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Acta Ortopedica Mexicana 2018There are less and fewer opportunities for residents to learn and develop surgical skills in the operating room. In some parts of the world, the development and... (Review)
Review
BACKGROUND
There are less and fewer opportunities for residents to learn and develop surgical skills in the operating room. In some parts of the world, the development and adaptation of technology for the teaching of psychomotor skills in surgical specialties appears. Arthroscopy is a surgical technique that lends itself to simulation. So far there is no such thing as a structured and validated arthroscopy training program for orthopaedic residents in Mexico.
OBJECTIVE
To propose a structured arthroscopy training plan that incorporates the simulation for orthopaedic residents.
METHOD
A review of the literature on teaching with simulation in orthopaedics and arthroscopy was performed, a study was conducted to establish reference values for arthroscopy exercises in a virtual reality simulator and a training plan was developed with Arthroscopy simulation for orthopaedic residents.
RESULTS
A seven-stage program was developed with theoretical classes and simulation to improve motor skills. The complexity of the procedures increases through the practical modules. It is complemented by a semester evaluation.
DISCUSSION
Currently most of the efforts in teaching with simulators focus on medical students and first-and second-year residents. I believe that efforts should be focused to include residents of higher ranks and surgeons. This design will be proposed to the orthopaedic Unique Medical Education Program (PUEM in Spanish). It is important to develop validated curricula that incorporate the simulation for the development of motor skills in orthopaedic residents.
Topics: Arthroscopy; Clinical Competence; Computer Simulation; Internship and Residency; Knee Joint; Mexico; Orthopedics
PubMed: 30726593
DOI: No ID Found -
Arthroscopy : the Journal of... Oct 2014The purpose of this systematic review was to evaluate the literature to determine complications of hip arthroscopy, with a secondary focus on how to minimize... (Review)
Review
PURPOSE
The purpose of this systematic review was to evaluate the literature to determine complications of hip arthroscopy, with a secondary focus on how to minimize complications and risks.
METHODS
Two independent reviewers performed a search of PubMed for articles that contained at least 1 of the following terms: complications and hip arthroscopy, hip impingement, femoral acetabular impingement and complications, or femoroacetabular impingement (FAI) and complications. The search was limited to articles published between 1999 and June 2013. An additional search was performed for articles evaluating techniques on how to minimize complications.
RESULTS
We identified 81 studies (5,535 patients; 6,277 hips). The mean age was 35.48 years, and the mean body mass index was 25.20 kg/m(2). Of the participants, 52% were male and 48% were female. The majority of studies were Level IV Evidence (63%). A total of 285 complications were reported, for an overall rate of 4.5%. There were 26 major complications (0.41%) and a 4.1% minor complication rate. The overall reoperation rate was 4.03%. A total of 94 hips underwent revision arthroscopy. Regarding open procedures, 150 patients (93%) underwent either total hip arthroplasty or a hip resurfacing procedure. The conversion rate to total hip arthroplasty or a resurfacing procedure was 2.4%.
CONCLUSIONS
Overall, primary hip arthroscopy is a successful procedure with low rates of major (0.41%) and minor (4.1%) complications. The reoperation rate was 4.03% in our review. There is admittedly a learning curve to performing hip arthroscopy, and we present a systematic review of the complications and how to minimize these complications with careful technique and planning.
LEVEL OF EVIDENCE
Level IV, systematic review of Level II to V studies.
Topics: Arthroscopy; Femoracetabular Impingement; Hip Joint; Humans; Intraoperative Complications; Learning Curve; Postoperative Complications; Reoperation
PubMed: 25017649
DOI: 10.1016/j.arthro.2014.04.103 -
Archives of Orthopaedic and Trauma... Oct 2015Clinical assessments do not accurately reflect the status of meniscal transplants and cannot evaluate the graft condition itself and joint preservation effects of... (Review)
Review
INTRODUCTION
Clinical assessments do not accurately reflect the status of meniscal transplants and cannot evaluate the graft condition itself and joint preservation effects of meniscal allograft transplantation correctly. The purpose of this review was to assess the need and to ascertain the indication and the role of second-look arthroscopy for objective evaluation after MAT.
