A Combination of Tisseel Fibrin Glue and Orthokine ACS improves Knee Meniscus Injury Treatment and helps Avoid Surgery 4-year follow-up Archive Study

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Fibrin Glue ◽  
Knee Meniscus ◽  
Meniscus Injury ◽  
Injury Treatment

Microvascular Transposition Without Teflon: A Single Institution's 17-Year Experience Treating Trigeminal Neuralgia

2021 ◽  
Vol 20 (4) ◽  
pp. 397-405
Author(s):  
Andrew R Pines ◽  
Richard J Butterfield ◽  
Evelyn L Turcotte ◽  
Jose O Garcia ◽  
Noel De Lucia ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Postoperative Pain ◽  
Trigeminal Neuralgia ◽  
Fibrin Glue ◽  
Microvascular Decompression ◽  
Inclusion Criteria ◽  
Kaplan Meier ◽  
Trigeminal Nerve Root

Abstract BACKGROUND Trigeminal neuralgia (TN) refractory to medical management is often treated with microvascular decompression (MVD) involving the intracranial placement of Teflon. The placement of Teflon is an effective treatment, but does apply distributed pressure to the nerve and has been associated with pain recurrence. OBJECTIVE To report the rate of postoperative pain recurrence in TN patients who underwent MVD surgery using a transposition technique with fibrin glue without Teflon. METHODS Patients were eligible for our study if they were diagnosed with TN, did not have multiple sclerosis, and had an offending vessel that was identified and transposed with fibrin glue at our institution. All eligible patients were given a follow-up survey. We used a Kaplan-Meier (KM) model to estimate overall pain recurrence. RESULTS A total of 102 patients met inclusion criteria, of which 85 (83%) responded to our survey. Overall, 76 (89.4%) participants responded as having no pain recurrence. Approximately 1-yr pain-free KM estimates were 94.1% (n = 83), 5-yr pain-free KM estimates were 94.1% (n = 53), and 10-yr pain-free KM estimates were 83.0% (n = 23). CONCLUSION Treatment for TN with an MVD transposition technique using fibrin glue may avoid some cases of pain recurrence. The percentage of patients in our cohort who remained pain free at a maximum of 17 yr follow-up is on the high end of pain-free rates reported by MVD studies using Teflon. These results indicate that a transposition technique that emphasizes removing any compression near the trigeminal nerve root provides long-term pain-free rates for patients with TN.

Does an Injection of Adipose-Derived Mesenchymal Stem Cells Loaded in Fibrin Glue Influence Rotator Cuff Repair Outcomes? A Clinical and Magnetic Resonance Imaging Study

2017 ◽  
Vol 45 (9) ◽  
pp. 2010-2018 ◽  
Author(s):  
Yong Sang Kim ◽  
Chang Hun Sung ◽  
Sung Hoon Chung ◽  
Sang Joon Kwak ◽  
Yong Gon Koh
Keyword(s):  
Rotator Cuff ◽  
Fibrin Glue ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Conventional Group ◽  
Injection Group ◽  
The Mean ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: The mesenchymal stem cell (MSC)–based tissue engineering approach has been developed to improve the treatment of rotator cuff tears. Hypothesis/Purpose: The purpose was to determine the effect of an injection of adipose-derived MSCs loaded in fibrin glue during arthroscopic rotator cuff repair on clinical outcomes and to evaluate its effect on structural integrity using magnetic resonance imaging (MRI). The hypothesis was that the application of adipose-derived MSCs would improve outcomes after the surgical repair of a rotator cuff tear. Study Design: Cohort study; Level of evidence, 3. Methods: Among 182 patients treated with arthroscopic surgery for a rotator cuff tear, 35 patients treated with arthroscopic rotator cuff repair alone (conventional group) were matched with 35 patients who underwent arthroscopic rotator cuff repair with an injection of adipose-derived MSCs loaded in fibrin glue (injection group) based on sex, age, and lesion size. Outcomes were assessed with respect to the visual analog scale (VAS) for pain, range of motion (ROM) (including forward flexion, external rotation at the side, and internal rotation at the back), and functional measures of the Constant score and University of California, Los Angeles (UCLA) shoulder rating scale. Repaired tendon structural integrity was assessed by using MRI at a minimum of 12 months after surgery, and the mean clinical follow-up was 28.8 ± 4.2 months in the conventional group and 28.3 ± 3.8 months in the injection group. Results: The mean VAS score at rest and during motion improved significantly in both groups after surgery. However, there were no significant differences between the groups at the final follow-up ( P = .256 and .776, respectively). Compared with preoperative measurements, forward flexion and external rotation at the side significantly improved at the final follow-up in both groups (all P < .05). However, no significant improvements in internal rotation at the back were observed in either group ( P = .625 and .834 for the conventional and injection groups, respectively). There were also no significant differences between the groups at the final follow-up for any of the 3 ROM positions (all P > .05). The mean Constant score and UCLA score improved significantly in both groups after surgery, but there were no significant differences between the groups at the final follow-up ( P = .634 and .302, respectively). MRI indicated a retear rate of 28.5% in the conventional group and 14.3% in the injection group ( P < .001). Conclusion: This study revealed that an injection of adipose-derived MSCs loaded in fibrin glue during rotator cuff repair could significantly improve structural outcomes in terms of the retear rate. There were, however, no clinical differences in the 28-month period of follow-up. Although still in the early stages of application, MSC augmentation of surgical rotator cuff repair appears useful for providing an adequate biological environment around the repair site.

