Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital.Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed. Short-term complications (3 months after surgery), age gender, types of surgery (elective, scheduled urgency, non-scheduled urgency, and emergency), operative time, surgical start time (morning, afternoon or evening), American Society of Anesthesiologists score and surgeon's experience were assessed. Complications were classified based on their severity according to Dindo-Clavien system: Grade I complications do not require alterations in the postoperative course or additional treatment; Grade II complications require pharmacological treatment; Grade III require surgical, endoscopic, or radiological interventions without (IIIa) or with (IIIb) general anesthesia; Grade IV are life-threatening with single (IVa) or multi-organ (IVb) dysfunction(s), and require ICU management; and Grade V result in death of the patient. Complications were further classified in minor (Dindo I, II, IIIa) and major (Dindo IIIb, IVa, IVb and V), according to clinical severity.Results: 1960 surgeries were performed. The overall 90-day complication rate was 12.7% (249/1960). Twenty-three complications (9.2 %) were type I, 159 (63.8%) type II, 9 (3.6%) type IIIa, 42 (16.8%) type IIIb, 7 (2.8%) type IVa and 9 (3.6%) were grade V according to Dindo-Clavien classification (DCC). The most frequent complication was anemia that required blood transfusion (27%) followed by wound infection (15.6%) and urinary tract infection (6%).Discussion: The overall complication rate after orthopedic surgery in our department was 12.7%. The implementation of the DCC following orthopedic surgery was an important tool to measure the standard of care.

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<p>Introducción: En pacientes sometidos a cirugía ortopédica y con antecedente de Enfermedad tromboembolica, la profilaxis común suele ser insuficiente para prevenir eventos tromboembólicos. Los filtros de vena cava (FVC) removibles pueden considerarse una alternativa. Objetivos: Estimar la tasa de complicaciones hematológicas, mecánicas y muertes asociadas al uso de FVC removibles en cirugía ortopédica. Métodos: Se diseñó una cohorte retrospectiva de pacientes con historia previa de Enfermedad tromboembolica (ETE) sometidos a procedimientos ortopédicos que requirieron FVC removible, entre el 2006-2014 en el servicio de ortopedia del Hospital Italiano de Buenos Aires. Se definió complicación asociada al FVC a las complicaciones mecánicas, hematológicas (recurrencia de ETE, síndrome postrombotico  y sangrado mayor) y muerte. Para estimar la asociación con factores de riesgo, subclasificamos a las cirugías en 5 grupos: 1, artroplastia/no artroplastia; 2, primaria/revisión; 3, electiva/urgente; 4, oncológica/no oncológica; 5, filtro pre/postoperatorio. Resultados: Se incluyeron 68 pacientes, de los cuales 31 presentaron algún tipo de complicación. Las complicaciones mecánicas ostentaron un 16%, precisando de una revisión del filtro. 64% de los filtros revisados fallaron mecánicamente y no pudieron ser extraídos. Las tasas de recurrencia de ETE, síndrome postrombotico  y sangrado mayor fueron del 33%, 15% y 4.5%, respectivamente. Las cirugías espinales presentaron un mayor riesgo de recurrencia de ETE. La mortalidad global fue del 28% y  4% asociada a recurrencia de ETE. Conclusiones: Las cirugías ortopédicas exhibieron un riesgo elevado de complicaciones mecánicas y hematológicas luego de usar un FVC removible. Empero, la mortalidad debido a dichas complicaciones fue baja.</p>

Objective:Anterior Cruciate Ligament (ACL) tears are diagnosed through a clinical examination and imaging confirmation. Magnetic Resonance Imaging (MRI) is the diagnostic image method of choice; however the sensitivity is variable for the different kind of partial injuries. The objective of this study is to evaluate the effectiveness of the MRI in the diagnosis of clinically unstable partial ACL tears that already underwent surgical treatment and define which bundle was compromised.Methods:A retrospective review of the preoperative MRI of 40 patients who were surgically operated because of ACL tears was executed. In all cases, arthroscopic findings defined one bundle was intact. All MRI were reviewed by a single osteo-articular specialist staff of the Image Department. All injuries were classified according to which bundle was involved (anteromedial (AM) or posterolateral (PL)). Results were compared with the surgical findings.Results:Concordance between MRI and arthroscopic findings was 42.5% (17/40 patients). If we analyze AM and PL tears separately we found that the concordance was 51.5% for AM bundle tears (17/33) and 0% for PL bundle tears (0/7).Conclusion:Definitive diagnosis and surgical indication for ACL tears requires both, clinical examination and image diagnosis. Over 65% of partial tears are misdiagnosed by MRI only.

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