scholarly journals Case Report – Accidental Epidural Catheter Breakage and Its Management

2021 ◽  
pp. 1-5
Author(s):  
Karuna Taksande ◽  
Krishnendu S. ◽  
Nikhil Bhalerao ◽  
Jui Jadhav ◽  
Dnyanashree Wanjari ◽  
...  
Keyword(s):  
Case Report ◽  
Epidural Catheter ◽  
Cruciate Ligament ◽  
Surgical Removal ◽  
Technical Error ◽  
Successful Management ◽  
Anterior Cruciate ◽  
Anesthesia Epidural

Aim: Epidural anaesthesia which is preferred in most of the prolonged and painful procedures can be dreadful when the catheter breaks inside. In this case report we report accidental breakage of epidural catheter and its successful management. Presentation of Case: 47 year old male patient was posted for arthroscopic Anterior cruciate ligament (ACL) and Posterior Cruciate Ligament (PCL) repair under spinal and epidural anesthesia. Epidural catheter got sheared while securing it. It was managed by surgical removal to avoid further complications. Discussion: There are different causes for epidural catheter breakage including technical error and manufacture error. Catheter should be checked for any manufacturing defect or kinking. If there is resistant while inserting the catheter careful removal of catheter along with the needle should be performed to avoid breakage of catheter. Conclusion: Epidural catheter breakage can be disastrous for any anaesthesiologist, so it is important to be vigilant while securing epidural catheter. If accidentally epidural catheter is retained it should be discussed with the patient and surgeons, and it is either removed since it is a foreign body or if left in situ. Serial follow-up for any neurological symptoms should be done.

scholarly journals Combined Intra- and Extra-Articular Technique in Revision Anterior Cruciate Ligament Reconstruction

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 156-163 ◽  
Author(s):  
Jessica Zanovello ◽  
Federica Rosso ◽  
Alessandro Bistolfi ◽  
Roberto Rossi ◽  
Filippo Castoldi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Return To Sport ◽  
Surgical Removal ◽  
Level Of Evidence ◽  
Anterior Cruciate ◽  
Over The Top

Purpose The aim of the study was to evaluate the “over the top” (OTT) nonanatomical technique for revision of anterior cruciate ligament (ACL) reconstruction. Methods Twenty-four patients with a mean age of 31.9 ± 11.2 years underwent revision of ACL reconstruction using OTT technique. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, Tegner score, Subjective Patient Outcome for Return to Sport (SPORTS) score, Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale, and KT-1000 evaluation were recorded at a mean follow-up of 30.7 ± 18.9 months. Results Postoperatively, the IKDC objective total score significantly improved (p = 0.0046). The KOOS, Lysholm, and Tegner scores also improved, but the results were not statistically significant (62.4 vs. 72.6, 6.5 vs. 75.8, and 4.1 vs. 6.0, respectively). The subjective IKDC evaluation score improved from an average of 51.1 points to 63.7 points at the last follow-up (p = 0.0027). The RTP prevalence was 81.8%, with 44.4% of the patients returning to the same preinjury level. According to the SPORTS score, 16.6% of patients played sport without limitations in activity and performance. The average ACL-RSI score was 52.1 ± 27.0. No major complications were reported. A total of 21.5% of patients underwent surgical removal of staples. The failure prevalence was 14.3% and the cumulative survivorship, calculated using the Kaplan–Meier method, was equal to 70% at 60 months of follow-up. Conclusion The OTT technique in the revision ACL reconstruction provided improvement in objective and subjective scores, good RTP prevalence, and acceptable rate of complication and failure. One of the advantages was the possibility to avoid the femoral tunnel. Level of Evidence Level IV, therapeutic case series.

scholarly journals Managing Recurrent Orbital Lymphangioma in a Pubertal Female with Negative Pressure Aspiration and Intralesional Bleomycin Injection: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 157-161
Author(s):  
Santosh Chaudhary ◽  
Aashish Raj Pant ◽  
Badri Prasad Badhu
Keyword(s):  
Case Report ◽  
Negative Pressure ◽  
Surgical Excision ◽  
Successful Management ◽  
Minimal Intervention ◽  
Sclerosing Agents ◽  
Complete Surgical Excision ◽  
The Right

Introduction: Management of orbital lymphangioma is challenging. Complete surgical excision is often impossible due to its infiltrative nature. Sclerosing agents have been used in its management with variable outcomes. We report a case of recurrent orbital lymphangioma managed with intralesional bleomycin.  Case: A 14-year-old female presented with proptosis of the right eye for two weeks. She had a similar history at five years of age for which she underwent surgical excision. We performed negative pressure aspiration using a 20-gauge angiocatheter, injected bleomycin, and left the cannula in situ for repeat aspiration to maintain cyst collapse.  Observation: The lymphangioma regressed, and there was no recurrence at six months of follow-up.  Conclusion: This report highlights the use of negative pressure aspiration and intralesional bleomycin injection by minimal intervention using angiocatheter in the successful management of orbital lymphangioma.

