Lauritzenmalik8035

utility. Additional research regarding its external validation and clinical impact is needed.

One of the goals of anterior cruciate ligament (ACL) reconstruction is a meniscal protective effect on the knee. Despite the advancement of ACL reconstruction techniques, subsequent meniscal tears after ACL reconstruction remain a problem, and the risk factors for recurring lesions are still unclear.

To investigate the incidence of subsequent meniscal surgery after primary ACL reconstruction without revision ACL surgery and to determine the risk factors associated with this reoperation.

Case series; Level of evidence, 4.

Overall, 518 patients who underwent primary ACL reconstruction between 2004 and 2012 at one instution participated in this study. Data on body mass index, graft type and femoral tunnel-drilling technique of ACL reconstruction, and location and type of meniscal injury and its treatment at ACL reconstruction were collected from medical records. Clinical outcomes were investigated, including side-to-side difference of anterior laxity, pivot-shift grade, and subsequent meniscal surgery wirative anterior tibial translation (OR, 1.91;

= .032), and follow-up period after ACL reconstruction (OR, 1.02;

= .003) were risk factors of subsequent meniscal surgery after ACL reconstruction.

Incidence of subsequent meniscal surgery after successful ACL reconstruction was <5%. Presence of MM tear at the time of ACL reconsturuction, small amount of increased anterior laxity, and long-term period after ACL reconstruction were predictive of subsequent meniscal surgery.

Incidence of subsequent meniscal surgery after successful ACL reconstruction was less then 5%. Presence of MM tear at the time of ACL reconsturuction, small amount of increased anterior laxity, and long-term period after ACL reconstruction were predictive of subsequent meniscal surgery.Enhanced recovery protocols (ERPs) have shown to improve outcomes in multiple specialties and were recently applied to hepatic resections. The objective of this study was to determine the safety and efficacy of ERP in hepatic resection. selleck chemical Between 2013-2017, 208 patients underwent hepatectomy. The ERP included early ambulation, early oral intake, and multimodal analgesia. Primary study end points were hospital length of stay (LOS) and overall morbidity; secondary end points were return of bowel function (ROBF), 30-day readmission, and 90-day mortality. Major hepatectomies were selected for separate analysis. Overall, pre-ERP (N = 99) and ERP (N = 109) were similar in demographics. ERP patients had earlier oral intake and ROBF with similar overall morbidity. Although median LOS was 5 days, 43% of ERP patients had LOS ≤4 days vs. 27% in the pre-ERP cohort (P = .02). 30-day readmission was similar (12%), and 90-day mortality was 2.8% vs. 3.0% (pre-ERP vs. ERP, P = .90). In major hepatectomies, pre-ERP (N = 41) and ERP (N = 33) demographics and operative characteristics were similar. ERP patients had earlier oral intake and ROBF with similar morbidity and mortality. There was no significant difference in median LOS; however, 36% of the major hepatectomy ERP patients had LOS ≤4 days vs. 17% of pre-ERP patients, P = .06. In conclusion, ERP can be safely implemented in hepatectomy, with earlier oral intake and ROBF, shorter LOS in some patients, and no increase in morbidity or mortality.

Multiligament knee injuries (MLKIs) can result from high-energy injury mechanisms such as motor vehicle accidents or low-energy injury mechanisms such as activities of daily living or sports.

The purpose was to conduct a systematic review on postoperative patient-reported outcomes after MLKIs and to conduct a meta-analysis of comparable outcome variables based upon high- versus low-energy injury mechanisms. It was hypothesized that MLKIs with low-energy injury mechanisms would demonstrate significantly improved subjective clinical outcome scores compared with high-energy injuries.

Meta-analysis and systematic review.

A systematic review was performed with the inclusion criteria of postoperative MLKI outcomes based upon high-versus low-energy mechanisms of injury with a minimum 2-year follow-up. Outcome scores included were the Lysholm knee scoring scale, Tegner activity scale, and the International Knee Documentation Committee (IKDC) score. High-energy mechanisms included motor vehicle accidents or faanalysis that patients with low-energy mechanisms of MLKI surgery had improved postoperative Tegner activity scores compared with those patients with high-energy mechanisms after MLKI surgery. However, there were no differences in Lysholm score, IKDC score, or failure rates between high- and low-energy MLKI patients at an average of 5.3 years postoperatively.

We found in this systematic review and meta-analysis that patients with low-energy mechanisms of MLKI surgery had improved postoperative Tegner activity scores compared with those patients with high-energy mechanisms after MLKI surgery. However, there were no differences in Lysholm score, IKDC score, or failure rates between high- and low-energy MLKI patients at an average of 5.3 years postoperatively.

To develop and validate a CT-based nomogram to predict the occurrence of loculated pneumothorax due to hook wire placement.

Patients (

= 177) were divided into pneumothorax (

= 72) and non-pneumothorax (

= 105) groups. Multivariable logistic regression analysis was applied to build a clinical prediction model using significant predictors identified by univariate analysis of imaging features and clinical factors. Receiver operating characteristic (ROC) was applied to evaluate the discrimination of the nomogram, which was calibrated using calibration curve.

Based on the results of multivariable regression analysis, transfissure approach [odds ratio (OR) 757.94; 95% confidence interval CI (21.20-27099.30)

< 0.0001], transemphysema [OR 116.73; 95% CI (12.34-1104.04)

< 0.0001], localization of multiple nodules [OR 8.04; 95% CI (2.09-30.89)

= 0.002], and depth of nodule [OR 0.77; 95% CI (0.71-0.85)

< 0.0001] were independent risk factors for pneumothorax and were included in the predictive model (

< 0.