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Insights into complications after unicompartmental knee arthroplasty

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World Journal of Clinical Cases 2024年第25期12卷 5662-5664页

作者： Tomas Nicolino ignacio garcia-Mansilla Knee Division Hospital Italiano de Buenos AiresCapital Federal 1109Argentina

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.

关键词： Unicompartmental knee arthroplasty UKA Complications Revision Total knee arthroplasty

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

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World Journal of Orthopedics 2022年第9期13卷 812-824页

作者： Ezequiel Ortiz Juan Pablo Zicaro ignacio garcia Mansilla Carlos Yacuzzi Matias Costa-Paz Knee Division Hospital Italiano de Buenos AiresCiudad Autónoma 1181Buenos AiresArgentina

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 re

关键词： Return to sport Revision anterior cruciate ligament Arthroscopy Knee Functional outcome

Overview of the anterolateral complex of the knee

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World Journal of Clinical Cases 2022年第24期10卷 8474-8481页

作者： ignacio garcia-Mansilla Juan Pablo Zicaro Ezequiel Fernando Martinez Juan Astoul Carlos Yacuzzi MatiasCosta-Paz Knee Surgery Hospital Italiano de Buenos AiresBuenos Aires 1199Argentina

In the last few years,much more information on the anterolateral complex of the knee has become available.It has now been demonstrated how it works in conjunction with the anterior cruciate ligament(ACL)controlling anterolateral rotatory laxity.Biomechanical studies have shown that the anterolateral complex(ALC)has a role as a secondary stabilizer to the ACL in opposing anterior tibial translation and internal tibial rotation.It is of utmost importance that surgeons comprehend the intricate anatomy of the entire anterolateral aspect of the knee.Although most studies have only focused on the anterolateral ligament(ALL),the ALC of the knee consists of a functional unit formed by the layers of the iliotibial band combined with the anterolateral joint capsule.Considerable interest has also been given to imaging evaluation using magnetic resonance and several studies have targeted the evaluation of the ALC in the setting of ACL injury.Results are inconsistent with a lack of association between magnetic resonance imaging evidence of injury and clinical findings.Isolated ACL reconstruction may not always reestablish knee rotatory stability in patients with associated ALC injury.In such cases,additional procedures,such as anterolateral reconstruction or lateral tenodesis,may be indicated.There are several techniques available for ALL reconstruction.Graft options include the iliotibial band,gracilis or semitendinosus tendon autograft,or allograft.

关键词： Anterolateral complex Knee instability Anterolateral ligament Anterior cruciate ligament reconstruction

Failure rate,return-to-sports and magnetic resonance imaging after meniscal repair:119 patients with 7 years mean follow up

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世界骨科杂志:英文版 2023年第8期14卷 612-620页

作者： Juan Pablo Zicaro Nicolas Garrido ignacio garcia-Mansilla Carlos Yacuzzi Matias Costa-Paz Department of Knee Hospital Italiano de Buenos AiresBuenos Aires 1109Argentina

BACKGROUND One of the most important factors to consider in relation to meniscal repair is the high failure rate reported in the existing literature.AIM To evaluate failure rates,return to sports(RTS)rate,clinical outcomes and magnetic resonance image(MRI)evaluation after meniscus suture repair for longitudinal tears at a minimum 2-year-follow-up.METHODS We conducted a retrospective review of meniscal repairs between January 2004 and December 2018.All patients treated for longitudinal tears associated or not with an anterior cruciate ligament reconstruction(ACL-R)were included.Meniscal ramp lesions,radial and root tears,associated with multiligament injuries,tibial fracture and meniscal allograft transplants were excluded.Surgical details and failure rate,defined as symptomatic patients who underwent a revision surgery,were analyzed.As isolated bucket handle tears(BHTs)were usually associated with higher failure rates,we compared BHTs and not BHTs associated or not with an ACL-R.Since 2014,the inside-out technique using cannulas and suture needles with 2-0 Tycron began to predominate.In addition,the number of stitches per repair was increased.In view of differences in surgical technique,we compared two different cohorts:before and after 2014.We recorded the RTS according to the level achieved and the time to RTS.Lysholm and IKDC scores were recorded.Patients were studied with x-rays and MRI as standard postoperative control.RESULTS One hundred and nineteen patients were included with a mean follow up of 7 years(SD:4.08).Overall failure rate was 20.3%at a mean 20.1 mo.No statistically significant differences were found when comparing failure for medial and lateral meniscal repair(22.7%and 15.3%,P=0.36),BHTs and not BHTs(26%and 17.6%,P=0.27),isolated or associated with an ACL-R(22.9%and 18%,P=0.47),or when comparing only BHTs associated with an ACL-R(23%and 27.7%,P=0.9)or not.When comparing cohorts before and after 2014,we found a significant decrease in the overall failure rate from 26%to 11%(P<0.03).Isolated lesi

关键词： Meniscus repair Bucket handle tears Meniscal suture Failure rate Longitudinal meniscus tears

Land-use change and windstorms legacies drove the recolonization dynamics of laurel forests in Tenerife, Canary islands

