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1.
Acta Ortop Mex ; 37(3): 152-158, 2023.
Article in Spanish | MEDLINE | ID: mdl-38052436

ABSTRACT

INTRODUCTION: all-in meniscal suture devices have evolved and simplified meniscal repair. In this study we will formulate the following research questions: what is the rate of survival and failure? What are the risk factors associated with failure? And what are the functional results after meniscal repair surgery? MATERIAL AND METHODS: ambispective study from 2001 to 2021 of patients with repairable meniscal injury with all-in meniscal suture devices. The survival and failure ratio were obtained with the Kaplan-Meier test, the risk factors associated with meniscal suture failure were assessed with the logistic regression test, and the pre- and post-surgical functional results were estimated with the test. t-Student. RESULTS: in 20 years of follow-up of 316 menisci repaired with all-in meniscal sutures, a survival rate of 95.9% was obtained. The absence of injury to the anterior horn of the meniscus was shown to be a protective factor [OR = 0.12], together with not practicing impact sports [OR = 0.2]. Post-surgery IKDC and Tegner-Lysholm results were shown to be very good to excellent (p < 0.0001). CONCLUSION: all-in meniscal suture devices are and will continue to be front-line weapons in the repair of meniscal tears. In 20 years of follow-up, a lower failure rate was evidenced, associated with excellent functional results.


INTRODUCCIÓN: los dispositivos de suturas meniscal todo adentro han evolucionado y simplificado la reparación meniscal. En este estudio formulamos las siguientes preguntas de investigación: ¿cuál es la tasa de supervivencia y falla?, ¿cuáles son los factores de riesgo asociado a falla? y ¿cuáles son los resultados funcionales posterior a la cirugía de reparación meniscal? MATERIAL Y MÉTODOS: estudio ambispectivo desde el 2001 al 2021 de pacientes con lesión meniscal reparable con dispositivos meniscales de sutura todo adentro. La razón de supervivencia y falla se obtuvo con el test de Kaplan-Meier, los factores de riesgo asociado con falla de la sutura meniscal se valoraron con el test de regresión logística y los resultados funcionales pre y postquirúrgicos fueron estimados con la prueba t-Student. RESULTADOS: en 20 años de seguimiento de 316 menisco reparados con suturas meniscal todo adentro se obtuvo que la razón de supervivencia de 95.9%. La ausencia de lesión del cuerno anterior del menisco se mostró como un factor protector [OR = 0.12], junto a la no práctica de deportes de impacto [OR = 0.2]. Se mostraron resultados del IKDC y Tegner-Lysholm posterior a la cirugía de muy buenos a excelentes (p < 0.0001). CONCLUSIÓN: los dispositivos de sutura de meniscal todo adentro son y seguirán siendo armas de primera línea en la reparación de las roturas meniscales. En 20 años de seguimiento se evidenció una menor tasa de falla, asociados con excelentes resultados funcionales.


Subject(s)
Menisci, Tibial , Tibial Meniscus Injuries , Humans , Arthroscopy , Menisci, Tibial/surgery , Retrospective Studies , Suture Techniques , Sutures , Tibial Meniscus Injuries/surgery
2.
Acta ortop. mex ; 37(3): 152-158, may.-jun. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1556750

ABSTRACT

Resumen: Introducción: los dispositivos de suturas meniscal todo adentro han evolucionado y simplificado la reparación meniscal. En este estudio formulamos las siguientes preguntas de investigación: ¿cuál es la tasa de supervivencia y falla?, ¿cuáles son los factores de riesgo asociado a falla? y ¿cuáles son los resultados funcionales posterior a la cirugía de reparación meniscal? Material y métodos: estudio ambispectivo desde el 2001 al 2021 de pacientes con lesión meniscal reparable con dispositivos meniscales de sutura todo adentro. La razón de supervivencia y falla se obtuvo con el test de Kaplan-Meier, los factores de riesgo asociado con falla de la sutura meniscal se valoraron con el test de regresión logística y los resultados funcionales pre y postquirúrgicos fueron estimados con la prueba t-Student. Resultados: en 20 años de seguimiento de 316 menisco reparados con suturas meniscal todo adentro se obtuvo que la razón de supervivencia de 95.9%. La ausencia de lesión del cuerno anterior del menisco se mostró como un factor protector [OR = 0.12], junto a la no práctica de deportes de impacto [OR = 0.2]. Se mostraron resultados del IKDC y Tegner-Lysholm posterior a la cirugía de muy buenos a excelentes (p < 0.0001). Conclusión: los dispositivos de sutura de meniscal todo adentro son y seguirán siendo armas de primera línea en la reparación de las roturas meniscales. En 20 años de seguimiento se evidenció una menor tasa de falla, asociados con excelentes resultados funcionales.


Abstract: Introduction: all-in meniscal suture devices have evolved and simplified meniscal repair. In this study we will formulate the following research questions: what is the rate of survival and failure? What are the risk factors associated with failure? And what are the functional results after meniscal repair surgery? Material and methods: ambispective study from 2001 to 2021 of patients with repairable meniscal injury with all-in meniscal suture devices. The survival and failure ratio were obtained with the Kaplan-Meier test, the risk factors associated with meniscal suture failure were assessed with the logistic regression test, and the pre- and post-surgical functional results were estimated with the test. t-Student. Results: in 20 years of follow-up of 316 menisci repaired with all-in meniscal sutures, a survival rate of 95.9% was obtained. The absence of injury to the anterior horn of the meniscus was shown to be a protective factor [OR = 0.12], together with not practicing impact sports [OR = 0.2]. Post-surgery IKDC and Tegner-Lysholm results were shown to be very good to excellent (p < 0.0001). Conclusion: all-in meniscal suture devices are and will continue to be front-line weapons in the repair of meniscal tears. In 20 years of follow-up, a lower failure rate was evidenced, associated with excellent functional results.