MATERIALS AND METHODS
We performed a literature search to identify all published clinical studies on MAT with the following medical subject heading (MeSH) terms: "meniscus," "meniscal transplant," "transplantation and allograft," "meniscal and transplant." Include in the review are studies with at least 6 months clinical, radiological, and/or histological follow-up in human subjects. Evaluation method of MAT was reviewed with an aim to describe the frequency of second-look arthroscopy, its feasibility, patient compliance, purposes, and results.
RESULTS
We identified 15 clinical studies that satisfied our inclusion and exclusion criteria. Only two studies always performed second-look arthroscopies. Most of the second-look arthroscopy was conducted mainly for the objective evaluation of meniscal allograft transplantation but, in several studies, arthroscopy was performed to treatment of other knee problem.
CONCLUSIONS
Although second-look arthroscopy has inevitably ethical issues, especially for asymptomatic and well-functioning knees, in this review, it could be a more dependable method available to detect meniscal healing if performed for certain indications such as a symptomatic patient with a magnetic resonance image indicating abnormalities.
Topics: Allografts; Arthroscopy; Humans; Knee Injuries; Menisci, Tibial; Second-Look Surgery
PubMed: 26142541
DOI: 10.1007/s00402-015-2274-y -
Medicine May 2024Over the past 10 years, hip arthroscopy has been increasingly employed to effectively diagnose and safely treat a range of hip pathologies. With research related to hip...
Over the past 10 years, hip arthroscopy has been increasingly employed to effectively diagnose and safely treat a range of hip pathologies. With research related to hip arthroscopy continually expanding, the number of articles connected with hip arthroscopy has also consistently grown. We aimed to investigate trends and hotspots in hip arthroscopy-related research, and analyze the top 100 most-cited articles on hip arthroscopy. We searched for ("hip arthroscopy") AND ("article" OR "review") AND "English" in the Web of Science database from 1900 to 2022, which was used to obtain all publications relating to hip arthroscopy. Distribution of country, affiliated institution, journal, authors, citation frequency and keywords were analyzed using VOSviewer. A total of 1094 articles were selected from the Web of Science Core Collection (WoSCC) from 1900 to 2022. The number of publications concerning hip arthroscopy displayed an ascending trend over time. Among the countries, the United States emerged as the largest contributor to the number of articles. The highest prolific institution was American Hip Institute. Among the journals, the highest-ranking journal was "Arthroscopy-the Journal of Arthroscopic and Related Surgery," with 8316 citation counts and 262 articles. The area of greatest research interest was diagnosis and therapy in the field. The scientific articles on the subject of hip arthroscopy have risen continuously in recent years. The United States was the most influential country and made the most significant contributions to this field globally. We identified the research direction and trend for the first time and provided the most recent bibliometric analysis on hip arthroscopy, which may assist researchers in conducting studies on hip arthroscopy.
Topics: Arthroscopy; Bibliometrics; Humans; Biomedical Research; Hip Joint; Periodicals as Topic
PubMed: 38788035
DOI: 10.1097/MD.0000000000038198 -
Clinics in Sports Medicine Apr 2018The rates of arthroscopic meniscus repair continue to increase with excellent reported outcomes. Complications, sometimes catastrophic, following meniscus repair may... (Review)
Review
The rates of arthroscopic meniscus repair continue to increase with excellent reported outcomes. Complications, sometimes catastrophic, following meniscus repair may occur. The rate of postoperative complications may be reduced by adequate diagnosis, appropriate patient selection, meniscus repair selection, surgical techniques, and postoperative management. When complications occur, the provider must identify and take steps to rectify as well as prevent further complications from occurring. The purpose of this article is to detail the common diagnostic, technical, and postoperative pitfalls that may result in poor patient outcomes.
Topics: Arthroscopy; Humans; Knee Injuries; Postoperative Complications; Tibial Meniscus Injuries; Treatment Outcome
PubMed: 29525029
DOI: 10.1016/j.csm.2017.12.007 -
BMC Musculoskeletal Disorders May 2022Different from arthroscopy in other joints, more perfusion is required for a better access to perform surgical procedures in hip arthroscopic operations. The significant...
