scholarly journals Resident Involvement in Arthroscopic Knee Surgery Is Not Associated With Increased Short-term Risk to Patients

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096746
Author(s):  
Bryce A. Basques ◽  
Bryan M. Saltzman ◽  
Shane S. Korber ◽  
Ioanna K. Bolia ◽  
Erik N. Mayer ◽  
...  
Keyword(s):  
Adverse Events ◽  
Operative Time ◽  
Statistical Significance ◽  
Knee Surgery ◽  
Improvement Program ◽  
Level Of Evidence ◽  
Arthroscopic Knee Surgery ◽  
Increased Risk ◽  
Resident Involvement ◽  
Arthroscopic Knee

Background: Whether resident involvement in surgical procedures affects intra- and/or postoperative outcomes is controversial. Purpose/Hypothesis: The purpose of this study was to compare operative time, adverse events, and readmission rate for arthroscopic knee surgery cases with and without resident involvement. We hypothesized that resident involvement would not negatively affect these variables. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of the prospectively maintained National Surgical Quality Improvement Program was performed. Patients who underwent arthroscopic knee surgery between 2005 and 2012 were identified. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts. Because of multiple statistical comparisons, a Bonferroni correction was used, and statistical significance was set at P < .004. Results: A total of 29,539 patients who underwent arthroscopic knee surgery were included in the study, and 11.3% of these patients had a resident involved with the case. The overall rate of adverse events was 1.62%. On multivariate analysis, resident involvement was not associated with increased rates of adverse events or readmission. Resident cases had a mean 6-minute increase in operative time ( P < .001). Conclusion: Overall, resident involvement in arthroscopic knee surgery was not associated with an increased risk of adverse events or readmission. Resident involvement was associated with only a mean increased operative time of 6 minutes, a difference that is not likely to be clinically significant. These results support the safety of resident involvement with arthroscopic knee surgery.

scholarly journals Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881629 ◽  
Author(s):  
Bryce A. Basques ◽  
Bryan M. Saltzman ◽  
Erik N. Mayer ◽  
Bernard R. Bach ◽  
Anthony A. Romeo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Operative Time ◽  
Shoulder Arthroscopy ◽  
Error Variance ◽  
Improvement Program ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Resident Involvement ◽  
American College Of Surgeons ◽  
Perioperative Risks

Background: Shoulder arthroscopy is a commonly performed, critical component of orthopaedic residency training. However, it is unclear whether there are additional risks to patients in cases associated with resident involvement. Purpose: To compare shoulder arthroscopy cases with and without resident involvement via a large, prospectively maintained national surgical registry to characterize perioperative risks. Study Design: Cohort study; Level of evidence, 3. Methods: The prospectively maintained American College of Surgeons National Surgical Quality Improvement Program registry was queried to identify patients who underwent 1 of 12 shoulder arthroscopy procedures from 2005 through 2012. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts. Results: A total of 15,774 patients with shoulder arthroscopy were included in the study, and 12.3% of these had a resident involved with the case. The overall rate of adverse events was 1.09%. On multivariate analysis, resident involvement was not associated with increased rates of any aggregate or individual adverse event. There was also no association between resident involvement and risk of readmission within 30 days. Resident involvement was not associated with any difference in operative time ( P = .219). Conclusion: Resident involvement in shoulder arthroscopy was not associated with increased risk of adverse events, increased operative time, or readmission within 30 days. The results of this study suggest that resident involvement in shoulder arthroscopy cases is a safe method for trainees to learn these procedures.

scholarly journals Thromboembolic Events after Arthroscopic Knee Surgery: Increased Risk at High Altitude

2014 ◽  
Vol 2 (7_suppl2) ◽  
pp. 2325967114S0008 ◽  
Author(s):  
Jared J. Tyson ◽  
Brian Bjerke ◽  
James Genuario ◽  
Thomas J. Noonan
Keyword(s):  
High Altitude ◽  
Knee Surgery ◽  
Thromboembolic Events ◽  
Arthroscopic Knee Surgery ◽  
Increased Risk ◽  
Arthroscopic Knee

scholarly journals Impact of Residents on Operative Time in Aesthetic Surgery at an Academic Institution

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Erin C Peterson ◽  
Trina D Ghosh ◽  
Ali A Qureshi ◽  
Terence M Myckatyn ◽  
Marissa M Tenenbaum
Keyword(s):  
Breast Augmentation ◽  
Operative Time ◽  
Statistical Significance ◽  
Cohort Analysis ◽  
Aesthetic Surgery ◽  
Academic Institution ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Duration Of Surgery ◽  
Resident Involvement

