Results of arthroscopic meniscal repair

Objectives: Currently the arthroscopic treatment of meniscal pathology has become one of the most common procedures in orthopedic practice and although in most cases meniscectomy is done, meniscal sutures are the treatment of choice when a reparable lesion is diagnosed, especially in young patients. It has been reported that the meniscal repair leads to a lower incidence of developing degenerative changes in the long-term when compared with meniscectomy and nonsurgical treatment of meniscal injuries. The aim of this study was to determine the success rate of meniscal repair achieved in our sports medicine practice. Methods: Between 2006 and 2015, 62 meniscal tears in 58 patients with a mean age of 31 years (range 15-58) were repaired. Mean follow-up was 52 months (range 6-120 months). In 16 patients (28%) was associated with arthroscopic ACL reconstruction. The repair techniques used included outside-in sutures, inside-out sutures, all-inside sutures and a combination of techniques. Failure of the repair was defined by the requirement for repeat knee arthroscopy and partial or subtotal meniscectomy. The indication of arthroscopic revision was based on the presence of mechanical symptoms, after the suture. Results: Failure of meniscus repair occurred in four patients (failure rate: 6.45%), one case was associated with ACL reconstruction (failure rate: 6.25%) and 3 had undergone isolated meniscal suture (failure rate: 8%). The average time for the reoperation was 15 months (4-24). We had no intraoperative complications. Conclusion: The reported failure rate of meniscal repair in stable knees varies between 12% and 43%, with reports that demonstrate a clinical success rate of 100%. In this study, we obtained a success rate of 93.5%. These results are slightly higher than those in the literature, which can be attributed to careful selection of patients and the fact that clinical success tends to be better than the assessed arthroscopically. In summary, we consider the meniscal repair as a successful option in the treatment of meniscal rupture. Due to the importance it has recovered in the last time preserving the meniscus, in the future we should greatly increase our rate of meniscal suture. We hold that careful selection of patients and the type of injury to repair, optimizes the success of meniscal repairs.

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Endoscopic Treatment of Subglottic and Tracheal Stenosis by Radial Laser Incision and Dilation

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948709600609 ◽

1987 ◽

Vol 96 (6) ◽

pp. 661-664 ◽

Cited By ~ 123

Author(s):

Stanley M. Shapshay ◽

Roger L. Hybels ◽

John F. Beamis ◽

R. Kirk Bohigian

Keyword(s):

Carbon Dioxide ◽

Tracheal Stenosis ◽

Endoscopic Treatment ◽

Mechanical Trauma ◽

Careful Selection ◽

Tracheal Collapse ◽

Laser Incision ◽

Selection Of Patients ◽

Selection Of

Five patients with severe fibrous subglottic and tracheal stenosis were treated by endoscopic radial laser incision and dilation using both carbon dioxide and neodymium:yttrium aluminum garnet lasers. Good results were noted without complications in all patients in a follow-up period of at least 1 year. Careful selection of patients, excluding those with tracheal collapse or tracheomalacia, and preservation of tracheal epithelium with minimal heat and mechanical trauma are considered essential for good results.

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Subtotal laryngectomy with myomucosal shunt

The Journal of Laryngology & Otology ◽

10.1017/s0022215100156725 ◽

1989 ◽

Vol 103 (5) ◽

pp. 504-507 ◽

Cited By ~ 13

Author(s):

H. R. Chandrachud ◽

M. K. Chaurasia ◽

K. P. Sinha

Keyword(s):

Squamous Cell Carcinoma ◽

Frozen Section ◽

Careful Selection ◽

Voice Production ◽

Tracheal Stoma ◽

The Voice ◽

Selection Of Patients ◽

Thyroarytenoid Muscle ◽

Tumour Extent ◽

Selection Of

AbstractThis is a modified subtotal laryngectomy. On the tumour-free side of the larynx, some posterior structures, with their neurovascular supply are preserved. The endolaryngeal mucosa is tubed in continuity with the trachea below and projects into the pharynx above. Thus a myomucosal shunt is formed. Air is directed into it by finger occlusion of the tracheal stoma.The voice production is highly satisfactory. Aspiration is prevented by constriction of the thyroarytenoid muscle which provides a valved upper end of the tube.The possibility of leaving tumour in the laryngeal remnant is eliminated by careful selection of patients, and re-confirmation of tumour extent intra-operatively and a frozen section.Eleven such operations have been performed since October 1983 for squamous cell carcinoma, some previously irradiated. None of the patients had local recurrence. Only one had an aspiration problem which later resolved. All acquired a satisfactory voice

