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Serious complication 1 year after sacrospinous ligament fixation.

ABSTRACT: Myositis of the gluteal region caused by group A streptococci 1 year after a sacrospinous ligament fixation was recognised as a serious complication of this procedure. Most likely, the infection was spread to the gluteal region through a port d'entree caused by vaginal atrophy, via the non-resorbable sutures. The patient was treated successfully with antibiotics intravenous and local estrogens.

SUBMITTER: Faber VJ

PROVIDER: S-EPMC2515550 | biostudies-other | 2008 Sep

REPOSITORIES: biostudies-other

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Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse.

Project description:Objective: To evaluate the rates of serious complications and reoperation for recurrence following sacrospinous ligament fixation (SSLF) for apical pelvic organ prolapse. Methods: This was a national registry ancillary cohort comparative study. The VIGI-MESH registry includes data from 24 French health centers prospectively collected between May 2017 and September 2021. Time to occurrence of a serious complication or reoperation for genital prolapse recurrence was explored using the Kaplan-Meier curve and Log-rank test. The inverse probability of treatment weighting, based on propensity scores, was used to adjust for between-group differences. Results: A total of 1359 women were included and four surgical groups were analyzed: Anterior SSLF with mesh (n = 566), Anterior SSLF with native tissue (n = 331), Posterior SSLF with mesh (n = 57), and Posterior SSLF with native tissue (n = 405). Clavien-Dindo Grade III complications or higher were reported in 34 (2.5%) cases, with no statistically significant differences between the groups. Pelvic organ prolapse recurrence requiring re-operation was reported in 44 (3.2%) women, this was higher following posterior compared with anterior SSLF (p = 0.0034). Conclusions: According to this large database ancillary study, sacrospinous ligament fixation is an effective and safe surgical treatment for apical prolapse. The different surgical approaches (anterior/posterior and with/without mesh) have comparable safety profiles. However, the anterior approach and the use of mesh were associated with a lower risk of reoperation for recurrence compared with the posterior approach and the use of native tissue, respectively.

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Coronary Artery Perforation: A Rare Serious Complication of Pericardiocentesis

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A new anterior cruciate ligament reconstruction fixation technique (quadrupled semitendinosus anterior cruciate ligament reconstruction with polyetheretherketone cage fixation).

Project description:Fixation of the graft during anterior cruciate ligament reconstruction surgery has been the subject of numerous technical innovations but still remains a challenge. This article describes a novel technique of graft fixation for hamstring tendon reconstruction: the Cage For One system (Sacimex, Aix-en-Provence, France). The technique uses only the semitendinosus tendon, which is looped to create a 4-strand graft. Leaving the gracilis tendon intact probably reduces the loss of knee flexion strength. The graft is indirectly anchored into both tunnels with polyetheretherketone cages by use of polyethylene terephthalate tape strips. Both cages and strips are magnetic resonance imaging compatible and do not create artifacts. The tunnels are drilled by an outside-in method with minimal incisions. This type of fixation creates a 360° bone contact at 1.5 cm in each tunnel and is compatible with double-bundle reconstruction. This easy-to-use novel technique of fixation for anterior cruciate ligament reconstruction produces a strong 4-strand graft while harvesting only the semitendinosus tendon and leaving the gracilis tendon intact to reduce flexion strength loss and preserve rotatory stability of the knee. It creates an immediate solid fixation that is independent of graft integration in the early postoperative period, allowing the patient to start immediate rehabilitation without the use of a brace.

| S-EPMC3678617 | biostudies-literature

A rare but serious complication of ticagrelor therapy: a case report.

Project description:BackgroundTicagrelor is a widely used P2Y12 inhibitor and represents a fundamental therapeutic agent in acute coronary syndrome treatment and selected post-percutaneous coronary intervention (PCI) cases. Dyspnoea and bradycardia are the most common side effects but the latter has been reported to be of trivial clinical significance.Case summaryA 51-year-old gentleman underwent PCI to left anterior descending and obtuse marginal for unstable angina receiving a loading dose of ticagrelor (180 mg). During hospital stay, whilst on telemetry monitoring, a 16 s long, symptomatic, asystolic ventricular standstill was recorded prompting ticagrelor interruption and a switch to prasugrel.DiscussionDespite ventricular pauses have been reported in dedicated analyses of Phase III trials, no apparent clinical consequences were documented. However, several reports have shown that significant brady-arrhythmic events might be linked to ticagrelor administration presenting both as sino-atrial and atrio-ventricular conduction disturbances. We report a case of asystole occurring 36 h after the administration of a loading dose.

