Arthroscopy--'no-problem surgery'. An analysis of complications in two thousand six hundred and forty cases.

Sherman, Orrin H.; Fox, James M.; Snyder, Stephen J.; Pizzo, Wilson Del; Friedman, Marc J.; Ferkel, Richard D.; Lawley, M J

doi:10.2106/00004623-198668020-00011

Cited by 335 publications

(159 citation statements)

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“…To reiterate, given the lack of symptomatic VTE diagnosed in our series, further statistical analysis of the risk factors mentioned here was not possible. Despite our results not appearing to suggest a correlation with tourniquet use and symptomatic VTE, it is recommended to avoid the use of tourniquet compression in cases of multiligamentous knee reconstruction in which the patient underwent vascular repair with their initial trauma [7,10,38,44,46,47].…”

Section: Discussioncontrasting

confidence: 64%

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Born¹,

Engasser

King

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Reconstruction of the multiligament-injured knee often involves extended surgical and tourniquet use times and often is performed in patients who have sustained concomitant fractures as well as vascular injuries, all of which would appear to predispose the patient to the potentially serious complications of deep vein thrombosis and perhaps pulmonary embolism, yet little is known about the frequency of venous thromboembolic (VTE) events after multiligamentous knee reconstruction. Questions/purposes The purposes of this study were to (1) determine the frequency of symptomatic VTE after multiligamentous knee reconstruction at a single institution; and (2) to determine associated risk factors for VTE in these patients. Methods The records of 134 (63% of the 213 consented individuals in our longitudinal database) patients who underwent primary (129 [96%]) or revision (five [4%]) multiligamentous knee reconstruction at a single institution between 1992 and 2013 were retrospectively reviewed. With two patients undergoing procedures bilaterally, this resulted in a total of 136 multiligamentous knee reconstructions. VTE for which clinical symptoms were evident and confirmed by imaging within 3 months after the reconstructive procedure was noted. Pre-and perioperative data were collected with respect to demographics, associated injuries, medical history, smoking status, and surgical data. Standard rehabilitation and thromboprophylaxis protocols were used in all patients. Results Three cases of symptomatic VTE (three deep vein thromboses) occurred after the 136 reconstructions (2%; 95% confidence interval, 0.53%-7.3%). Two of the three patients were obese and the remaining patient smoked and abused alcohol. However, as a result of a low frequency of VTE, no risk factors could be identified in this series. Conclusions Symptomatic VTE occurred in 2% of multiligamentous knee reconstructions at our institution while receiving thromboprophylaxis. This is similar to rates documented after anterior cruciate ligament reconstruction without thromboprophylaxis. Further multicenter research is required to identify the true frequency of and risk factors for developing VTE in patients undergoing multiligamentous knee reconstruction after knee dislocation. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussioncontrasting

confidence: 64%

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Born¹,

Engasser

King

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…[17][18][19][20] However, arthroscopy is an invasive and expensive tool that requires hospitalization and regional or general anesthesia, thus presenting all the potential complications of an open surgical procedure. [21][22][23][24][25][26][27] During the last decade, magnetic resonance imaging has been confirmed as the ideal approach for primary diagnosis of traumatic intraarticular knee lesions. [28][29][30][31] It is noninvasive, fast, can be done on an outpatient basis, and is free of complications.…”

mentioning

confidence: 99%

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Vaz

Camargo

Santana

et al. 2005

Clinics

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PURPOSE:To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. METHOD: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). RESULTS: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. CONCLUSION: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions.

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“…Iatrogenic infection resulting from arthroscopy is an increasingly frequent source of septic arthritis. In general, the risk of procedure-related septic arthritis has been estimated at 0.15-4.2% for arthroscopies [34][35][36]. In 70 ligament reconstruction surgeries performed by Viola et al, infection was detected in 10 patients, and they found that the origin of contamination (coagulase-negative Staphylococcus) was the supposedly sterile inflow cannula.…”

Section: Discussionmentioning

confidence: 99%

Mini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report

Ceylan¹

2018

Ann Clin Anal Med

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Surgical treatment of knee septic arthritis with local anesthesiaMini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report DOI: 10.4328 AbstractAim: Good pain management is provided via spinal and general anesthesia during knee joint drainage to treat septic arthritis, but the side effects are greater than those associated with local anesthesia, and the preparation process is long. Arthroscopic drainage under local anesthesia for knee septic arthritis treatment have been described, but this method requires special equipment. In this study, we aimed to evaluate the applicability of mini-open surgery under local anesthetic infiltration in cases of septic knee arthritis. Material and Method: 14 consecutive patients (eight men, six women) were admitted for knee septic arthritis treatment. Patient age ranged from 18 to 56 years, with an average age of 33 years. Drainage procedure was performed under local anesthesia, and the results were evaluated clinically. Results: The visual analog scale scores were between two and four (mean 2.8). The follow-up period was 10-21 months (mean 14.3). The Tegner and International Knee Documentation Committee scores were acceptable except for one patient. Discussion: This prospective study included mini-open surgery performed under local anesthesia on 14 septic knees, and showed that this method is safe, effective, well tolerated and be alternative to conventional techniques.

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Arthroscopy--'no-problem surgery'. An analysis of complications in two thousand six hundred and forty cases.

Cited by 335 publications

References 0 publications

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Low Frequency of Symptomatic Venous Thromboembolism After Multiligamentous Knee Reconstruction With Thromboprophylaxis

Accuracy of Magnetic Resonance in Identifying Traumatic Intraarticular Knee Lesions

Mini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report

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