POST-OPERATIVE COMPLICATIONS FOLLOWING ARTHROSCOPIC ACL RECONSTRUCTION USING VARIOUS GRAFTS; A PROSPECTIVE STUDY

2021 ◽  
pp. 48-50
Author(s):  
Himanshu Patel ◽  
Kashif Iqbal ◽  
Deependra Chourey ◽  
Manoj Kumar ◽  
Abhishek Pathak
Keyword(s):  
Acl Reconstruction ◽  
Small Sample Size ◽  
Cruciate Ligament ◽  
Deep Infection ◽  
Small Sample ◽  
Bptb Graft ◽  
Operative Complications ◽  
A Prospective Study ◽  
Post Operative Complications

Anterior cruciate ligament tear is a common occurrence and with advent of arthroscopic ligament reconstruction, the surgery is minimally invasive with good functional outcomes. The aim of this study is to evaluate the post-operative complications following arthroscopic ACLreconstruction. In this study we tried to analyse the post-operative complications in patients with arthroscopic ACL reconstructions using various autografts. The autografts used in this study were Bone patellar tendon bone graft, hamstring graft and peroneus graft. 26 patients were included in the study. 2 patients lost to follow up. The study result comprised of 24 patients. there were 45.8% of the patients who were below the age of 25 years whereas 54.2% patients were older than 25 years. Only 3 females were recruited in the present study, accounting for 12.5% of the total patients of the study. Majority 87.5% were males. Majority of the recruited patients were having right sided knee injury (54.2%) whereas remaining (45.8%) were having left sided injury. Majority of the patients were treated using hamstring and peroneus grafts (41.7%). 16.7% patients were treated with BPTB graft. There were 16.7% patients who developed deep infection after the surgery. Out of these, 30% were with hamstring grafts and 25% were with BPTB graft. 41.7% patients didn't develop any complications afterwards. 12.5% patients complained of post-operative knee pain. 16.7% patients reported occurrence of supercial infection. There are no signicant differences among complications for different grafts used in this study. The study concluded that arthroscopic ACL reconstruction is a safe surgical procedure with no signicant differences for various autograft options in terms of complications. The study is limited by small sample size and short follow up.

scholarly journals Supratentorial and infratentorial brain metastases: a single centre, retrospective cohort study

2021 ◽  
Author(s):  
Moritz Steinruecke ◽  
Savva Pronin ◽  
Anda-Veronica Gherman ◽  
John Emelifeonwu ◽  
Imran Liaquat
Keyword(s):  
Brain Metastases ◽  
Small Sample Size ◽  
Performance Status ◽  
Univariate Analysis ◽  
Small Sample ◽  
Operative Outcomes ◽  
Operative Complications ◽  
And Performance ◽  
Demographic Covariates ◽  
Post Operative Complications

Abstract Purpose 15–30% of primary cancers metastasise to the brain. Of these, 10–25% involve the posterior fossa. It remains unclear whether patients undergoing resection for infratentorial brain metastases experience poorer prognosis than those with supratentorial lesions. We aim to compare the post-operative outcomes of these two groups. Methods We searched the electronic health records of all patients undergoing brain metastases resection at our regional neurosurgical centre between February 2014 and August 2019. Demographic and clinical data was collected on 85 patients (61 supratentorial, 24 infratentorial metastases). Outcome measures included survival, post-operative complications, and performance status. Patients were followed up until April 21st 2020. Results Median post-operative survival of patients with supratentorial metastases was 323 days (95% CI 235–411), compared to 277 days (95% CI 195–359) for those with infratentorial metastases. These two groups experienced comparable survival (log rank = 0.276, p = 0.60) in univariate analysis. Infratentorial metastasis location was not significantly prognostic of survival in multivariate analysis of six key clinical and demographic covariates (HR 1.51, 95% CI 0.780–2.92, p = 0.22). However, neurological and non-neurological post-operative complications were significantly more common in patients with infratentorial metastases (neurological = 21% v 13%, non-neurological = 25% v 2%, p = 0.002). Conclusions Infratentorial metastasis location alone was not associated with a significant change in survival in our patient cohort, but was linked to a higher incidence of post-operative complications. Prospective, multi-centre outcomes monitoring following brain metastasis resection is required to overcome the limitations of small sample size and evolving neurosurgical practices.

scholarly journals Preperitoneal mesh repair in incisional hernia: a prospective study

