Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs

2014 ◽  
Vol 27 (04) ◽  
pp. 263-270 ◽  
Author(s):  
M. Havlicek ◽  
N. R. Perkins ◽  
D. R. James ◽  
S. M. Fearnside ◽  
A. M. Marchevsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kirschner Wire ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Sartorius Muscle ◽  
Kirschner Wires ◽  
Major Complications ◽  
Fold Reduction ◽  
Tension Bands

SummaryDogs treated for congenital medial patellar luxation were reviewed for the purpose of determining the incidence of postoperative major complications requiring surgical revision and the risk factors for their occurrence. Major complications occurred in 18.5% of the patellar luxation stabilization procedures with implant associated complications being the most frequent, patellar reluxation the second, and tibial tuberosity avulsion the third most common major complication. Other complications included patellar ligament rupture and trochlear wedge displacement. When recession trochleoplasty was performed in addition to tibial tuberosity transposition, a 5.1-fold reduction in the rate of patellar reluxation was observed. Release of the cranial belly of the sartorius muscle further reduced the incidence of patellar reluxation, while patella alta (pre- or postoperative) and patellar luxation grade were not found to influence the rate of reluxation. Tibial tuberosity avulsion was 11.1-times more likely when using a single Kirschner wire to stabilize a transposition, compared with two Kirschner wires. Independent to the number of Kirschner wires used, the more caudodistally the Kirschner wires were directed, the higher the risk for tibial tuberosity avulsion. Tension bands were used in 24.4% of the transpositions with no tuberosity avulsion occurring in stifles stabilized with a tension band. Overall, grade 1 luxations had a significantly lower incidence of major complications than other grades, while body weight, age, sex, and bilateral patellar stabilization were not associated with risk of major complication development.

scholarly journals Tibial Plateau Leveling Following Tibial Tuberosity Advancement: A Case Series

2022 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Daniele Serrani ◽  
Pierre Paul Picavet ◽  
Juan Marti ◽  
Bernard Bouvy ◽  
Marc Balligand ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Case Series ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Short Term ◽  
Long Term Follow Up ◽  
Persistent Instability

Persistent stifle instability is a recognized complication following tibial tuberosity advancement techniques (TTAT). The aim of this study is to report the feasibility and outcome of tibial plateau leveling techniques (TPLT) to treat dogs with persistent lameness, suspected to be secondary to persistent stifle instability, following (TTAT). Medical records of dogs presented for persistent lameness after TTAT were reviewed. Preoperative data included orthopedic examination, lameness score and radiographs. Inclusion criteria included performance of a surgery to address persistent lameness and suspected instability. Short-term follow up data included orthopedic examination and radiographs of the stifle. Long-term follow up was based on postoperative Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Seven dogs were included in the study. Mean subjective preoperative lameness score was 3 ± 1.53. Mean preoperative patellar ligament angle relative to the tibial plateau (PLATP) was 94° and mean tibial plateau angle (TPA) was 28°. Six dogs had tibial plateau leveling osteotomy and one had modified cranial closing wedge ostectomy. Mean postoperative PLATP was 79° and mean TPA was 5°. Mean subjective lameness score at follow up was 0.57 ± 0.49. Minor complications were present in 2 dogs and major complication in 1 dog. Mean LOAD questionnaire score was 6.6/52. TPLT can be performed after TTAT and may improve clinical function and stability in these cases in which persistent instability is suspected.

scholarly journals The Interaction between Diabetes, Body Mass Index, Hepatic Steatosis, and Risk of Liver Resection: Insulin Dependent Diabetes Is the Greatest Risk for Major Complications

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
M. G. Wiggans ◽  
J. T. Lordan ◽  
G. Shahtahmassebi ◽  
S. Aroori ◽  
M. J. Bowles ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Liver Resection ◽  
Hepatic Steatosis ◽  
Significant Risk ◽  
Major Complication ◽  
Significant Risk Factor ◽  
Insulin Dependent Diabetes ◽  
Major Complications ◽  
Insulin Dependent

Background. This study aimed to assess the relationship between diabetes, obesity, and hepatic steatosis in patients undergoing liver resection and to determine if these factors are independent predictors of major complications. Materials and Methods. Analysis of a prospectively maintained database of patients undergoing liver resection between 2005 and 2012 was undertaken. Background liver was assessed for steatosis and classified as <33% and ≥33%. Major complications were defined as Grade III–V complications using the Dindo-Clavien classification. Results. 504 patients underwent liver resection, of whom 56 had diabetes and 61 had steatosis ≥33%. Median BMI was 26 kg/m2 (16–54 kg/m2). 94 patients developed a major complication (18.7%). BMI ≥ 25 kg/m2 (P=0.001) and diabetes (P=0.018) were associated with steatosis ≥33%. Only insulin dependent diabetes was a risk factor for major complications (P=0.028). Age, male gender, hypoalbuminaemia, synchronous bowel procedures, extent of resection, and blood transfusion were also independent risk factors. Conclusions. Liver surgery in the presence of steatosis, elevated BMI, and non-insulin dependent diabetes is not associated with major complications. Although diabetes requiring insulin therapy was a significant risk factor, the major risk factors relate to technical aspects of surgery, particularly synchronous bowel procedures.

