Bony Impingement: Aetiology, Classifications, Treatment, Arthroscopic Procedures, Pitfalls and Tricks

2020 ◽  
pp. 41-52
Author(s):  
Fabrizio Cortese ◽  
Domenico Mercurio ◽  
Maria Pia Pasquali ◽  
Piero Giardini
Keyword(s):  
Bony Impingement ◽  
Arthroscopic Procedures

Outbreak of Pseudomonas aeruginosa Surgical Site Infections after Arthroscopic Procedures: Texas, 2009

2011 ◽  
Vol 32 (12) ◽  
pp. 1179-1186 ◽  
Author(s):  
Pritish K. Tosh ◽  
Maureen Disbot ◽  
Jonathan M. Duffy ◽  
Marc L. Boom ◽  
Gary Heseltine ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Shoulder Arthroscopy ◽  
Surgical Site Infections ◽  
Case Control ◽  
Surgical Instrument ◽  
Case Patient ◽  
Surgical Equipment ◽  
Control Study ◽  
Arthroscopic Procedures

Setting.Seven organ/space surgical site infections (SSIs) that occurred after arthroscopic procedures and were due to Pseudomonas aeruginosa of indistinguishable pulsed-field gel electrophoresis (PFGE) patterns occurred at hospital X in Texas from April 22, 2009, through May 7, 2009.Objective.To determine the source of the outbreak and prevent future infections.Design.Infection control observations and a case-control study.Methods.Laboratory records were reviewed for case finding. A case-control study was conducted. A case patient was defined as someone who underwent knee or shoulder arthroscopy at hospital X during the outbreak period and subsequently developed organ/space SSI due toP. aeruginosa. Cultures of environmental and surgical equipment samples were performed, and selected isolates were analyzed by PFGE. Surgical instrument reprocessing practices were reviewed, and surgical instrument lumens were inspected with a borescope after reprocessing to assess cleanliness.Results.The case-control study did not identify any significant patient-related or operator-related risk factors. P. aeruginosa grew from 62 of 388 environmental samples. An isolate from the gross decontamination sink had a PFGE pattern that was indistinguishable from that of the case patient isolates. All surgical instrument cultures showed no growth. Endoscopic evaluation of reprocessed arthroscopic equipment revealed retained tissue in the lumen of both the inflow/outflow cannulae and arthroscopic shaver handpiece. No additional cases occurred after changes in instrument reprocessing protocols were implemented. After this outbreak, the US Food and Drug Administration released a safety alert about the concern regarding retained tissue within arthroscopic shavers.Conclusions.These SSIs were likely related to surgical instrument contamination with P. aeruginosa during instrument reprocessing. Retained tissue in inflow/outflow cannulae and shaver handpieces could have allowed bacteria to survive sterilization procedures.

scholarly journals Opioid Overprescription in Adolescents and Young Adults Undergoing Hip Arthroscopy

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0005
Author(s):  
Mahad M. Hassan ◽  
Omar F. Rahman ◽  
Zaamin B. Hussain ◽  
Stephane L. Burgess ◽  
Yi-Meng Yen ◽  
...  
Keyword(s):  
Young Adult ◽  
Hip Arthroscopy ◽  
Pain Syndrome ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Bivariate Analysis ◽  
Opioid Use ◽  
Duration Of Surgery ◽  
Opioid Medications ◽  
Arthroscopic Procedures

