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Huang B, Yang M, Kou Y, Jiang B. Absorbable implants in sport medicine and arthroscopic surgery: A narrative review of recent development. Bioact Mater 2024; 31:272-283. [PMID: 37637087 PMCID: PMC10457691 DOI: 10.1016/j.bioactmat.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/29/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
Over the past two decades, advances in arthroscopic and minimally invasive surgical techniques have led to significant growth in sports medicine surgery. Implants such as suture anchors, interference screws, and endo-buttons are commonly used in these procedures. However, traditional implants made of metal or inert materials are not absorbable, leading to complications that affect treatment outcomes. To address this issue, absorbable materials with excellent mechanical properties, good biocompatibility, and controlled degradation rates have been developed and applied in clinical practice. These materials include absorbable polymers, absorbable bioceramics, and absorbable metals. In this paper, we will provide a comprehensive summary of these absorbable materials from the perspective of clinicians, and discuss their clinical applications and related research in sport medicine.
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Affiliation(s)
- Boxuan Huang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, 100044, China
- National Center for Trauma Medicine, Beijing, 100044, China
| | - Ming Yang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, 100044, China
- National Center for Trauma Medicine, Beijing, 100044, China
| | - Yuhui Kou
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, 100044, China
- National Center for Trauma Medicine, Beijing, 100044, China
| | - Baoguo Jiang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, 100044, China
- National Center for Trauma Medicine, Beijing, 100044, China
- Medical School, Shenzhen University, Shenzhen, 518060, Guangdong, China
- Shenzhen University General Hospital, Shenzhen, 518055, Guangdong, China
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Nha KW, Kim SJ, Park JH, Bae JH, Jang KM, Kim SG. Arthroscopic cystectomy for Baker's cysts with and without one-way valve lesions: incidence of one-way valve lesion, associated pathologies, and clinical outcomes. Arch Orthop Trauma Surg 2023; 143:287-294. [PMID: 34283278 DOI: 10.1007/s00402-021-04076-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/12/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION A one-way valve lesion plays an important role in the formation of Baker's cysts and serves as an important landmark for accessing these cysts during arthroscopic surgery. This study aimed to investigate the incidence of one-way valve lesions and their effect on clinical outcomes in patients who underwent arthroscopic cystectomy for Baker's cysts. MATERIALS AND METHODS Patients who underwent arthroscopic cystectomy for Baker's cysts between June 2005 and November 2017 were retrospectively reviewed. Patient demographic characteristics, radiologic/arthroscopic findings (presence of one-way valve lesions, concurrent chondral and meniscal lesions, and cyst wall thickness), and clinical outcomes (clinical recurrence rate, Lysholm score, and complications) at the 2-year follow-up were evaluated. Subgroup analysis was performed to compare clinical outcomes between patients with and without one-way valve lesions. RESULTS Thirty patients (mean age, 57.4 ± 9.4 years) were included in this study. One-way valve lesions were surgically documented in 11 patients (36.7%). Ten patients (33.3%) had chondral lesions with an International Cartilage Repair Society grade ≥ 3, and 23 patients (76.7%) had concurrent chondral and meniscal lesions. At the 2-year follow-up, none of the patients had experienced clinical recurrence; the mean Lysholm score was 76.3 ± 17.5 (48-100). Three patients reported persistent pain, while two reported numbness or paresthesia. Subgroup analysis showed no significant differences in clinical recurrence rates, Lysholm scores, and complication rates between the groups. CONCLUSIONS The incidence of one-way valve lesions during arthroscopic cystectomy for Baker's cysts was lower than that previously reported. Arthroscopic cystectomy showed good clinical results in patients with and without these lesions.
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Affiliation(s)
- Kyung Wook Nha
- Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Gyeonggi-do, Republic of Korea
| | - Seung Joo Kim
- Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Gyeonggi-do, Republic of Korea
| | - Jong Hun Park
- Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Gyeonggi-do, Republic of Korea
| | - Ji Hoon Bae
- Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ki-Mo Jang
- Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Sang-Gyun Kim
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea.