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Forest Ecosystems 2023年第1期10卷 113-124页

作者： Vicente Rozas Maria A.garcia-Lopez Jose M.Olano Gabriel Sanguesa-Barreda Miguel garcia-Hidalgo Susana Gomez-Gonzalez Roberto Lopez-Rubio Jose M.Fernandez-Palacios ignacio garcia-Gonzalez Laura Lozano-Lopez Paula garcia-Gonzalez Ana I.garcia-Cervigon EiFAB-iuFOR Universidad de ValladolidCampus Duques de Soria42004SoriaSpain Departamento de Biologia-IVAGRO Universidad de CadizCampus Rio San Pedro11510Puerto RealSpain Center for Climate and Resilience Research(CR)2 Blanco Encalada 20028370449SantiagoChile Area de Biodiversidad y Conservacion Universidad Rey Juan Carlosc/Tulipan s/n28933MostolesSpain Grupo de Ecologia y Biogeografia Insular Universidad de La Laguna38206La LagunaTenerifeSpain BIOAPLIC Departamento de BotanicaEscola Politecnica Superior de EnxenariaCampus TerraUniversidade de Santiago de CompostelaLugo27002Spain

Laurel forests are quite relevant for biodiversity conservation and are among the island ecosystems most severely damaged by human activities.In the past,Canary laurel forests have been greatly altered by logging,livestock and agriculture.The remains of laurel forests are currently protected in the Canary Islands(Spain).However,we miss basic information needed for their restoration and adaptive management,such as tree longevity,growth potential and responsiveness to natural and anthropogenic disturbances.Using dendrochronological methods,we studied how forest dynamic is related to land-use change and windstorms in two well-preserved laurel forests on Tenerife Island.Wood cores were collected from over 80 trees per stand at three stands per forest.We used ring-width series to estimate tree ages and calculate annual basal area increments(BAI),cumulative diameter increases,and changes indicative of released and suppressed growth.Twelve tree species were found in all stands,with Laurus novocanariensis,Ilex canariensis and Morella faya being the most common species.Although some individuals were over 100 years old,61.8%-88.9% of the trees per stand established between 1940 and 1970,coinciding with a post-war period of land abandonment,rural exodus and the onset of a tourism economy.Some trees have shown growth rates larger than 1 cm diameter per year and most species have had increasing BAI trends over the past decades.Strong growth releases occurred after windstorms at both sites,but the effects of windstorms were site-dependent,with the 1958 storm affecting mainly the eastern tip of the island(Anaga massif)and the 1991 storm the western tip(Teno massif).Given the great ability of laurel forest trees to establish after land use cessation and to increase growth after local disturbances such as windstorms,passive restoration may be sufficient to regenerate this habitat in currently degraded areas.

关键词： Canary islands Dendroecology Disturbance Forest structure Macaronesia Management cessation Tree rings

Anticoagulation in elderly patients at high risk of atrial fibrillation without documented arrhythmias

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Journal of Geriatric Cardiology 2017年第3期14卷 166-168页

作者： Manuel Martinez-Selles Eusebio garcia-Izquierdo Jaen ignacio Fernandez Lozano Servicio de Cardiologia Hospital General Universitario Gregorio Maranon Universidad Complutense CIBERCV Madrid Spain Servieio de Cardiologia Hospital Universitario Puerta de Hierro Majadahonda Madrid Spain

Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hypertension, Age ≥ 75 years (doubled), Diabetes, Stroke (doubled), Vascular disease, Age 65–74 years, Sex category (female sex)] thromboembolic complications occurred irrespective of the presence of atrial fibrillation (AF) and anticoagulant therapy may be initiated irrespective of documented AF. In fact, Tischer, et al., found that up to a score of 6, the prevalence of stroke was higher in patients with AF. However, beyond a score of 6, the prevalence of stroke was high irrespective of AF. Other authors have suggested that the risk of stroke is particularly high in the presence of arrhythmic symptoms, previous myocardial infarction, or heart failure therapy in patients with high CHA_2DS_2VASc-score, even in the absence of documented arrhythmias. These data advocate that AF is a risk factor for ischemic stroke, but not necessarily the direct cause of it. Moreover, the causality of the association AF—ischemic stroke—is questioned by the reported lack of temporal relation between stroke events and AF paroxysms or atrial high-rate episodes detected by implantable loop recorders or devices.

