1/19. Intra-articular detachment of the Endobutton more than 18 months after anterior cruciate ligament reconstruction.We report a case of detachment of an Endobutton (Acufex Microsurgical, Mansfield MA) used for femoral fixation of a reconstructed anterior cruciate ligament. The Endobutton, which was confirmed to be in place on the suprapatellar space of the femur by radiograph 18 months postoperatively, was found in the popliteal space by radiograph 25 months after surgery. This is a rare complication, but our case suggests that the Endobutton should not be fixed too distal close to the femoral groove.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/19. Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation.PURPOSE: To report the clinical and histological findings of a luxated intraocular lens (IOL) in the capsular bag. methods: review of a case. RESULTS: Twenty-three months after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation for diabetic vitreous hemorrhage and cataract, the encapsulated IOL spontaneously luxated. Scanning electron microscopy showed sparsely distributed anterior and equatorial zonules, with only a few posterior zonules on the surface of the removed capusular bag. CONCLUSION: The absence of the anterior hyaloid membrane and posterior zonules and contraction of the lens capsule may cause dialysis of the zonules. Therefore, the anterior hyaloid membrane should be left in place in patients at low risk for the development of postoperative proliferation to maintain the long-term stability of the IOL.- - - - - - - - - - ranking = 0.0023655941853401keywords = membrane (Clic here for more details about this article) |
3/19. Triangular transchamber suture.A 64-year-old woman with a fibrous membrane at the lens plane after traumatic loss of all the iris and massive intraocular hemorrhage had posterior chamber intraocular lens (PCIOL) implantation anterior to the fibrous membrane with a triangular transchamber suture to prevent possible PCIOL-corneal touch and enhance the stability of the PCIOL. After 3 years, the PCIOL remained in a good position and visual rehabilitation was satisfactory and without complications.- - - - - - - - - - ranking = 0.0023655941853401keywords = membrane (Clic here for more details about this article) |
4/19. tracheoesophageal fistula in AIDS: stent versus primary repair.tracheoesophageal fistula arising secondary to mycobacterium tuberculous infection in AIDS patients is extremely rare. We describe a case with a fistula lesion that initially failed to close using a four-drug antituberculosis regimen. The original lesion closed following placement of an esophageal stent. However, the stent migrated, causing an iatrogenic tracheoesophageal fistula that needed surgical repair. tracheoesophageal fistula (TEF) is an uncommon clinical condition, most frequently arising as a sequelae to esophageal malignancy. Iatrogenic injury to the membraneous trachea secondary to cuffed endotracheal or tracheostomy tubes in the presence of an in-dwelling nasogastric tube and corrosive burns, accounts for most of the remainder of occurring fistulas. Infections such as candidiasis, syphilis, and tuberculosis are also known to cause this condition. We report stent migration with perforation and subsequent TEF formation in an hiv-positive patient who originally had stent placement for a tuberculous tracheoesophageal fistula.- - - - - - - - - - ranking = 0.00118279709267keywords = membrane (Clic here for more details about this article) |
5/19. Intra-articular migration of femoral interference screw: Open or arthroscopic removal.Migration of the femoral interference screw in to the knee joint following anterior cruciate reconstruction is a rare complication. A migrated interference screw usually requires removal as it often results in mechanical symptoms. Formal arthrotomy may be required to remove a dislodged screw lying in the femoral notch because arthroscopic removal can be difficult or not possible in the presence of an intact integrated anterior cruciate ligament graft or scarring in the notch. When attempting arthroscopic removal in a similar situation, one should foresee the possibility of a formal arthrotomy and this should be discussed with the patient and consent obtained preoperatively.- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
