Amir Mohammad Navali, MD; Mehraban Mehraeen, MD
Abstract
Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more ...
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Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more than 7 years delay in ACL reconstruction.
Methods: In a cross sectional study, 43 patients (39 men, 4 women) at mean age of 38 years, who underwent ACL reconstruction with a delay of more than 7 years, were studied. The Lysholm, IKDC, Tenger and KOOS scores were evaluated before surgery and at the last follow up. The observed meniscal or chondral lesions were collected from the patients’ arthroscopic records. The mean follow-up was 34 months.
Results: The mean time interval between primary trauma and ACL reconstruction surgery was 121 months. A total of 39 cases (90/7%) had chondral lesions which include 20 cases of grade I/II and 19 cases of grade III/IV lesions. In 35 patients (81.4%) meniscal tear was observed. Only two cases (4.6%) had isolated ACL tear. A statistically significant improvement in IKDC, Lysholm, KOOS, and Tegner score was observed following surgical treatment (p < /em><.001).
Conclusions: Longstanding ACL tear leads to increase the occurrence of meniscal and cartilage injuries. Delayed ACL reconstruction in this group of patients can improve IKDC, Lysholm and KOOS knee scores and Tegner activity level.
Amir Mohammad Navali, MD; Amin Moradi, MD; Abolfazl Mokhtari, MD
Abstract
Background: Post-operative pain control is an important issue in orthopaedics. Narcotics do not properly control pain and may have many complications. The non-steroidal anti-inflammatory drugs can, however, play an important role in postoperative pain management. This study evaluates the effect ...
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Background: Post-operative pain control is an important issue in orthopaedics. Narcotics do not properly control pain and may have many complications. The non-steroidal anti-inflammatory drugs can, however, play an important role in postoperative pain management. This study evaluates the effect of intra-articular Ketorolac injection on pain control after knee arthroscopy.
Methods: In a randomized double blind clinical trial study, 60 age and sex-matched patients of around 45 years of age were divided into two groups of 30. Tirthy mg of intra-articular ketorolac in one group and 30 millimeters of saline in the control group were injected at the end of arthroscopic knee surgery. The postoperative pain control and need for other pain medications were compared between the two groups.
Results: In the Ketorolac group the pain at 4 hours and 8 hours after surgery was significantly lower than the control group. At 12, and 24 hours after surgery, no significant difference in severity of pain was observed. The need for the use of opioid drugs was not significantly different between the two groups. The Sleep disturbance of 42.8% in the Ketorolac and 57.1% in the saline group was not significantly different.
Conclusions: Intra-articular ketorolac is effective in pain reduction only in the first few hours after knee arthroscopy, and does not reduce the need for other analgesics.