Operative Outcomes after Open Abdominal Wall Reconstruction with Retromuscular Mesh Fixation Using Fibrin Glue versus Transfascial Sutures

2017 ◽  
Vol 83 (9) ◽  
pp. 937-942 ◽  
Author(s):  
Adam S. Weltz ◽  
Udai S. Sibia ◽  
H. Reza Zahiri ◽  
Alexa Schoeneborn ◽  
Adrian Park ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Wall ◽  
Fibrin Glue ◽  
Mesh Fixation ◽  
Abdominal Wall Reconstruction ◽  
Safe Alternative ◽  
Operative Outcomes ◽  
Fixation Techniques

Ideal fixation techniques have not been fully elucidated at the time of complex open abdominal wall reconstruction (AWR). We compared operative outcomes and quality of life with retromuscular mesh fixation using fibrin glue (FG) versus transfascial sutures (TS). Retrospective review identified complex hernia patients who underwent open AWR with mesh from November 2012 through April 2016. Multivariate analysis examined postoperative outcomes between groups. Quality of life was assessed using the Carolinas Comfort Scale. Seventy-five patients (18 FG vs 57 TS) with mean age (54.3 vs 53.9 years, P = 0.914), body mass index (35.8 vs 34.7 kg/m2, P = 0.623) and American Society of Anesthesiologist score (2.6 vs 2.5, P = 0.617) were reviewed. No differences in wound (P = 0.072) and nonwound (P = 0.639) related complications were noted between groups. Risk of reoperations (P = 0.275) and 30-day readmissions (P = 0.137) were also comparable. The TS group was twelve times more likely to report pain at six-month follow-up compared with FG (12.29 OR, 95 per cent confidence interval 1.26–120.35, P = 0.031). No hernia recurrences were noted in either group at a mean follow-up of 390 ± 330 days. The use of FG to secure mesh in the retromuscular space during complex open AWR may be a safe alternative to penetrating transfascial fixation with potential to reduce chronic pain.

Clinical Diagnostic Value of Magnetic Resonance Imaging in Knee Joint Sports Injury

2021 ◽  
Vol 11 (2) ◽  
pp. 453-461
Author(s):  
Bing Wang ◽  
Li Wang ◽  
Yingyi Wang ◽  
Fen Qin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Joint ◽  
Clinical Judgment ◽  
Lateral Meniscus ◽  
Clinical Effects ◽  
Resonance Imaging ◽  
Knee Meniscus ◽  
Meniscus Injury ◽  
Sensitivity Specificity

