral notch marginal line and medial tibial spine, and PTS were evaluated. ACL status was arthroscopically graded from grade 1 (best) to 4 (worst). The MRI signal of the graft in three portions (proximal, middle, and distal) was graded from grade 1 (best) to 4 (worst).

RESULTS: High grade (3: partial, and 4: complete rupture) was noted in 28 cases (38.9%) at the second-look arthroscopy compared with 10 cases (13.9%) at index arthroscopy. The MRI signal grade significantly increased at follow up MRI compared with preoperative MRI (P<0.01). An increased signal was commonly noted in the middle and distal portions of the graft.

CONCLUSIONS: Geometric changes after OWHTO were related to ACL deterioration. The ACL was commonly affected at the middle and distal portions and rarely at the proximal portion. There is a possibility of impingement because of the geometric changes.

LEVEL OF EVIDENCE: Level IV.

Matched MeSH terms: Arthroscopy

A Case of Posterior Tibial Nerve Injury After Arthroscopic Calcaneoplasty

Retrouvey H, Silvanathan J, Bleakney RR, Anastakis DJ

J Foot Ankle Surg, 2018 01 05;57(3):587-592.

PMID: 29307741 DOI: 10.1053/j.jfas.2017.10.004

We report the first case of distal posterior tibial nerve injury after arthroscopic calcaneoplasty. A 59-year-old male had undergone right arthroscopic calcaneoplasty to treat retrocalcaneal bursitis secondary to a Haglund's deformity. The patient complained of numbness in his right foot immediately after the procedure. Two years later and after numerous assessments and investigations, a lateral plantar nerve and medial calcaneal nerve lesion was diagnosed. In the operating room, the presence of an iatrogenic lesion to the distal right lateral plantar nerve (neuroma incontinuity involving 20% of the nerve) and the medial calcaneal nerve (complete avulsion) was confirmed. The tarsal tunnel was decompressed, and both the medial and the lateral plantar nerve were neurolyzed under magnification. To the best of our knowledge, our case report is the first to describe iatrogenic posterior tibial nerve injury after arthroscopic calcaneoplasty. It is significant because this complication can hopefully be avoided in the future with careful planning and creation of arthroscopic ports and treated appropriately with early referral to a nerve specialist if the patient's symptoms do not improve within 3 months.

Matched MeSH terms: Arthroscopy/adverse effects*; Arthroscopy/methods

Reverse Wafer Procedure for Ulnar Impaction Syndrome

Ozcelik IB, Jusoh MH, Cavit A

Tech Hand Up Extrem Surg, 2024 Mar 01;28(1):16-18.

PMID: 37702374 DOI: 10.1097/BTH.0000000000000453

Ulnar impaction syndrome occurs when excessive load across the ulnocarpal joints results in pathologic changes, especially over the articular surface of the ulnar head and proximal ulnar corner of the lunate. The 2 main surgical options in ulnar impaction syndrome are ulnar shortening osteotomy and wafer procedure, whether open or arthroscopically, to decompress the ulnocarpal joint load. However, all of these techniques have their shortcomings and drawbacks. The current study demonstrates a novel technique to decompress the ulnocarpal joint load: the "reverse wafer procedure" for ulnar impaction syndrome. In this surgical technique, we resected the proximal ulnar side of the lunate instead of partial resection of the thin wafer of the distal ulnar head dome in the standard wafer procedure. This technique avoids iatrogenic central tear of triangular fibrocartilage and distal radioulnar joint portal arthroscopy, which is technically demanding while preserving the distal radioulnar joint.

Matched MeSH terms: Arthroscopy/methods

Fulltext Congenital rudimentary medial meniscus--report of a case of development arrest of medial meniscus

Aranha A, Nor M

Singapore Med J, 1990 Apr;31(2):189-90.

PMID: 2371587

We present an unusual case, where the medial meniscus does not coincide with the embryological development of the formation of a discoid cartilage. A fairly, careful perusal of English literature since 1945 to date makes us feel that the following case merits recording. The meniscus had a normal anterior horn attached to the intercondylar area, in front of the anterior cruciate ligament. Medially, it was attached to the capsule and the condylar surface of the medial tibial plateau. The posterior horn was rounded, smooth, and floating free of any attachments. It was approximately 2 cms in length, semilunar in shape, and extended posteriorly up to the anterior margin of the medial collateral ligament. The rest of the medial tibial plateau had no other protective covering.

Matched MeSH terms: Arthroscopy

Role of simulation in arthroscopy training

Madan SS, Pai DR

Simul Healthc, 2014 Apr;9(2):127-35.

