ABSTRACT
Background: Latest studies have shown effective clinical outcomes after arthroscopic Bankart repair [ABR] but have shown some risk factors for re-dislocation after surgery. We assessed whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to recognize new risk factors
Materials and Methods: We performed ABR utilizing bioabsorbable suture anchors in 51 consecutive shoulders [50 patients] with traumatic anterior shoulder instability. Average patient age was 26.5 [range, 15-40] years. We assessed re-dislocation after ABR using patient telephone interviews [follow-up rate, 100%] and correlated re-dislocation with several risk factors
Results: Re-dislocation after ABR occurred in five shoulders [9.8%], of which 4 sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 46 shoulders without re-dislocation, 4 had re-injury under the same conditions within the first year. Consequently, re-injury within the first year was a risk for re-dislocation after ABR [P < 0.001, chi-squared test]. Using multivariate analysis, large Hill-Sachs lesions [odds ratio, 6.75; 95% CI, 1.35-64.5] and <4 suture anchors [odds ratio, 9.45; 95% CI, 1.88-72.5] were significant risk factors for re-dislocation after ABR
Conclusion: The recurrence rate after ABR was not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR
ABSTRACT
Background: the occurrences of diabetes mellitus and diabetic nephropathy have increased quickly in the past few decades and have become an economic burden to the healthcare system in KSA. Diabetic nephropathy is a major complication of diabetes mellitus and is a primary cause of end-stage renal disease [ESRD]. The occurrence of non-diabetic renal disease [NDRD] in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse diabetic nephropathy, whereas some cases of non-diabetic renal disease are readily treatable and remittable. However, diabetic nephropathy is known to co-exist with non-diabetic renal disease in a poorly defined population of patients with type 2 diabetes mellitus. This study estimated the pervasiveness of co-existing diabetic nephropathy and non-diabetic renal disease in Saudi patients
Methods: data were retrospectively analyzed from 122 patients with type 2 diabetes mellitus who had experienced a renal biopsy between February 2014 and June 2017 at King Abdulaziz Hospital, region[s], KSA. Male patients numbered 75 [61.5%] of the study population. The biopsies were performed as urinary abnormalities or renal functions were atypical of a diagnosis of diabetic nephropathy. Biopsy samples were examined using light, immunofluorescence [IF] and electron microscopy [EM]. Clinical parameters were recorded for each patient at the time of biopsy
Results: nineteen of 122 diabetic patients [8%] had co-existing diabetic nephropathy and non-diabetic renal disease. These patients showed clinical features and pathologic characteristics of diabetic nephropathy, containing a high prevalence of diabetic retinopathy [88.8%], a long duration of diabetes, increased thickness of the glomerular basement membrane [GBM] and mesangial expansion. Nonetheless, they similarly presented with clinical findings which were inconsistent with diabetic nephropathy, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A [IgA] nephropathy was apparent in 5 out of the 10 patients [50%], tubulointerstitial lesions were found in two patients [20%], membrano-proliferative glomerulonephritis [MPGN] in two patients [20%] and membranous nephropathy [MN] in one patients [10%]
Conclusion: retrospective analysis of biopsy data suggests that approximately 8% of Saudi patients with type 2 diabetes mellitus may have co-existing diabetic nephropathy and non-diabetic renal disease. The most common histological diagnosis in our small series was IgA nephropathy