This article mainly analyzes the clinical effects of magnetic resonance diagnosis in knee meniscus injury. Patients with knee meniscus injury were taken as the research object. All patients used magnetic resonance examination and surgery and arthroscopy examination, and surgery and arthroscopy examination as the control parameters. The analysis used magnetic resonance diagnosis results and the classification of meniscus injury diagnosed by magnetic resonance and surgery and arthroscopy. The results showed that the sensitivity, specificity, and accuracy of conventional MR1 sequence diagnosis of medial meniscus injury were 86.3%, 95.6%, and 92.4%, respectively. The sensitivity, specificity and accuracy of conventional MRI in diagnosing lateral meniscus injury of the knee joint were 91.3%, 94.5%, and 92.5% respectively. The sensitivity of MRI to medial and lateral meniscus injury was (χ2 = 0.07, P > 0.77), There were no significant differences in specificity χ2 = 0.01, P > 0.77) and accuracy χ2 = 0.01, P > 0.77). The knee meniscus injury has a greater impact on patients. The diagnostic effect of magnetic resonance imaging is better and the diagnostic accuracy is higher. It can help clinical judgment and treatment. The effect is obvious and worthy of clinical promotion.

Headache after Removal of Vestibular Schwannoma Via the Retrosigmoid Approach: A Long-Term Follow-Up-Study

2003 ◽  
Vol 128 (3) ◽  
pp. 387-395 ◽  
Author(s):  
Bernhard Schaller ◽  
Ariane Baumann
Keyword(s):  
Fibrin Glue ◽  
Aseptic Meningitis ◽  
Vestibular Schwannoma ◽  
Internal Auditory Canal ◽  
Retrosigmoid Approach ◽  
Bone Flap ◽  
Posterior Aspect ◽  
Dural Closure ◽  
Postoperative Headache

OBJECTIVE: Our goal was to study the occurrence and source of origin of postcraniotomy headache syndrome after removal of vestibular schwannoma via the retrosigmoid approach. METHODS: A retrospective chart analysis was conducted of all patients with headache at 3 months after removal of vestibular schwannoma from January 1981 through March 1997 and with a minimum of 24 months of follow-up. Diagnosis was made according to the headache classification and was graded using the HARNER scale. Recovery outcome was compared in selected groups of patients with and without headache. A descriptive statistical analysis was used to analyze differences between groups. RESULTS: Of the patients who underwent retrosigmoid craniotomy for removal of vestibular schwannomas, 52 of 155 patients (34%) reported having severe headache of requiring medication every day and/or feeling incapacitated 3 months after surgery. Headache was more prevalent in those who had the bone flap replaced (94% versus 27%), if there was duraplastic or direct dura closure (0% versus 100%). Laboratory-proven aseptic meningitis, most likely due to the use of fibrin glue and drilling of posterior aspect of the internal auditory canal, was mainly associated with postoperative headache (81% versus 2%). In 75% of these cases, calcifications along the brainstem had been noted. CONCLUSION: The origin of postoperative headaches after retrosigmoid vestibular schwannoma resections is not yet fully understood. Different factors may play a role in preventing or reducing headache: dural adhesions to nuchal muscles or to subcutaneous tissues and dural tension in the case of direct dural closure may explain postoperative headache from dural tension. Intradural drilling and the use of fibrin glue may be the source of aseptic meningitis as the etiology of persistent postoperative headache. Prevention of postoperative headache may include the replacement of bone flap at the end of surgery, duraplastic instead of direct dural closure, and prevention of the use of fibrin glue or extensive drilling of the posterior aspect of internal auditory canal.

Taming the Cavernous Sinus: Technique of Hemostasis Using Fibrin Glue

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-E52-ONS-E52 ◽  
Author(s):  
Niklaus Krayenbühl ◽  
Ahmad Hafez ◽  
Juha A. Hernesniemi ◽  
Ali F. Krisht
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Base ◽  
Sinus Surgery ◽  
Microsurgical Anatomy ◽  
Glue Injection