Background: Previous studies have examined factors related to the increased use of opioids after hip arthroscopy in adults. However, few have focused on the adolescent population. Purpose: The purpose of this study was to compare the opioids prescribed to opioids consumed after hip arthroscopic procedures in adolescent and young adult patients, and to determine patient or surgical factors associated with increased postoperative opioid use. Methods: Adolescent and young adult patients who underwent hip arthroscopy and associated arthroscopic interventions between January 2017 and January 2020 were included. Patients with a diagnosed pain syndrome or history of chronic pain, as determined by the patient taking opioid medications prior to surgery, were excluded. Daily postoperative opioid intake was recorded via pain-control logbooks. The outcome of the study was defined as the average total number of opioid tablets consumed postoperatively. Results: Fifty-eight patients returned completed logbooks, 72% of whom were female patients. The average age was 21.30 years (range, 14.9 – 34.2). Most patients (73%) were prescribed 30 oxycodone tablets. The median amount of tablets consumed was 7 (range, 0-41) over a median duration of 7 days (range, 1-22). The median ratio of tablets consumed to prescribed was 20% and the 95th percentile of opioids consumed was 28 tablets. Bivariate analysis showed that patient age at surgery was positively correlated to the total amount of tablets consumed (r=0.28, p=0.04) and to the ratio of tablets consumed to prescribed (r=0.30, p=0.03). Duration of surgery was negatively correlated to the number of days tablets were consumed (r=-0.31, p=0.03). Multivariate analysis showed that patients who were prescribed more than 30 tablets took on average 7.8 more tablets overall compared to those prescribed 30 or fewer tablets (p=0.003), and that for each additional year of age, the ratio of tablets consumed to prescribed increased by 1% (p=0.02). Conclusion: After undergoing hip arthroscopy and associated arthroscopic procedures, adolescents and young adult patients are commonly overprescribed opioids, consuming on average only one-fifth of the tablets prescribed. This finding mirrors trends in the pediatric knee arthroscopy literature and provides an opportunity to reassess current opioid prescribing behaviors in the adolescent and young adult populations. [Table: see text][Table: see text][Table: see text][Table: see text][Table: see text]

The Importance of Bony Impingement in Restricting Flexion After Total Knee Arthroplasty

2012 ◽  
Vol 27 (9) ◽  
pp. 1710-1716 ◽  
Author(s):  
Hideki Mizu-uchi ◽  
Clifford W. Colwell ◽  
Shingo Fukagawa ◽  
Shuichi Matsuda ◽  
Yukihide Iwamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Bony Impingement ◽  
Total Knee

Etiology, Classifications, and Treatment by Arthroscopic Procedures

2020 ◽  
pp. 251-261
Author(s):  
Alberto Marangon ◽  
Yoshiharu Shimozono ◽  
Michele Montanari ◽  
Angelo Bertelli ◽  
Paolo Sembenini ◽  
...  
Keyword(s):  
Arthroscopic Procedures

Classification, Treatment, and Arthroscopic Procedures

2020 ◽  
pp. 117-123
Author(s):  
Alberto Branca ◽  
Marco Merlo ◽  
Clara Terzaghi ◽  
Cecilia Pasquali
Keyword(s):  
Arthroscopic Procedures

scholarly journals A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Eui Yub Jung ◽  
Seongmin Jeong ◽  
Sun-Kyu Kim ◽  
Sung-Sahn Lee ◽  
Dong Jin Ryu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Discoid Lateral Meniscus ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Signal Change ◽  
Magnetic Resonance Imaging Mri ◽  
Arthroscopic Procedures ◽  
Group 1

Abstract Purpose The purpose of this study is to classify the discoid lateral meniscus (DLM) according to the signal and shape in magnetic resonance imaging (MRI), and to provide information not only in diagnosis but also in treatment. Materials and Methods We reviewed 162 cases who diagnosed with DLM by MRI and underwent arthroscopic procedures from April 2010 to March 2018. Three observers reviewed MRI findings of all cases and predicted arthroscopic tear using three MRI criteria (criterion 1,2 and 3). Among three criteria, the criterion that most accurately predicts arthroscopic tear was selected. Using this criterion, the cases of predicted tear were named group 1. In addition, group 1 was divided into three subgroups (group 1a, 1b and 1c) by deformation or displacement on MRI and arthroscopic type of tear and procedures were analyzed according to these subgroups. Results The intra-meniscal signal change itself (criterion 3) on MRI showed the highest agreement with the arthroscopic tear. No meniscal deformation and displacement on MRI (group 1a) showed no specific type of tear and more cases of meniscal saucerization. The meniscal deformation on MRI (group 1b) showed more simple horizontal tears and more cases of meniscal saucerization. The meniscal displacement on MRI (group 1c) showed more peripheral tears and more cases of meniscal repair and subtotal meniscectomy. Comparing arthroscopic type of tear and type of arthroscopic procedure between three subgroups, there were significant differences in three groups (P < .05). Conclusions Intra-meniscal signal change itself on MRI is the most accurate finding to predict arthroscopic tear in symptomatic DLM. In addition, subgroup analysis by deformation or displacement on MRI is helpful to predict the type of arthroscopic tear and procedures.

