Hinsonbryant3080
The conservative treatment is the preferred option in asymptomatic patients. Sauceriziation and eventual repair represent the suggested surgical treatment in symptomatic cases.
Bilateral discoid medial meniscus is a rare abnormality involving active young patients. The conservative treatment is the preferred option in asymptomatic patients. Sauceriziation and eventual repair represent the suggested surgical treatment in symptomatic cases.
Knee septic arthritis rapidly damages the knee joint. Gächter described a classification of joint infections based on arthroscopic findings an arthroscopic staging of the common disease has prognostic and therapeutic consequences. The aim of this systematic review was to analyze the application of the Gächter classification system to knee septic arthritis, evaluating prognostic and therapeutic implications of this classification.
A comprehensive electronic search of the literature was performed. The following search terms were used (Arthroscopy* OR Arthrotom* OR Aspiration) AND Knee AND Septic AND Arthritis. The study reported the Gächter classification in septic knee arthritis and the eradication rate according to the type. The primary endpoint is the eradication rate of septic knee arthritis according to the Gächter sort. Secondary endpoints are surgical procedures according to Gächter classification and the rate of re-operations.
Seven studies were included. The overall eradication rate of knee septic arthritis ranged from 90% to 100% 95%-100% Gächter I; 97%-100% Gächter II; 67%-100% Gächter III; 50%-100% Gächter IV. Surgical treatments for knee septic arthritis included arthroscopic irrigation alone, articular irrigation, and debridement in knee arthroscopy or knee arthrotomy according to Gächter stage. However, 28% required re-operations for persistent infection secondary procedures included further irrigation and debridement with the arthroscopic or arthrotomic approach.
Gächter classification showed a crucial prognostic role in predicting the outcome of surgical treatment of septic knee arthritis. Regardless of the procedure performed, a prompt operation and an accurate debridement of the synovial membrane are the most critical factors for eradicating infection and good clinical outcomes.
Level II, prognostic study.
Level II, prognostic study.Debridement, antibiotic, and implant retention (DAIR) can be used as a first surgical procedure for acute infections in patients who have well-fixed components. However, its use in hematogenous or late acute infections is still debated. This systematic review of literature aims to clarify the effectiveness of DAIR procedure in the treatment of hematogenous periprosthetic knee infections. DAIR is an effective way to treat acute hematogenous PJIs of the knee and reaches its best efficacy when performed within one week from the onset of symptoms, modular components are exchanged, and a pathogen-oriented antibiotic therapy can be set. It is safe, economic, and effective technique, but has to be performed in a very narrow temporal window.
Distal femur osteotomies (DFOs) are well-accepted procedures in treating unicompartmental knee osteoarthritis associated with valgus malalignment. This study aims to investigate the Return to sport (RTS) after DFO.
We conducted a systematic review of the literature according to the PRISMA guidelines, including all articles published in English, with no time limit, excluding double-level knee osteotomies.
Five articles were included for an overall cohort of 76 patients. The mean follow-up was 45.53 months. The mean age of the patients at the time of surgery was 33.87 years, and the mean malalignment was 5.59° in valgus. In 70 cases, patients received a lateral DFO, while in 6 cases, a medial closing-wedge DFO. An RTS of 86.1% was observed after DFO and a mean time to RTS of 12.3 months. 76.8% of patients recovered to a level equal to or higher than that practiced before the onset of symptoms. No statistically significant differences were observed in the RTS rate between those who performed lateral or medial DFO.
RTS after DFO is ubiquitous and occurs around one year after surgery. In most cases, patients report improved performance compared to what they experienced before the onset of symptoms. Unfortunately, while athletes often have RTS at a similar or better level, other patients often see a return to lower impact sports.