Abstract Objective: Improved understanding of the microsurgical anatomy of the cranial base region has made surgery in and through the cavernous sinus safer. However, continuous venous oozing that occurs during cavernous sinus surgery can cause significant blood loss and poor visualization. We describe a technique that will help minimize cavernous sinus bleeding and improve the safety of the surgical steps. Methods: The lateral wall of the cavernous sinus is exposed. Cavernous sinus access windows between the V1 and V2 branches of the trigeminal nerve and posterior to the clinoidal internal carotid artery are used to inject fibrin glue into the different cavernous sinus compartments. Postoperative follow-up cerebral angiography in basilar apex aneurysms clipped using the transcavernous approach were evaluated for cavernous sinus patency during the venous phase. Results: Fibrin glue injection between V1 and V2 obliterated the lateral cavernous sinus compartment. Fibrin glue injection posterior to the clinoidal segment of the internal carotid artery obliterated the medial compartment of the cavernous sinus. These steps were used in 217 surgical procedures (95 benign and 9 malignant neoplastic lesions; 113 aneurysms). There were no significant clinical side effects. Follow-up angiographic controls of basilar aneurysms operated on via the transcavernous approach consistently showed the reestablishment of flow within the cavernous sinus as early as 2 to 3 months postoperatively. Conclusion: Presently, the use of hemostatic agents and the better understanding of the microsurgical anatomy of the cranial base and cavernous sinus enable us to tame the cavernous sinus and operate in and around it with a high degree of safety.

scholarly journals Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up

Spinal Cord ◽  
2014 ◽  
Vol 52 (6) ◽  
pp. 462-467 ◽  
Author(s):  
N Yıldız ◽  
◽  
Y Akkoç ◽  
B Erhan ◽  
B Gündüz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurogenic Bladder ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Injury Treatment

scholarly journals Clinical and Quality of Life Outcomes of a Combined Synthetic Scaffold and Autogenous Tissue Graft Procedure for Articular Cartilage Repair in the Knee

2021 ◽  
Author(s):  
Fernando Martins Rosa ◽  
Julio Cesar Fernandes ◽  
Josée Delisle ◽  
Pierre Ranger ◽  
Mauro Batista Albano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Articular Cartilage ◽  
Fibrin Glue ◽  
Cartilage Graft ◽  
Life Outcomes ◽  
Sf 36 ◽  
Synthetic Scaffold ◽  
Articular Cartilage Lesions

Abstract Background: Injuries to the articular cartilage of the knee often fail to heal properly, due to the hypocellular and avascular nature of this tissue. Subsequent disability can limit participation in sports and decrease quality of life. Subchondral bone perforations are used for the treatment of small defects. Larger lesions filling out the central portion becomes difficult, and scaffolds can be used as adjuvants, providing a matrix onto which the defect can be filled in completely and also autogenous cartilage grafts can be combined, acting as an inducer and improving healing quality, all in a single procedure.Methods: Evaluate the clinical and quality of life outcomes of patients with articular cartilage lesions of the knee undergoing repair via a microfracture technique combined with a synthetic scaffold and autogenous cartilage graft, with transosseous sutures and fibrin glue fixation, at 12 months of follow-up. Secondarily, assess whether combined procedures, previous surgical intervention, traumatic aetiology, lesion location, and age affect outcomes. Observational study of adult patients (age 18–66 years) with symptoms consistent with chondral or osteochondral lesions, isolated or multiple, ICRS grade III/IV, 2–12 cm2 in size. Patients with corrected angular deviations or instabilities were included. Those with BMI > 40 kg/m2, prior total or subtotal (> 30%) meniscectomy, second-look procedures, and follow-up < 6 months were excluded. Pain (VAS), physical activity (IKDC), osteoarthritis (WOMAC), and general quality of life (SF-36) were assessed.Results: 64 procedures were included, comprising 60 patients. There was significant improvement (P < 0.05) in VAS (5.92 to 2.37), IKDC score (33.44 to 56.33), and modified WOMAC score (53.26 to 75.93) after surgery. The SF-36 showed significant improvements in the physical and mental domains (30.49 to 40.23 and 46.43 to 49.84 respectively; both P < 0.05).Conclusions: Combination of microfractures, autogenous crushed cartilage graft, synthetic scaffold, and transosseous sutures with fibrin glue provides secure fixation for treatment of articular cartilage lesions of the knee. At 12-month follow-up, function had improved by 20 points on the IKDC and WOMAC, and quality of life by 10 points on the SF-36. Age > 45 years had a negative impact on outcomes.

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