scholarly journals Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Masashi Koide ◽  
Yuichi Tojo ◽  
Yoshihiro Hagiwara ◽  
Souichi Nakajima ◽  
Minoru Tanaka ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Clinical Condition ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Joint Aspiration ◽  
Good Clinical Condition ◽  
Open Arthrotomy

Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012)).

scholarly journals Functional Outcome for Arthroscopic Treatment of Septic Arthritis of the Wrist

2019 ◽  
Vol 09 (03) ◽  
pp. 190-196 ◽  
Author(s):  
Esther M. W. Chow ◽  
Jimmy K. Y. Lau ◽  
Lucci L. C. Liyeung ◽  
W. W. Chau ◽  
Michael C. K. Mak ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Functional Outcome ◽  
Case Reports ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Arthroscopic Lavage ◽  
Open Treatment

Abstract Background Septic arthritis is a potentially joint-destructing condition if not treated properly. Septic wrist accounts for ∼5% of all septic arthritis. Arthroscopic lavage is a well-documented treatment for septic arthritis of the knee, hip, or shoulder only. Previous studies on septic wrist were limited to case reports or retrospective studies focusing on open treatment, and functional outcome was seldom documented. Our study aims to evaluate the effectiveness of arthroscopic treatment and to investigate the functional outcome. Materials and Methods Patients were retrospectively reviewed over a period of 10 years. Parameters including age, gender, history of prior injury, duration of symptoms, joint aspirates and intraoperative tissue culture, radiological and arthroscopic findings, antibiotics used, number of operations, and hospital stay were reviewed. Functional outcomes were evaluated with QuickDASH (disabilities of the arm, shoulder, and hand) score. Results From 2007 to 2016, 14 patients (15 septic wrists) underwent arthroscopic surgery. One patient had bilateral involvement. The average age was 63.9 years and the average duration of symptoms was 6.08 days. Average follow-up time was 10 months. All except two patients (85.7%) responded to single arthroscopic treatment. Two required subsequent operations for concomitant tenosynovitis. There were no major complications. The most common isolated organism was Staphylococcus aureus. Only one case had severe joint erosion during follow-up. The average QuickDASH score was 19.7. Duration of symptoms 5 days or more before admission was associated with higher QuickDASH score (p = 0.04). Conclusion Early arthroscopic treatment should be considered for all patients admitted for septic arthritis of the wrist if not contraindicated. Level of Evidence This is a Level III, retrospective review.

Outcomes of Hip Arthroscopic Surgery in Patients With Tönnis Grade 1 Osteoarthritis at a Minimum 5-Year Follow-up: A Matched-Pair Comparison With a Tönnis Grade 0 Control Group

2017 ◽  
Vol 45 (10) ◽  
pp. 2294-2302 ◽  
Author(s):  
Benjamin G. Domb ◽  
Edwin O. Chaharbakhshi ◽  
Danil Rybalko ◽  
Mary R. Close ◽  
Jody Litrenta ◽  
...  
Keyword(s):  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Matched Pair ◽  
Harris Hip Score ◽  
Control Group ◽  
Pair Comparison ◽  
Labral Tears ◽  
Vas Scores ◽  
Tönnis Grade