BACKGROUND
Different from arthroscopy in other joints, more perfusion is required for a better access to perform surgical procedures in hip arthroscopic operations. The significant fluid perfused may lead to complications of partial tissue injury and electrolyte imbalance. However, there were few studies on the change of serum electrolyte after hip arthroscopy and the influential factors were still unknown.
METHODS
We evaluated consecutive patients who underwent hip arthroscopy in our hospital between October 2021 and February 2022. Age, sex, and BMI matched patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction at the same time were also included as the control group. Preoperative and postoperative serum electrolyte of sodium (Na +), potassium (K +), chloride (Cl-), magnesium (Mg2 +), and carbon dioxide capacity (CO2CP) were analyzed. The correlations between influential factors like perfusion volume, operating time, BMI and hip circumference, and changes in serum electrolyte were also analyzed.
RESULTS
A total of 79 patients were involved in this study, including 49 patients who underwent hip arthroscopy and 30 patients who underwent knee arthroscopy. For hip arthroscopy, decrease of potassium levels was observed in 40.8% of the patients, and postoperative hypokalemia was found in 10.2% patients. There were significant variations in postoperative sodium, magnesium, chloride and carbon dioxide capacity in hip arthroscopy (p < 0.05). No correlations were found between each of the electrolyte concentrations and influential factors like perfusion volume, operating time, BMI, sex and hip circumference. The significant variations were found in chloride and carbon dioxide capacity in knee arthroscopy (p < 0.05).
CONCLUSIONS
Hip arthroscopy would significantly influence postoperative serum electrolyte, and hypokalemia could be a postoperative complication. The correlation between serum electrolyte and fluid perfusion volume is remained to be investigated. We therefor advocate that performing a systematic care of preoperative and postoperative serum electrolyte analysis as perioperative management is necessary.
Topics: Anterior Cruciate Ligament Injuries; Arthroscopy; Carbon Dioxide; Chlorides; Electrolytes; Humans; Hypokalemia; Magnesium; Potassium; Retrospective Studies; Sodium; Treatment Outcome
PubMed: 35590402
DOI: 10.1186/s12891-022-05451-1 -
Arthroscopy : the Journal of... Jan 2018One of the joys of the editorial team is selecting the annual Journal Awards. Recognizing research excellence is what we do. If a manuscript was ultimately selected for...
One of the joys of the editorial team is selecting the annual Journal Awards. Recognizing research excellence is what we do. If a manuscript was ultimately selected for publication, it is already excellent, as we publish less than 20% of original scientific article submissions, and we received more than 1,300 such submissions in 2017. To be one of our award winners is to be truly "elite."
Topics: Arthroscopy; Awards and Prizes; Humans; Publishing
PubMed: 29304954
DOI: 10.1016/j.arthro.2017.11.007 -
Arthroscopy : the Journal of... Jun 2016Gross hip instability is a rare complication after hip arthroscopy, and there is limited literature surrounding this topic. This systematic review investigates cases of... (Review)
Review
PURPOSE
Gross hip instability is a rare complication after hip arthroscopy, and there is limited literature surrounding this topic. This systematic review investigates cases of gross hip instability after arthroscopy and discusses the risk factors associated with this complication.
METHODS
A systematic search was performed in duplicate for studies investigating gross hip instability after hip arthroscopy up to October 2015. Study parameters including sample size, mechanism and type of dislocation, surgical procedure details, patient characteristics, postoperative rehabilitation protocol, and level of evidence were analyzed.
RESULTS
The systematic review identified 9 case reports investigating gross hip instability after hip arthroscopy (10 patients). Anterior dislocation occurred in 66.7% of patients, and most injuries occurred with a low-energy mechanism. Common surgical factors cited included unrepaired capsulotomy (77.8%) and iliopsoas release (33.3%), whereas patient factors included female gender (77.8%), acetabular dysplasia (22.2%), and general ligamentous laxity (11.1%). Postoperative restrictions and protocols were variable and inconsistently reported, and their relation to post-arthroscopy instability was difficult to ascertain.