Abstract Background Duration of surgery is a known risk factor for increased complication rates. Longer operations may lead to increased cost to the patient and institution. While previous studies have looked at the safety of aesthetic surgery with resident involvement, little research has examined whether resident involvement increases operative time of aesthetic procedures. Objectives We hypothesized that resident involvement would potentially lead to an increase in operative time as attending physicians teach trainees during aesthetic operations. Methods A retrospective cohort analysis was performed from aesthetic surgery cases of two surgeons at an academic institution over a 4-year period. Breast augmentation and abdominoplasty with liposuction were examined as index cases for this study. Demographics, operative time, and resident involvement were assessed. Resident involvement was defined as participating in critical portions of the cases including exposure, dissection, and closure. Results A total of 180 cases fit the inclusion criteria with 105 breast augmentation cases and 75 cases of abdominoplasty with liposuction. Patient demographics were similar for both procedures. Resident involvement did not statistically affect operative duration in breast augmentation (41.8 ± 9.6 min vs 44.7 ± 12.4 min, P = 0.103) or cases for abdominoplasty with liposuction (107.3 ± 20.5 min vs 122.2 ± 36.3 min, P = 0.105). Conclusions There was a trend toward longer operative times that did not reach statistical significance with resident involvement in two aesthetic surgery cases at an academic institution. This study adds to the growing literature on the effect resident training has in aesthetic surgery. Level of Evidence: 2

scholarly journals High incidence of acute self-reported sleep disturbances in patients following arthroscopic-assisted knee surgery

2021 ◽  
pp. jisakos-2020-000594
Author(s):  
Nicholas N DePhillipo ◽  
Robert S Dean ◽  
Lars Engebretsen ◽  
Christopher M Larson ◽  
Jill Monson ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Final Analysis ◽  
Knee Surgery ◽  
Team Approach ◽  
Pain Level ◽  
Level Of Evidence ◽  
Arthroscopic Knee Surgery ◽  
Knee Effusion ◽  
Postoperative Physical Therapy ◽  
Arthroscopic Knee

ObjectivesTo evaluate the self-reported incidence of sleep disturbances, defined as ≤7 hours of sleep per 24-hour period, in patients undergoing arthroscopic-assisted knee surgery.MethodsPatients who underwent arthroscopic knee surgery over the course of a 4-month period were prospectively included. Patients were excluded if a history of insomnia or other sleep altering medical history was reported. Self-reported sleep metrics included average number of hours of sleep per night, average number of awakenings during sleep per night, perceived quality of sleep, average pain level during sleep and number of hours of physical activity/therapy per week. Data were collected at weeks 1, 3, and 6 postoperatively. Joint circumference was measured on postoperative day 1 and served as an indicator of a knee effusion. Paired t-tests were used to compare preoperative to postoperative hours of sleep. Simple and multiple linear regression were used to evaluate relationships between surgical variables and postoperative sleep metrics.ResultsThere were 123 patients who underwent arthroscopic knee surgery during the prospective enrolment period; 83 patients were included in the final analysis. The overall incidence of preoperative sleep disturbances was 20% (n=17). The overall incidence of self-reported postoperative sleep disturbances was 99%, 96% and 90% at weeks 1, 3 and 6, respectively. The average number of hours slept was significantly reduced at 1, 3 and 6 weeks postoperatively compared with the preinjury state (p<0.001). Knee joint circumference had a significantly negative correlation with average number of hours of sleep in the first 6 weeks postoperatively (R=−0.704; p=0.001). Surgical variables including severity of surgery, weekly postoperative pain level and weekly hours of postoperative physical therapy were not significant independent predictors of acute postoperative sleep disturbances (p>0.05).ConclusionSleep disturbances were commonly reported in patients following arthroscopic knee surgery without correction of sleep metrics by 6 weeks postoperatively. The majority of sleep disturbances in this cohort correlated with an increased knee effusion. A multidisciplinary team approach is recommended to counsel patients regarding the potential for and problems with acute sleep disturbances following arthroscopic knee surgery.Level of evidence: 3.

scholarly journals Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Opioid Consumption ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.

Clinical analgesic efficacy and side effects of dexmedetomidine in the early postoperative period after arthroscopic knee surgery

2007 ◽  
Vol 19 (8) ◽  
pp. 576-582 ◽  
Author(s):  
Maria E. Gómez-Vázquez ◽  
Eduardo Hernández-Salazar ◽  
Abel Hernández-Jiménez ◽  
Arturo Pérez-Sánchez ◽  
Vilma A. Zepeda-López ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Period ◽  
Analgesic Efficacy ◽  
Early Postoperative Period ◽  
Knee Surgery ◽  
Arthroscopic Knee Surgery ◽  
Arthroscopic Knee

Endovascular repair of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery: case report and review of literature

Vascular ◽  
2013 ◽  
Vol 21 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Zachary Aburahma ◽  
Stephen M Hass
Keyword(s):  
Case Report ◽  
Endovascular Repair ◽  
Popliteal Artery ◽  
Knee Surgery ◽  
Review Of Literature ◽  
Safe Alternative ◽  
Arthroscopic Knee Surgery ◽  
Arthroscopic Knee

We report a case of a pseudoaneurysm of the popliteal artery following arthroscopic knee surgery. Endovascular repair was successfully used as the treatment for this patient and studies have shown this to be a safe alternative to surgery.

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