PS01.072: IT IS NOT ALWAYS RISKY USING MESH IN THE TREATMENT OF HIATAL HERNIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 69-69
Author(s):  
Maximiliano Loviscek ◽  
Mauro Acosta ◽  
Oscar Crespin ◽  
Guido Orbe ◽  
Cesar Villamil ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Conflicts Of Interest ◽  
Synthetic Mesh ◽  
Gastric Erosion ◽  
Type I ◽  
Intrathoracic Stomach ◽  
Type Iii ◽  
Type Iv ◽  
Low Incidence

Abstract Background Many studies have shown that the importance of using mesh for paraesophageal hernia repair (PEHR) is to prevent recurrence. Unfortunately, it is associated with high risk of complications such as esophageal or gastric erosion. The aim of this study is to report the results of 38 patients who underwent laparoscopic PEHR with the use of a BioSynthetic mesh (GoreÒ Bio AÒ tissue Reinforcement.USA). Methods Observational, retrospective, single-center cohort study. We analysed retrospectively 38 consecutive patients with diagnosis of symptomatic Hiatal Hernia (HH) treated laparoscopically with an absorbable BioSynthetic mesh, between 2011–2017. The classic radiologic classification was used to classify the HH before surgery. This classification consists in four types/stages (I-IV). I: Sliding HH, II: Paraesophageal HH, III: Mixed form and IV: Intrathoracic stomach—upside-down hernia. All patients with Type III—IV hiatal hernia who underwent laparoscopic PEHR using an absorbable BioSynthetic mesh were included. We evaluated the results after PEHR with a symptoms questionnaire using a score 0–4 (Likert scale) and with an esophagogram and an esophagogastroduodenoscopy (EGD) analyzing the surgical success. Success was considered with symptomatic score improvement and/or absence of any symptomatic HH at the esophagogram and/or EGD. Results 38 patients: 7 males and 31 women. Median age: 66 (range 40–71). 12/38 (31,6%) patients had a type III HH and 26/38 (68,4%) a type IV. All these patients had been treated with a laparoscopic PEHR, using an absorbable BioSynthetic mesh as a reinforcement of the crura and Nissen fundoplication. The median follow-up was 12 months. 16/38 (42%) had a follow-up > 24 months. Success was evident in 95% of the patients. We observed 2 recurrences, one with a symptomatic type I HH and the other with an early type III HH recurrence. Conclusion The use of an absorbable synthetic mesh as a reinforcement of the crura in the treatment of the PEH has encouraging good results in the mild term follow up, with an extremely low incidence of complications. Disclosure All authors have declared no conflicts of interest.

scholarly journals 416 LV only fusion pacing CRT without RV lead induces size and shape LA reverse remodelling

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Vacarescu ◽  
L Petrescu ◽  
C T Luca ◽  
C Mornos ◽  
A Gurgu ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Diastolic Dysfunction ◽  
Real Life ◽  
Transverse Diameter ◽  
Type I ◽  
Baseline Characteristic ◽  
Type Iii ◽  
Reverse Remodelling ◽  
Low Incidence