scholarly journals Arthroscopic treatment of anteromedial ankle impingement

2020 ◽  
Vol 14 (3) ◽  
pp. 260-263
Author(s):  
Guillermo Arrondo ◽  
Daniel Gómez ◽  
Germán Joannas ◽  
Xavier Martín-Oliva ◽  
Matías Iglesias ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Case Series ◽  
Functional Results ◽  
Level Of Evidence ◽  
Bony Impingement ◽  
Soft Tissue Impingement ◽  
Arthroscopic Removal ◽  
Physical Impact

Objective: Impingement syndromes are recognized as an important cause of chronic ankle pain, which results from the entrapment of an inflamed soft-tissue component between the osteophytes. The predominant site of occurrence is the anterolateral aspect of the ankle for soft-tissue impingement, and anteromedial aspect for bony impingement. Symptoms related to the physical impact of bone or soft-tissue pain often result in limited ankle range of motion. Methods: We conducted a retrospective study of 34 patients (34 ankles) with anteromedial bony impingement. All patients underwent arthroscopy, with a mean follow-up of 34 months. Results: All osteophytes were removed, and the ankle range of motion improved. The AOFAS score improved from 73 preoperatively to 95 postoperatively. Conclusion: The arthroscopic removal of the anteromedial osteophytes of the ankle had excellent functional results. It is an effective procedure that allows rapid patient recovery. Level of Evidence IV; Therapeutic Studies; Case Series.

Deep Brachial Artery Pseudoaneurysm Following Arthroscopic Shoulder Debridement

2018 ◽  
Vol 52 (5) ◽  
pp. 378-381
Author(s):  
Andrew E. Yang ◽  
Jamie M. Hall ◽  
Gilford S. Vincent ◽  
Lowell Chambers
Keyword(s):  
Brachial Artery ◽  
Orthopedic Procedures ◽  
Vascular Injuries ◽  
Review Of The Literature ◽  
Artery Pseudoaneurysm ◽  
Pseudoaneurysm Formation ◽  
Arthroscopic Procedures

Vascular injuries resulting from arthroscopic surgeries are rare with a reported incidence of 0.005% of elective orthopedic procedures. We report a case of a 49-year-old male who developed a deep brachial artery pseudoaneurysm following an arthroscopic shoulder debridement and lysis of adhesions. He was successfully embolized with resolution of the pseudoaneurysm within 6 weeks of treatment. A review of the literature demonstrates that pseudoaneurysm formation after arthroscopic procedures is rare and pseudoaneurysms of the deep brachial artery have yet to be reported.

Tranexamic Acid: When is It Indicated in Orthopaedic Surgery?

2021 ◽  
Author(s):  
Bjarke Viberg
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Joint Replacement ◽  
Orthopaedic Surgery ◽  
Thromboembolic Events ◽  
Reduce Blood Loss ◽  
Fracture Surgery ◽  
Arthroscopic Procedures

AbstractTranexamic acid (TXA) has been studied extensively during the last 5–8 years. It inhibits clot dissolution during surgery and can therefore reduce blood loss. However, there has been concern that this could result in more frequent complications, specifically in terms of thromboembolic events. The indications for TXA are widespread, and this review covers the literature on orthopaedic indications such as joint replacement, fracture surgery, and arthroscopic procedures. In general, TXA is safe and can be used in a wide variety of orthopaedic procedures, lowering blood loss without increasing the risk of complications.

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