Analysis of Risk Factors for Posterior C1 Screw-Related Complication: A Retrospective Study of 358 Posterior C1 Screws

2019 ◽  
Vol 17 (5) ◽  
pp. 509-517 ◽  
Author(s):  
Ho Jun Yi ◽  
Jae Taek Hong ◽  
Jong Beom Lee ◽  
Jong-Hyeok Park ◽  
Jung Jae Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Complication ◽  
Entry Point ◽  
Posterior Arch ◽  
Occipital Neuralgia ◽  
Lateral Mass ◽  
Surgical Experience ◽  
Related Complication ◽  
Major Complications ◽  
Screw Malposition

Abstract BACKGROUND Although C1 screw fixation is becoming popular, only a few studies have discussed about the risk factors and the patterns of C1 screw complications. OBJECTIVE To investigate the incidence of C1 screw complications and analyze the risk factors of the C1 screw complications. METHODS A total of 358 C1 screws in 180 consecutive patients were analyzed for C1 screw complications. Screw malposition, occipital neuralgia, major complications, and total C1 screw complications were analyzed. RESULTS The distribution of C1 screw entry point is as follows: inferior lateral mass, 317 screws (88.5 %); posterior arch (PA), 38 screws (10.7 %); and superior lateral mass, 3 screws (0.8 %). We sacrificed the C2 root for 127 screws (35.5 %). C1 instrumentation induced 3.1 % screw malposition, 6.4 % occipital neuralgia, 0.6 % vascular injury, and 3.4 % major complications. In multivariate analysis, deformity (odds ratio [OR]: 2.10, P = .003), traumatic pathology (OR: 4.97, P = .001), and PA entry point (OR: 3.38, P = .001) are independent factors of C1 screw malposition. C2 root resection can decrease the incidence of C1 screw malposition (OR: 0.38, P = .012), but it is a risk factor of occipital neuralgia (OR: 2.62, P = .034). Advanced surgical experience (OR: 0.09, P = .020) correlated with less major complication. CONCLUSION The incidence of C1 screw complications might not be uncommon, and deformity or traumatic pathology and PA entry point could be the risk factors to total C1 screw complications. The PA screw induces more malposition, but less occipital neuralgia. C2 root resection can reduce screw malposition, but increases occipital neuralgia.

Single-stage bilateral tibial tuberosity advancement for treatment of bilateral canine cranial cruciate ligament deficiency

2015 ◽  
Vol 28 (03) ◽  
pp. 215-219 ◽  
Author(s):  
A. Langenbach ◽  
J. Boim ◽  
S. Gordon ◽  
D. J. Marcellin-Little ◽  
J. E. Kiefer
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Single Stage ◽  
Cranial Cruciate Ligament ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Major Complications ◽  
Increased Risk ◽  
Cranial Cruciate Ligament Rupture

SummaryObjective: To report complications in dogs with naturally occurring cranial cruciate ligament rupture following single-stage bilateral tibial tuberosity advancement (SS-BTTA) procedures, and to compare these complications to a population of dogs undergoing unilateral tibial tuberosity advancement (UTTA).Methods: Medical records and radiographs of client-owned dogs treated with tibial tuberosity advancement between August 2008 and December 2011 were reviewed. Forty-four client-owned dogs with bilateral cranial cruciate ligament rupture that underwent SS-BTTA procedures and 82 client-owned dogs that underwent UTTA proced -ures were randomly selected from our hospital population. Complications were recorded and analysed. Major complications were defined as fractures or any complication requiring a second surgery. Minor complications were any problem identified that did not require surgical management.Results: Incidence for major and minor complications in the UTTA group was 2.3% and 24.4%, respectively. Incidence for major and minor complications in the SS-BTTA group was 12.5% and 26.1%, respectively. Single-stage bilateral tibial tuberosity advancement procedures had a four- to five-fold increase in odds of a major complication (p <0.050) compared to UTTA.Clinical significance: The findings of our study indicate that SS-BTTA procedures are associated with an increased risk of major complications compared to UTTA procedures.