Abstract Background Adaptive CRT pacing induces significant left atrium (LA) reverse remodelling comparing to biventricular (BiV) pacing, although the algorithm delivers compulsory BiV pacing in heart rate over 100/min! Purpose: to assess LA remodelling in LV only pacing without RV lead in a real-life situation of permanent CRT fusion pacing. Methods Prospective data were analysed from a cohort of patients with CRT-P indication implanted with right atrium/left ventricle (RA/LV) DDD pacing system. Complete follow-up at every 6 months included device interrogation, exercise test, transthoracic echocardiography (TE) and individualised drug optimisation. LA evaluation included: parasternal dimension (LAd), 4 chambers view: mid-LA transverse diameter (LAt), basal LA maximal transverse diameter (LAb); volume (LA vol) and shape assessment: trapezoidal LA shape was defined by LAt less than Lab, the reverse situation was considered ellipsoidal shape. Results 55 pts (30 males) with idiopathic DCM aged 62 ± 11 y.o. were included. Baseline characteristic: QRS 164 ± 18 ms; EF 27 ± 5.2%; mitral regurgitation was severe in 22 pts, moderate in 27 pts and mild in 6 pts; 15 pts had type III diastolic dysfunction, 37 pts with type II diastolic dysfunction, 3 pts with type I diastolic dysfunction. Average follow-up was 42 ± 18 months: all patients were responders, EF increased at 37 ± 7.9%; mitral regurgitation decreased in 38 pts (69%), diastolic profile improved in 36 pts (65%). Trapezoidal LA shape was documented in 31 (56%) patients. Atrial fibrillation was noted in 4 pts (7%) and cardioversion was needed. Non-sudden cardiac death occurred in 5 patients (9%), all deaths were noted in pts with severe LA vol, trapezoidal shape and type III diastolic dysfunction. Statistically significative LA reverse remodelling was noted regarding LA volume, but not shape. Conclusions RA/LV fusion CRT pacing was associated with important LA reverse remodelling and a low incidence of AF. Larger randomised studies are needed to validate these results and assess the role of LA shape remodelling in CRT. before RA/LV CRT-P Follow-up 42 ± 18 months p LV EF, %, mean ± SD 27 ± 5.2 37 ± 7.9 <0.0001 LA diameter (mm), mean ± SD 50 ± 4.9 44 ± 2.8 <0.0001 LA area (cm2), mean ± SD 24 ± 5.6 22 ± 0.7 0.0138 LA volume (ml), mean ± SD 104.9 ± 34 80 ± 28.2 0.0001 Abstract 416 Figure.

The value of CT findings for prognostic prediction of spontaneous superior mesenteric artery dissection

2018 ◽  
Vol 60 (4) ◽  
pp. 542-548 ◽  
Author(s):  
Rika Yoshida ◽  
Takeshi Yoshizako ◽  
Minako Maruyama ◽  
Yoshikazu Takinami ◽  
Yoshihide Shimojo ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Type I ◽  
Treatment Methods ◽  
Type Iii ◽  
Type Iv ◽  
Contrast Enhanced Ct ◽  
Prognostic Prediction

Background Spontaneous superior mesenteric artery (SMA) dissection is rare cause of acute abdomen. Time-dependent change of SMA dissection has not been established. Purpose To determine Sakamoto classification (SC) type of acute and chronic SMA dissection (aSMAD and cSMAD) to predict the treatment methods and outcome. Material and Methods From April 2003 to March 2017, unenhanced and contrast-enhanced CT were used to diagnose acute symptomatic or chronic asymptomatic SMA dissection in 25 consecutive patients without aortic dissection. Correlations between SCs and treatment methods and outcomes were investigated. Results All 13 patients with aSMAD initially received conservative treatment. Initial SCs in aSMAD were type I = 1, type III = 9, and type IV = 3. Three of nine initial type III and two of three initial type IV changed to type I at follow-up. One of nine type III changed to type II at follow-up. Ohers did not change. One with initial type III required vascular repair, so the final SC was not available. Three patients required bowel resection. In cSMAD of 12 patients, the initial/final SC were type I and IV in ten and two patients, respectively, without change during follow-up. cSMAD was significantly older than aSMAD. The initial length of dissection of aSMAD was longer than in the cSMAD group. In aSMAD, the final length of dissection was significantly shorter than in the initial computed tomography scan. Conclusion Initial SC differed significantly between aSMAD and cSMAD. Initial SC types in aSMAD were type III and IV mainly, and changed during the observation period. In cSMAD, SC types were I and IV without change.

Gamma surgery for vein of Galen malformations

2000 ◽  
Vol 93 (2) ◽  
pp. 229-236 ◽  
Author(s):  
Bryan Rankin Payne ◽  
Dheerendra Prasad ◽  
Melita Steiner ◽  
Hernan Bunge ◽  
Ladislau Steiner
Keyword(s):  
Additional Patient ◽  
Consecutive Series ◽  
Type I ◽  
Vein Of Galen ◽  
Content Type ◽  
Type Iii ◽  
Type Iv ◽  
Flow Through ◽  
Fine Print