2020 ◽  
Vol 7 (12) ◽  
pp. 3994
Author(s):  
Uma Dhanasekaran ◽  
Ramesh Arumugam
Keyword(s):  
Incisional Hernia ◽  
Prospective Study ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernias ◽  
Post Surgery ◽  
Operative Complications ◽  
A Prospective Study ◽  
Post Operative Complications

Background: Incisional hernia is a common surgical condition encountered in day to day practice. Based on national operative statistics, incisional hernias account for 15 to 20% of all abdominal wall hernias. Of all hernias encountered incisional hernias can be the most frustrating and challenging to treat. This prospective study aims to assess the efficacy of preperitoneal mesh repair technique using polypropylene mesh in the management of incisional hernia.Methods: A total of 40 patients with incisional hernia undergone open preperitoneal polypropylene mesh repair. It had evaluated for post-operative complications and recurrence for six months to one-year post-surgery. The results had tabulated statistically analysed and compared with other published reports in the literature.Results: Out of 40 patients, the size of the defect, 10 patients had less than 2 cm, 28 patients had between 2.1-4 cm, 1 patient between 4.1-6 cm and 1 patient between 6.1-8 cm. The type of hernia, 32 patients had infra umbilical hernia, and 8 patients had a supraumbilical hernia. Post-operative complication 3 patients had seroma, 1 patient had edge necrosis, 1 patient had post-op ileus, and 1 patient had chronic pain. Based on follow up, 4 patients had followed until 6 months, 10 patients till 9 months and 26 patients till one year.Conclusions: Post-operative complications following open preperitoneal polypropylene mesh repair are considerably less compared to other techniques of mesh repair and showed no recurrence among its subjects during the follow-up period, and longer follow-up is required to draw a definitive conclusion.

scholarly journals A prospective study of clinical presentation, management, and post-operative complications of benign parotid swellings

2019 ◽  
Vol 6 (7) ◽  
pp. 2318 ◽  
Author(s):  
Hareesh G. S. R. ◽  
Prabhakar Naidu Pulipati
Keyword(s):  
Pleomorphic Adenoma ◽  
Late Presentation ◽  
Common Benign Tumor ◽  
Operative Complications ◽  
Benign Tumours ◽  
Parotid Tumours ◽  
Operative Findings ◽  
A Prospective Study ◽  
Post Operative Complications

Background: The incidence of parotid tumours is between 1-3/100000 per year, most of them are benign and 80% benign tumours are pleomorphic adenoma. Their management is more troublesome because of their late presentation, poor economic condition and lack of awareness of health.Methods: This is a prospective observational study carried out from August 2016 to march 2018 in the Department of General Surgery, S.V.R.R.G.H., Tirupati. Detailed pre-operative workup done operative findings and post-operative complications were noted and biopsy reports analyzed.Results: Total 30 patients were included in the study of which 28 were pleomorphic adenoma and 2 were Warthin’s tumor. Post-operative complications and histopathology were studied and analyzed.Conclusions: Pleomorphic adenoma was most common benign tumor. Conservative superficial parotidectomy was the common surgical procedure done. Most common complication was temporary facial nerve palsy. No recurrence was seen in 6 months follow up.

scholarly journals Post-operative complications of displaced unstable distal end radius fracture treated by volar plating

2020 ◽  
Vol 6 (5) ◽  
pp. 1008
Author(s):  
Rajesh K. Ambulgekar ◽  
Vishal Gurnani
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Radius Fracture ◽  
Volar Plating ◽  
Operative Complications ◽  
One Year ◽  
Definition Of ◽  
A Prospective Study ◽  
Post Operative Complications

<p class="abstract"><strong>Background:</strong> Fracture of the distal radius (DRF) is one of the most common fractures present in emergency. The most common operative treatments of these fractures are open reduction and internal fixation with volar locking plates. The incidents and types of complications associated with the use of these operations is an ongoing process till date. The objective of the study was to find demographic profile of patients of displaced unstable distal end radius fracture, and to study the post-operative complications among above patients treated by volar plating.</p><p class="abstract"><strong>Methods:</strong> We performed a prospective study documenting types of complications and their occurrence in a group of patients who received open reduction and internal fixation. Our definition of a complication was a case in which the patient had one or more complications which required an intervention medical or surgical.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 33 patients were included, most of the cases, (63.63%) were from the age group 21-40 years. We had 4 cases (12. 12%) females, and 29 cases (87.88%) males. Post-operative complications were noted in 7 individuals 22.2 % and no complications noted in 26 cases (78.8%). In 30 cases there was no any deformity found in postoperative one year follow up, 2 patients develop prominent ulnar styloid found in follow up of one year ,and 1 residual dorsal tilt found after one year.</p><p class="abstract"><strong>Conclusions:</strong> Our finding that 22.2% suffer from complication when treated using a volar locking plate must be taken into consideration when surgeons choose between conservative or operative treatment for DRF treatment. A few other studies have looked at the incidents of complications and have reported similar results.</p>