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Luo Z, Hu Y, Han Q, Gao Z, Cheng S. Safe femoral condyle range for the reverse Rigidfix femoral fixation device in anterior cruciate ligament reconstruction. BMC Musculoskelet Disord 2022; 23:288. [PMID: 35337308 PMCID: PMC8951699 DOI: 10.1186/s12891-022-05250-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/21/2022] [Indexed: 12/05/2022] Open
Abstract
Background To determine the characteristics of cross-pin protrusion in patients treated with the reverse Rigidfix femoral fixation device for femoral tunnel preparation through the anteromedial portal in Arthroscopic anterior cruciate ligament reconstruction (ACLR), analyse the reasons for this outcome, and identify safety hazards of this surgical technique for improvement. Methods A retrospective analysis of patients who underwent ACLR using this technology at our hospital in 2018 was conducted. Patients with and without cross-pin protrusion were included in the protrusion positive and negative groups, respectively. The sex, age and imaging characteristics of the patients with cross-pin protrusion were identified, and the reasons for cross-pin protrusion were analysed. Results There were 64 and 212 patients in the protrusion positive and negative groups, respectively. The proportion of cross-pin protrusion cases was 23.19% (64/276). There was a significant difference in the ratio of males to females (P < 0.001, χ2 = 185.184), the mediolateral femoral condyle diameter (protrusion positive group, 70.59 ± 2.51 mm; protrusion negative group, 82.65 ± 4.16 mm; P < 0.001, t = 28.424), and the anteroposterior diameter of the lateral femoral condyle (protrusion positive group, 58.34 ± 2.89 mm; protrusion negative group, 66.38 ± 3.53 mm; P < 0.001, t = 16.615). The cross-pins did not penetrate the lateral femoral condyle cortex in patients with a mediolateral femoral condyle diameter ≥ 76 mm, but the cross-pins definitely penetrated the cortex when the diameter was ≤ 70 mm. The cross-pins did not penetrate when the anteroposterior lateral femoral condyle diameter was ≥ 66 mm, but the cross-pins definitely penetrated it when the diameter was ≤ 59 mm. Conclusion The patients with cross-pin protrusion after reverse Rigidfix femoral fixation treatment to prepare the femoral tunnel through the anteromedial portal in ACLR were mainly females with small femoral condyles. For patients with a mediolateral femoral condyle diameter ≥ 76 mm and an anteroposterior lateral femoral condyle diameter ≥ 66 mm, there is no risk of cross-pin protrusion, so this technique can be used with confidence. Levels of evidence III. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05250-8.
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Affiliation(s)
- Zhongliu Luo
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, No. 232, Outer Ring East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province, China.,Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, No. 132, West Section, First Ring Road, Sichuan Province, Chengdu, China
| | - Yong Hu
- Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, No. 132, West Section, First Ring Road, Sichuan Province, Chengdu, China.
| | - Qingmin Han
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, No. 232, Outer Ring East Road, Guangzhou University City, Panyu District, Guangzhou City, Guangdong Province, China
| | - Zhi Gao
- Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, No. 132, West Section, First Ring Road, Sichuan Province, Chengdu, China
| | - Songmiao Cheng
- Department of Knee Joint Sports Injury, Sichuan Provincial Orthopedic Hospital, No. 132, West Section, First Ring Road, Sichuan Province, Chengdu, China
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Joshi A, Singh N, Pradhan I, Basukala B. Pseudoaneurysm of the Popliteal Artery Leading to Foot Drop After Arthroscopic Anterior Cruciate Ligament Reconstruction: A Rare Complication: A Case Report. JBJS Case Connect 2019; 9:e0481. [PMID: 31609751 DOI: 10.2106/jbjs.cc.18.00481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 32-year-old man underwent arthroscopic anterior cruciate ligament reconstruction (ACLR) using hamstring autograft. He complained of persistent posterior knee pain in the postoperative period and at 4 weeks postsurgery developed foot drop and intense posterior knee pain. On clinicoradiological evaluation, a popliteal pseudoaneurysm (PSA) was diagnosed. The patient underwent surgical exploration, excision of the PSA, and primary repair of the popliteal artery. The foot drop recovered at 3 months post-second surgery follow-up. CONCLUSIONS Persistent posterior knee pain and popliteal fossa swelling in a patient after ACLR should raise a suspicion of popliteal PSA. Identifying these lesions early can prevent further complications such as common peroneal nerve palsy.