Object. The goal of this study was to evaluate the results of gamma surgery in nine patients treated for vein of Galen malformations (VGMs).Methods. A consecutive series of nine VGMs in eight children aged 4 to 14 years and in one adult were treated with gamma surgery. Six of the patients were male, including the adult, and three were female. Among these patients there were three Yaşargil Type I, one Type II, two Type III, and three Type IV malformations. Previous embolization had failed in four cases. Three VGMs were treated with gamma surgery twice. An additional patient with a Type III VGM underwent stereotactic angiography in preparation for gamma surgery but was judged to be suitable for direct embolization.Follow-up angiograms were obtained in eight of the VGMs treated. Four no longer filled; one has probably been obliterated, but this cannot be confirmed because the patient refused to undergo final angiography; one patient has residual fistulas not included in the initial treatment field, which were retreated recently; and two other patients have marked reduction of flow through their VGMs.Conclusions. Gamma surgery is a viable option in the treatment of VGMs in clinically stable patients. Combined endovascular therapy and gamma surgery is of benefit in complex malformations.

scholarly journals Endovascular strategies for treatment of posterior communicating artery aneurysm according to angiographic architecture: Preservation vs. sacrifice of posterior communication artery

2017 ◽  
Vol 23 (6) ◽  
pp. 620-627 ◽  
Author(s):  
Jung Ho Ko ◽  
Young-Joon Kim
Keyword(s):  
Treatment Strategies ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Ischemic Complications ◽  
Type V

We report ischemic complications related to obstruction of the posterior communicating artery (PcomA) and suggest treatment strategies according to the angiographic characteristics of the PcomA and the posterior cerebral artery (PCA). Twenty-one patients with PcomA aneurysm who had initially undergone endovascular treatment and had an identifiable PcomA occlusion on immediate or follow-up angiography were enrolled. We classified PcomA aneurysm according to the characteristics of the PcomA and PCA (P1) on baseline angiography, as follows: type I was defined as PcomA aneurysm with an absent PcomA and a normal-sized P1. Type II was defined as a hypoplastic PcomA and a normal-sized P1. Type III was defined as a normal-sized PcomA and an absent P1. Type IV was defined as a normal-sized PcomA and a hypoplastic P1. Type V was a normal-sized PcomA and a normal-sized P1. Among all cases of PcomA obstruction, 15 (71.4%) were type II PcomA aneurysms, four were type IV, one was type III, and one was type V. Ischemic events related to PcomA obstruction occurred in three cases (type II, III and VI), which included two tuberothalamic infarctions (type III and IV) and one cortical infarction in the territory of the PCA (type II). Follow-up angiographies showed flow change in the PcomA in 14 cases. It is relatively safe to sacrifice type II PcomA if necessary. However, physicians should pay attention to unexpected flow changes, such as recanalization or occlusion of the PcomA, which are possible after treatment.

scholarly journals The Modified West China Hospital Radiographic Classification for Fibrous Dysplasia in Femur: A Retrospective Analysis of 238 Patients

2020 ◽  
Author(s):  
Yitian Wang ◽  
Li Min ◽  
Yong Zhou ◽  
Jie Wang ◽  
Yuqi Zhang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Fibrous Dysplasia ◽  
Kappa Statistic ◽  
Diagnosis And Treatment ◽  
Type I ◽  
Type Iii ◽  
Type Iv ◽  
Significant Difference ◽  
Radiographic Classification

Abstract Background: To investigate the reliability and clinical outcome of a newly developed classification system for patients, who had fibrous dysplasia (FD) in the femur.Methods: A total of 238 patients with FD in the femur were included in this retrospective study. All affected femurs were measured and treated based on our classification. The intraobserver and interobserver reproducibility were assessed using the Cohen kappa statistic. The clinical outcome was evaluated using the criteria of Guille.Results: At a median follow-up of 60 months, 238 patients were categorized into the following five types: type I to V. The interobserver and intraobserver kappa scores were excellent. For clinical outcomes, there was no significant difference in the postoperative Guille score between type I (mean 9.01 ± 1.22), II (mean 8.40 ± 1.38), and V (mean 8.47 ± 1.69). Type III and IV had significantly lower postoperative Guille scores than type I, II, and V. Moreover, type III had a significantly higher Guille score (mean 7.81 ± 0.96) than type IV (mean 6.57 ± 2.09).Conclusion: Our classification is reproducible and provides a one-to-one correspondence between diagnosis and treatment. Therefore, we recommend this classification for the diagnosis and treatment of the FD in the femur.