Incidence and Preoperative Risk Factors for Major Complications After Capsulectomy: Analysis of 3,048 Patients

2022 ◽  
Author(s):  
Ashkan Afshari ◽  
Lyly Nguyen ◽  
Gabriella E Glassman ◽  
Galen Perdikis ◽  
James C Grotting ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cosmetic Surgery ◽  
Breast Implant ◽  
Major Complication ◽  
Implant Removal ◽  
Class Iii ◽  
Public Attention ◽  
Preoperative Risk Factors ◽  
Major Complications ◽  
Insurance Database

Abstract Background While there are many indications for periprosthetic breast capsulectomy, heightened public attention surrounding breast implant illness has resulted in increased rates of capsulectomy. Objectives This study aims to identify the incidence of major complications and risk factors associated with capsulectomy. Methods Using a prospectively enrolled cosmetic surgery insurance database, CosmetAssure (Birmingham, AL, USA), patients undergoing capsulectomy between January 2, 2017 and July 31, 2019 were identified. Outcomes measured included the occurrence of and risk factors for major complication(s) necessitating an emergency department visit, hospitalization, or reoperation within 45 postoperative days. Results Among 76,128 patients evaluated, 3048 (4.0%) underwent capsulectomy. There was a significant increase in number of capsulectomies following January 6, 2019 (2.7/day vs 5.2/day, p&lt;0.05). Capsulectomy patients had more likely to have any complication and specifically hematoma than those undergoing breast implant removal or replacement without capsulectomy (2.8% vs 1.9% and 1.6% vs 0.9%, respectively, p&lt;0.05). Eighty-four (2.8%) developed at least one complication. The most common complications included hematoma (1.6%) followed by infection (0.5%). ASA class III/IV was an independent risk factor for any complication and BMI ≥30 and office-based surgical suites were risk factors for infection. Conclusions There is a growing number of capsulectomies being performed. The most common major complication is hematoma. Patients undergoing capsulectomy confer a higher complication rate compared to those undergoing breast implant removal or replacement without capsulectomy. Patients should be counseled regarding the potential for major complications.

Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight

2017 ◽  
Vol 30 (04) ◽  
pp. 299-305 ◽  
Author(s):  
Matthew Barnhart ◽  
Shawn Kennedy ◽  
Steven Naber ◽  
Eric Hans
Keyword(s):  
Antibiotic Therapy ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Major Complication ◽  
Surgical Revision ◽  
Tibial Tuberosity ◽  
Cranial Cruciate Ligament ◽  
Major Complications ◽  
One Year ◽  
Cranial Cruciate Ligament Disease

SummaryObjectives: To analyse and compare major complications in dogs ≥50 kg undergoing tibial tuberosity advancement (TTA) or tibial plateau levelling osteotomy (TPLO) for treatment of cranial cruciate ligament disease.Methods: Medical records and radiographs of client-owned dogs (≥50 kg) treated for cranial cruciate ligament disease with either TTA or TPLO between January 2011 and November 2015 were reviewed. Ninety-one TTA cases and 54 TPLO cases met the study inclusion criteria. All complications within one year of surgery were recorded. Major complications were those requiring surgical revision or intervening medical therapy to resolve. Logistic regression analysis evaluated for associations with major complication occurrence. Major complications were statistically compared between TTA and TPLO treatment groups.Results: Incidence of major complications following TTA and TPLO surgery were 19.8% and 27.8%, respectively. Surgical site infection (SSI) was the single most common major complication following both TTA (15.4%) and TPLO (25.9%) surgery. There were no significant differences between TTA and TPLO treatment regarding the rate of SSI, surgical revision, or overall occurrence of major complications. Postoperative antibiotic therapy significantly reduced the risk of a major complication in all dogs ≥50 kg (p = 0.015; OR: 0.201: 95%CI: 0.055–0.737).Clinical significance: Major complications occurred frequently following TTA and TPLO treatment of cranial cruciate ligament disease in dogs ≥50 kg. The increased chance for SSI should be considered and postoperative antibiotic therapy is recommended.

scholarly journals Frequency and risk factors for major complications after stereotactic radiofrequency ablation of liver tumors in 1235 ablation sessions: a 15-year experience

2020 ◽  
Author(s):  
Peter Schullian ◽  
Edward Johnston ◽  
Gregor Laimer ◽  
Daniel Putzer ◽  
Gernot Eberle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Complication Rate ◽  
Tumor Size ◽  
Liver Tumors ◽  
Major Complication ◽  
Major Complications ◽  
History Of ◽  
Major Complication Rate ◽  
Simple Logistic

