Objectives: The authors evaluate the learning of the videoarthroscopic technique, using the video surgery simulator SAM® (Shoulder Arthroscopy Model). Methods: Twenty medical residents in Orthepaedics, without prior knowledge of the arthroscopic technique, were evaluated before and after training. The tasks consisted of positioning, in holes that simulated portals, four surgical threads attached to an anchor placed in the anatomical neck of the humerus in the synthetic model. Time, number of movements, number of attempts, amount of errors and comparison between the two phases of training before and after - were observed and noted. Results: The data was submitted to statistical analysis, and a significant difference was found in the comparison of the variables before and after the training. Conclusion: The result of this study enables us to conclude that training in the videoarthroscopic technique using the video surgery simulator SAM enables the surgeon to execute essential tasks involved in these techniques, in less time, making less mistakes, and developing the ability to deal better with the videoarthrocopic image.
Although thromboembolic phenomena are frequent complications in lower-limb surgery, there are only two cases of pulmonary thromboembolism following shoulder arthroscopy in the literature. We describe the case of a 76-year-old patient with pulmonary embolism in both lungs after shoulder arthroscopy. No vascular abnormalities were found and no origin for the thrombus was detected. The exact cause of the thromboembolism remains unknown.
Bioabsorbable implants are very frequently used to treat rotator cuff and shoulder labrum injuries. Many researchers have observed small areas of osteolysis after treating pathological conditions of the shoulder using bioabsorbable anchors. Biological and mechanical theories have been put forward to account for the osteolysis caused by these materials. The case of a patient who was simultaneously treated for a rotator cuff lesion using the double-row technique and a Bankart lesion using bioabsorbable PLLA anchors and Fiber Wire®, and developed extensive osteolysis of the anatomical neck of the humerus, is described. Given that an anchor was used in the glenoid, and this did not present osteolysis, the hypothesis that mechanical factors are important in the etiology of this complication is raised.
To present the arthroscopic surgical technique and the evaluation of the results from this technique for treating elbow stiffness. Methods: Between April 2007 and January 2010, ten elbows of ten patients with elbow stiffness underwent arthroscopic treatment to release the range of motion. The minimum follow-up was 11 months, with an average of 27 months. All the patients were male and their average age was 32.8 years (ranging from 22 to 48 years). After the arthroscopic treatment, they were followed up weekly in the first month and every three months thereafter. The clinical evaluation was made using the criteria of the University of California at Los Angeles (UCLA). Results: All the patients were satisfied with the results from the arthroscopic treatment. The average UCLA score was 33.8 points. Conclusion: Arthroscopic treatment for elbow stiffness is a minimally invasive surgical technique that was shown to be efficient for treating this complication.
The authors declare that there was no conflict of interest in conducting this work ABSTRACTObjectives: The authors evaluate the learning of the videoarthroscopic technique, using the video surgery simulator SAM ® (Shoulder Arthroscopy Model). Methods: Twenty medical residents in Orthepaedics, without prior knowledge of the arthroscopic technique, were evaluated before and after training. The tasks consisted of positioning, in holes that simulated portals, four surgical threads attached to an anchor placed in the anatomical neck of the humerus in the synthetic model. Time, number of movements, number of attempts, amount of errors and comparison between the two phases of training before and after -were observed and noted. Results: The data was submitted to statistical analysis, and a significant difference was found in the comparison of the variables before and after the training. Conclusion: The result of this study enables us to conclude that training in the videoarthroscopic technique using the video surgery simulator SAM enables the surgeon to execute essential tasks involved in these techniques, in less time, making less mistakes, and developing the ability to deal better with the videoarthrocopic image.
A trombose venosa profunda (TVP) e a embolia pulmonar (EP) são complicações conhecidas das cirurgias ortopédicas dos membros inferiores. Nas artroplastias de joelho e quadril sem profilaxia, os fenômenos tromboembólicos apresentam incidência de 29% a 60% (1,2) . Nas cirurgias artroscópicas do joelho, encontra-se incidência de TVP em até 4% (3) , sendo que a EP sintomática está presente em menos de 1% dos pacientes (4) . Embora existam relatos de tromboembolia pulmonar fatal após artroplastia de ombro (5) , esta complicação é pouco frequente após videoartroscopia desta articulação.O objetivo deste trabalho é relatar o caso de uma paciente que desenvolveu tromboembolia pulmonar bilateral após videoartroscopia de ombro. RELATO DE CASOPaciente NMF, 76 anos, sexo feminino, do lar, apresentava queixa de dor em ombro esquerdo havia um ano. Keywords -Arthroscopy; Shoulder; Pulmonary embolismA dor era como agulhadas, principalmente ao levantar o braço ou em movimentos ocasionais e inesperados. A paciente apresentava diabetes tipo II, hipertensão arterial sistêmica, fazia reposição hormonal e estava acima de seu peso (70kg, 1,60m). Ao exame físico apresentava mobilidade do ombro direito e esquerdo simétrica (150, 45, T 9), força de abdução quatro, força de rotação interna e externa cinco, Speed +, Jobe + Neer +. Ao elevar o braço, fazia um movimento específico para evitar a dor.No exame radiográfico do ombro apresentava acrô-mio tipo II e cistos subcondrais na região do sulco intertubercular do úmero. Na ressonância nuclear magnética (RNM) (Figuras 1 e 2), apresentava líquido subacromial aumentado, lesão do supraespinhal com 2cm de retração, tendão do bíceps alargado com lesões intramurais e artrose acromioclavicular.Nos exames pré-operatórios, a paciente não apresentava anormalidades sanguíneas, função renal preservada e sem hipercolesterolemia.Rev Bras Ortop. 2010;45(3):312-5
Objective: To present the arthroscopic surgical technique and the evaluation of the results from this technique for treating elbow stiffness.
RESUMOOs implantes bioabsorvíveis são usados com muita frequência no tratamento das lesões do manguito rotador e lesões labiais do ombro. Vários pesquisadores observaram áreas pequenas de osteólise depois da utilização destas âncoras bioabsorvíveis no tratamento das patologias do ombro. Teorias biológicas e mecâ-nicas são levantadas para justificar a osteólise causada por estes materiais. É descrito o caso de um paciente que realizou, simultaneamente, sutura do manguito rotador com a técnica de dupla fileira e sutura da lesão de Bankart com âncoras bioabsorvíveis de PLDLA e fios Fiber Wire ® , evoluindo com extensa osteólise do colo anatômico do úmero. Tendo em vista que foi utilizada uma âncora na glenoide e esta não apresentou osteólise, levantase a hipótese de que os fatores mecânicos sejam importantes na etiologia desta complicação.
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