scholarly journals Vascular complication after anterior ankle arthroscopy

2019 ◽  
Vol 13 (1) ◽  
pp. 87-90
Author(s):  
Tatiana Ferreira dos Santos ◽  
Mauro Cesar Matos e Dinato
Keyword(s):  
Postoperative Complications ◽  
Expert Opinion ◽  
Current Literature ◽  
Arterial Occlusion ◽  
Treatment Recommendations ◽  
Vascular Complication ◽  
Ankle Arthroscopy ◽  
Level Of Evidence

Postoperative complications are a concern for surgeons, and their incidence reaches 9% in ankle arthroscopy. Of these, neurovascular complications are particularly concerning. This report aims to show a vascular complication not previously reported in the literature, in order to alert about its possibility and to provide information on the treatment recommendations in the current literature. It is a case of distal arterial occlusion in the foot after anterior ankle arthroscopy. The patient was operated upon, and the problem was resolved four months after surgery. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Gunshot-Related Injuries to the Foot & Ankle: Review Article

2020 ◽  
Vol 41 (4) ◽  
pp. 486-496 ◽  
Author(s):  
Tyler Gonzalez ◽  
Jorge Briceno ◽  
Brian Velasco ◽  
Philip Kaiser ◽  
Derek Stenquist ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Current Literature ◽  
Scientific Literature ◽  
Review Article ◽  
The Body ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Evidence Level

Gunshot-related injuries remain a significant and important cause of global morbidity and cost. The foot and ankle has certain anatomic and functional considerations that make gunshot-related injuries challenging to manage. While the scientific literature regarding gunshot-related injuries is extensive, little of the existing literature focuses on the foot and ankle. While principles of management can be somewhat extrapolated from the current literature, an understanding of the body of work specific to the foot and ankle is valuable. Therefore, this review provides an overview of ballistic injuries to the foot and ankle as well as specific guidelines to aid surgeons in treating these difficult injuries. Level of Evidence: Level V, expert opinion.

scholarly journals Severe complications of posterior ankle arthroscopy

2019 ◽  
Vol 13 (3) ◽  
pp. 223-7
Author(s):  
Celso Garreta Prats Dias ◽  
Nacime Salomão Barbachan Mansur ◽  
Inácio Diogo Asaumi ◽  
Andre Vitor Kerber Cavalcanti Lemos ◽  
Rafael Mohriak Azevedo ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Ankle Arthrodesis ◽  
Ankle Arthroscopy ◽  
Level Of Evidence ◽  
Posterior Ankle Arthroscopy ◽  
Extreme Care ◽  
Arthroscopic Procedures

Posterior ankle and hindfoot arthroscopic procedures are associated with a series of possible complications that must be taken into consideration by physicians when performing surgery. This article intends to assess the severe complications, such as subtalar ankle arthrodesis, occurring in patients undergoing ankle arthroscopy procedures in which at least one posterior portal is used. A series of five consecutive patients undergoing posterior ankle arthroscopy-related procedures were assessed. All the complications described in this article were considered severe by the group. We suggest that extreme care is necessary for the training and indications of this very useful but underestimated and complex tool. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Outcomes of minimally invasive nephroureterectomy in octogenarians: a single centre experience and review of literature

2021 ◽  
pp. 205141582110065
Author(s):  
Gerard McCabe ◽  
Jane Hendry ◽  
Khaver N Qureshi ◽  
Grenville Oades ◽  
Nkem Umez-Eronini ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Current Literature ◽  
Survival Data ◽  
Case Series ◽  
Radical Nephroureterectomy ◽  
Single Centre ◽  
Recurrence Rates ◽  
Level Of Evidence ◽  
Upper Tract

Introduction: The gold standard treatment for high risk upper tract urothelial cancers is radical nephroureterectomy. Little evidence exists specifically directed for octogenarians with this disease, therefore we highlight our centre’s outcomes and compare to current literature. Methods: Demographic, operative and postoperative data were collected on all octogenarian patients who underwent minimally invasive radical nephroureterectomy between 2010 and 2018 in a single centre. Outcomes including intraoperative and postoperative complications, disease recurrence rates and survival data were analysed. A literature search was performed, with six included articles of cases series and retrospective cohort studies after screening of full manuscripts. Results: Twenty-three patients of average age 82.6 years (range 80–85) were included. Length of stay was median 10 days (range 5–53). Six patients (25%) had postoperative complications ranging from Clavien–Dindo classification 2–3. Eight patients were found to have recurrence, with median time to recurrence of 18 months. Of the 13 patients who died during a follow-up of median 38.4 months, five patients (22%) died of disease related to their original diagnosis (median survival 20 months). Conclusions: From this single centre case series results combined with a review of current literature, radical nephroureterectomy is safe for octogenarian patients for upper tract urothelial cancers when appropriately selected. Further work will need to be carried out to assess the role of lymphadenectomy and adjuvant chemotherapy in the older patient cohort. Level of evidence Level 4

Use of Small-Pin Distraction and Low-Speed, High-Torque Burring for Talar Osteochondral Allografts: Technique Tip