Background: Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited. Purpose: To evaluate outcomes of the arthroscopic treatment of FAI and labral tears in patients with mild preoperative OA (Tönnis grade 1) at a minimum 5-year follow-up, and to perform a matched-pair comparison to a control group with Tönnis grade 0. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected on patients who underwent hip arthroscopic surgery between February 2008 and April 2011. Inclusion criteria were arthroscopic treatment for FAI and labral tears and having preoperative patient-reported outcome (PRO) scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) scores for pain. Exclusion criteria were workers’ compensation claims, preoperative Tönnis grade ≥2, and previous hip conditions (ipsilateral surgery, slipped capital femoral epiphysis, avascular necrosis, and dysplasia). Patients with minimum 5-year outcomes were eligible for matching on a 1:1 ratio (Tönnis grade 0 vs 1) based on age ±5 years, body mass index ±5 kg/m2, sex, labral treatment, and capsular treatment. Results: Of 356 eligible hips, 292 hips had minimum 5-year outcomes (82%). Eighty-five hips with Tönnis grade 1 were evaluated. At 5-year follow-up, patients with Tönnis grade 1 had significant improvements in all PRO and VAS scores ( P < .0001). The overall satisfaction score was 8.2. The survivorship rate with respect to conversion to total hip arthroplasty for the Tönnis grade 1 group was 69.4% at 5 years, while in the Tönnis grade 0 group, it was 88.4% ( P = .0002). Sixty-two hips with Tönnis grade 0 were matched to 62 hips with Tönnis grade 1. Both groups demonstrated improvements in all PRO and VAS scores from preoperatively to postoperatively ( P < .0001). No significant differences existed between preoperative or postoperative scores or survivorship between the groups. Conclusion: The arthroscopic treatment of FAI and labral tears in patients with Tönnis grade 1 had good results at 5-year follow-up. After controlling for other variables using a matched-pair comparison, patients with Tönnis grade 1 had similar, durable improvements to those with Tönnis grade 0. While strict surgical indications and appropriate expectations are recommended for patients with mild OA, Tönnis grade 1 alone should not be considered a contraindication to hip arthroscopic surgery.

Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase

2021 ◽  
pp. 159101992110053
Author(s):  
İsmail Okan Yıldırım ◽  
Mehmet Kolu ◽  
Mehmet Akif Durak ◽  
Bora Tetik ◽  
Ramazan Paşahan ◽  
...  
Keyword(s):  
Acute Phase ◽  
Clinical Condition ◽  
Demographic Data ◽  
Severe Disabilities ◽  
Technical Failure ◽  
Total Occlusion ◽  
Class 1 ◽  
Good Clinical Condition ◽  
Wide Neck

Background The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization. Methods This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed. Results The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.3%) patients; and two (6.6%) patients were symptomatic. A periprocedural asymptomatic intracranial hemorrhage was detected in two patients. At discharge, 17 (56.6%) patients were in good clinical condition, six (20%) were in a severe disability condition, and seven (23.3%) patients had died. At the final follow-up visit (mean: 18.9 months), 16 (76,2%) of 21 patients were in a good clinical condition and five (23.8%) had severe disabilities. Conclusions Y-stent assisted coiling in might be a feasible and promising option for treatment in acute phase in selected wide-necked ruptured intracranial aneurysms.

scholarly journals A comparison between arthroscopic and open surgery for treatment outcomes of chronic lateral ankle instability accompanied by osteochondral lesions of the talus

2019 ◽  
Author(s):  
Can Xu ◽  
Mingqing Li ◽  
Chenggong Wang ◽  
Hua Liu
Keyword(s):  
Complication Rate ◽  
Ankle Instability ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Functional Score ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Arthroscopic Procedure ◽  
Lateral Ankle Instability

Abstract Background : The present study aimed to examine the efficacy and safety of concurrent arthroscopic treatment of osteochondral lesion of talus (OLT) and lateral ankle instability. It was hypothesized that the outcome of all arthroscopic surgery was no worse than that of the combined open and arthroscopic surgery for treating chronic lateral ankle instability accompanied by OLT. Methods : All the patients diagnosed of chronic lateral ankle instability accompanied by OLT who were surgically treated between May 2015 and May2017 were targeted for inclusion. A total of 32 patients received concurrent arthroscopic treatment of OLT and lateral ankle instability, and 35 patients received arthroscopic treatment of OLT and open lateral ankle stabilization. All these patients were followed up using Karlsson Ankle Functional Score, visual analog scale (VAS) scores, Tegner activity score, and American Orthopaedic Foot and Ankle Society Score (AOFAS). The satisfaction and complication rate was evaluated and compared. Results : At 24-month follow-up, the Karlsson score, VAS score, Tegner score and AOFAS score were significantly improved in both groups in relation to the pre-operative condition. The two groups did not differ significantly from each other in terms of functional outcomes, satisfaction and complication rate. Conclusion : In comparison with the open lateral ankle stabilization and arthroscopic treatment of OLT, the all arthroscopic procedure showed no difference in clinical outcome at 24-month follow-up for treating chronic lateral ankle instability accompanied by OLT. With the benefits of minimal invasive arthroscopic procedure and an aggressive rehabilitation protocol, the treatment efficacy for the patients with chronic lateral ankle instability accompanied by OLT was still inferior to that for the patients with chronic ankle instability. Trial registration : The present study was carried out with the retrospectively registered data starting from May 28, 2015

