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1.
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1142106

ABSTRACT

Dada la creciente popularidad de las actividades deportivas, el número de roturas del ligamento cruzado anterior (LCA) y lesiones meniscales ha aumentado en particular en niños y adolescentes. El manejo de estas lesiones es desafiante debido las fisis abiertas. Por un lado las opciones de reconstrucción del LCA incluyen técnicas: transfisarias, extra-articulares y intraepifisarias. Por otro lado se han descrito diferentes técnicas de reparación meniscal: "all-inside", "inside-out" y "outside-in". Estas tiene como objetivo lograr la cicatrización meniscal, evitando los efectos adversos de la meniscectomía. Presentamos un reporte de caso de un adolescente de 14 años con una rotura completa del LCA y una lesión del cuerno posterior del menisco interno que fue sometido a una reconstrucción transfisaria del LCA y a una reparación meniscal "inside-out".


With the raising popularity of sporting activity, the number of anterior cruciate ligament (ACL) ruptures and meniscal tears has increased in particular in children and adolescents. Management of these injuries is challenging due to open growth plates. On the one hand the ACL reconstructions options includes: transphyseal, extra-articular and epiphyseal-only techniques. On the other hand there have been described different meniscal repair techniques: "all-inside", "inside-out" and "outside-in". These aim to achieve meniscal healing, avoiding the adverse effects of meniscectomy. We present a case report of a 14-year adolescent with an ACL complete rupture and a posterior horn tear of the medial meniscus who underwent an ACL transphyseal reconstruction and a "inside-out" meniscal repair.


Dada a crescente popularidade das atividades esportivas, o número de rupturas do ligamento cruzado anterior (LCA) e lesões meniscais aumentou especialmente em crianças e adolescentes. O manejo destas lesões é desafiador devido às fissuras abertas. Por um lado as opções de reconstrução do LCA incluem técnicas: transfisárias, extra-articulares e intraepifisárias. Por outro lado, foram descritas diferentes técnicas de reparação meniscal: "all-inside", "inside-out" e "outside-in". Estes têm como objetivo alcançar a cicatrização meniscal, evitando os efeitos adversos da meniscectomia. Apresentamos um relatório de caso de um adolescente de 14 anos com uma ruptura completa do LCA e uma lesão do corno posterior do menisco interno que foi submetido a uma reconstrução transfisária do LCA e a uma reparação meniscal "inside-out".


Subject(s)
Humans , Male , Adolescent , Anterior Cruciate Ligament Reconstruction/instrumentation , Anterior Cruciate Ligament Reconstruction/methods , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Injuries/diagnostic imaging , Tibial Meniscus Injuries/surgery , Tibial Meniscus Injuries/diagnostic imaging , Age Factors , Treatment Outcome , Anterior Cruciate Ligament Reconstruction/adverse effects
4.
Artrosc. (B. Aires) ; 26(2): 63-66, 2019.
Article in Spanish | LILACS, BINACIS | ID: biblio-1016582

ABSTRACT

En la reconstrucción primaria del LCA existen variantes como injertos, túneles, fijaciones y rehabilitación, que actúan como factores determinantes del éxito de la cirugía. Las principales causas de fracaso son errores técnicos, inestabilidades asociadas, sexo, edad, hiperlaxitud y aumento del slop tibial (inclinación platillo tibial). Este último es un factor importante a tener en cuenta ante el fracaso de una cirugía de revisión de LCA. En pacientes con antecedente de 2 fallas previas de LCA se recomienda la corrección del slope tibial cuando este excede los 12°, sobre todo en presencia de lesiones meniscales asociadas para disminuir el riesgo de re-ruptura. Se describe la técnica quirúrgica de deflexión anterior de tibia. La reconstrucción de LCA es una de las cirugías más frecuentes en lesiones deportivas. Hay una constante evolución en todos los aspectos del tratamiento de estas lesiones. Estos cambios van desde la técnica quirúrgica hasta el proceso de rehabilitación, pasando por el mejoramiento de los implantes, la implementación de terapias biológicas, etc. A pesar de esta constante evolución, aún existe un porcentaje alto de re rupturas. Creemos que en aquellos pacientes con dos o más rupturas de la plástica de LCA y en donde se han descartado fallas técnicas, o inestabilidades asociada no diagnosticadas previamente, el slope tibial aumentado (más de 12 grados) es un factor a corregir. La técnica quirúrgica descripta, si bien requiere una curva de aprendizaje y es de cierta complejidad, es un procedimiento reproducible. Los trabajos hasta ahora publicados presentan buenos resultados. Tipo de estudio: Nota técnica. Nivel de evidencia: V


