ABSTRACT
Anterior cruciate ligament reconstruction is a demanding procedure; complications may arise at any of its stages. This is the report of three cases in which the tibial fixation devices (IntraFix and Bio-IntraFix) led to intraarticular lesions. The complications were detected in one of the cases while the patient was still in the operating room and in the remaining two during the follow-up. All the patients had a stable knee, but all of them sustained chondral lesions resulting from the inadequate placement of the implants used for tibial fixation. Several suggestions to avoid the complications stemming from these devices are provided.
La reconstrucción del ligamento cruzado anterior es un procedimiento exigente; las complicaciones pueden presentarse en cualquiera de sus etapas. Presentamos tres casos en los cuales los dispositivos para la fijación tibial (IntraFix y Bio-IntraFix) condicionaron lesiones intraarticulares. Las complicaciones fueron detectadas, en uno de los casos, mientras el paciente se encontraba aún en la sala de operaciones, y en los otros dos, durante el seguimiento. Todos los pacientes contaban con una rodilla estable, pero tuvieron lesiones condrales causadas por la inadecuada colocación de los implantes para la fijación tibial. Se exponen algunas sugerencias para evitar complicaciones con estos dispositivos.
Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Anterior Cruciate Ligament Injuries/surgery , Humans , Knee Joint/surgery , Tendons , Tibia/surgeryABSTRACT
OBJECTIVES: The objective of this study is to report the clinical and functional outcomes of Hamstring graft ACL reconstruction fixed with femoral Rigid-fix and tibial Bio-intrafix devices. METHODS: In a prospective study, the clinical (Lysholm score) and functional outcomes (International Knee Documentation Committee, IKDC) of 44 patients who underwent autologus hamstring graft ACL reconstruction using femoral Rigid-fix and tibial Bio-intrafix devices, were evaluated at the end of one year. Joint laxity was assessed with KT-1000 arthrometer (MEDmetric, San Diego, CA). RESULTS: None of the patients complained of instability, joint swelling or severe pain in the postoperative period. The IKDC score improved from 66.62 + 5.36 to 92.36 + 5.30 (P < 0.001). Lysholm scores in the preoperative and follow up period were 68.28 + 5.54 and 93.87 + 4.75 respectively; the improvement was statistically significant with P value < 0.001. Similarly, the mean anterior translation of tibia improved from 7.45 mm in the preoperative period to 3.89 mm after one year of ACL reconstruction. Associated meniscus injury didn't have significant impact on the overall outcome. No intraoperative or postoperative complications were documented. CONCLUSION: Hamstring graft fixation using femoral Rigid-fix and tibial Bio-intrafix devices provide secure graft fixation and allows aggressive rehabilitation. The clinical and functional outcome of this hybrid fixation technique is rewarding.
ABSTRACT
Resumen: La reconstrucción del ligamento cruzado anterior es un procedimiento exigente; las complicaciones pueden presentarse en cualquiera de sus etapas. Presentamos tres casos en los cuales los dispositivos para la fijación tibial (IntraFix y Bio-IntraFix) condicionaron lesiones intraarticulares. Las complicaciones fueron detectadas, en uno de los casos, mientras el paciente se encontraba aún en la sala de operaciones, y en los otros dos, durante el seguimiento. Todos los pacientes contaban con una rodilla estable, pero tuvieron lesiones condrales causadas por la inadecuada colocación de los implantes para la fijación tibial. Se exponen algunas sugerencias para evitar complicaciones con estos dispositivos.
Abstract: Anterior cruciate ligament reconstruction is a demanding procedure; complications may arise at any of its stages. This is the report of three cases in which the tibial fixation devices (IntraFix and Bio-IntraFix) led to intraarticular lesions. The complications were detected in one of the cases while the patient was still in the operating room and in the remaining two during the follow-up. All the patients had a stable knee, but all of them sustained chondral lesions resulting from the inadequate placement of the implants used for tibial fixation. Several suggestions to avoid the complications stemming from these devices are provided.
Subject(s)
Humans , Anterior Cruciate Ligament Reconstruction , Anterior Cruciate Ligament Injuries/surgery , Tendons , Tibia/surgery , Knee Joint/surgeryABSTRACT
Objective To find out some ways to solve the problems which are dealing with the clinical application of intrafix.Methods From February to May 2013,324 patients with back blood using intrafix in emergency department were randomly assigned to the experimental group A and the control group A,with 162 patients in each group.The experimental group A used the method of pressing pipe while pulling out the needles when transfusion was over,while the control group A used traditional ways.206 patients who occurred bubbles in the intrafix among the above two groups were divided into the experimental group B and the control group B.The experimental group B got rid of the bubbles using top-down method,the control group B used traditional ways.The effect of withdrawing the needles and exhaustion of bubbles were compared.The least flushing time of remaining liquid using transfusion pipe flushing method was calculated.Results The experimental group A and the experimental group B were better in withdrawing the needles and exhaustion of bubbles compared with those of the control group A and the control group B.Using the method of drop coefficient to calculate the least flushing time can ensure the drug to be transfused into the body thoroughly.Conclusions When transfusion is over,pressing intrafix pipe will have a better result than the traditional way when pulling out the pipe.Top-down method can clearly settle the problem of intrafix pipe,which can not get rid of bubble via traditional way.Flushing pipe and press pipe method can apparently decrease drug waste.
