scholarly journals Thrombolysis of Postoperative Acute Pulmonary Embolism with a Thrombus in Transit

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Cynthia Mardinger ◽  
Paul J. E. Boiteau ◽  
John B. Kortbeek
Keyword(s):  
Standard Dose ◽  
Case Reports ◽  
Cruciate Ligament ◽  
Physically Active ◽  
Future Studies ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Lateral Meniscectomy ◽  
Anterior Cruciate ◽  
In Transit

Right heart thrombus in transit clot (RHTT) associated with a pulmonary thromboembolism (PTE) is a rare but potentially fatal diagnosis. Early diagnosis and immediate intervention are crucial. This report describes the case of a healthy, physically active 32-year-old female who presented 19 days postoperatively, following an anterior cruciate ligament reconstruction and partial lateral meniscectomy with a saddle PE, RHTT, and right ventricular (RV) strain. The patient received half of the standard dose of intravenous tissue plasminogen activator (TPA) in combination with anticoagulation and survived. Case reports of RHTT will inform future studies designed to evaluate whether and when thrombolysis should be administered.

Thrombolytic Treatment of Acute Cerebral Infarction

CNS Spectrums ◽  
2005 ◽  
Vol 10 (7) ◽  
pp. 539-549 ◽  
Author(s):  
Kathleen M. Burger ◽  
Deborah R. Horowitz
Keyword(s):  
Case Reports ◽  
Optimal Management ◽  
Thrombolytic Treatment ◽  
Acute Stroke Patient ◽  
Acute Therapy ◽  
Common Cause ◽  
Intravenous Tissue Plasminogen Activator ◽  
The World ◽  
Tissue Plasminogen ◽  
Improved Outcome

AbstractStroke is a common cause of death and disability throughout the world. Acute neurologic deficits due to ischemic injury deserve rapid recognition and diagnosis in order to provide effective therapy. Intravenous tissue plasminogen activator (t-PA) provided to carefully selected patients that can be treated within 3 hours of stroke onset results in improved outcome in these patients. Intra-arterial administration of t-PA within a 6-hour window is performed at several academic centers in patients with middle cerebral and other intracranial artery occlusions based on results of one randomized clinical trial and numerous case reports. Although acute therapy of ischemic stroke has received much attention since the approval of intravenous t-PA, only a small percentage of individuals suffering a stroke actually receive t-PA. This article will review the optimal management of the acute stroke patient and discuss thrombolytic clinical trials that have been completed as well as those that are in progress.

scholarly journals Evaluation of the Bone-ligament and tendon insertions based on Raman spectrum and its PCA and CLS analysis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Yang Wu ◽  
Yu Dong ◽  
Jia Jiang ◽  
Haiqing Li ◽  
Tongming Zhu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cruciate Ligament ◽  
Physically Active ◽  
Mapping Procedure ◽  
Raman Spectroscopic ◽  
Co Morbidity ◽  
Tissue Interface ◽  
Anterior Cruciate ◽  
Raman Spectral ◽  
Artificial Prosthesis

Abstract Injuries to the Anterior Cruciate Ligament (ACL) and Rotator Cuff Tendon (RCT) are common in physically active and elderly individuals. The development of an artificial prosthesis for reconstruction/repair of ACL and RCT injuries is of increasing interest due to the need for viable tissue and reduced surgically-related co-morbidity. An optimal prosthesis design is still elusive, therefore an improved understanding of the bone-soft tissue interface is extremely urgent. In this work, Raman spectral mapping was used to analyze, at the micron level, the chemical composition and corresponding structure of the bone-soft tissue interface. Raman spectroscopic mapping was performed using a Raman spectrometer with a 785 nm laser coupled to a microscope. Line-mapping procedure was performed on the ACL and RCT bone insertion sites. The classical least squares (CLS) fitting model was created from reference spectra derived from pure bone and soft-tissue components, and spectral maps collected at multiple sites from ACL and RCT specimens. The results suggest that different source of interface shows different boundary, even they seems have the same components. Compared to the common histology results, it provided intact molecular information that can easily distinguished some relative component change.

