Complications of the recovery period after arthroscopic reconstruction of the anterior cruciate ligament

A review of the literature is devoted to the problem of complications after arthroscopic reconstruction of the anterior cruciate ligament. The authors covered questions of epidemiology and surgical technique, touched on important aspects of the main complications, such as graft damage, arthrofibrosis and impingement syndrome, the formation of synovial cysts, infections, the development of osteoarthritis and cartilage degeneration. Despite the prevalence of pathology, a huge number of publications and the development of arthroscopic surgery, there are many theoretical and technical problems, that have not yet found a satisfactory solution and require further development. A relevant question for the doctor is the problem of correctly choosing the method or combination methods for anterior cruciate ligament reconstruction in relation for each patient, considering the individual characteristics and possible risks of developing different complications in patient.

Clinical efficacy of arthroscopic reconstruction of the anterior talofibular ligament with preservation of the stump

Background The purpose of this study was to investigate the clinical efficacy of anatomic reconstruction of the anterior talofbular ligament with preservation of the stump. Methods This retrospective study included 42 patients who underwent an endoscopic lateral ligament reconstruction between from June 2015 to June 2019.Fourteen consecutive patients (10 [71.4%] males and 4 [28.6%] female, mean age 27.79 ± 4.56[range 26 to 36] years) with preserved anterior tibiofibular ligament stump were enrolled in this study.On the other side ,there were 18 patients with unpreserved tibiofibular ligament stumps (unpreserved stump group), 12 males and 6 females, aged 20–36 years, mean (28.56 ± 5.67) years.The functional evaluation was carried out according to the Ankle-Hindfoot Score by the American Orthopaedic Foot and Ankle Society.The Tegner system was used to evaluate range of motion after the index procedure. Ankle proprioception was assessed using the visual analogue scale (VAS) to assess the degree of subjective pain symptoms. Operative time, fever time and wound healing time were also recorded. Results There were no statistically significant differences in postoperative outcomes such as postoperative fever time and wound healing time between the two groups (P > 0.05). The operative time was slightly longer in the stump-preserving group than in the non-stump-preserving group (94.14 ± 11.59 vs. 82.94 ± 15.61 P < 0.05). There were no statistically significant differences in preoperative AOFAS ankle-hindfoot scores, Tegner motor level scores, and VAS scores between patients in the retained-stump group and the non-reserved-stump group (P > 0.05). At 1 year after surgery, the AOFAS ankle-hindfoot scores and Tegner motor level scores improved and the VAS pain scores decreased in both the presurgical and non-presurgical groups. The AOFAS ankle-hindfoot scores and Tegner motion level scores 1 year after surgery were higher in the group with preserved stump than in the group without preserved stump (P < 0.05). Conclusion Arthroscopic reconstruction of the anterior talofibular ligament with and without preservation of the stump can achieve good clinical outcomes. Although arthroscopic anterior talofibular ligament reconstruction with preserved stump prolonged the operative time compared with surgery without preserved stump, it could better improve the subjective ankle function and motion status of patients and improve the prognosis.

Revolutions in arthroscopic wrist surgeries

Recent technical and technological developments in wrist arthroscopic surgery allow for advanced treatments of difficult wrist disorders. In this review, world leaders of wrist arthroscopy describe bone graft for scaphoid nonunion, transosseous repair for triangular fibrocartilage fovea avulsion, palmaris longus reconstruction of the triangular fibrocartilage, and arthroscopic reconstruction of the scapholunate and lunotriquetral ligaments.

ANALGESIC EFFECT OF ROPIVACAINE AFTER ARTHROSCOPIC RECONSTRUCTION OF THE LIGAMENT IN ATHLETES

ABSTRACT After arthroscopic ligament reconstruction, athletes still need to go through a postoperative rehabilitation training period and suffer the possible pain that can go from moderate to severe. Commonly used analgesic medications, ropivacaine and fentanyl have the effect of relieving athletes’ pain. To study the analgesic effect of ropivacaine on arthroscopic reconstruction of the knee ligament, the steps of reconstruction and pharmacology of ropivacaine were first introduced. Next, the analgesic effects of ropivacaine and fentanyl in 86 athletes were compared on muscle strength recovery, patient satisfaction, and pain score. The results showed that the satisfaction of patients with ropivacaine was 95.35%, and the incidence of postoperative adverse reactions was only 9.30%. These results indicate that ropivacaine has a better analgesic effect in arthroscopic reconstruction of the knee ligament in athletes, which is suitable for postoperative rehabilitation.

Results of Anterior Cruciate Ligament Injuries by Arthroscopic Reconstruction Using Semitendinosus Tendon

Objectives: This study was designed to evaluate the surgical management of anterior cruciate ligament injuries by arthroscopic reconstruction using semitendinosus grafts. Methodolgy: This study was conducted by Dibba Hospital Fujairah, United Arab Emirates from March 2017- to March 2020. A total of 40 patients were selected for this research. In our study, we used arthroscopy assisted ACL reconstruction technique with single bundle quadrupled semitendinosus tendon autograft. This autograft was inserted from the ipsilateral limb with the help of endobutton femoral side of graft was fixed and with bioabsorbable screw tibial side of graft was stabilized. A single surgeon performed all the surgeries. Results: In our observations, we reported that the majority of the patients had exposure of ACL injury in their middle adult age (32-38 years old) due to high engagement in physical activities (67.8%) like biking, playing sports and many others. The ratio of right knee injury site was comparatively high (53.5%) than the left one (46.4%). Conclusion: From the results, we concluded that the younger age group is more prone to anterior Cruciate ligament injury. ACL reconstruction with Semitendinosus tendon autograft helps in maintaining knee movement and assist in early knee stability.

