Highlights Patients, when asked if they would complete another telemedicine encounter again, 92.9% (278/299) of patients reported they would. Physicians reported high satisfaction, and that 78.4% of the time a telemedicine encounter was successful in replacing an in-person visit. During our study period, over 600 telemedicine encounters were performed with extremely favourable ratings from patients and physicians.
Background: In young patients, anterior cruciate ligament (ACL) reconstruction often results in graft failure. This may be due, in part, to concomitant injury to anterolateral complex (ALC) of the knee leading to rotatory laxity. The modified Lemaire lateral extra-articular tenodesis (LET) technique is intended to address the anterolateral rotatory instability due to injury to the ALC and to protect the ACL graft and meniscus. Indications: The International Anterolateral Complex Consensus Group Meeting identified 4 appropriate indications for the modified Lemaire LET procedure: revision ACL, high-grade pivot shift, generalized ligamentous laxity/genu recurvatum, and young patients returning to pivoting activities. Technique Description: The technique consists of harvesting an 8-cm long by 1-cm wide graft from the iliotibial band. The graft is released proximally and remains attached distally to Gerdy’s tubercle. The graft is then passed deep to the lateral collateral ligament (LCL) from distal to proximal. The graft is then affixed to a point proximal and posterior to the lateral femoral epicondyle with an all-suture button. The graft is then tensioned with knee at 30° of flexion and neutral rotation, and then secured in place. Results: With the modified Lemaire LET, there was previously concern for overconstraint and lateral compartment degeneration. However, recent studies have shown that there is no increased risk for these complications with the LET procedure. The STABILITY trial found that the addition of LET to ACL reconstruction significantly reduces re-rupture and residual laxity when compared with ACL reconstruction alone. Moreover, the addition of LET to ACL reconstruction can restore native knee kinematics. Conclusion: The addition of the modified Lemaire LET technique to traditional ACL reconstruction is a safe and effective adjunct that reduces the occurrence of graft rupture, addresses residual rotational laxity, and can restore native knee kinematics in appropriately indicated patient populations. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
inadequate staffing (fewer nurses and residents available), job control (frequent reassignment), and time pressure (increased daily tasks). Stressors thought to emerge since COVID-19 included moral distress (fear of infecting family members), physical work environment (lack of safely distanced workspaces), and guilt (reporting exposures and worsening peer workload during quarantines).CONCLUSION: Since COVID-19, surgical residents continue to demonstrate high levels of burnout, as their well-being is being affected by a complex set of interrelated workplace stressors, causing a lower quality of work and personal distress. Interventions to deal with pandemic-related stress are needed.
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