scholarly journals In-office arthroscopy for the evaluation of chronic knee pain: A case report

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774099
Author(s):  
Jacob A West ◽  
Nirav H Amin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Knee Pain ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Chronic Knee Pain ◽  
Diagnostic Arthroscopy ◽  
Anterior Cruciate

This is a case report detailing the use of in-office needle arthroscopy (mi-eye 2™) in a patient with chronic knee pain and inconclusive magnetic resonance imaging findings. The patient is a 40-year-old male who presented to our clinic after an extended history of right knee pain along the medial aspect with previous failed treatments. Magnetic resonance imaging without contrast had demonstrated full-thickness chondral fissuring of the lateral patellar facet, mild abnormal signals of the proximal patellar tendon and Hoffa’s fat pad, and intact anterior cruciate ligament and posterior cruciate ligament. The patient was previously treated with an ultrasound-guided injection of 2 cm3 of 1% lidocaine without epinephrine and 1 cm3 of Kenalog-40 and scheduled for follow-up. At follow-up, clinical examination showed antalgic gait, minimal tenderness along medial joint line, medial pain in deep flexion, and no pain when in varus or valgus. Due to continued discomfort with a negative magnetic resonance imaging, in-office diagnostic arthroscopy was performed using mi-eye 2 revealing a tear of the mid-body of the medial meniscus. The patient subsequently underwent arthroscopic repair and is recovering well with complete resolution of medial joint pain. This report highlights the clinical utility of in-office diagnostic arthroscopy in the management of patients with persistent knee pain and negative or equivocal findings on magnetic resonance imaging.

Intramedullary Teratoma: Case Report and Review of the Literature

1996 ◽  
Vol 82 (6) ◽  
pp. 616-620 ◽  
Author(s):  
Riccardo Caruso ◽  
Mariano Antonelli ◽  
Luigi Cervoni ◽  
Maurizio Salvati
Keyword(s):  
Case Report ◽  
Surgical Removal ◽  
International Literature ◽  
Review Of The Literature ◽  
Personal Case

Aims and Background Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed. Methods The authors present a personal case with some unusual aspects. Results Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.

scholarly journals Comparison of hamstring and quadriceps strength after anatomical versus non-anatomical anterior cruciate ligament reconstruction: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hai Jiang ◽  
Lei Zhang ◽  
Rui-Ying Zhang ◽  
Qiu-Jian Zheng ◽  
Meng-Yuan Li
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Strength ◽  
Anatomical Reconstruction ◽  
Single Bundle ◽  
Knee Stability ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Reconstruction Group

Abstract Background Strength recovery of injured knee is an important parameter for patients who want to return to sport after anterior cruciate ligament reconstruction (ACLR). Comparison of muscle strength between anatomical and non-anatomical ACLR has not been reported. Purpose To evaluate the difference between anatomical and non-anatomical single-bundle ACLR in hamstring and quadriceps strength and clinical outcomes. Methods Patients received unilateral primary single-bundle hamstring ACLR between January 2017 to January 2018 were recruited in this study. Patients were divided into anatomical reconstruction group (AR group) and non-anatomical reconstruction group (NAR group) according to femoral tunnel aperture position. The hamstring and quadriceps isokinetic strength including peak extension torque, peak flexion torque and H/Q ratio were measured at an angular velocity of 180°/s and 60°/s using an isokinetic dynamometer. The isometric extension and flexion torques were also measured. Hamstring and quadriceps strength were measured preoperatively and at 3, 6, and 12 months after surgery. Knee stability including Lachman test, pivot-shift test, and KT-1000 measurement and subjective knee function including International Knee Documentation Committee (IKDC) and Lysholm scores were evaluated during the follow-up. Results Seventy-two patients with an average follow-up of 30.4 months (range, 24–35 months) were included in this study. Thirty-three were in AR group and 39 in NAR group. The peak knee flexion torque was significant higher in AR group at 180°/s and 60°/s (P < 0.05 for both velocity) at 6 months postoperatively and showed no difference between the two groups at 12 months postoperatively. The isometric knee extension torque was significant higher in AR group at 6 months postoperatively (P < 0.05) and showed no difference between the two groups at 12 months postoperatively. No significant differences between AR group and NAR group were found regarding knee stability and subjective knee function evaluations at follow-up. Conclusions Compared with non-anatomical ACLR, anatomical ACLR showed a better recovery of hamstring and quadriceps strength at 6 months postoperatively. However, the discrepancy on hamstring and quadriceps strength between the two groups vanished at 1 year postoperatively.

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