scholarly journals Assessing Biomarkers of Breast Cancer Risk in Underserved Women in a Midwestern County

2021 ◽  
Vol 12 ◽  
pp. 215013272110177
Author(s):  
Marla A. DeWitt ◽  
Ivana T. Croghan ◽  
Celine M. Vachon ◽  
Thomas D. Thacher ◽  
Marcia R. Venegas Pont ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mammographic Density ◽  
Small Sample Size ◽  
Vitamin D Insufficiency ◽  
Screening Mammography ◽  
Small Sample ◽  
Vitamin D Status ◽  
Small Pilot Study ◽  
Unexpected Findings

Objective: The primary aim of this study was to evaluate the feasibility of collecting risk factor information and accessing digitized mammographic data in a medically marginalized population. A secondary aim was to examine the association between vitamin D status and mammographic density. Methods: Breast-screening examinations were provided for age-appropriate patients, and a referral for no-cost screening mammography was offered. Study participants were asked to undergo 25-hydroxyvitamin D testing at mammography and 1-year follow-up. Results: Of 62 women approached, 35 (56%) consented to participate. Of 32 participants who had baseline mammography, the median mammographic density measured by VolparaDensity (Volpara Solutions Limited) was 5.7%. After 1 year, 9 women obtained follow-up mammograms, with a median density of 5.7%. Vitamin D status was measured for 31 participants at baseline and 13 participants in the following year. Insufficient vitamin D status (<30 ng/mL) was noted in 77% at each time point. Mammographic density was not significantly correlated with vitamin D status ( P = .06). Conclusions: On the basis of this small pilot study, vitamin D insufficiency is common in this study population. Owing to the small sample size, an association between vitamin D insufficiency and breast density was not clear. Additional unexpected findings included substantial barriers in initial access to care and longitudinal follow-up in this population. Further study of these issues is needed.

Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

2021 ◽  
pp. 036354652110273
Author(s):  
Joshua S. Everhart ◽  
Sercan Yalcin ◽  
Kurt P. Spindler
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Increased Risk ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

Role of multiparametric MRI in long-term surveillance following focal laser ablation of prostate cancer

2021 ◽  
pp. 20210414
Author(s):  
Mark Paxton ◽  
Eitan Barbalat ◽  
Nathan Perlis ◽  
Ravi J Menezes ◽  
Mark Gertner ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Recurrent Disease ◽  
Small Sample Size ◽  
Focal Therapy ◽  
Outcome Data ◽  
Small Sample ◽  
Restricted Diffusion ◽  
Treatment Site ◽  
Imaging Characteristics

Objective: Determine the multiparametric magnetic resonance imaging (mpMRI) appearance of the prostate following focal laser ablation (FLA) for PCa and to identify imaging characteristics associated with recurrent disease. Methods: Retrospective analysis of patients who underwent FLA for low-intermediate risk PCa between 2010 and 2014 was performed. Early (median 4 months) and late mpMRI (median 49 months) follow-up were qualitatively assessed for T2-weighted, dynamic contrast enhanced (DCE) and diffusion weighted imaging (DWI) appearances and also compared to corresponding PSA values and biopsy results. Results: 55 cancers were treated in 54 men (mean age 61.0 years). Early mpMRI was performed in 30 (54.5%) patients while late follow-up mpMRI in 42 (84%). Ill-defined scarring with and without atrophy at the treatment site were the most common appearances. In patients with paired MRI and biopsy, one of four patients with clinically significant PCa on biopsy (≥GG2 or≥6 mm GG1) showed hyperenhancement or restricted diffusion at early follow-up. At late follow-up, positive biopsies were seen in 5/8 (63%) cases with hyperenhancement and 5/6 (83%) cases with restricted diffusion at the treatment site. PSA change was not associated with biopsy results at either time point. Conclusion: mpMRI is able to document the morphological and temporal changes following focal therapy. It has limited ability to detect recurrent disease in early months following treatment. Late-term mpMRI is sensitive at identifying patients with recurrent disease. Small sample size is, however, a limitation of the study. Advances in knowledge: Implementing MRI in follow-up after FT may be useful in predicting residual or recurrent PCa and therefore provide reliable outcome data.

