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Temporomandibular Joint Arthrocentesis: A Simplified Treatment for Severe, Limited Mouth Opening
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Arthrocentesis has less potential risks than arthroscopic surgery,3,4 but until this study was performed, it was not clear that similar results could be obtained using lavage alone. Subsequent studies5–8 have shown that arthocentesis can reduce pain from internal derangement and can offer improvements in maximal mouth opening. Arthrocentesis does not require specialist training in arthroscopic techniques, rendering it widely available to all maxillofacial surgeons who treat TMJ patients but who lack the training or confidence to undertake TMJ arthroscopy.9 A Cochrane review10 has shown that outcomes from both techniques are comparable but highlight the lack of quality evidence in this area.
Telescopes for Inner Space: Fiber Optics and Endoscopes
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
Many areas of medicine now make use of fiber optic scopes for both surgery and examination; the tiniest can go virtually anywhere a needle can. The laparoscope (named after the Greek word for flank) can be used for surgery in the abdomen, including gynecological procedures, as well as gallbladder removals, hernia repairs, and stomach surgery. Surgeons often can achieve equally good success rates and lower complication rates compared to conventional, or open surgery, which requires large incisions in the abdomen. Similarly, arthroscopes are widely used for operations on the knee, ankle, shoulder, and other joints (Figure 2.2). Patients who have undergone laparoscopic and arthroscopic surgery generally require much shorter hospital stays and fewer days of recovery time. In fact, after undergoing arthroscopic surgery a person can usually leave the hospital the same day. This is in part because the surgery is performed through tiny keyhole-sized incisions that leave equally small scars.
The arthroscopic Latarjet
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Johannes E. Plath, Laurent Lafosse
The arthroscopic modification allows accurate bone block placement under visualization from different perspectives, the treatment of concomitant lesions (SLAP, posterior labral lesions, rotator cuff lesions, etc.) and offers all advantages of arthroscopic surgery (reduced postoperative pain, superior cosmesis, fewer adhesions between tissue layers, earlier mobility, fast rehabilitation, reduced risk of infection).
Synovitis in hemophilia: preventing, detecting, and treating joint bleeds
Published in Expert Review of Hematology, 2023
In 1985 Wiedel reported for the first time the value of arthroscopic synovectomy in CHS, with satisfactory results [85]. In 1987, Klein et al also advised early arthroscopic synovectomy for the treatment of repeated hemarthrosis in PWH [86]. In 1997 Eickhoff et al reported that arthroscopic surgery, a relatively low risk technique, can be used to achieve satisfactory results in PWH [87]. In 2007 Verma et al reported that the results of arthroscopic synovectomy demonstrated a remarkable decline in hemarthrosis and substantial improvements in pain, range of motion, and function [88]. The principal predictor of outcome was the degree of preexisting degenerative changes within the joint. In more severe cases, the results of arthroscopic synovectomy were unpredictable, and in those cases, consideration should be given to total joint replacement.
Post-surgery rehabilitation following rotator cuff repair. A survey of current (2020) Italian clinical practice
Published in Disability and Rehabilitation, 2022
Fabrizio Brindisino, Andrea De Santis, Giacomo Rossettini, Leonardo Pellicciari, Marco Filipponi, Giuseppe Rollo, Jo Gibson
Shoulder surgery has evolved over the years, moving from open procedures to the current minimal access and arthroscopic techniques [13]. Arthroscopic surgery has become the gold standard, largely as a result of its efficacy in relation to postoperative pain, skin incisions, and minimal invasiveness; it also ensures a potentially better recovery process (e.g., smaller incisions, less soft-tissue dissection, no need for deltoid detachment, less postoperative pain, and potential accelerated recovery) if compared to open surgical procedures [13]. Several studies have investigated which suturing techniques are most efficacious (e.g., simple row versus double row) [13], both in terms of clinical outcomes, such as pain, function, and residual disability (e.g., using American Shoulder and Elbow Surgeon [ASES] scores and University of California, Los Angeles [UCLA] scores) [14], and impact on recurrence rates. However, there continues to be a lack of consensus as to which arthroscopic technique is associated with optimal outcomes.
Factors associated with RVU generation in common sports medicine procedures
Published in The Physician and Sportsmedicine, 2022
R. Timothy Kreulen, Micheal Raad, Farah N. Musharbash, Suresh K. Nayar, Matthew J. Best, Varun Puvanesarajah, Majd Marrache, Uma Srikumaran, John H. Wilckens
The NSQIP dataset enabled direct comparison between open and closed procedures in the shoulder, where both approaches are commonly used. For each procedure, the arthroscopic technique generated higher wRVUs/hour than the open technique. Arthroscopic surgery requires more surgical expertise and has a higher equipment cost but is associated with lower infection rates compared with open procedures [27]. Interestingly, patients also perceive many benefits to arthroscopic surgery compared with open surgery [28]. However, no long-term functional difference has been shown [29]. Although patient perceptions are not part of the RVU calculation algorithm, it is interesting that they correlate with wRVU generation in this case. It should also be noted that surgeons may choose an open approach for more difficult cases.