2021 ◽  
pp. 107110072110031
Author(s):  
Ryan O’Leary ◽  
Ian M. Foran ◽  
David J. Dalstrom
Keyword(s):  
Expert Opinion ◽  
Level Of Evidence ◽  
Low Speed ◽  
Evidence Level ◽  
High Torque ◽  
Osteochondral Allografts

Level of Evidence: Level V, expert opinion.

scholarly journals Telemedicine Foot and Ankle Visits in the COVID-19 Era

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142199406
Author(s):  
Sameh A. Labib ◽  
Rahul Goel ◽  
Wesley Manz ◽  
Jason Bariteau
Keyword(s):  
Patient Experience ◽  
Expert Opinion ◽  
Foot And Ankle ◽  
Office Visits ◽  
Level Of Evidence ◽  
Excellent Care ◽  
Musculoskeletal Care

Background: The COVID-19 pandemic created a difficult environment to provide musculoskeletal care to patients with foot and ankle pathology given the limitations placed on in-office visits. Telemedicine offered a unique avenue to reach these patients; however, the efficacy of telemedicine visits in patients with foot and ankle pathology is not well studied. We propose a telemedicine protocol that has allowed us to effectively see and treat patients with foot and ankle pathology. Methods: A 12-step standardized telemedicine protocol was created within the Foot and Ankle division that was used for seeing patients through telemedicine. Also included in this is previsit preparation and follow-up recommendations. Press Ganey surveys were retrospectively reviewed to understand patient experience with telemedicine. Results: 85.2% of patients surveyed responded with scores indicating excellent care. When comparing patients who were seen in-office and through telemedicine, 89.2% and 83.4% responded with scores indicating excellent care, respectively ( P = .37). Conclusion: Telemedicine offers an effective and convenient way to provide excellent musculoskeletal care to patients affected with foot and ankle pathology. This is the first study that evaluated a comprehensive protocol for telemedicine encounters and can be used to implement telemedicine by others using this approach. Level of Evidence: Level V, expert opinion.

scholarly journals Arthroscopic Posterior Ankle Ligament Anatomy

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110006
Author(s):  
Richard D. Ferkel ◽  
Cory Kwong ◽  
Randall Farac ◽  
Mark Pinto ◽  
Nader Fahimi ◽  
...  
Keyword(s):  
Distal Tibia ◽  
Case Series ◽  
Ankle Arthroscopy ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Tibiofibular Ligament ◽  
Ankle Ligament

Background: The purpose of this article is to document the normal arthroscopic appearance of the posterior ankle capsular and ligamentous structures, and variations in their anatomical relationships. Methods: 102 ankle arthroscopy videotapes were evaluated retrospectively for the configuration of the posterior capsuloligamentous structures. Based on these observations, the variations in the appearance and position of the posterior tibiofibular ligament (PTFL) and transverse (tibiofibular) ligament (TTFL) were documented. In addition, differences in the appearance of the flexor hallucis longus (FHL) were also noted. Results: All patients had evidence of both a PTFL and TTFL, which formed a labrum or meniscus-like addition to the posterior distal tibia. No patients demonstrated disruption of the PTFL; 3 had tears of the TTFL. We noted 4 distinct patterns of the PTFL and the TTFL. Thirty-four patients (33%) had a gap of ≥2 mm between the 2 ligamentous structures. Thirty-three (32.4%) had a gap <2 mm between the PTFL and TTFL. Twenty-six (25.5%) had a confluence of the 2 ligaments without a gap. Nine (9%) demonstrated a sizable gap between the 2 ligaments, and the TTFL appeared as a “cord-like” structure. Conclusion: To our knowledge, this is the first article to describe the variations in the arthroscopic normal posterior capsuloligamentous structures and FHL of the ankle. Level of Evidence: Level IV, case series.

scholarly journals Systematic review of the factors affecting cat and dog owner compliance with pharmaceutical treatment recommendations

2018 ◽  
Vol 184 (5) ◽  
pp. 154-154 ◽  
Author(s):  
Kathryn Jennifer Wareham ◽  
Marnie Louise Brennan ◽  
Rachel S Dean
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Relevant Literature ◽  
Evidence Base ◽  
Treatment Recommendations ◽  
Social Risk ◽  
Dosing Regimen ◽  
Pharmaceutical Treatment ◽  
Level Of Evidence ◽  
Factors Affecting

The aim of this systematic review is to describe and assess the quality of the existing evidence base concerning factors that influence the compliance of cat and dog owners to pharmaceutical and specifically polypharmacy treatment recommendations. PubMed, CAB Abstracts and Google were searched to identify relevant literature and search results were filtered according to predetermined inclusion and exclusion criteria. Standardised data extraction and critical appraisal were carried out on each included study, and a Centre for Evidence-Based Medicine level of evidence grading was applied. Of the 8589 studies, eight studies were included in the review. Majority (five of eight) of the included studies were examining compliance with short-term antimicrobial therapies and none examined polypharmacy. Multiple definitions of compliance, methods of measurement and different factors potentially affecting compliance were used. Factors reported to have affected compliance in at least one study were dosing regimen, discussion of dosing regimen in light of owners’ circumstances, consultation time, disease, month of consultation/treatment, physical risk, social risk and method of administration. The evidence available regarding factors affecting client compliance with pharmaceutical treatment recommendations in cats and dogs is scarce and of poor quality.