3.
Acta Ortop Mex ; 33(4): 247-251, 2019.
Article in Spanish | MEDLINE | ID: mdl-32246596

ABSTRACT

INTRODUCTION: Dislocation of the acromioclavicular joint is a common injury, which is observed mainly in young adults; indications for surgical management and the most appropriate technique remain controversial. MATERIAL AND METHODS: We present a surgical technique, whose objective is the anatomical reconstruction of the coracoclavicular ligaments with autologous semitendinous graft, without tunnels in the collarbone and without fixing devices. RESULTS: This technique is reliable for stabilizing the joint in the short term and we consider that it could neutralize the anteroposterior translation of the distal collarbone. DISCUSSION: Studies are required to report on functional and radiological results, with the use of this surgical technique so that we can then point out that it has advantages over other therapeutic options existing today.


INTRODUCCIÓN: La luxación de la articulación acromioclavicular es una lesión común que se observa principalmente en adultos jóvenes. Las indicaciones para el manejo quirúrgico y la técnica más adecuada siguen siendo controvertidas. MATERIAL Y MÉTODOS: La técnica quirúrgica presentada se basa en una reconstrucción anatómica de los ligamentos coracoclaviculares mediante un injerto autólogo del tendón del semitendinoso, sin túneles en la clavícula y sin ningún dispositivo de fijación, ya que se utilizan sólo suturas. RESULTADOS: Se logró la reconstrucción anatómica y biológica de los ligamentos coracoclaviculares, la cual utilizó un autoinjerto tendinoso sin ningún dispositivo de fijación adicional, lo que minimiza el riesgo de complicaciones relacionadas con el uso de tornillos o implantes metálicos. DISCUSIÓN: Este procedimiento es un método eficaz y confiable para estabilizar la articulación. Se requieren estudios que informen los resultados funcionales y radiológicos con el empleo de esta técnica quirúrgica para entonces poder asegurar que tiene ventajas sobre otras opciones terapéuticas existentes en la actualidad.


Subject(s)
Acromioclavicular Joint , Hamstring Muscles , Joint Dislocations , Tendons , Acromioclavicular Joint/surgery , Autografts , Clavicle , Humans , Joint Dislocations/surgery , Ligaments, Articular , Tendons/transplantation , Young Adult
4.
Epidemiol Infect ; 140(2): 283-9, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21554779

ABSTRACT

Routine laboratory testing may not detect non-O157 Shiga toxin-producing Escherichia coli (STEC) reliably. Active clinical, epidemiological, environmental health, and laboratory collaboration probably influence successful detection and study of non-O157 STEC infection. We summarized two outbreak investigations in which such coordinated efforts identified non-O157 STEC disease and led to effective control measures. Outbreak 1 involved illness associated with consuming unpasteurized apple cider from a local orchard. Public health personnel were notified by a local hospital; stool specimens from ill persons contained O111 STEC. Outbreak 2 involved bloody diarrhoea at a correctional facility. Public health personnel were notified by the facility infection control officer; O45 STEC was the implicated agent. These reports highlight the ability of non-O157 STEC to cause outbreaks and demonstrate that a coordinated effort by clinicians, infection-control practitioners, clinical diagnostic laboratorians, and public health personnel can lead to effective identification, investigation, and prevention of non-O157 STEC disease.


Subject(s)
Diarrhea/epidemiology , Diarrhea/microbiology , Disease Outbreaks , Epidemiologic Methods , Escherichia coli Infections/epidemiology , Escherichia coli Infections/microbiology , Shiga-Toxigenic Escherichia coli/isolation & purification , Adult , Animals , Cattle , Diarrhea/diagnosis , Escherichia coli Infections/diagnosis , Escherichia coli Infections/transmission , Feces/microbiology , Food Microbiology , Humans , Immunoenzyme Techniques , Incidence , New York , Real-Time Polymerase Chain Reaction , Shiga Toxin 1/analysis , Shiga Toxin 1/genetics , Shiga Toxin 2/analysis , Shiga Toxin 2/genetics , Shiga-Toxigenic Escherichia coli/genetics
5.
Epidemiol Infect ; 135(3): 492-501, 2007 Apr.
Article in English | MEDLINE | ID: mdl-16870028

ABSTRACT

In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%). In multivariate analysis, sauna use [odds ratio (OR) 19.1, 95% confidence interval (CI) 2.7-206.1] and antimicrobial use within 12 months before infection (OR 11.7, 95% CI 2.9-47.6) were risk factors for infection. MRSA nasal carriage rate was 0.6% (1/174). Nine of 10 clinical isolates and an isolate from an administrative office within the community had the pulsed-field gel electrophoresis type USA300. Targeted hygiene improvement, wound care, and environmental cleaning were implemented. We describe the first reported outbreak of MRSA SSTI in a religious community. Adherence to appropriate personal and environmental hygiene might be critical factors in controlling transmission.


Subject(s)
Community-Acquired Infections/epidemiology , Disease Outbreaks , Methicillin Resistance , Staphylococcal Infections/epidemiology , Staphylococcal Skin Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cohort Studies , Community-Acquired Infections/prevention & control , Female , Humans , Hygiene , Infant , Male , Middle Aged , Nasal Mucosa/microbiology , Religion , Staphylococcal Infections/prevention & control , Staphylococcal Skin Infections/prevention & control
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