scholarly journals Transtemporal approach to hypothalamic hamartomas in children: report of 3 cases

2020 ◽  
Vol 25 (6) ◽  
pp. 588-596
Author(s):  
Adikarige H. D. Silva ◽  
William B. Lo ◽  
Nilesh R. Mundil ◽  
A. Richard Walsh
Keyword(s):  
Substantial Reduction ◽  
Intractable Epilepsy ◽  
Surgical Approaches ◽  
Middle Temporal Gyrus ◽  
Type I ◽  
Type Iii ◽  
Hypothalamic Hamartomas ◽  
Type Iv ◽  
Neurovascular Structures

The surgical approach to hypothalamic hamartomas (HHs) associated with medically refractory epilepsy is challenging because of these lesions’ deep midline or paramedian location. Whether the aim is resection or disconnection, the surgical corridor dictates how complete a procedure can be achieved. Here, the authors report a transtemporal approach suitable for Delalande type I, inferior extraventricular component of type III, and type IV lesions. This approach provides optimal visualization of the plane between the hamartoma and the hypothalamus with no manipulation to the pituitary stalk and brainstem, allowing for extensive disconnection while minimizing injury to adjacent neurovascular structures.Through a 1-cm corticectomy in the middle temporal gyrus, a surgical tract is developed under neuronavigational guidance toward the plane of intended disconnection. On reaching the mesial temporal pia-arachnoid margin, it is opened, providing direct visualization of the hamartoma, which is then disconnected or resected as indicated. Critical neurovascular structures are generally not exposed through this approach and are preserved if encountered.Three patients (mean age 4.9 years) with intractable epilepsy were treated using this technique as part of the national Children’s Epilepsy Surgery Service. Following resection, the patient in case 1 (Delalande type I) is seizure free off medication at 3 years’ follow-up (Engel class IA). The patient in case 2 (Delalande type III) initially underwent partial disconnection through a transcallosal interforniceal approach and at first had significant seizure improvement before the seizures worsened in frequency and type. Complete disconnection of the residual lesion was achieved using the transtemporal approach, rendering this patient seizure free off medication at 14 months postsurgery (Engel class IA). The patient in case 3 (Delalande type IV) underwent incomplete disconnection with a substantial reduction in seizure frequency at 3 years’ follow-up (Engel class IIIC). There were no surgical complications in any of the cases.The transtemporal approach is a safe and effective alternative to more conventional surgical approaches in managing HHs with intractable epilepsy.

Labelling of non-A, non-B hepatitis infected chimpanzee hepatocytes with nuclease-gold conjugates

1984 ◽  
Vol 42 ◽  
pp. 250-251
Author(s):  
G. D. Gagne ◽  
M. F. Miller ◽  
D. A. Peterson
Keyword(s):  
Endoplasmic Reticulum ◽  
Experimental Infection ◽  
Uranyl Acetate ◽  
Type I ◽  
Cellular Injury ◽  
Type Ii ◽  
Tubular Structures ◽  
Type Iii ◽  
Type Iv ◽  
Infected Chimpanzee

Experimental infection of chimpanzees with non-A, non-B hepatitis (NANB) or with delta agent hepatitis results in the appearance of characteristic cytoplasmic alterations in the hepatocytes. These alterations include spongelike inclusions (Type I), attached convoluted membranes (Type II), tubular structures (Type III), and microtubular aggregates (Type IV) (Fig. 1). Type I, II and III structures are, by association, believed to be derived from endoplasmic reticulum and may be morphogenetically related. Type IV structures are generally observed free in the cytoplasm but sometimes in the vicinity of type III structures. It is not known whether these structures are somehow involved in the replication and/or assembly of the putative NANB virus or whether they are simply nonspecific responses to cellular injury. When treated with uranyl acetate, type I, II and III structures stain intensely as if they might contain nucleic acids. If these structures do correspond to intermediates in the replication of a virus, one might expect them to contain DNA or RNA and the present study was undertaken to explore this possibility.