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective

2019 ◽  
Vol 33 (01) ◽  
pp. 034-041 ◽  
Author(s):  
Theodore S. Wolfson ◽  
David Novikov ◽  
Kevin K. Chen ◽  
Kelvin Y. Kim ◽  
Afshin A. Anoushiravani ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Complications ◽  
Knee Arthroplasty ◽  
Subgroup Analysis ◽  
Blood Management ◽  
Folate Supplementation ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Total Knee

AbstractDespite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demographics, intraoperative details, and postoperative complications including in-hospital complications, revisions, and 90-day readmissions were collected and compared between the groups. Additionally, subgroup analysis was performed comparing JW patients who were administered tranexamic acid (TXA) between the two groups. Baseline demographics did not vary significantly between the study cohorts. The mean follow-up was 3.1 years in both the JW and non-JW cohorts. Postoperative complications, including in-hospital complications (7.9 vs. 4.8%; p = 0.47), revision TKA (1.6 vs. 1.6%; p = 1.00), and 90-day readmission (1.6 vs. 4.8%; p = 0.31) were not significantly different between the JW and non-JW groups. Subgroup analysis demonstrated JW patients who received TXA had a significantly lower decline in postoperative hemoglobin (Hgb) (8.6 vs. 14.0%; p < 0.01). At a follow-up of up to 12 years, JW patients who underwent TKA have outcomes equivalent to non-JW patients without the need for transfusion. Our findings support that surgeons are more likely to optimize JW patients preoperatively with iron and folate supplementation. Despite these variations in preoperative optimization efforts, no significant difference with regard to Hgb or hematocrit levels was demonstrated. Level of evidence is III, retrospective observational study.

scholarly journals Calcaneonavicular coalition resection

2020 ◽  
Vol 14 (3) ◽  
pp. 297-300
Author(s):  
Mercedes Juncay ◽  
Rafael Sposeto ◽  
Alexandre Godoy-Santos ◽  
Túlio Fernandes
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Conservative Treatment ◽  
Treatment Option ◽  
Expert Opinion ◽  
Tarsal Bone ◽  
Tarsal Coalition ◽  
Level Of Evidence ◽  
Calcaneonavicular Coalition ◽  
Tarsal Bones

Tarsal coalition is an abnormal connection between tarsal bones, caused by an embryogenic failure. Its most common forms are calcaneonavicular and talocalcaneal coalition, which are present in 53% and 37% of the cases, respectively. The onset of symptoms is related to tarsal bone ossification, and mean age for this event is estimated at 16 years for calcaneonavicular coalition. Surgical treatment is indicated for patients who did not improve symptoms with conservative treatment. The aim of this study is to present a surgical technique as a treatment option for resection of calcaneonavicular coalition associated with abnormal cuboid-navicular joint. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Treatment Recommendations for Suspected Scapholunate Ligament Pathology

2021 ◽  
Author(s):  
Daniel Bakker ◽  
Joost T.P. Kortlever ◽  
Gerald A. Kraan ◽  
Nina Mathijssen ◽  
Joost W. Colaris ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Treatment Recommendations ◽  
Wrist Pain ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
Interosseous Ligament ◽  
Recent Onset ◽  
Diagnostic Arthroscopy ◽  
Reconstructive Option

Abstract Background The diagnosis and treatment of scapholunate interosseous ligament (SLIL) pathology is debated and notably variable. This study assessed the influence of diagnostic arthroscopy on treatment recommendations and the interobserver reliability of the arthroscopic classification of SLIL pathology. Methods The influence of diagnostic arthroscopy on treatment recommendations and the reliability of the arthroscopic classification of SLIL pathology were tested in a survey-based experiment. Seventy-seven surgeons evaluated 16 scenarios of people with wrist pain with variation in symptoms, scaphoid shift, time of symptom onset, and MRI appearance of the SLIL. Participants were randomized to view or not to view diagnostic wrist arthroscopy. Factors associated with recommendation for repair, capsulodesis, or tenodesis were analyzed. Results Viewing arthroscopic videos was associated with both offering surgery and a more reconstructive option. Other factors independently associated with recommendation for surgery included greater pain intensity and activity intolerance, women surgeons, an asymmetric scaphoid shift, and a recent onset of symptoms. The interobserver reliability of SLIL classification was slight. Conclusions Diagnostic arthroscopy leads to more surgery, and more invasive surgery, in spite of unreliable assessment of pathology. Clinical Relevance This points to the need to measure the potential benefits and harms of diagnostic wrist arthroscopy among people with wrist pain and no clear diagnosis on interview, examination, and radiographs. Level of Evidence Not applicable.

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