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BackgroundThe purpose of this research is to evaluate the results of arthroscopic suture fixation with fiber wires used as treatment for ACL avulsion fracture, and to determine how effective such a technique is when it comes to restoring of knee function.Materials and methodsThis prospective study involves 28 patients, who underwent arthroscopic fixation of displaced ACL avulsion fractures at Saint Paul Hospital (Hanoi) from January 2014 to March 2018.ResultsThe first three weeks were not marked with any abnormalities associated with post-operative sutures and hematomas, infectious complications were not detected either. Post-operative displacement of fracture fragments did not take place among the patients involved in the study. At the 3-month follow-up, the average IKDC score was 90.7 (range: 76–100), and the average Lysholm score was 93.6 (range 82–100). The percentage of excellent scores was 42.9% (12 patients), good scores accounted for 50% (14 patients), while fair/poor scores accounted for 3.6% each (1 patient on each score). The percentage of excellent/good scores was 92.9% in total.ConclusionThis study shows that ACL avulsion fracture can be treated effectively by arthroscopic suture fixation with fiber wires. In fact, this technique may restore knee function and stability.

Background: Estimating the cost of postoperative respiratory complications is crucial in developing appropriate strategies to mitigate the global and national economic burden. However, systematic analysis of the economic burden in low-and middle-income countries is lacking. Methods:We used the nationwide database of the Vietnam Social Insurance agency and extracted data from January 2017 to September 2018. The data contain 1 241 893 surgical patients undergoing one of seven types of surgery. Propensity score matching method was used to match cases with and without complications. We used generalized gamma regressions to estimate the direct medical costs; logistic regressions to evaluate the impact of postoperative respiratory complications on re-hospitalization and outpatient visits.Findings: Postoperative respiratory complications increased the odds of re-hospitalization and outpatient visits by 3 •49 times (95% CI: 3 •35-3 •64) and 1 •39 times (95% CI: 1 •34-1 •45) among surgical patients, respectively. The mean incremental cost associated with postoperative respiratory complications occurring within 30 days of the index admission was 1053 •3 USD (95% CI: 940 •7-1165 •8) per procedure, which was equivalent to 41% of the GDP per capita of Vietnam in 2018. We estimated the national annual incremental cost due to respiratory complications occurring within 30 days after surgery was 13 •87 million USD. Pneumonia contributed the greatest part of the annual cost burden of postoperative respiratory complications. Interpretation:The economic burden of postoperative respiratory complications is substantial at both individual and national levels. Postoperative respiratory complications also increase the odds of rehospitalization and outpatient visits and increase the length of hospital stay among surgical patients.