scholarly journals Diastolic dyssynchrony in patients with LV only fusion pacing CRT without RV lead

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Gurgu ◽  
L Petrescu ◽  
C Vacarescu ◽  
CT Luca ◽  
C Mornos ◽  
...  
Keyword(s):  
Lateral Wall ◽  
Positive Outcome ◽  
Type I ◽  
Exercise Tests ◽  
Type Iii ◽  
Funding Sources ◽  
End Diastolic Volume ◽  
Chamber View ◽  
Systolic And Diastolic Function

Abstract Funding Acknowledgements Type of funding sources: None. Background CRT improves both systolic and diastolic function, thus increasing cardiac output. However, less data is available concerning diastolic dyssynchrony and fusion pacing CRT. The aim of our study was to assess the outcome of LV diastolic asynchrony in a population of fusion pacing CRT without right ventricular (RV)  lead. Methods Prospective data were collected from a cohort of patients (pts) with right atrium/left ventricle leads (RA/LV CRT). Baseline and every 6 months follow-up included standard ETT and classical dyssynchrony parameter measurements. Diastolic dyssynchrony was done by offline speckle-tracking derived TDI timing assesment of the simultaneity of E" and A"  basal septal and lateral wall 4 chamber view. New parameters were introduced: E" and respectively A" time (E"T / A"T) as the time difference between E" (respectively A" ) peaks septal and lateral wall. Exercise tests, drugs optimization and device individual programmimg were systematically performed in order to maintain constant fusion and improve CRT response. Patients were divided in three groups: super-responders (SR), responders (R) and non responders (NR). Results Sixty-two pts (35 male) aged 62 ± 11 y.o. with idiopathic DCM implanted with a RA/LV CRT were analyzed: 34%SR / 61%R / 5%NR. Baseline initial characteristics: QRS 164 ± 18 ms; EF 27 ± 5.2; 29% had type III diastolic dysfunction (DD), 63% type II DD, 8% type I DD. Average follow-up was 45 ± 19 months; mean LVEF at the last follow-up was 37 ± 7.9%. The E"T decreased from 90 ± 20 ms to 25 ± 10 ms in SR with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs 243.2 ± 82 ml at baseline, p < 0.0028) and lower LV filling pressures (E/E" 13.2 ± 4.6 vs 11.4 ± 4.5, p =0.0295). DD profile improved in 65% of R with a reduction in E/A ratio (1.46 ± 5.3 vs. 0.82 ± 3.9 at baseline, p= 0.4453). Non-sudden cardiac death occurred in 3 NR pts (2%) with type III DD, severe LA volume and larger E" T /A"T (E"T> 85 msec A"T > 30 msec).  Significant cut off value calculated by ROC curve for LV diastolic dyssynchrony is E"T > 80 ms and A"T of > 25 msec. Conclusions Fusion pacing CRT without RV lead showed a positive outcome; improving LV diastolic dyssynchrony in responders and super-responders patients is obvious. Larger randomized studies are needed to define the role of diastolic asynchronism as a predictor of favorable response in fusion pacing. Abstract Figure. Typical TDI patterns in LV fusion pacing

scholarly journals Perforator preservation technologies (PPT) based on a new neuro-interventional classification in endovascular treatment of perforator involving aneurysms (piANs)

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chen Li ◽  
Ao-Fei Liu ◽  
Han-Cheng Qiu ◽  
Xianli Lv ◽  
Ji Zhou ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Saccular Aneurysm ◽  
Type I ◽  
Type Ii ◽  
Fusiform Aneurysm ◽  
Type Iii ◽  
Perforating Artery ◽  
Protection Technology ◽  
Perforating Arteries