In primary ACL reconstruction there are variables such as grafts, tunnels, fixations and rehabilitation which play a determinant role in the success of the surgery. The main causes of failure are: technical errors, associated instabilities, gender, age, hyper laxity and an increase in the tibial slope (a inclination in the tibial plateau). The latter is an important factor to take into account when there is failure of an ACL revision surgery. In patients with a background of two previous ACL failures, correction of the tibial plateau is recommended when it exceeds 12°, mainly in the presence of associated meniscal lesions to lower the risk of a re-rupture. The anterior tibial deflexion surgical technique will be described. LCA reconstruction is one of the most frequent surgeries in sports lesions. There is a constant evolution in all aspects of the treatment of these lesions. These changes range from the surgical technique to the rehab process, going through the improvement of implants, the implementation of biologic therapies, etc. Despite this constant evolution, there is still a high percentage of re ruptures. We believe that, in those patients with two or more ruptures of ACL reconstruction, and in whom technical failure or associated instabilities, which were not previously diagnosed, have been ruled out, the increased tibial slope (over 12°) is a factor to be corrected. The surgical technique described, even though it requires a learning curve and is of a certain complexity, is a reproducible procedure. And papers published so far present good results. Type of study: Technical note. Level of evidence: V


Subject(s)
Osteotomy , Reoperation , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Reconstruction/adverse effects , Knee Joint/surgery
5.
Article in Spanish | LILACS, BINACIS | ID: biblio-1048476

ABSTRACT

La ruptura del ligamento cruzado anterior es una patología frecuente en deportistas, siendo la reconstrucción del mismo uno de los procedimientos más frecuentes en la cirugía ortopédica. Se han descripto múltiples técnicas quirúrgicas, con distintos injertos y sistemas de fijación. Si bien la fijación femoral es controvertida, el sistema de fijación suspensoria con Endobutton demostró tener una fuerza biomecánica mayor que la de los tornillos interferenciales. La migración intraarticular del Endobutton es una complicación infrecuente que ha sido descripta previamente en la literatura. Presentamos el caso de un paciente masculino de 24 años de edad, con una migración intraarticular del Endobutton posterior a una plástica del ligamento cruzado anterior de cuatro meses de evolución


The anterior cruciate ligament (LCA) ruptures are a frequent pathology in athletes, being the reconstruction one of the most frequent procedures in orthopedic surgery. Many surgical techniques have been described, with different grafts and fixation systems. Although femoral fixation is controversial, the suspensory fixation system with Endobutton have demonstrated a greater biomechanical force in comparison with interferential screws. The intra-articular migration of Endobutton is an infrequent complication that has been previously described in the literature. We present a 24 years male patient, with an intraarticular migration of the Endobutton posterior LCA reconstruction of four months of evolution. Two stage revision ACL reconstruction were performed modifying the fixation method to a bone patellar bone graft


Subject(s)
Adult , Orthopedic Fixation Devices/adverse effects , Foreign-Body Migration/surgery , Plastic Surgery Procedures/methods , Anterior Cruciate Ligament Reconstruction/adverse effects , Anterior Cruciate Ligament Injuries/surgery , Knee Joint/surgery , Time Factors , Treatment Outcome
6.
Rev. chil. ortop. traumatol ; 59(3): 95-99, dic. 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-1095708