scholarly journals Uncommon Complications after Anterior Cruciate Ligament Reconstruction

Joints ◽  
2018 ◽  
Vol 06 (03) ◽  
pp. 188-203 ◽  
Author(s):  
Anna Palazzolo ◽  
Federica Rosso ◽  
Davide Bonasia ◽  
Francesco Saccia ◽  
Roberto Rossi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Case Reports ◽  
Cruciate Ligament ◽  
Saphenous Nerve ◽  
Fixation Device ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Bone Tunnels

AbstractAnterior cruciate ligament reconstruction (ACL-R) is a common surgical procedure, with good outcome in 75 to 97% of the cases. However, different complications have been described including infection, hemarthrosis, deep vein thrombosis (DVT), and pulmonary embolism (PE) with a rate ranging from 1 to 15%. There are few case reports in the literature describing rare complications after ACL-R and they can be divided into: (1) complications related to the fixation device (rupture, migration); (2) fractures (tibial or femoral side); (3) infections due to uncommon bacteria, mycobacterium, and mycosis; (4) rare vascular injuries; (5) nerve injuries; and (6) other rare complications. In case of fixation device rupture or migration, device removal can be easy but the diagnosis may be challenging. Patellar fracture after ACL-R may be related to harvesting and it is not uncommon. Conversely, femoral or tibial fractures are most frequently due to bone weakness related to bone tunnels. Some rare infections related to uncommon bacteria or mycosis are also described with potentially devastating joint damage. Popliteal artery injuries are uncommon in ACL-R but minor vessels damages are described with possible severe consequences for patients. Injuries to the infrapatellar branch of the saphenous nerve are not uncommon in ACL-R. However, there are few case reports also describing injuries to the saphenous nerve, the common peroneal nerve and the sciatic nerve. The aim of this paper is to review the literature describing uncommon complications after ACL-R, giving some more information about diagnosis and treatment.

Evaluation of the Viscoelastic Properties of the Intact Medial Collateral Ligament in a Goat Model

1999 ◽  
Author(s):  
Theodore D. Clineff ◽  
Richard E. Debski ◽  
Sven U. Scheffler ◽  
John D. Withrow ◽  
Savio L.-Y. Woo
Keyword(s):  
Medial Collateral Ligament ◽  
Viscoelastic Properties ◽  
Analytical Approach ◽  
Cruciate Ligament ◽  
Collateral Ligament ◽  
Future Studies ◽  
Linear Viscoelastic ◽  
Viscoelastic Theory ◽  
Anterior Cruciate ◽  
Linear Viscoelastic Theory

Abstract The time and history dependent viscoelastic properties have been determined for the normal medial collateral ligament (MCL) of canine (Woo, 1981), porcine anterior cruciate ligament (Kwan, 1993), and human patellar tendon in a cadaver model (Johnson, 1994). The objective of this study was to use a combined experimental and analytical approach to quantify the viscoelastic properties of the intact MCL in a goat model. A thorough understanding of the viscoelastic properties at low strain levels is necessary to future studies of the healing MCL. The quasi-linear viscoelastic theory (QLV) (Fung, 1972) was used to characterize the properties of the MCL during stress relaxation.