CONCLUSIONS
This systematic review discussed various patient, surgical, and postoperative risk factors of gross hip instability after arthroscopy. Patient characteristics such as female gender, hip dysplasia, and ligamentous laxity may be risk factors for post-arthroscopy dislocation. Similarly, surgical risk factors for iatrogenic hip instability may include unrepaired capsulotomies and iliopsoas debridement, although the role of capsular closure in iatrogenic instability is not clear. The influences of postoperative restrictions and protocols on dislocation are also unclear in the current literature. Surgeons should be cognizant of these risk factors when performing hip arthroscopy and be mindful that these factors appear to occur in combination.
LEVEL OF EVIDENCE
Level IV, systematic review of Level IV studies.
Topics: Arthroscopy; Debridement; Hip; Hip Dislocation; Humans; Joint Instability; Ligaments; Postoperative Complications; Risk Factors; Sex Factors
PubMed: 27013107
DOI: 10.1016/j.arthro.2016.01.011 -
ANZ Journal of Surgery May 2017Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted... (Comparative Study)
Comparative Study Review
BACKGROUND
Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arthroscopic knee surgery by conducting a detailed audit at a major Victorian public hospital.
METHODS
A database of orthopaedic procedures at St Vincent's Hospital Melbourne was used to retrospectively identify cases of knee arthroscopy from 1 December 2011 to 1 April 2014. Procedures were categorized as diagnostic or interventional, and native and prosthetic joints were analysed separately. Procedure codes were reviewed by comparing a registrar, auditor and hospital coders for agreement.
RESULTS
Of the 401 cases for analysis, 375 were conducted in native knees and 26 in prosthetic joints. Of native knees, 369 (98.4%) were considered interventional. The majority of these were conducted for meniscal pathology (n = 263, 70.1%), osteoarthritis (OA) (n = 25, 6.7%) and infection (n = 28, 7.6%). Comparison of codes assigned by different parties were found to be between 57% (k = 0.324) and 70% (k = 0.572) agreement, but not statistically significant.
CONCLUSIONS
In this study, the most common indication for arthroscopy was meniscal pathology. Arthroscopy was rarely performed for OA in the absence of meniscal pathology. Diagnostic arthroscopy was rarely performed in the native knee, and fair to moderate agreement existed between parties in assigning Medicare Benefits Schedule procedure codes.
Topics: Adult; Aged; Arthroscopy; Australia; Clinical Audit; Clinical Coding; Female; Humans; Knee Joint; Male; Meniscectomy; Middle Aged; Osteoarthritis, Knee; Practice Guidelines as Topic; Retrospective Studies
PubMed: 27677890
DOI: 10.1111/ans.13664 -
Musculoskeletal Surgery Aug 2017The purpose is to describe the rate of complications in a series of hip arthroscopies performed at our center, as well as perform a systematic review of the current... (Review)
Review
PURPOSE
The purpose is to describe the rate of complications in a series of hip arthroscopies performed at our center, as well as perform a systematic review of the current literature in order to compare our outcomes.
METHODS
Two hundred and fifty-eight patients affected of femoroacetabular impingement and treated with hip arthroscopy have been studied. All minor and major complications were studied during the first postsurgery year. Furthermore, a systematic review was performed comparing major and minor complications with our series. Two attending orthopedic surgeons selected the different studies with the same inclusion and exclusion criteria, remaining with 48 studies that have been reviewed and included in the present study.
RESULTS
Mean age was 36.6 years old (SD 17.45), and the ratio men:women was 137:121. The mean complication rate observed was 14.34% (37/258) of global complications. Only three patients showed major complications: femoral neck fracture, septic arthritis and avascular necrosis of the femoral head. Any of these patients had permanent side effects.
CONCLUSIONS
Hip arthroscopy has a low rate of major complications, but a higher number of minor complications that could be avoided with certain preventive measures.
Topics: Adolescent; Adult; Arthroscopy; Female; Femoracetabular Impingement; Hip Joint; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Retrospective Studies; Time Factors; Young Adult
PubMed: 27928731
DOI: 10.1007/s12306-016-0444-x