EVALUATION OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE-PATELLAR TENDON-BONE GRAFT

AIM- Anterior cruciate ligament (ACL) is most common injured ligament in the knee joint. Surgical management of ACL rupture is technically demanding as improper reconstruction can lead to an unstable joint. The aim of present study was to nd out the outcome of Arthroscopic reconstruction of ACLusing Bone patellar tendon bone (BPTB) graft. METHOD – It is a retrospective observational study where arthroscopic reconstruction of ACLwas done over a period of 5 years. IKDC score was applied to nd out the outcome of surgery. Strict post operative rehabilitation regime was followed. RESULT- After evaluation of 25 cases, 60% (15cases) showed very good outcome, 36%(9 cases) showed good outcome and 4% (1 case) showed poor outcome. Implant related local irritation is seen in 2 patients and low grade infection was seen in 1 patient. CONCLUSION – Majority of the patients were satised with the result so it is purposeful to perform ACL reconstruction arthroscopically using BPTB graft.

Risk Analysis of Perioperative Injections in Arthroscopic Reconstruction of the Rotator Cuff of the Shoulder – A Systematic Review

Background The present study used a systematic review to analyse the risk of perioperative injections during arthroscopic reconstruction of the rotator cuff of the shoulder. The questions of interest were whether perioperative local injection increases the infection risk and whether the number of postoperative revisions is increased. Material and Methods A systematic review of the U. S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was performed using the PRISMA checklist. The keywords used were “shoulder” and “arthroscopy” and “injection” and “risk”. In the course of the study, work that was not also primarily concerned with the reconstruction of the rotator cuff was excluded. English original articles and case series were included that contained at least some arthroscopic reconstructions of the rotator cuff. The risk of bias was determined using the Newcastle-Ottawa Scale. The content of the articles relevant to the research questions was analysed. Results 48 hits were primarily generated. 9 articles corresponded to the inclusion criteria and were analysed. In the 6 studies with details on the injected substances, cortisone was used in 98 – 100% of the cases. The reported infection and revision rates based on insurance data were higher with injection than without. The risk of bias in the studies analysed here was rather low based on the Newcastle-Ottawa Score. The risk of infection after a cortisone injection before, during or after surgery was increased. Injection was associated with infection in up to 8% of cases with injections within two weeks of surgery. The risk of infection was increased by up to 11 times with injections within 4 weeks after the operation. Likewise, the risk of revision surgery after injection was increased, with the time intervals between injection and surgery sometimes differing between studies. Discussion Local infections and to a lesser extent revision surgery are associated with perioperative injections (with cortisone) within 3 months preoperatively and 4 weeks postoperatively. However, there were only database studies of insurance data with several studies from a few centres. Thus, no causal relationships could be proven. Currently, however, the following can be recommended using a cautious approach: The interval between injection with cortisone before surgery should be at least 2 weeks, better 3 months. No cortisone injections should be applied intraoperatively. Postoperatively, cortisone should not be injected for at least 4 weeks. If, in exceptional cases, deviations from these time limits are required, patients should be informed about an increased risk of complications.

Current methods of rehabilitation after arthroscopic reconstruction of the anterior cruciate ligament of the knee joint (review of literature)

Introduction The leading method for treating patients with injuries of the anterior cruciate ligament is its reconstruction. Although this operation is a common procedure, the issues of rehabilitation have not been fully studied. The aim of study Collection and analysis of available published studies on current methods of rehabilitation treatment after arthroscopic reconstruction of the anterior cruciate ligament. Materials and methods We analyzed the publications that were devoted to current methods of rehabilitation treatment of patients after arthroscopic reconstruction of the anterior cruciate ligament. The materials were searched for in the PubMed and Web of Science databases using the keywords “anterior cruciate ligament reconstruction”, “anterior cruciate ligament rehabilitation”. Inclusion criteria were compliance with the general topic, relevance, introduction of new rehabilitation treatments. Studies published earlier than the last 10 years were excluded. Results The analysis found that the main rehabilitation treatments used in patients after reconstruction of the anterior cruciate ligament are of protective character (wearing a functional orthosis or other immobilizing appliance, dosed walking with crutches) and physical activity (complex of exercises, swimming). The most effective way to prevent contractures is early activation of the limb and the maintenance of muscle tone. In turn, the main task of immobilization is prevention or relief of pain. Our study proposes the authors’ methods of rehabilitation which can be used for restorative treatment and accelerate the process of ligament repair. The work includes rehabilitation procedures performed at home after reconstruction of the anterior cruciate ligament under the supervision of a rehabilitation instructor. Discussion Rehabilitation of patients after reconstruction of the anterior cruciate ligament is a necessary complement to surgical treatment. Fast recovery of patients and a full return to an active lifestyle depend on a proper rehabilitation program.