No abstract

No abstract

In this prospective study high tibial osteotomy for medial gonarthrosis was performed in 95 patients (105 knee joints). The patients underwent simultaneously diagnostic and operative arthroscopic surgery of the knee joint. A follow-up arthroscopic examination could be performed in 75 patients (85 knee joints) at the time of implant removal. In group 1 (20 knee joints), the osteotomy was performed after diagnostic arthroscopy without arthroscopic operation of the knee joint. The fixation of the osteotomy was accomplished by staples, postoperative plaster fixation and physiotherapy. In group 2 (20 knee joints), osteotomy was performed without additional operative arthroscopy after diagnostic arthroscopy, internal fixation by AOT-plate, no external fixation postoperatively and physiotherapy. In group 3 (22 knee joints), osteotomy was performed with additional operative arthroscopy (Pridie drilling), internal fixation by AOT-plate no external fixation postoperatively no external fixation, physiotherapy and continuous passive motion. In group 4 (23 knee joints), osteotomy was performed with additional operative arthroscopy (abrasio-arthroplasty), internal fixation by AOT-plate, no external fixation postoperatively, physiotherapy and continuous passive motion. All patients underwent arthroscopic examination of the knee with cartilage biopsies taken from three different regions of the femoral condyle during the same operative session as the osteotomy. At follow-up arthroscopy cartilage biopsies were taken from the same regions. There was no great difference in clinical outcome after 1 year between all groups. Arthroscopy as well as routine and electron microscopy showed better cartilage regeneration in groups 3 and 4. Groups 1 and 2 showed only regeneration isles, sometimes not well fixed to the underlying bone, while in groups 3 and 4 cartilage regeneration was thicker and more stable, sometimes covering all of the pre-existing erosions. Therefore, we recommend osteotomy of the tibia for osteoarthritis together with operative arthroscopy in the same operative session.

In this prospective study of 433 patients undergoing surgery for bronchial carcinoma 3 main factors influencing the operative risk were identified: (1) extent of resection, (2) pulmonary function and (3) age. The 30-day mortality rate was 8.3% in the whole group which comprised a high percentage of patients over 70 years of age (27%) and with a disturbed pulmonary function (45%). The value of various functional criteria proposed in the extensive literature is assessed and compared with the results of the study in which the use of FEV1 and quantitative regional analysis by perfusion scanning and 'regions of interest' proved to be highly efficient, allowing, in addition, the prediction of postoperative lung function even in sleeve resections. A new formula for estimation of the additional loss of function in the early postoperative phase after lobectomies is proposed along with a flow sheet for routine preoperative evaluation of pulmonary function.

No abstract