scholarly journals GRAFT CHOICE FOR ADOLESCENT ATHLETES RETURNING TO HIGH-RISK SPORTS: A MATCHED COHORT ANALYSIS OF PATELLAR TENDON AND HAMSTRING AUTOGRAFTS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0007
Author(s):  
Crystal Perkins ◽  
Michael Busch ◽  
Melissa Christino ◽  
Belinda Schaafsma ◽  
S. Clifton Willimon
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Graft Rupture ◽  
Graft Choice ◽  
Anterior Cruciate

Background: Graft selection for skeletally mature adolescents undergoing anterior cruciate ligament (ACL) reconstruction is guided by surgeon and patient preference. In young patients returning to high-risk cutting and pivoting sports, graft rupture is the most feared complication of ACL reconstruction. Some studies have demonstrated slightly lower rates of graft failure and decreased laxity in the short term associated with patellar tendon (BTB) autografts as compared to hamstring (HS) autografts, but these studies are limited by their heterogeneity of ages and activity level1-3. The purpose of this study is to compare the rates of graft failure between BTB and HS ACL reconstruction cohorts matched by age, sex, and sport. Methods: A single-institution retrospective review was performed of consecutive patients less than 19 years of age treated with ACL reconstructions using either patellar tendon (BTB) or hamstring (HS) autograft performed by a single surgeon. Skeletally mature or nearly mature patients in “high-risk” ACL injury sports (basketball, football, soccer, lacrosse, and gymnastics) were initially treated with hamstring autografts but the graft preference transitioned to BTB autografts as the preferred graft choice during the study period. This transition in graft preference for adolescents participating in “high risk” sports allows for a comparison of outcomes based on graft types. Inclusion criteria were ages 13 – 18 years, participation in a “high risk” sport, and minimum 6-month follow-up. The two cohorts of patients were matched by age, gender, and sport. The primary outcome measure was graft rupture. Results: One hundred fifty-two patients with an average age of 16 years (range 13 – 18 years) underwent ACL reconstruction during the study period. There were 71 BTB reconstructions and 81 HS reconstructions. There were 64 females and 88 males. There was no difference in age, sex, BMI, or laterality between groups. There were more patients who played soccer in the BTB cohort (44%) vs HS cohort (20%) and fewer who played basketball in the BTB cohort (24%) vs HS cohort (41%), p = 0.005. There were no differences between the BTB and HS cohorts in terms of meniscus tears (61% v 72%, p = 0.15), meniscus repair (21% v 32%, p = 0.13), or partial meniscectomy (32% v 33%, p = 0.90). Mean duration of follow-up was 28 months (range 7-57 months). There was no difference in follow-up between cohorts (BTB 28 months and HS 29 months, p = 0.19). There were a total of 16 graft ruptures (10.5%). There was no difference in the rate of graft rupture between cohorts (BTB 8.5% vs HS 12.3%, p = 0.60). Mean time to graft rupture was 21 months (range 8 – 35 months) and Kaplan-Meier survival curves demonstrated no difference between cohorts. Conclusions: ACL reconstruction in adolescents returning to high-risk sports can be performed utilizing BTB or HS autografts with similar rates of graft rupture. There is a trend toward lower rates of graft rupture associated with BTB autografts, but additional patients will be necessary to determine if this trend will become a statistically significant difference. Beynnon BD, Johnson RJ, Fleming BC, et al. Anterior cruciate ligament replacement: comparison of bone-patellar tendon bone grafts with two-strand hamstring grafts. A prospective, randomized study. J Bone Joint Surg Am 2002;84(9):1503-1513. Ho B, Edmonds EW, Chambers HG et al. Risk factors for early ACL reconstruction failure in pediatric and adolescent patients: a review of 561 cases. J Pediatr Orthop 2016. Samuelsen BT, Webster KE, Johnson NR, et al. Hamstring autograft versus patellar tendon autograft for ACL reconstruction: is there a difference in graft failure rate? A meta-analysis of 47,613 patients. Clin Orthop Relat Res 2017;475(10):2459-2468.

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