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Affiliation(s)
- Amit Joshi
- Department of Orthopedics, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.,Department of Orthopedics and Traumatology, B&B Teaching Hospital, Lalitpur, Nepal
| | - Nagmani Singh
- Department of Orthopedics, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.,Department of Orthopedics and Traumatology, B&B Teaching Hospital, Lalitpur, Nepal
| | - Ishor Pradhan
- Department of Orthopedics and Traumatology, B&B Teaching Hospital, Lalitpur, Nepal
| | - Bibek Basukala
- Department of Orthopedics, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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Pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2017; 25:2721-2724. [PMID: 25986096 DOI: 10.1007/s00167-015-3639-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/04/2015] [Indexed: 01/14/2023]
Abstract
UNLABELLED This report describes a case of a pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament (ACL) reconstruction. An 18-year-old male received double-bundle ACL reconstruction. During ACL reconstruction, a far anteromedial portal was created for femoral tunnel drilling. The patient presented with pulsatile swelling on the medial side of the knee on the second post-operative day. The pseudoaneurysm was diagnosed using contrast computed tomography and Doppler ultrasonography and was subsequently treated by embolization with a microcatheter. Although a vascular injury is a very rare complication of knee arthroscopy, it should be considered a possibility in patients who undergo such procedures. LEVEL OF EVIDENCE V.
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Janssen RPA, Reijman M, Janssen DM, van Mourik JBA. Arterial complications, venous thromboembolism and deep venous thrombosis prophylaxis after anterior cruciate ligament reconstruction: A systematic review. World J Orthop 2016; 7:604-617. [PMID: 27672574 PMCID: PMC5027016 DOI: 10.5312/wjo.v7.i9.604] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/14/2016] [Accepted: 06/03/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To summarize the current knowledge on vascular complications and deep venous thrombosis (DVT) prophylaxis after anterior cruciate ligament (ACL) reconstruction.
METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. MEDLINE, EMBASE, Cochrane, Web of Science, CINAHL, PubMed publisher, and Google scholar medical literature databases were searched up to November 10, 2015. Any arthroscopic surgical method of primary or revision intra-articular ACL reconstruction of all graft types in humans was included. A risk of bias assessment was determined.
RESULTS Fourty-seven studies were included in the review. Pseudaneurysms were the most frequently reported arterial complication after ACL reconstruction, irrespective of graft type or method of graft fixation with an incidence of 0.3%. The time to diagnosis of arterial complications after ACL reconstruction varied from days to mostly weeks but even years. After ACL reconstruction without thromboprophylaxis, the incidence of DVT was 9.7%, of which 2.1% was symptomatic. The incidence of pulmonary embolism was 0.1%. Tourniquet time > 2 h was related to venous thromboembolism. Thromboprophylaxis is indicated in patients with risk factors for venous thromboembolism.
CONCLUSION After ACL reconstruction, the incidence of arterial complications, symptomatic DVT and pulmonary embolism was 0.3%, 2.1% and 0.1% respectively. Arterial complications may occur with all types of arthroscopic ACL reconstruction, methods of graft fixation as well as any type of graft. Patients considered to be at moderate or high risk of venous thromboembolism should routinely receive thromboprophylaxis after ACL reconstruction.
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Major vascular injuries complicating knee arthroscopy. Wideochir Inne Tech Maloinwazyjne 2015; 10:266-74. [PMID: 26240627 PMCID: PMC4520854 DOI: 10.5114/wiitm.2015.52559] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/14/2015] [Accepted: 05/24/2015] [Indexed: 12/03/2022] Open
Abstract
Starting with a case report, we made a detailed review of the literature, with the purpose of identifying and analyzing the type of iatrogenic vascular lesion following knee arthroscopy and the method of vascular repair. A PubMed literature search was undertaken to locate all reported cases of major vascular iatrogenic injuries during arthroscopic knee procedures. We identified 39 papers which report a total of 62 cases of major iatrogenic popliteal lesions after knee arthroscopy, between 1985 and 2014. The type of arthroscopic intervention performed, the type of iatrogenic vascular lesion encountered, the time passed until its discovery and treatment, the method of vascular reconstruction, and the postoperative course are presented. Postarthroscopy vascular complications are infrequent but potentially disastrous for the condition of the affected inferior limb. An early diagnosis and reintervention are mandatory for a good postoperative outcome.
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