关键词：治疗心律失常抗凝房颤充血性心力衰竭患者老年血管疾病

Size effects on the tensile strength and fracture toughness of granitic rock in different tests

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第9期15卷 2179-2192页

作者： ignacio Pérez-Rey Andrea Muñoz-Ibáñez Manuel A.González-Fernández Mauro Muñiz-Menéndez Miguel Herbón Penabad Xian Estévez-Ventosa Jordi delgado Leandro RAlejano Laboratorio de Geotecnia CEDEXMadridSpain CINTECX GESSMin GroupDepartment of Natural Resources and Environmental EngineeringUniversidade de VigoVigoSpain School of Civil Engineering Universidade da CoruñaA CoruñaSpain

This study investigates the tensile failure mechanisms in granitic rock samples at different scales by means of different types of tests.To do that,we have selected a granitic rock type and obtained samples of different sizes with the diameter ranging from 30 mm to 84 mm.The samples have been subjected to direct tensile strength(DTS)tests,indirect Brazilian tensile strength(BTS)tests and to two fracture toughness testing approaches.Whereas DTS and fracture toughness were found to consistently grow with sample size,this trend was not clearly identified for BTS,where after an initial grow,a plateau of results was observed.This is a rather complete database of tensile related properties of a single rock type.Even if similar databases are rare,the obtained trends are generally consistent with previous scatter and partial experimental programs.However,different observations apply to different types of rocks and experimental approaches.The differences in variability and mean values of the measured parameters at different scales are critically analysed based on the heterogeneity,granular structure and fracture mechanics approaches.Some potential relations between parameters are revised and an indication is given on potential sample sizes for obtaining reliable results.Extending this database with different types of rocks is thought to be convenient to advance towards a better understanding of the tensile strength of rock materials.

关键词： Size effect Tensile strength Fracture toughness Granite Finite fracture mechanics

Clinical,imaging,arthroscopic,and histologic features of bilateral anteromedial meniscofemoral ligament:A case report

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World Journal of Methodology 2023年第4期13卷 359-365页

作者： Juan Bautista Luco Damian Di Memmo Valentina Gomez Sicre Tomas ignacio Nicolino Matias Costa-Paz Juan Astoul ignacio garcia-Mansilla Division of Knee Department of OrthopaedicsHospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Radiology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Pathology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina

BACKGROUND The anteromedial meniscofemoral ligament(AMMFL)is a very rare entity,commonly unrecognized and underreported.Although it was not proved to be a cause of anterior knee pain,concerns have been raised on the relationship between the presence of this structure and medial meniscus injury secondary to its abnormal motion.Regarding histologic examination,some studies have shown meniscus-like fibrocartilage,while others have identified it as ligament-like collagenous fibrous connective tissue.CASE SUMMARY We report the case of a 34-year-old ballerina with an AMMFL associated with a torn medial meniscus of both knees.Surgery was performed to treat the meniscal injury and two biopsies of each AMMFL were taken in different locations to define the histopathological composition.Histologic examination revealed fibrocartilaginous tissue compatible with meniscus.Follow-up evaluation one year after surgery evidenced full remission of symptoms and the patient had resumed her athletic activities.CONCLUSION Clinical,magnetic resonance imaging,arthroscopic,and histological features have been carefully described to better characterize the AMMFL.

关键词： Meniscofemoral Ligaments Knee arthroscopy Histology Case report

Usefulness of the CONUT index upon hospital admission as a potential prognostic indicator of COVID-19 health outcomes

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Chinese Medical Journal 2022年第2期135卷 187-193页

作者： Adrian K.Bengelloun Guillermo J.Ortega Julio Ancochea Ancor Sanz-garcia Diego A.Rodriguez-Serrano Guillermo Fernandez-Jimenez Rosa Giron Elena Avalos Joan B.Soriano J.ignacio de Ulibarri Facultad de Medicina Universidad Autónoma de MadridMadridSpain Unidad de Análisis de Datos Instituto de Investigación Sanitaria del Hospital de la PrincesaMadridSpain Servicios de Neumología Admisión y Documentación ClínicaCuidados Intensivos y Nutrición y DietéticaHospital Universitario de La PrincesaMadridSpain Centro de Investigación en Red de Enfermedades Respiratorias(CIBERES) Instituto de Salud Carlos III(ISCIII)MadridEspañaSpain

Background:In-hospital mortality in patients with coronavirus disease 2019(COVID-19)is high.Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes.We aimed to determine the usefulness of the CONtrolling NUTritional status(CONUT)index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.Methods:Our study design is of a retrospective observational study in a large cohort of COVID-19 patients.In addition to descriptive statistics,a Kaplan-Meier mortality analysis and a Cox regression were performed,as well as receiver operating curve(ROC).Results:From February 5,2020 to January 21,2021,there was a total of 2969 admissions for COVID-19 at our hospital,corresponding to 2844 patients.Overall,baseline(within 4 days of admission)CONUT index could be scored for 1627(57.2%)patients.Patients’age was 67.3±16.5 years and 44.9%were women.The CONUT severity distribution was:194(11.9%)normal(0-1);769(47.2%)light(2-4);585(35.9%)moderate(5-8);and 79(4.9%)severe(9-12).Mortality of 30 days after admission was 3.1%in patients with normal risk CONUT,9.0%light,22.7%moderate,and 40.5%in those with severe CONUT(P<0.05).An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model(P<0.05).An increasing baseline CONUT stage was associated with a longer duration of admission,a greater requirement for the use of non-invasive and invasive mechanical ventilation,and other clinical outcomes(all P<0.05).The ROC of CONUT for mortality had an area under the curve(AUC)and 95%confidence interval of 0.711(0.676-0746).Conclusion:The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.

关键词： Admission Clinical risk CONUT COVID-19 Prognosis Score