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Patellar Fixation With Suspensory Fixation Device in Single-Tunnel Medial Patellofemoral Ligament Reconstruction.

Project description:The medial patellofemoral ligament (MPFL) is the primary soft-tissue stabilizer of the patellofemoral joint. Among the patellofemoral instability surgery options, MPFL reconstruction is the most preferred soft-tissue procedure. There is no gold-standard surgical treatment method in MPFL reconstruction, and many surgical methods have been described. We describe our surgical technique for MPFL reconstruction wherein the semitendinosus autograft is fixed to a single tunnel opened in the patella with a suspensory fixation device and only a single interference screw on the femoral side.

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Triple Hybrid Tibial Anterior Cruciate Ligament Graft Fixation

Project description: Not available

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Double-Row Fixation for Avulsion of Anterior Cruciate Ligament.

Project description:Avulsion fractures of the tibial spine (also called "tibial eminence fractures" or "ACL avulsion fractures"), leading to discontinuity of anterior cruciate ligament (ACL) fibers, have been well described in the literature in both the pediatric and adult populations. To ensure the stability of the knee joint and good range of motion with minimal to no laxity, surgical reduction of the fracture and fixation are necessary to restore ACL length. Several arthroscopic techniques have been described to reduce and fix these fractures. We describe a technique using 2 anchors to fix the fractured tibial spine with no need to make any tibial tunnels or any extra leg wounds for the sutures.

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A 2-year follow-up of isolated Medial Patellofemoral Ligament Reconstruction by using soft suture anchor and adjustable cortical fixation system.

Project description:PurposeNumerous surgical techniques and fixation methods have been described in medial patellofemoral ligament (MPFL) reconstruction such as choice of graft, graft fixation method of patella/femur and initial tension. We describe short term clinical results of MPFL reconstruction by using soft suture anchor and adjustable cortical fixation system.MethodsTwenty-four patients who underwent isolated MPFL reconstruction by using soft suture anchor and adjustable cortical fixation system were included in this study. All patients were followed up for at least 2 years, and pre-operative and 2 years post-operative Kujala score, IKDC score and Knee Injury and Osteoarthritis Outcome Score were used to assess clinical outcome. Radiographic evaluation included the Q angle, congruence angle and patellar tilt angle. Pre- and post-operative changes were evaluated by Mann-Whitney U test.ResultsThere were no complications including re-dislocation, patella fracture, infection, and joint contracture. The apprehension test was positive in 4.2% post-operatively. A statistically significant improvement in clinical scores and radiographic evaluation were evident after surgery.ConclusionsIsolated MPFL Reconstruction using soft suture anchor and adjustable cortical fixation system led good restoration of patellar stability and significant improvement of knee function in short-term results. This surgical technique can reduce complications such as patella fractures, and can be done safely.Clinical relevanceThis technique may be a treatment option with little associated complications in the treatment for patellar instability.Level of evidenceCase series, Level IV.

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All-Arthroscopic Posterior Cruciate Ligament Distal Reattachment With Extracortical Fixation.

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| S-EPMC6926378 | biostudies-literature

Arthroscopic Primary Bundle-Specific Posterior Cruciate Ligament Repair with Transosseous Fixation.

Project description:Posterior cruciate ligament (PCL) injuries are most commonly associated with multiligamentous knee injuries. Isolated rupture can be treated nonoperatively with bracing, but with concomitant surgical injuries or high-grade instability, operative intervention may be warranted. While historically PCL injuries were surgically managed with open primary repair, contemporary surgical options include arthroscopic primary repair and reconstruction. Appropriate patient selection is critical in avoiding residual laxity following primary repair, and innovations in advanced imaging and arthroscopic technology now allow for identification of suitable patients. In this technical vote, we describe a method for anatomic bundle-specific primary PCL repair with transosseous fixation. The appropriate patient for this procedure has a femoral-sided avulsion of 1 or both PCL bundles, presents with an acute or subacute injury, and has adequate tissue quality for bundle reapproximation to the footprint. This allows for minimally invasive, anatomic restoration of tension for each bundle.

| S-EPMC6823862 | biostudies-literature

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