Abstract Objectives To assess the frequency of major complications after multi-probe stereotactic radiofrequency ablation (SRFA) in a large cohort of patients over 15 years and to elucidate risk factors for adverse events. Materials and methods A retrospective study was carried out between July 2003 and December 2018. Seven hundred ninety-three consecutive patients (median 65.0 years (0.3–88), 241 women and 552 men, were treated in 1235 SRFA sessions for 2475 primary and metastatic liver tumors with a median tumor size of 3.0 cm (0.5–18 cm). The frequency of major complications was evaluated according to SIR guidelines and putative predictors of adverse events analyzed using simple and multivariable logistic regression. Results Thirty-day mortality after SRFA was 0.5% (6/1235) with an overall major complication rate of 7.4% (91/1235). The major complication rate decreased from 11.5% (36/314) (before January 2011) to 6.0% (55/921) (p = 0.001). 50.5% (46/91) of major complications were successfully treated in the same anesthetic session by angiographic coiling for hemorrhage and chest tube insertion for pneumothorax. History of bile duct surgery/intervention, number of coaxial needles, and location of tumors in segment IVa or VIII were independent prognostic factors for major complications following multivariable logistic regression analysis. Simple logistic regression revealed the number of tumors, tumor size, location close to the diaphragm, tumor conglomerate, and segment VII as other significant predictors. Conclusion SRFA of liver tumors is safe and can extend the treatment spectrum of conventional RFA. Adaptations over time combined with increasing experience resulted in a significant decrease in complications. Key Points • In 1235 ablation sessions in 793 patients over 15 years, we found a mortality rate of 0.5% (6/1235) and an overall major complication rate of 7.4%, which fell from 11.5 (36/314) to 6.0% (55/921, p = 0.001) after January 2011, likely due to procedural adaptations. • History of bile duct surgery/intervention (p = 0.013, OR = 3.290), number of coaxial needles (p = 0.026, OR = 1.052), and location of tumors in segment IVa (p = 0.016, OR = 1.989) or VIII (p = 0.038, OR = 1.635) were found to be independent prognostic factors. • Simple logistic regression revealed that number of tumors, tumor size, location close to the diaphragm, tumor conglomerates, and segment VII were other significant predictors of major complications.

Kirschner wire pin site infection in hand and wrist fractures: incidence rate and risk factors

2016 ◽  
Vol 41 (9) ◽  
pp. 990-994 ◽  
Author(s):  
W. F. van Leeuwen ◽  
B. T. J. A. van Hoorn ◽  
N. Chen ◽  
D. Ring
Keyword(s):  
Risk Factors ◽  
Kirschner Wire ◽  
Multivariable Logistic Regression Analysis ◽  
Site Infection ◽  
Kirschner Wires ◽  
Level Of Evidence ◽  
Wrist Fractures ◽  
Kirschner Wire Fixation ◽  
Number Of Patients ◽  
Pin Site

Kirschner wires are widely used for skeletal fixation of unstable fractures, but the pin tracks create a potential pathway through the skin and into the bone for bacteria to cause an infection. We tested the null hypothesis that there are no demographic, patient-related, injury, or treatment variables independently associated with the occurrence of pin site infection after percutaneous fixation of hand and wrist fractures using Kirschner wires. A retrospective review of 1213 patients with one or more fractures of the hand and wrist treated with percutaneous Kirschner wire fixation identified 85 patients (7%) who had additional treatment with oral antibiotics, early pin removal, or reoperation related to a pin site infection. We found no factors were independently associated with higher or lower risks of pin site infection in multivariable logistic regression analysis. Pin site infections – most benign – occur in a notable number of patients and we could not identify any modifiable risk factors. Level of Evidence: III

The Modified Maquet Procedure (MMP) in Dogs: Technical Development and Initial Clinical Experience

2016 ◽  
Vol 52 (4) ◽  
pp. 242-250 ◽  
Author(s):  
Malcolm Graham Ness
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Radiographic Examination ◽  
Computer Assisted ◽  
Clinical Report ◽  
Modified Technique ◽  
Cranial Cruciate Ligament ◽  
Titanium Foam

ABSTRACT The literature about tibial tuberosity advancement surgery in dogs and humans informed the development of a version of the operation using a wedge-shaped implant of titanium foam. Computer-assisted drawing and stereolithography was used to create instruments and implants that were evaluated by cadaver surgery. A trial, involving 26 client-owned dogs with lameness due to cranial cruciate ligament failure, was started. Follow-up was done by clinical and radiographic examination after 4 wk and clinical examination again 6–11 mo after surgery. The titanium foam implant maintained tibial tuberosity advancement easily and effectively. The same major complication occurred in 2 of the first 6 cases before, a slightly modified technique was used to treat 20 dogs without complication. At mid-term follow-up (6–11 mo), 20/26 dogs (77%) had returned to full function, two dogs (7.7%) had acceptable function, two dogs (7.7%) could not be evaluated due to recent contra lateral modified Maquet procedure surgery, and two (7.7%) dogs had died for reasons unrelated to the study. This is the first clinical report of the use of titanium foam in veterinary orthopaedics. Modified Maquet procedure appears to be an effective treatment for lameness due to failure of the cranial cruciate ligament in dogs.

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