6/19. Biodegradable screw presents as a loose intra-articular body after anterior cruciate ligament reconstruction.We report a case of intra-articular movement of a broken piece of a poly-L-lactide (PLLA) bioabsorbable interference screw from the femoral tunnel in anterior cruciate ligament (ACL) reconstruction with quadrupled semi-tendinosus and gracilis tendon grafts. Eleven months after initially successful ACL surgery, the patient felt a sudden locking of the knee without associated trauma or injury. The patient experienced pain and swelling episodes after heavy lifting with knee flexion at work, but without symptoms of giving way or locking. On revision arthroscopy, a broken part of a bioabsorbable interference screw was seen in the lateral compartment, which was subsequently removed without incident. The semitendinosus-gracilis graft appeared intact without disruption. After revision surgery, the patient's recovery was uneventful, with return to activity within a few months. This case further shows the problem of biointerference screw breakage in ACL reconstructive surgery and the need to bury the femoral bioabsorbable interference screw on graft fixation.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
7/19. Transcutaneous migration of a tibial bioabsorbable interference screw after anterior cruciate ligament reconstruction.We present a case of a poly-L-lactic acid (PLLA) tibial bioabsorbable interference screw disengaging and migrating transcutaneously 12 months after successful anterior cruciate ligament reconstruction with quadrupled hamstrings autograft. No graft insufficiency or joint inflammatory reaction was present. The screw was removed surgically with no evidence of resorption. The graft was well incorporated into the tibial tunnel. The patient recovered without difficulties and returned to her preinjury level of activity. To our knowledge, this is the first case reported of disengagement and extrusion of a PLLA bioabsorbable interference screw.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
8/19. Dropping of an EndoButton into the knee joint 2 years after anterior cruciate ligament repair using proximal fixation methods.One of the most discussed subjects regarding anterior cruciate ligament (ACL) repair methods is femoral fixation. One of the materials often used for fixation in recent years is the EndoButton (Acufex Microsurgical, Mansfield, MA), which provides rapid and secure fixation. Although many reports about femoral fixation with EndoButton have been published, insufficient information is available on possible complications. We have used 240 EndoButtons in our clinic for ACL repairs since 1997. The goal of this study was to report a case of ACL repair with an EndoButton, in which we experienced a complication. In this case, the EndoButton dropped into the knee joint after 2 years.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
9/19. Migration of intravitreal silicone oil through a Baerveldt tube into the subconjunctival space.A 28-year-old patient developed proliferative diabetic retinopathy with florid rubeosis iridis and ultimately required the placement of a Baerveldt tube to control his secondary glaucoma. Eighteen months later, he underwent a pars plana vitrectomy, scleral buckle, lensectomy, and membrane peeling to reattach a severe diabetic retinal detachment. Ultimately, some of the 5000 cs silicone oil migrated through the tube to the episcleral region under the plate of the Baerveldt device. The oil intermittently blocked the shunt, causing elevated intraocular pressure. Despite ultimate surgical removal of the oil from around the tube and plate, a substantial amount remained encapsulated in the subconjunctival space. Prevention of this complication includes placement of a short tube well anterior to the iris in the inferior portion of the anterior chamber.- - - - - - - - - - ranking = 0.00118279709267keywords = membrane (Clic here for more details about this article) |
10/19. Loose intra-articular body following anterior cruciate ligament reconstruction.We report a case of intra-articular fracture of a bioabsorbable fixation device from the femoral tunnel in an anterior cruciate ligament reconstruction using a bone-tendon-bone graft. Thirteen months after successful reconstruction surgery, the patient experienced episodes of locking and medial joint pain. There was no history of trauma and no symptoms of instability or swelling. On revision arthroscopy, a fractured tip of a bioabsorbable RIGIDfix cross pin (Mitek, Westwood, MA) was identified in the medial compartment of the knee. There was a broad area of chondral erosion affecting the medial femoral condyle and a small defect to the medial tibial plateau where the loose body had been lodged. The bone-tendon-bone graft was intact without disruption. After arthroscopy, the patient was symptom free for 3 weeks but then developed further symptoms of locking. magnetic resonance imaging showed another loose body within the knee. A repeat arthroscopy was performed 6 weeks after the earlier procedure and another piece of the polylactic acid RIGIDfix cross pin was removed, this time from the lateral gutter. This case raises concern about the potential for breakage and resultant loose body formation that may occur after bioabsorbable cross-pin fixation and, particularly, the associated chondral damage that can occur if early intervention is not conducted.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
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