ABSTRACT

La rigidez de rodilla en cirugía de Reconstrucción del Ligamento Cruzado Anterior (R-LCA) es una complicación devastadora, alcanzando una incidencia variable entre el 4% y el 38%. La definición de artrofibrosis es aún poco clara, lo que ha llevado a distintos esquemas terapéuticos. Conocer la etiopatogenia es clave para entender los procesos y las posibles alternativas de tratamiento. Distintas clasificaciones han sido descritas, siendo la de Shelbourne la más usada, debido a su valor pronóstico asociado. El objetivo del tratamiento en una rodilla estable es mejorar la movilidad articular, la satisfacción del paciente, y disminuir el riesgo de artrosis a largo plazo. El tratamiento se puede dividir en quirúrgico y conservador. Ese último, se enfoca principalmente en buscar la causa y lograr una prevención e intervención temprana, siendo el manejo que con mayor frecuencia se realiza. El tratamiento quirúrgico es una opción cuando el tratamiento conservador falla. Se realizó una revisión de la literatura y de 150 pacientes sometidos a R-LCA, de los cuales 4 presentaron artrofibrosis a un seguimiento de 2 años. Además, presentamos nuestro algoritmo de manejo terapéutico.


Knee stiffness in Anterior Cruciate Ligament Reconstruction (ACL-R) is a devastating complication, with a variable incidence of 4% to 38%. The definition of arthrofibrosis is still unclear, which has led to different therapeutic schemes. Knowing the etiopathogenesis is key to understanding the processes and possible treatment alternatives. Different classifications have been described, with Shelbourne being the most used, due to its associated prognostic value. The aim of treatment in a stable knee is to improve joint mobility, patient satisfaction, and decrease the risk of long-term osteoarthritis. The treatment can be divided into operative and non-operative. The latter focuses mainly on finding the cause and achieving prevention and early intervention, being the management that is most frequently performed. Surgical treatment is an option when conservative treatment fails. A review of the literature and of 150 patients undergoing R-LCA was performed, of which 4 presented arthrofibrosis at a 2-year follow-up. In addition, we present our therapeutic management algorithm.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Anterior Cruciate Ligament Reconstruction/adverse effects , Knee Injuries/etiology , Knee Injuries/physiopathology , Range of Motion, Articular/physiology , Knee Injuries/classification , Knee Injuries/therapy
7.
Artrosc. (B. Aires) ; 25(1): 14-20, 2018. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-907453

ABSTRACT

Introducción: La aparición de quiste sinovial pretibial posterior a cirugía de reconstrucción de LCA es una complicaciónpoco frecuente, de origen multifactorial que puede suceder incluso años luego de la cirugía. El objetivo del presentetrabajo fue analizar una serie de pacientes tratados por esta complicación. Material y métodos: Se evaluaron retrospectivamente 14 pacientes operados de resección de quiste pretibial posterior auna cirugia de LCA entre el año 2008 y 2016. Se analizó el tipo de injerto, técnica quirúrgica e implante utilizado, la clínicadel paciente y el tiempo de aparición de los síntomas. Se realizó una evaluación radiológica pre y post operatoria. Sedescribió la cirugía de resección del quiste y la anatomía patológica. Evaluamos el índice de recidiva. Resultados: Nueve hombres y 5 mujeres con edad promedio de 38 años. El seguimiento promedio fue de 35 meses.Todos operados con isquiotibiales cuádruple y técnica trans-tibial. El tiempo promedio entre la cirugía de LCA y aparicióndel quiste fue de 29 meses. Clínicamente presentaban una tumoración entre 1.1 y 3 cm sin signos de inestabilidad. Através de Rx y RM se evidenció ensanchamiento del túnel tibial en todos los casos. Se rellenó el túnel tibial con injertoóseo en 7 casos. La anatomía patológica informó: 12 quistes sinoviales (5 asociados a remanentes de sutura) y 2 casosúnicamente fibrosis. Un paciente evolucionó con recidiva...


Introduction: Among complications following ACL reconstruction, the formation of a pre-tibial cyst in the site of the tibialtunnel is very rare and might happen even years after surgery. The purpose of this study was to analyze 14 patients with tibialsynovial cyst after ACL reconstruction.Material and method: We retrospectively evaluated patients operated between 2008 and 2016. We analyzed the graftselection and surgical technique for ACL reconstruction, the time between primary surgery and the onset of symptoms andthe clinical presentation. A pre and postoperative radiological evaluation was performed for every patient. Surgical techniquefor cyst excision, histological analysis and culture results were also analyzed. The recurrence rate was evaluated at finalfollow-upResults: Nine patients were male, with an average age of 38 years. The average follow-up was of 35 months. All ACLreconstructions were performed using hamstring graft and a trans-tibial technique. The average time between primary ACLsurgery and onset of the cyst was 29 months. All patients presented a palpable tumor at proximal tibia and a stable knee.The cyst size varied between 1.1 and 3 cm. In all cases, Rx and MRI could appreciate a widening of the tibial tunnel. Thetibial tunnels were filled with cancellous bone in 7 cases. Pathological anatomy reported 12 synovial cysts (5 associated withremaining suture) and 2 fibrosis. One recurrence was reported...


