Einer koreanischen Studie zufolge bringt die Teilresektion des Innenmeniskus nach Einreißen keine Vorteile gegenüber einer konservativen Behandlung. Von 102 Pati-enten mit Knieschmerz und degenerativ bedingtem horizontalem Riss im Hinter-horn des Innenmeniskus unterzogen sich 50 einer arthroskopischen Meniskusteil-resektion, 52 machten nur kräftigende Übungen. Hinsichtlich der Funktionsfähigkeit unter-schieden sich operierte Patienten nicht von konservativ behandelten (Durchschnitts-wert im VAS-Score 1,8 vs. 1,7). Nach zwei Jahren waren 68% der Operierten und 67% der konservativ Behandelten komplett schmerzfrei, und die Kniefunktion hatte sich in gleichem Maß verbessert. Die Be-funde sind umso wichtiger, als nach Me-niskektomie das Arthroserisiko steigt und oft Revisionsoperationen nötig sind.
Background Several studies have shown mechanical alignment influences the outcome of TKA. Robotic systems have been developed to improve the precision and accuracy of achieving component position and mechanical alignment. Questions/purposes We determined whether roboticassisted implantation for TKA (1) improved clinical outcome; (2) improved mechanical axis alignment and implant inclination in the coronal and sagittal planes; (3) improved the balance (flexion and extension gaps); and (4) reduced complications, postoperative drainage, and operative time when compared to conventionally implanted TKA over an intermediate-term (minimum 3-year) followup period.
MethodsWe prospectively randomized 100 patients who underwent unilateral TKA into one of two groups: 50 using a robotic-assisted procedure and 50 using conventional manual techniques. Outcome variables considered were postoperative ROM, WOMAC scores, Hospital for Special Surgery (HSS) knee scores, mechanical axis alignment, flexion/extension gap balance, complications, postoperative drainage, and operative time. Minimum followup was 41 months (mean, 65 months; range, 41-81 months). Results There were no differences in postoperative ROM, WOMAC scores, and HSS knee scores. The roboticassisted group resulted in no mechanical axis outliers ([ ± 3°from neutral) compared to 24% in the conventional group. There were fewer robotic-assisted knees
The DB technique, compared with SB, was not more effective in preventing OA and did not have a more favorable failure rate. Although the DB ACLR technique produced a better IKDC subjective scale result than did the SB ACLR technique, the 2 modalities were similar in terms of clinical outcomes and stability after a minimum 4 years of follow-up.
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