Abstract Background Treatment of perforator involving aneurysm (piAN) remains a challenge to open and endovascular neurosurgeons. Our aim is to demonstrate a primary outcome of endovascular therapy for piANs with the use of perforator preservation technologies (PPT) based on a new neuro-interventional classification. Methods The piANs were classified into type I: aneurysm really arises from perforating artery, type II: saccular aneurysm involves perforating arteries arising from its neck (IIa) or dome (IIb), and type III: fusiform aneurysm involves perforating artery. Stent protection technology of PPT was applied in type I and III aneurysms, and coil-basket protection technology in type II aneurysms. An immediate outcome of aneurysmal obliteration after treatment was evaluated (satisfactory obliteration: the saccular aneurysm body is densely embolized (I), leaving a gap in the neck (IIa) or dome (IIb) where the perforating artery arising; fusiform aneurysm is repaired and has a smooth inner wall), and successful perforating artery preservation was defined as keeping the good antegrade flow of those perforators on postoperative angiography. The periprocedural complication was closely monitored, and clinical and angiographic follow-ups were performed. Results Six consecutive piANs (2 ruptured and 4 unruptured; 1 type I, 2 type IIa, 2 type IIb, and 1 type III) in 6 patients (aged from 43 to 66 years; 3 males) underwent endovascular therapy between November 2017 and July 2019. The immediate angiography after treatment showed 6 aneurysms obtained satisfactory obliteration, and all of their perforating arteries were successfully preserved. During clinical follow-up of 13–50 months, no ischemic or hemorrhagic event of the brain occurred in the 6 patients, but has one who developed ischemic event in the territory of involving perforators 4 h after operation and completely resolved within 24 h. Follow-up angiography at 3 to 10M showed patency of the parent artery and perforating arteries of treated aneurysms, with no aneurysmal recurrence. Conclusions Our perforator preservation technologies on the basis of the new neuro-interventional classification seem feasible, safe, and effective in protecting involved perforators while occluding aneurysm.

scholarly journals Outcomes of one-stage reconstruction for chronic multiligament injuries of knee

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Tarun Goyal ◽  
Souvik Paul ◽  
Sushovan Banerjee ◽  
Lakshmana Das
Keyword(s):  
Cruciate Ligament ◽  
Lysholm Score ◽  
Activity Level ◽  
Type Ii ◽  
Hamstring Tendons ◽  
Peroneus Longus ◽  
Type Iii ◽  
Type Iv ◽  
Ikdc Score

Abstract Purpose This article aims to evaluate patterns of chronic multiligament injuries and outcomes of treatment with single-stage reconstruction using autografts. Methods All patients with clinicoradiologically diagnosed multiligament knee injury (MKI) were included in this prospective observational study. As the time since injury was more than 6 weeks in all of the patients, they were categorized as having chronic MKI. Patients were assessed clinically for laxity, and the diagnosis was confirmed radiologically. Ipsilateral hamstring tendons were used for medial collateral ligament (MCL) or posterolateral corner reconstruction in a patient with Schenck knee dislocation (KD) type III. In these cases, the posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) were reconstructed by using the peroneus longus and contralateral hamstring tendons respectively. Ipsilateral hamstring tendons were used for ACL reconstruction and an ipsilateral peroneus longus tendon graft was used for reconstruction of the PCL in a KD type II injury. In two cases of KD type IV injury, the lateral laxity was only grade II and was managed conservatively; the rest of the ligaments were addressed like a KD type III injury. Outcome evaluation was done using a visual analogue scale (VAS) for pain, International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity level, preoperatively and postoperatively at 2 years’ follow-up. Results A total of 27 patients of mean age 33.48 ± 9.9 years with MKI were included in the study. The patients were classified as eight KD type II, 17 KD type III, and two KD type IV. The majority of the patients had associated meniscal (59.2%) or chondral (40.7%) injuries. At the 2 years’ follow-up visit, there were significant improvements in VAS score (p = 0.0001) IKDC score (p = 0.0001), Lysholm score (p = 0.0001), and range of motion (p = 0.001). None of the patients had residual laxity on clinical examination of the knee joint at the 2 years’ follow-up. All but two of the patients went back to their previous activity level. These two patients had progressive knee arthritis and needed knee arthroplasty. Conclusion Single-stage surgical reconstruction for chronic MKI has favourable functional outcomes. Level of evidence Level IV, case series.

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