Stenting as Monotherapy for Uncoilable Intracranial Aneurysms

2012 ◽  
Vol 73 (suppl_1) ◽  
pp. ons80-ons85 ◽  
Author(s):  
Ketan R. Bulsara ◽  
Gregory A. Kuzmik ◽  
Ryan Hebert ◽  
Vincent Cheung ◽  
Charles C. Matouk ◽  
...  
Keyword(s):  
Clinical Condition ◽  
Intracranial Aneurysms ◽  
Senior Author ◽  
Radiographic Outcomes ◽  
Effective Option ◽  
Good Clinical Condition ◽  
Aneurysm Occlusion ◽  
Flow Diverters

Abstract BACKGROUND: Small, blister-like aneurysms (BLAs), by virtue of their unique morphology, are difficult to treat with conventional modalities. The use of oversized self-expanding stents as monotherapy for BLAs is a relatively new and promising concept that warrants further investigation. OBJECTIVE: To clarify the role of oversized self-expanding stents as monotherapy for BLAs. METHODS: Five consecutive patients were treated for BLAs with oversized self-expanding stents alone by the senior author (K.R.B.). We report on their clinical and radiographic outcomes. RESULTS: All 5 patients in our series were discharged in good clinical condition. Complete aneurysm occlusion was observed in all patients at the time of most recent radiographic follow-up. Mean follow-up time was 13.6 months (range, 1 month to 4.5 years). CONCLUSION: The use of oversized self-expanding stents to redirect flow away from aneurysms is an effective option for patients with BLAs. This approach represents an alternative to the use of flow diverters.

scholarly journals Results of Arthroscopic Treatment in Unresolved Osgood-Schlatter Disease in Athletes

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0005
Author(s):  
Esra Circi ◽  
Tahsin Beyzadeoglu
Keyword(s):  
Arthroscopic Surgery ◽  
Activity Level ◽  
Arthroscopic Treatment ◽  
Tibial Tubercle ◽  
Preoperative Period ◽  
Level Of Evidence ◽  
Refractory Pain ◽  
The Mean ◽  
One Year

Purpose: Osgood-Schlatter disease (OSD) is common causes of knee pain in adolescent. Most patients respond to conservative treatment. However surgical treatment has been recommended for unresolved OSD. The aim of this study was to determine the outcomes of arthroscopic ossicle excision in athletes with unresolved OSD. Methods: Between September 2008 and November 2014, arthroscopy was performed 11 knees of 11 patients with OSD. The inclusion criteria were patients who underwent arthroscopic surgery with more than one year follow-up after surgery. Patients have a documented history of OSD with refractory pain over the tibial tubercle for a mean of 15.5 months (range, 7 to 24 months; SD, 7.5 months). The mean age was 23 years (range, 19 to 29 years; SD, 2.8 years). The mean follow-up period was 66.1 months (range, 15 to 96 months; SD, 25.6 months). Results: The mean return the sports activities after the surgery was 6.7 weeks (range 5 to 9 weeks; SD 1.3 weeks). The mean Kujala patellofemoral score improved from 82.9 (range 80 to 88 points; SD 2.6) preoperatively to 98.5 (range 96 to 100 points; SD 1.6) at final follow-up (p<0.01).In addition, the mean Lysholm knee scale was 87.5 (range 86 to 90 points; SD 1.7) in the preoperative period and increased to 96.9 (range 94 to 100 points; SD 2.5) at final follow-up(p<0.01). The mean Tegner activity level was 7.5 (range 6 to 8; SD 0.9) in the preoperative period and increased to 8.5 (range 7 to 9; SD 0.9) after surgery (p<0.01). Conclusions: We investigated the functional outcomes after arthroscopic treatment of unresolved OSD in athletes. In the all athletes, the arthroscopic treatment of OSD yielded satisfactory functional recovery. No postoperative complication were located. All patients were able to return the same level athletic activity. Level of evidence: Therapeutic Level IV. Key terms: Osgood-Schlatter disease, athletes, knee arthroscopy, ununited ossicle