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M1540 High Complication Rate After Pancreas Preserving Surgical Procedures for Benign or Borderline Pancreatic Lesions. Careful Selection of Patients Is Needed

Gastroenterology ◽

10.1016/s0016-5085(08)64072-x ◽

2008 ◽

Vol 134 (4) ◽

pp. A-869

Author(s):

Cosimo Sperti ◽

Claudio Pasquali ◽

Mattia Berselli ◽

Laura Frison ◽

Tania Saibene ◽

...

Keyword(s):

Surgical Procedures ◽

Complication Rate ◽

Careful Selection ◽

High Complication Rate ◽

Selection Of Patients ◽

Selection Of

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Seventeen-Year Follow-up After Meniscal Repair With Concomitant Anterior Cruciate Ligament Reconstruction in a Pediatric and Adolescent Population

The American Journal of Sports Medicine ◽

10.1177/0363546518803934 ◽

2018 ◽

Vol 46 (14) ◽

pp. 3361-3367 ◽

Cited By ~ 5

Author(s):

Adam J. Tagliero ◽

Vishal S. Desai ◽

Nicholas I. Kennedy ◽

Christopher L. Camp ◽

Michael J. Stuart ◽

...

Keyword(s):

Acl Reconstruction ◽

Clinical Success ◽

Cruciate Ligament ◽

Meniscal Repair ◽

Clinical Success Rate ◽

Adolescent Population ◽

Long Term Follow Up ◽

Anterior Cruciate

Background: Studies have shown good and excellent clinical and radiographic results after meniscal repair. Limited published information exists on the long-term outcomes, however, especially in a pediatric and adolescent population. Purpose: To determine long-term results of meniscal repair and concomitant anterior cruciate ligament (ACL) reconstruction in a pediatric and adolescent population. Specifically, the aims were to determine the clinical success rate of meniscal repair with concomitant ACL reconstruction, compare results with midterm outcomes, and analyze risk factors for failure. Study Design: Case series; Level of evidence, 4. Methods: Cases of meniscal repair with concomitant ACL reconstruction between 1990 and 2005 were reviewed among patients aged ≤18 years. Patient demographics, injury history, and surgical details were recorded, and risk factors for failure were analyzed. Physical examination findings and clinical outcomes at latest available follow-up were collected. Subjective knee outcomes were compared with midterm results. Descriptive statistics and univariate analysis were used to evaluate the available data. Results: Forty-seven patients (30 females, 17 males) with a mean age of 16 years (SD, 1.37) and a mean follow-up of 16.6 years (SD, 3.57) were included in this study. Overall, 13 patients (28%) failed meniscal repair and required repeat surgery at the time of final follow-up. Of the 13 failures, 9 underwent a subsequent meniscectomy; 2, meniscectomy and revision ACL reconstruction; 1, meniscal repair and revision ACL reconstruction; and 1, meniscal repair and subsequent meniscectomy. Mean International Knee Documentation Committee scores improved from 47.9 preoperatively to 87.7 postoperatively ( P < .01), and the mean score at long-term follow-up (87.7) did not significantly differ from that at the midterm follow-up (88.5) at a mean 7.4 years ( P = .97). Mean Tegner Activity Scale scores improved from 1.9 preoperatively to 6.3 postoperatively ( P < .01) and decreased from 8.3 at preinjury to 6.3 at final long-term follow-up ( P < .01). Conclusion: In conclusion, the long-term overall clinical success rate (failure-free survival) was 72% for repair of pediatric and adolescent meniscal tears in the setting of concomitant ACL reconstruction. Patients reported excellent knee subjective outcome scores that remained favorable when compared with midterm follow-up.