The Contribution of Partial Meniscectomy to Preoperative Laxity and Laxity After Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction: In Vivo Kinematics With Navigation

2019 ◽  
Vol 47 (13) ◽  
pp. 3203-3211
Author(s):  
Alberto Grassi ◽  
Stefano Di Paolo ◽  
Gian Andrea Lucidi ◽  
Luca Macchiarola ◽  
Federico Raggi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Single Bundle ◽  
Anatomic Acl Reconstruction ◽  
Medial Meniscectomy ◽  
Lateral Meniscectomy ◽  
Anterior Cruciate

Background: Limited in vivo kinematic information exists on the effect of clinical-based partial medial and lateral meniscectomy in the context of anterior cruciate ligament (ACL) reconstruction. Hypothesis: In patients with ACL deficiency, partial medial meniscus removal increases the anteroposterior (AP) laxity with compared with those with intact menisci, while partial lateral meniscus removal increases dynamic laxity. In addition, greater postoperative laxity would be identified in patients with partial medial meniscectomy. Study design: Cross-sectional study; Level of evidence, 3. Methods: A total of 164 patients with ACL tears were included in the present study and divided into 4 groups according to the meniscus treatment they underwent: patients with partial lateral meniscectomy (LM group), patients with partial medial meniscectomy (MM group), patients with partial medial and lateral meniscectomy (MLM group), and patients with intact menisci who did not undergo any meniscus treatment (IM group). A further division in 2 new homogeneous groups was made based on the surgical technique: 46 had an isolated single-bundle anatomic ACL reconstruction (ACL group), while 13 underwent a combined single-bundle anatomic ACL reconstruction and partial medial meniscectomy (MM-ACL group). Standard clinical laxities (AP translation at 30° of knee flexion, AP translation at 90° of knee flexion) and pivot-shift (PS) tests were quantified before and after surgery by means of a surgical navigation system dedicated to kinematic assessment. The PS test was quantified through 3 different parameters: the anterior displacement of the lateral tibial compartment (lateral AP); the posterior acceleration of the lateral AP during tibial reduction (posterior acceleration); and finally, the area included by the lateral AP translation with respect to the flexion/extension angle (area). Results: In the ACL-deficient status, the MM group showed a significantly greater tibial translation compared with the IM group ( P < .0001 for AP displacement at 30° [AP30] and 90° [AP90] of flexion) and the LM group ( P = .002 for AP30 and P < .0001 for AP90). In the PS test, the area of LM group was significantly larger (57%; P = .0175) than the one of the IM group. After ACL reconstruction, AP translation at 30° was restored, while the AP90 remained significantly greater at 1.3 mm ( P = .0262) in the MM-ACL group compared with those with intact menisci. Conclusion: Before ACL reconstruction, partial medial meniscectomy increased AP laxity at 30° and 90° and lateral meniscectomy increased dynamic PS laxity with respect to intact menisci. Anatomic single-bundle ACL reconstruction decreased laxities, but a residual anterior translation of 1.3 mm at 90° remained in patients with partial medial meniscectomy, with respect to those with intact menisci.

The Irreducible Knee Dislocation

2019 ◽  
Vol 33 (04) ◽  
pp. 328-334
Author(s):  
Shahbaz S. Malik ◽  
Peter B. MacDonald
Keyword(s):  
Soft Tissues ◽  
Case Reports ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Knee Dislocation ◽  
Small Subset ◽  
Ligament Injuries ◽  
Small Series ◽  
Anterior Cruciate ◽  
Knee Dislocations

AbstractIrreducible knee dislocations are a small subset of acute knee dislocations and are extremely rare. The most common type of irreducible knee dislocation is posterolateral, which can be challenging to diagnose both clinically and on plain radiographs. Vascular injury is uncommon and closed reduction is seldom possible due to medial femoral condyle buttonholing through soft tissues requiring open or arthroscopic reduction. Ligament injuries mostly include medial collateral ligament, anterior cruciate ligament, and posterior cruciate ligament. Literature has numerous case reports with a couple of small series giving short- to mid-term outcomes of posterolateral knee dislocations. There is, however, no consensus on management of ligament injuries with case reports showing good outcomes in early or delayed ligament reconstruction. This article sheds light on previous case reports and describes how to identify irreducible knee dislocations and provides an algorithm on how to manage ligament injuries in posterolateral dislocations.

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