RTS after DFO is ubiquitous and occurs around one year after surgery. In most cases, patients report improved performance compared to what they experienced before the onset of symptoms. Unfortunately, while athletes often have RTS at a similar or better level, other patients often see a return to lower impact sports.Deep periprosthetic infection after total knee arthroplasty is a serious and challenging complication for the orthopedic surgeon. Muscular flaps may represent a valid treatment option for the treatment of this condition. We present a systematic literature review about the use of muscular flaps for the treatment of knee prosthetic joint infection. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 70 articles, out of 589 titles, were considered eligible for the full-text analysis. Finally, 27 studies that met inclusion criteria were included in this review. Overall, 345 patients (139 males, 206 females) suffering from TKA infection treated with muscular flaps were collected. The mean age was 57.3 years. Mean follow-up, reported in all studies, was 30.1 months. The results presented by the different authors, highlight the effectiveness of muscular flaps for the treatment of periprosthetic infection, in terms of function, limb salvage, prevention of recurrences, cost-effectiveness, and quality of life postoperatively. Muscle flaps provide an excellent management option for patients with persistent infection after total knee arthroplasty.Snapping a knee related to a biceps femoris tendon subluxation is an uncommon syndrome that could be disabling in patients with high functional requirements such as athletes. We report a case of a 21-year-old soccer player with a painful left snapping biceps femoris tendon due to a varus trauma. He underwent knee arthroscopy and surgical exploration of the knee the long head of the biceps femoris tendon was partially detached from his fibular insertion and there was a prominence on the fibular head. Reinsertion of the tendon and osteotomy of the fibular head allowed for resolution of all symptoms and the return to sport.Lateral extra-articular tenodesis (L.E.T.) have been proposed to reduce the tibia's anterior translation and internal rotation in concomitant to Anterior cruciate ligament (A.C.L.) reconstruction. Recent studies show that the addition of L.E.T. selleck chemical to A.C.L. reconstruction results in a statistically significant reduction in graft failure. The purpose of the present study was to evaluate the clinical outcomes, complications, and rate of return to preinjury sports level in pediatric patients who underwent combined A.C.L. reconstruction with L.E.T. at a minimum 2-year follow-up. The authors retrospectively evaluated 42 pediatric patients at high risk of graft failure who experienced ACLR connected to L.E.T. IKDC and Tegner-Lysholm Knee Scores Scale were used to assess clinical outcomes, and the Tegner Activity Scale to evaluate the return to sport. No graft failure or subsequent surgery related to A.C.L. reconstruction occurred. Furthermore, 88% of patients returned to the sport. Satisfactory clinical results were obtained on a short and medium-term follow-up. These findings help to consider this procedure for active adolescents at a high risk of graft failure to enhance A.C.L. reconstruction.The incidence of periprosthetic fractures of distal femur (PPDFFx) after primary total knee arthroplasties is described around 0.3% and 2.5% and it is increasing as the number of patients with total knee arthroplasty continues to arise. surgical options treatments for PPDFFx include fixation in the form of eather Open reduction and internal fixation (ORIF), or retrograde intramedullary nailing (RIMN), or conventional (non locked) plating, or locked plating such as the Less Invasive Stabilization System (LISS), or dynamic condylar screws. In recent years, however, the use of megaprostheses has been increasing. Patients with periprosthetic fractures of distal femur after primary total knee arthroplasties treated with ORIF or with the use of Distal femur replacement (DFR) were retrospectively analyzed in this to evaluate differences in intra-operative blood loss, need of blood trasfusion, weight bearing, range of motion, rate of complications, rate of revision surgery and functional outcome according Oxford Knee Score between two groups. Treatment of Periprosthetic distal femur fracture remains controversial. While ORIF seems to guarantee less percentage of complications and reoperation rate, those treated with megaprosthesis seem to gain better range of motion in a very short post-operative time. In the future it will be necessary to investigate with greater numbers possible advantages and disadvantages of the various treatments in periprosthetic distal femur fractures.
The purpose of this project was to improve ease and speed of physician comprehension when interpreting daily laboratory data for patients admitted within the Military Healthcare System (MHS).
A JavaScript program was created to convert the laboratory data obtained via the outpatient electronic medical record (EMR) into a "fishbone diagram" format that is familiar to most physicians. Using a balanced crossover design, 35 internal medicine trainees and staff at Naval Medical Center Portsmouth were asked to complete timed comprehension tests for laboratory data sets formatted in the outpatient EMR's format and in fishbone diagram format. The number of responses per second and error rate per response were measured for each format. Participants were asked to rate relative ease of use for each format and indicate which format they preferred.
Comprehension speed increased 37% (6.28 seconds per interpretation) with the fishbone diagram format with no observed increase in errors. Using a Likert scale of 1-5 (1 being hard, 5 easy), participants indicated the new format was easier to use (4.14 for fishbone vs 2.14 for table) with 89% expressing preference for the new format.
The publically available web application that converts tabular lab data to fishbone diagram format is currently used 10000-12000 times per month across the MHS, delivering significant benefit to the enterprise in terms of time saved and improved physician experience.
This study supports the use of fishbone diagram formatting for laboratory data for inpatients within the MHS.
This study supports the use of fishbone diagram formatting for laboratory data for inpatients within the MHS.Osteoarthritis Knee (OA) is the leading cause of pain and disability. This may affect the patient's quality of life (QoL) and lead to the onset of mental disorders. The aim of this study was 1) To find the correlation between the severity of OA, depression, and QoL. 2) To compare the severity of OA knee and QoL between urban and rural areas. 199 patients were diagnosed with OA. All patients had self-assessment with questionnaires in terms of 1) demographic data, 2) the knee severity by using Oxford Knee Score, 3) Depression screening by using Patient Health Questionnaire, and 4) World Health Organization Quality of Life Brief-Thai. The results revealed that OA knee patients had excellent (no abnormal symptoms) and good (mild symptoms) levels of severity were 34.2% and 32.2%, respectively. They also had a good level of QoL. The correlation between residential area and other variables were age group (p less then 0.01), severity of osteoarthritis (p less then 0.01), and depression (p less then 0.05). The severity of OA knee and QoL in the mental health aspect was a significant difference in patients in each age group.