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Combined Liver and Multivisceral Resections

HPB Surgery ◽

10.1155/2014/976546 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Martin de Santibañes ◽

Agustin Dietrich ◽

Eduardo de Santibañes

Keyword(s):

Liver Metastases ◽

Postoperative Morbidity ◽

Scientific Evidence ◽

Mortality Rates ◽

Careful Selection ◽

Colorectal Tumors ◽

Extensive Experience ◽

Electronic Search ◽

Selection Of Patients ◽

Selection Of

Background. Combined liver and multivisceral resections are infrequent procedures, which demand extensive experience and considerable surgical skills. Methods. An electronic search of literature related to this topic published before June 2013 was performed. Results. There is limited scientific evidence of the feasibility and clinical outcomes of these complex procedures. The majority of these cases are simultaneous resections of colorectal tumors with liver metastases. Combined liver and multivisceral resections can be performed with acceptable postoperative morbidity and mortality rates only in carefully selected patients. Conclusion. Lack of experience in these aggressive surgeries justifies a careful selection of patients, considering their comorbidities.

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High-dose interleukin2 – a 10-year single-site experience in the treatment of metastatic renal cell carcinoma: careful selection of patients gives an excellent outcome

Journal for ImmunoTherapy of Cancer ◽

10.1186/s40425-016-0174-5 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 13

Author(s):

S. Chow ◽

V. Galvis ◽

M. Pillai ◽

R. Leach ◽

E. Keene ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Single Site ◽

High Dose ◽

Careful Selection ◽

Excellent Outcome ◽

Selection Of Patients ◽

Selection Of

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Multidrug-resistant Gram-negative bacteria-resistant infections: epidemiology, clinical issues and therapeutic options

Italian Journal of Medicine ◽

10.4081/itjm.2016.802 ◽

2016 ◽

Vol 10 (4) ◽

pp. 364 ◽

Cited By ~ 11

Author(s):

Matteo Bassetti ◽

Davide Pecori ◽

Maddalena Peghin

Keyword(s):

Risk Factors ◽

Multidrug Resistant ◽

Therapeutic Options ◽

Gram Negative Bacteria ◽

Careful Selection ◽

Clinical Issues ◽

Gram Negative ◽

Severe Infections ◽

Selection Of Patients ◽

Selection Of

In the last decade, we have witnessed a dramatic increase in the number of multidrug resistant Gram-negative (MDRGN) bacterial pathogens, both in Italy and worldwide, with Enterobacteriacae (mostly Klebsiella pneumoniae), Pseudomonas aeruginosa and Acinetobacter baumannii being the major threats in clinical practice. Inadequate empirical antimicrobial therapy of severe infections caused by MDR Enterobacteriacae has been associated with an increased morbidity and mortality. However, a careful selection of patients who may receive empirical treatment covering MDR Enterobacteriacae is important to avoid the overuse of broad-spectrum antibiotics. The aim of this review is to describe the mechanism of resistance, epidemiology, risk factors, clinical issues, and therapeutic options for MDRGN pathogens.

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Safely Precautions for Bronchoscopic CO2 Laser Surgery

Otolaryngology ◽

10.1177/019459988609500222 ◽

1986 ◽

Vol 95 (2) ◽

pp. 242-244 ◽

Cited By ~ 3

Author(s):

James A. Duncavage ◽

Robert H. Ossoff

Keyword(s):

Co2 Laser ◽

Laser Surgery ◽

Tracheobronchial Tree ◽

Careful Selection ◽

Tumor Vascularity ◽

X Ray ◽

Malignant Lesions ◽

Selection Of Patients ◽

Selection Of ◽

Special Instrumentation

Certain safety precautions are necessary in the performance of CO2 laser bronchoscopy. These include special instrumentation and careful selection of patients. Assessment of tumor vascularity is mandatory because of the limited hemostasis provided by the CO2 laser. The x-ray film evaluation of the integrity of the tracheobronchial tree—for treatment that involves the palliation of obstructing malignant lesions—is outlined.

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