Comparison of open arthrotomy versus arthroscopic surgery for the treatment of septic arthritis in adults: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Carlos Acosta-Olivo ◽  
Félix Vilchez-Cavazos ◽  
Jaime Blázquez-Saldaña ◽  
Gregorio Villarreal-Villarreal ◽  
Victor Peña-Martínez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Meta Analysis ◽  
Arthroscopic Surgery ◽  
Open Arthrotomy

scholarly journals Arthroscopic Treatment for Primary Septic Arthritis of the Hip in Adults

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jörg Hartmut Schröder ◽  
David Krüger ◽  
Carsten Perka ◽  
Martin Hufeland
Keyword(s):  
Septic Arthritis ◽  
High Volume ◽  
Hip Pain ◽  
Arthroscopic Treatment ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Perioperative Morbidity ◽  
Rare Differential Diagnosis

Purpose.Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic treatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients.Methods.Seven patients, average age44±13.7years with acute hip pain since4.4±2.9days in the average, were included. Septic arthritis was confirmed by joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate arthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage.Results.Patients were treated in hospital for12.4±3.1days (range 7–16 days). WBC and CRP returned to physiological levels. During the mean follow-up of26.4±19.4months (range 13–66 months) no patient showed recurrence of infection. The 5 patients with an unimpaired hip joint prior to the infection had a mean modified Harris Hip Score of94±5.6points (range 91–100) at final follow-up.Conclusions.Arthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic arthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection.Level of Evidence.IV.

scholarly journals Arthroscopic treatment of refractory adhesive capsulitis of the shoulder

2014 ◽  
Vol 41 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Marcos Rassi Fernandes
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
External Rotation ◽  
Constant Score ◽  
Adhesive Capsulitis ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Left Shoulder ◽  
Significant Difference

OBJECTIVE: to evaluate the results of arthroscopic treatment of refractory adhesive capsulitis of the shoulder associated as for improved range of motion after a minimum follow up of six years. METHODS: from August 2002 to December 2004, ten patients with adhesive capsulitis of the shoulder resistant to conservative treatment underwent arthroscopic surgery. One interscalene catheter was placed for postoperative analgesia before the procedure. All were in Phase II, with a minimum follow up of two years. The mean age was 52.9 years (39-66), predominantly female (90%), six on the left shoulder. The time between onset of symptoms and surgical treatment ranged from six to 20 months. Four adhesive capsulitis were found to be primary (40%) and six secondary (60%). RESULTS: the preoperative mean of active anterior elevation was 92°, of external rotation was 10.5° of the L5 level internal rotation; the postoperative ones were 149°, 40° and T12 level, respectively. Therefore, the average gain was 57° for the anterior elevation, 29.5° for external rotation in six spinous processes. There was a significant difference in movements' gains between the pre and post-operative periods (p<0.001). By the Constant Score (range of motion), there was an increase of 13.8 (average pre) to 32 points (average post). CONCLUSION: the arthroscopic treatment proved effective in refractory adhesive capsulitis of the shoulder resistant to conservative treatment, improving the range of joint movements of patients evaluated after a minimum follow up of six years.

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