Subject(s)
Adult , Anterior Cruciate Ligament Reconstruction/adverse effects , Synovial Cyst/surgery , Tibia/surgery , Follow-Up Studies , Postoperative Complications , Retrospective Studies
8.
Artrosc. (B. Aires) ; 25(3): 92-99, 2018. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-972518

ABSTRACT

OBJETIVO: Describir la investigación epidemiológica de osteomielitis por Mucorales (OMM) post reparación artroscópica de LCA (RA-LCA) en Argentina. MATERIAL Y MÉTODO: 1) Revisión de los casos; 2) Relevamiento de 3 instituciones; 3) Cultivo micológico de materiales quirúrgicos; 4) Encuesta a instrumentadoras; 5) Secuenciación de las cepas de Rhizopus y 6) Redacción de recomendaciones. RESULTADOS: Del 2005 al 2017 se identificaron 40 casos de OMM (Rhizopus sp.) post reparación artroscópica de LCA en pacientes inmunocompetentes de 12 jurisdicciones de Argentina. El diagnóstico fue por cultivo (22/31), y por anatomía patológica (9). La edad promedio fue 29 años. El 84% de 38 casos eran varones. Intervinieron 13 ortopedias. El implante fue importado en 8/20 casos y nacional en 12. En las 3 instituciones se observó: manejo inadecuado del aire de quirófano, variabilidad en la limpieza del artroscopio, en el taladro utilizado, y en el manejo de materiales que llegan de las ortopedias y falta de trazabilidad de los implantes. Los cultivos micológicos de los materiales fueron negativos. La encuesta a instrumentadores confirmó los hallazgos de los relevamientos. La secuenciación de las cepas de Rhizopus demostró predominio de policlonalidad. CONCLUSIÓN: La OMM es una complicación posible luego de la RA-LCA en instituciones privadas de Argentina. No se identificó un origen único. Se detectaron múltiples prácticas que favorecen la contaminación de la cirugía con hongos filamentosos (manejo del aire de quirófano, del artroscopio, de los materiales provenientes de ortopedia, etc.). En base a estos hallazgos la Asociación Argentina de Artroscopía sugiere medidas de prevención. Implicancia clínica: Prevención de osteomielitis por Mucorales post- cirugía artroscópica para ligamento cruzado anterior. Tipo de estudio: Serie de casos. Nivel de Evidencia: IV.


OBJECTIVE: To describe the epidemiological investigation of Mucor osteomyelitis (MO) after arthroscopic repair of ACL (ARACL) in Argentina. MATERIAL Y METHODS: 1) Review of cases; 2) Survey of 3 institutions; 3) Mycological culture of surgical materials; 4) Survey of instrumentists; 5) Sequencing of Rhizopus strains and 6) Writing of recommendations. RESULTS: From 2005 to 2017, 40 cases of MO (Rhizopus sp.) Post AR-ACL were identified in immunocompetent patients from 12 jurisdictions of Argentina. The diagnosis was made by culture (22/31), and by pathology (9). The average age was 29 years. 84% of 38 cases were male. Thirteen orthopedics intervened. The implant was imported in 8/20 cases and national in 12. In the 3 institutions it was observed: inadequate handling of the operating room air, variability in the cleaning of the arthroscope, in the drill used, and in the handling of materials that come from the orthopedics and lack of traceability of the implants. The mycological cultures of the materials were negative. The survey of instrumentists confirmed the findings of the surveys. The sequencing of Rhizopus strains showed a predominance of polyclonality. CONCLUSION: MO is a possible complication after AR-ACL in private institutions in Argentina. A unique origin was not identified. Multiple practices that favor the contamination of surgery with filamentous fungi (handling of operating room air, arthroscope, materials from orthopedics, etc.) were detected. Based on these findings, the Argentine Association of Arthroscopy suggests prevention measures. Clinical relevance: Prevention of Mucor osteomyelitis after arthroscopic surgery for anterior cruciate ligament. Type study: Cases series. Level of evidence: IV.


