The aim of this study was to evaluate the effect of extracorporal shock wave therapy (ESWT) in tennis elbow and painful heel. Nineteen patients with tennis elbow and 44 patients with painful heel in which conservative treatment had failed underwent ESWT. Both groups received 3000 shock waves of 0.12 mJ/mm2 three times at weekly intervals. After a follow-up of 5 and 6 months respectively, pain measured on a visual analogue scale (VAS) decreased significantly in both groups. The success rate (excellent and good results) was 63% in tennis elbows and 70% in painful heels. ESWT seems to be a useful conservative alternative in the treatment of both conditions.
A patient with a large intra-articular osteochondroma of the posterior cavity of the knee joint is presented. Preoperative imaging included radiographs and magnetic resonance imaging, which revealed a completely intra-articular, locally expanding, mineralised mass in the intercondylar tunnel and posterior joint cavity. Flexion was limited to 70 deg. The osteochondroma was removed from a posterior approach. Gross and histologic pictures are presented, and the origin and pathogenesis of the tumour are discussed. After removal, the clinical course was benign. Full flexion was regained within 2 months. At the 2-year follow-up, no signs of recurrence were evident on radiographs and magnetic resonance imaging.
Extracorporeal shock wave therapy may be an alternative treatment of calcifying tendinitis of the shoulder. Both treatment protocols gave equivalent results.
Avulsion of the distal biceps tendon is a clear indication of operative therapy. Different techniques have been described. From 10/97 till 4/02 we have treated 25 patients with avulsion of the distal biceps tendon by anatomic reinsertion at the radial tuberosity with suture anchors by using a limited anterior approach. 24 patients underwent a clinical follow-up of at least 3 months, the average follow-up was 15.8 months. All patients were men with a mean age of 46 years (32-64 years). Surgery was performed within 9 days (1-28 days) after trauma. No wound healing complication was observed. 2-3 suture anchors have been used in each patient. After 3 months, most patients reached a free range of motion and full strength with unlimited recreational and professional activity. In three cases (12.5 %) a heterotopic ossification occurred, two of them (8.3 %) underwent surgical revision. In one case (4.2 %) we observed a rerupture after 6 weeks. 6 patients (12.5 %) described an intermittent disturbance of sensitivity in their radial forearm, in two cases (8.3 %) the lack of sensitivity persisted. Each patient would choose the same procedure in case of injury.
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