Background: Knee osteoarthritis is a frequent, debilitating, and degenerative condition. It is the most common operative indication for surgical arthroscopy. Hypothesis: Arthroscopy allows painless treatment of knee o...Background: Knee osteoarthritis is a frequent, debilitating, and degenerative condition. It is the most common operative indication for surgical arthroscopy. Hypothesis: Arthroscopy allows painless treatment of knee osteoarthritis and functional recovery. Patients and Methods: Our study was conducted in a private medical center in the city of Brazzaville in Congo, during the period from September 2020 to February 2023. It was prospective and based on patients with mechanical knee pain caused by osteoarthritis. A mobile arthroscopy device was used. The IKDC and KOOS scores allowed the evaluation of the treatment. Results: Our work involved 15 men and 7 women, with an average age of 39.9 years. Knee osteoarthritis was classified as type 2 according to Ahlbäck in 26 cases (70.27%) and type 3 in 11 cases (29.73%). In 7 patients, arthroscopy revealed lesions not visualized on MRI. Joint lavage was performed in all cases, synovial debridement in 17 cases (45.94%), and extraction of cartilaginous foreign bodies in 10 cases (27.03%). 20 patients were very satisfied with the surgery and 2 moderately satisfied. The EVA, subjective IKDC and KOOS scores were acceptable on a long-term follow-up. Discussion: Arthroscopy is a modern surgical technique for the management of intra-articular lesions of the knee. It relieves pain and stabilizes the degenerative process. A mobile arthroscopy device used here was preferred because of the low cost of installation and production.展开更多
Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling...Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.展开更多
文摘Background: Knee osteoarthritis is a frequent, debilitating, and degenerative condition. It is the most common operative indication for surgical arthroscopy. Hypothesis: Arthroscopy allows painless treatment of knee osteoarthritis and functional recovery. Patients and Methods: Our study was conducted in a private medical center in the city of Brazzaville in Congo, during the period from September 2020 to February 2023. It was prospective and based on patients with mechanical knee pain caused by osteoarthritis. A mobile arthroscopy device was used. The IKDC and KOOS scores allowed the evaluation of the treatment. Results: Our work involved 15 men and 7 women, with an average age of 39.9 years. Knee osteoarthritis was classified as type 2 according to Ahlbäck in 26 cases (70.27%) and type 3 in 11 cases (29.73%). In 7 patients, arthroscopy revealed lesions not visualized on MRI. Joint lavage was performed in all cases, synovial debridement in 17 cases (45.94%), and extraction of cartilaginous foreign bodies in 10 cases (27.03%). 20 patients were very satisfied with the surgery and 2 moderately satisfied. The EVA, subjective IKDC and KOOS scores were acceptable on a long-term follow-up. Discussion: Arthroscopy is a modern surgical technique for the management of intra-articular lesions of the knee. It relieves pain and stabilizes the degenerative process. A mobile arthroscopy device used here was preferred because of the low cost of installation and production.
文摘Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.
