Insights into complications after unicompartmental knee arthroplasty

Zhao's study,offers a comprehensive analysis of unicompartmental knee arthroplasty(UKA)revision indications.The study provides a detailed,case-by-case analysis of the factors leading to knee revision surgery in 13 patients.Not only elucidates the complexities of UKA revisions but also underscores the importance of continuous improvement in surgical techniques and the adoption of innovative technologies.

Navigating postoperative complications:Uveitis-glaucoma-hyphema syndrome after Ahmed glaucoma valve implantation

Altwijri and Alsirhy reported a case of uveitis-glaucoma-hyphema syndrome after an Ahmed glaucoma valve implantation surgery in an advanced primary open-angle glaucoma patient,being the first ever recorded of its kind.The author describes the position of the tube as the origin of the anterior chamber inflam-mation and hyphema,which resolved shortly after shortening and relocating it.This publication emphasizes the importance of precise implant positioning and close-up patient follow-up after glaucoma filtration surgery as an important standard for healthcare providers.

Has platelet-rich plasma any role in partial tears of the anterior cruciate ligament?Prospective comparative study

BACKGROUND Partial tears of the anterior cruciate ligament(ACL)are frequent,and there is still considerable controversy surrounding their diagnosis,natural history and treatment.AIM To examine patient-reported outcomes,physical examination and magnetic resonance imaging(MRI)findings of partial ACL tears treated with an intraarticular injection of platelet-rich plasma(PRP)compared to a control group.METHODS From January 2015 to November 2017,consecutive patients from a single institution with partial ACL tears treated nonoperatively were prospectively evaluated.Partial tears were defined as a positive Lachman test with a clear endpoint,a negative pivot-shift and less than 3 mm of side-to-side difference using the KT1000 arthrometer.Patients in group 1 were treated with one intraarticular injection of PRP and specific physical therapy protocol.Control group consisted of patients treated only with physical therapy.Prospective analyzed data included physical examination,Tegner activity level and Lysholm and International Knee Documentation Committee scores.Baseline MRI findings and at 6 mo follow-up were reviewed.Failure was defined as those patients with clinical instability at follow-up that required a subsequent ACL reconstruction.RESULTS A total of 40 patients where included,21 treated with PRP injection with a mean follow-up of 25 mo[standard deviation(SD):3.6]and 19 in the control group with a mean follow-up of 25 mo(SD:5.68).Overall failure rate was 32.0%(n=13).No significant differences were observed between groups regarding subjective outcomes,return to sport and failure rate.MRI findings revealed an improvement in the ACL signal in half of the patients of both groups.However,we did not find a significant relationship between MRI findings and clinical outcomes.CONCLUSION Overall,95.0%of patients returned to sports at a mean follow-up of 25 mo.Mean time to return to sports was 4 mo.Out of these patients,almost 30.0%in each group had a new episode of instability and required surgery at a median time of 5 mo in group 1 and 8 mo in group 2.The addition of PRP alone was not sufficient to enhance any of the outcome measures evaluated,including MRI images,clinical evaluation and failure rate.

Revision anterior cruciate ligament reconstruction:Return to sports at a minimum 5-year follow-up

BACKGROUND Between 43%and 75%of patients who undergo primary anterior cruciate ligament(ACL)surgery return to sport activity.However,after a revision ACL reconstruction(ACLR)the rate of return to sports is variable.A few publications have reported returns to sports incidence between 56%to 100%after revision ACLR.AIM To determine return to sports and functional outcomes after a single-stage revision ACLR with a 5-year minimum follow-up at a single institution.METHODS All patients operated between 2010 and 2016 with a minimum 5 years of followup were included.Type of sport,intensity,frequency,expectation,time to return to sport and failure rate were recorded.Lysholm,Tegner and International Knee Documentation Committee forms were evaluated prior to the first ACLR surgery,at 6 mo after primary surgery and after revision ACLR at 5 years minimum of follow-up.Objective stability was tested with the knee arthrometer test(KT-1000 knee arthrometer,Medmetric Corp).RESULTS A total of 41 patients who underwent revision ACLR during that period of time were contacted and available for follow-up.Median patient age at time of revision was 29 years old[interquartile range(IQR):24.0-36.0],and 39(95.0%)were male.The median time from revision procedure to follow-up was 70 mo(IQR:58.0-81.0).Regarding return to sports,16(39.0%)were at the same level compared to preinjury period,and 25 patients(61.0%)returned at a lower level.Sixty-three percent categorized the sport as very important and 37.0%as important.One patient(2.4%)failed with a recurrent ACL torn.Mean preoperative Lysholm and(SD)16]and 50(SD 11),respectively.At follow-up,mean Lysholm and subjective International Knee Documentation Committee scores were 89(SD 8)and 82(SD 9)(P=0.0001).Mean Tegner score prior to primary ACLR was 6.7(SD 1.3),5.1(1.5 SD)prior to revision ACLR and 5.6(1.6 SD)at follow-up(P=0.0002).Overall,knee arthrometer test measurement showed an average of 6 mm(IQR:4.0-6.0)side-to-side difference of displacement prior to revision ACLR and 3mm(IQR:1.5-4.0)after revision.CONCLUSION Almost 40.0%of patients returned to preinjury sports level and 60.0%to a lower level.These may be useful when counseling a patient regarding sports expectations after a revision ACLR.