Subject(s)
Adult , Anterior Cruciate Ligament Reconstruction/adverse effects , Arthroscopy/adverse effects , Cross Infection/epidemiology , Cross Infection/prevention & control , Mucormycosis/epidemiology , Mucormycosis/prevention & control , Mycoses/epidemiology , Mycoses/prevention & control , Osteomyelitis/epidemiology , Argentina , Risk Factors
9.
Artrosc. (B. Aires) ; 25(3): 100-104, 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-972519

ABSTRACT

Los injertos sintéticos representan una alternativa a los injertos biológicos para reconstrucción del ligamento cruzado anterior. Ciertas ventajas teóricas apoyan dicha técnica, la principal función del injerto sintético sigue siendo estructural. Las publicaciones respecto a esta alternativa quirúrgica brindan información controversial, y en la literatura no se observa evidencia suficiente aún que avale este sistema como alternativa en reconstrucción de LCA a largo plazo. En la literatura se describen múltiples complicaciones asociadas al injerto sintético. Se presenta un reporte de caso de falla de injerto sintético de LCA, el cual se resolvió con una planificación en dos tiempos quirúrgicos. Se detallan los hallazgos intraoperatorios y los detalles de técnica para dicha revisión quirúrgica.


Synthetic grafts represent an alternative to biological grafts for anterior cruciate ligament reconstruction. Certain theoretical advantages support this technique; the main function of the synthetic graft remains structural. Publications provide controversial information regarding this surgical alternative, and there is not enough data to support this system as an alternative to long-term outcomes ACL reconstruction. Multiple complications associated with synthetic graft are described in the literature. We present a case report of synthetic ACL graft failure, resolved in two stages ACL revision surgery. We describe intraoperative findings and technical details.


Subject(s)
Adult , Anterior Cruciate Ligament Reconstruction/adverse effects , Anterior Cruciate Ligament/surgery , Biocompatible Materials/adverse effects , Knee Joint/surgery , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Postoperative Complications , Reoperation
10.
Acta cir. bras ; 32(12): 1064-1074, Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-886190

ABSTRACT

Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion: The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Tibia/surgery , Anterior Cruciate Ligament Reconstruction/methods , Anterior Cruciate Ligament Injuries/surgery , Joint Instability/surgery , Osteotomy/methods , Postoperative Period , Thigh/pathology , Prospective Studies , Follow-Up Studies , Treatment Outcome , Preoperative Period , Anterior Cruciate Ligament Reconstruction/adverse effects , Anterior Cruciate Ligament Reconstruction/rehabilitation , Operative Time , Allografts/transplantation , Autografts/transplantation , Hamstring Tendons/transplantation
11.
Acta ortop. mex ; 30(6): 307-310, nov.-dic. 2016. graf
Article in Spanish | LILACS | ID: biblio-949769

ABSTRACT

Resumen: Las lesiones del ligamento cruzado anterior (LCA) hoy en día son tratadas principalmente con injerto de isquiotibiales y una amplia gama de técnicas y sistemas de fijación del LCA en busca de una menor morbilidad del paciente. Se reporta un caso de una paciente de 42 años que sufrió ruptura de LCA, tratada con reconstrucción de LCA con injerto autólogo de isquiotibiales, fijación femoral con pines transversos bioabsorbibles y fijación tibial con tornillo bioabsorbible. La paciente evolucionó con presencia de dolor en región lateral de rodilla, diagnosticado como síndrome de fricción de la banda iliotibial un año posterior a la cirugía. Se realizaron estudios de imagen que incluyeron rayos X y resonancia magnética (RM) donde se observó adecuada fijación del LCA con presencia de migración y ruptura del pin proximal bioabsorbible. Se decidió extraer el fragmento del pin bioabsrobile en un segundo tiempo quirúrgico y la paciente regresó a sus actividades cotidianas y deportivas sin dolor y con una adecuada estabilidad.


