1/3. Septic arthritis caused by erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction.A case of septic arthritis caused by erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, c-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/3. Arthroscopic humeral avulsion of the glenohumeral ligaments (HAGL) repair.Humeral avulsion of the glenohumeral ligaments (HAGL lesion) is one of the pathologic lesions that occurs secondary to anterior glenohumeral instability. Although HAGL lesions occur less commonly than Bankart lesions in cases of anterior instability, it is necessary to understand this pathology and to make the necessary repair. An all-arthroscopic technique using suture anchors can be used to repair HAGL lesions, but it is a difficult and demanding technique. To facilitate this type of repair, the surgeon must be: (1) comfortable with both the 30 degrees and 70 degrees arthroscopes, (2) able to establish and use the 5-o'clock portal, (3) able to abduct and externally rotate the arm, and (4) able to ensure secure fixation of the glenohumeral ligaments to bone through adequate knot and loop security.- - - - - - - - - - ranking = 1.2keywords = ligament (Clic here for more details about this article) |
3/3. The meniscal ossicle revisited: etiology and an arthroscopic technique for treatment.We describe a new arthroscopic technique for repair of meniscal ossicles in support of the theory that meniscal ossicles are traumatic in nature. Using a standard inferolateral portal, the arthroscope is passed under the posterior cruciate ligament to permit visualization of the "root" of the medial meniscus with a matching donor lesion on the tibia. A limited debridement should be performed of the donor site as well as the posterior horn of the meniscus if it has healed over with fibrocartilage to allow bone-to-bone healing. A posteromedial working portal is made at an angle amenable to the repair and a 6-mm cannula is placed. A Beath passing pin commonly used for anterior cruciate ligament reconstruction is used to pass suture for the outside-inside-out repair. The pin is passed through the cannula in the posterior medial portal. The root of the medial meniscus and the avulsed ossicle are pierced with the Beath pin and tensioned, after which the pin is drilled into the matching donor site and out through the tibia. Two passes are used to create a mattress suture through the ossicle, and the suture is tied over a bone bridge on the anterolateral tibia.- - - - - - - - - - ranking = 0.4keywords = ligament (Clic here for more details about this article) |