PMID: 24096921 DOI: 10.1097/SIH.0b013e3182a86165

Arthroscopy uses a completely different skill set compared with open orthopedic surgery. Hitherto, arthroscopy had not been given enough emphasis in the core orthopedic curricula. Simulation has been seen as an excellent way to teach the skills required in arthroscopy. The simulators used for arthroscopy training can be broadly classified into physical simulators such as cadavers, animals, models and box trainers, virtual-reality simulators, and hybrid simulators that combine virtual-reality simulation with physical components that allow real tactile feedback. The advantages and disadvantages of each of these types have been described in this article. The factors that determine skill acquisition using these simulators have been highlighted. In conclusion, simulation seems to be a valuable tool for arthroscopy training, although further studies are needed to state whether this translates into better operative skill on real patients.

Matched MeSH terms: Arthroscopy/education*

Fulltext Cartilage regeneration by chondrogenic induced adult stem cells in osteoarthritic sheep model

Ude CC, Sulaiman SB, Min-Hwei N, Hui-Cheng C, Ahmad J, Yahaya NM, et al.

PLoS One, 2014;9(6):e98770.

PMID: 24911365 DOI: 10.1371/journal.pone.0098770

In this study, Adipose stem cells (ADSC) and bone marrow stem cells (BMSC), multipotent adult cells with the potentials for cartilage regenerations were induced to chondrogenic lineage and used for cartilage regenerations in surgically induced osteoarthritis in sheep model.

Matched MeSH terms: Arthroscopy

Fulltext Defined Daily Dose and Appropriateness of Clinical Application: The Coxibs and Traditional Nonsteroidal Anti-Inflammatory Drugs for Postoperative Orthopaedics Pain Control in a Private Hospital in Malaysia

Bakrin FS, Makmor-Bakry M, Che Hon WH, Faizal SM, Manan MM, Ming LC

Pharmacy (Basel), 2020 Dec 08;8(4).

PMID: 33302438 DOI: 10.3390/pharmacy8040235

INTRODUCTION: Drug utilization of analgesics in a private healthcare setting is useful to examine their prescribing patterns, especially the newer injectable cyclooxygenase (COX)-2 inhibitors (coxibs).

OBJECTIVES: To evaluate the utilization of coxibs and traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) indicated for postoperative orthopaedic pain control using defined daily dose (DDD) and ratio of use density to use rate (UD/UR).

METHOD: A retrospective drug utilization review (DUR) of nonsteroidal anti-inflammatory drugs (NSAIDs) at an inpatient department of a private teaching hospital in Seremban, Malaysia was conducted. Patients' demographic characteristics, medications prescribed, clinical lab results, visual analogue scale (VAS) pain scores and length of hospital stay were documented. Orthopaedic surgeries, namely arthroscopy, reconstructive, and fracture fixation, were included. Stratified random sampling was used to select patients. Data were collected through patients' medical records. The DDD per 100 admissions and the indicator UD/UR were calculated with the World Health Organization's DDD as a benchmark. The inclusion criteria were patients undergoing orthopaedic surgery prescribed with coxibs (celecoxib capsules, etoricoxib tablets, parecoxib injections) and tNSAIDs (dexketoprofen injections, diclofenac sodium tablets). Data were analysed descriptively. This research was approved by the academic institution and the hospital research ethics committee.

RESULT: A total of 195 records of patients who received NSAIDs were randomly selected among 1169 cases. In term of the types of orthopaedic surgery, the ratio of included records for arthroscopy:fracture fixation:reconstructive surgery was 55.4:35.9:8.7. Most of the inpatients had low rates of common comorbidities such as cardiovascular disease as supported by their baseline parameters. The majority were not prescribed with other concomitant prescriptions that could cause drug interaction (74.9%), or gastroprotective agents (77.4%). Overall, DDDs per 100 admissions for all NSAIDs were less than 100, except for parecoxib injections (389.23). The UD/UR for all NSAIDs were less than 100, except for etoricoxib tablets (105.75) and parecoxib injections (108.00).

DISCUSSION: As per guidelines, the majority (96.9%) received other analgesics to ensure a multimodal approach was carried out to control pain. From the UD/UR results, the arthroscopy surgery was probably the most appropriate in terms of NSAID utilization.

CONCLUSION: The prescribing pattern of NSAIDs except parecoxib was appropriate based on adverse effect and concurrent medication profile. The findings of this DUR provide insight for a low-risk patient population at a private specialized teaching hospital on the recommended use of NSAIDs for postoperative orthopaedic pain control.

Matched MeSH terms: Arthroscopy

Displaying publications 1 - 20 of 47 in total