Abstract: Injuries of the anterior cruciate ligament are currently treated primarily with the use of hamstring graft with a wide range of different techniques and fixation systems for anterior cruciate ligament in reducing patient morbidity. We report the case of a female patient aged 42 that suffered an anterior cruciate ligament rupture and was treated with anterior cruciate ligament reconstruction with hamstring autograft with femoral fixation with bio-absorbable cross-pin and tibial fixation with bio-absorbable screw. The patient presented lateral knee pain that was diagnosed one year after the operation as an iliotibial band friction syndrome. Imaging studies were performed. X-rays and magnetic resonance imaging demonstrated adequate fixation of the anterior cruciate ligament with the presence of migration and rupture of the proximal bio-absorbable cross-pin. It was decided to remove the bio-absorbable cross-pin fragment in a second surgical procedure after which the patient went back to her daily activities and sports without pain and with stability stable knee.


Subject(s)
Humans , Female , Adult , Tendons , Bone Nails/adverse effects , Anterior Cruciate Ligament Reconstruction/adverse effects , Syndrome , Anterior Cruciate Ligament , Friction , Absorbable Implants , Anterior Cruciate Ligament Injuries
12.
Article in English | WPRIM | ID: wpr-101606

ABSTRACT

Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case.


Subject(s)
Adult , Humans , Male , Anterior Cruciate Ligament Reconstruction/adverse effects , Compartment Syndromes , Fasciotomy , Iatrogenic Disease , Necrosis , Postoperative Complications , Republic of Korea , Tibia/surgery , Tibial Arteries/injuries
13.
Article in English | WPRIM | ID: wpr-119045

ABSTRACT

Infections following anterior cruciate ligament reconstruction are rare, with no previous reports citing Mycobacterium abscessus as the culprit pathogen. A 22-year-old man presented twice over three years with a painful discharging sinus over his right tibia tunnel site necessitating repeated arthroscopy and washout, months of antibiotic therapy, and ultimately culminating in the removal of the implants. In both instances, M. abscessus was present in the wound cultures, along with a coinfection of Staphyloccocus aureus during the second presentation. Though rare, M. abscessus is an important pathogen to consider in postoperative wounds presenting with chronic discharging sinuses, even in healthy non-immunocompromised patients. This case illustrates how the organism can cause an indolent infection, and how the removal of implants can be necessary to prevent the persistence of infection. Coinfection with a second organism is not uncommon and necessitates a timely change in treatment regime as well.


Subject(s)
Humans , Male , Young Adult , Anterior Cruciate Ligament/injuries , Anterior Cruciate Ligament Reconstruction/adverse effects , Anti-Bacterial Agents/administration & dosage , Arthritis, Infectious/etiology , Arthroscopy , Coinfection , Device Removal , Mycobacterium Infections, Nontuberculous/microbiology , Recurrence , Reoperation , Staphylococcal Infections/microbiology , Staphylococcus aureus , Therapeutic Irrigation
14.
Artrosc. (B. Aires) ; 20(3): 95-97, sept. 2013. ilus
Article in Spanish | LILACS | ID: lil-743142

ABSTRACT

Se presentan cuatro pacientes con un ganglión pretibial como complicación post reconstrucción de ligamento cruzado anterior. En los cuatro pacientes se realizo la reconstrucción con injerto cuádruple de isquiotibiales sin fijación distal, preservando la inserción distal de los tendones. Se realizó resección del ganglión y los restos de suturas, se cureteó y rellenó con injerto óseo el túnel tibial. Tipo de Estudio: Reporte de casos. Nivel de evidencia: IV


We report 4 cases of pre-tibial cyst after anterior cruciate ligament reconstruction with no distal fixation, except for the native insertion of the tendons. Surgical resection of the cyst with removal of any residual nonabsorbable suture was done. Tibial tunnels were filled with bone grafts. Study Design: Case report. Evidence Level: IV


Subject(s)
Humans , Adult , Anterior Cruciate Ligament/surgery , Plastic Surgery Procedures/adverse effects , Bone Cysts/surgery , Bone Cysts/etiology , Anterior Cruciate Ligament Reconstruction/adverse effects , Postoperative Complications , Time Factors , Treatment Outcome
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