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S. K. Yasen - One of the best experts on this subject based on the ideXlab platform.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    Purpose All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Methods Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Results Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p  = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p  = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p  = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). Conclusions All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. Level of evidence IV.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery.
    Knee surgery sports traumatology arthroscopy : official journal of the ESSKA, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. IV.

A. D. Shearman - One of the best experts on this subject based on the ideXlab platform.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    Purpose All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Methods Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Results Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p  = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p  = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p  = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). Conclusions All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. Level of evidence IV.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery.
    Knee surgery sports traumatology arthroscopy : official journal of the ESSKA, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. IV.

M Silvasti - One of the best experts on this subject based on the ideXlab platform.

  • continuous epidural analgesia with bupivacaine fentanyl versus patient controlled analgesia with i v morphine for postoperative pain relief after Knee Ligament Surgery
    Acta Anaesthesiologica Scandinavica, 2000
    Co-Authors: M Silvasti, M Pitkanen
    Abstract:

    BACKGROUND Both epidural analgesia and intravenous patient-controlled analgesia (PCA) have been found efficacious after various types of Surgery. We compared the efficacy, safety, side effects and patient satisfaction of these methods in a randomized double-blind fashion after elective anterior cruciate Ligament reconstruction of the Knee. METHODS Fifty-six patients had an epidural catheter placed at the L2-L3 interspace. Spinal anaesthesia with 15 mg of plain bupivacaine 5 mg/ml was performed at the L3-L4 interspace. After Surgery the patients were randomly divided into three groups: 19 received a continuous epidural infusion with bupivacaine 1 mg/ml and fentanyl 10 mg/ml (F10), 19 patients received bupivacaine 1 mg/ml and fentanyl 5 microg/ml (F5) and 18 patients received saline (S). The rate of the epidural infusions was 0.1 ml kg(-1) h(-1). Each patient could also use an intravenous (i.v.) PCA device with 40 microg/kg bolus doses of morphine with a lockout period of 10 min and a maximum dose 240 microg kg(-1) h(-1). At the end of Surgery ketoprofen 100 mg i.v. was given and continued orally three times a day. Patients were assessed for pain with a visual analogue scale (VAS) at rest and during activity, side effects and satisfaction at 3, 9 and 20 h. RESULTS Both epidural infusions (F10, F5) provided better analgesia than epidural saline plus i.v. PCA (S) (P<0.05). There was slightly less nausea in the S group (NS). In spite of the difference in the quality of pain relief, there was no difference between the groups in patient satisfaction regarding analgesic therapy. CONCLUSION Epidural infusion of fentanyl (1 microg kg(-1) h(-1) or 0.5 microg kg(-1) h(-1)) and bupivacaine (0.1 mg kg(-1) h(-1)) provided better pain relief but more side effects than intravenous morphine patient-controlled analgesia after Knee Ligament Surgery. Almost all patients in all groups were satisfied with their pain relief.

  • Continuous epidural analgesia with bupivacaine-fentanyl versus patient-controlled analgesia with i.v. morphine for postoperative pain relief after Knee Ligament Surgery.
    Acta anaesthesiologica Scandinavica, 2000
    Co-Authors: M Silvasti, Mikko T. Pitkänen
    Abstract:

    BACKGROUND Both epidural analgesia and intravenous patient-controlled analgesia (PCA) have been found efficacious after various types of Surgery. We compared the efficacy, safety, side effects and patient satisfaction of these methods in a randomized double-blind fashion after elective anterior cruciate Ligament reconstruction of the Knee. METHODS Fifty-six patients had an epidural catheter placed at the L2-L3 interspace. Spinal anaesthesia with 15 mg of plain bupivacaine 5 mg/ml was performed at the L3-L4 interspace. After Surgery the patients were randomly divided into three groups: 19 received a continuous epidural infusion with bupivacaine 1 mg/ml and fentanyl 10 mg/ml (F10), 19 patients received bupivacaine 1 mg/ml and fentanyl 5 microg/ml (F5) and 18 patients received saline (S). The rate of the epidural infusions was 0.1 ml kg(-1) h(-1). Each patient could also use an intravenous (i.v.) PCA device with 40 microg/kg bolus doses of morphine with a lockout period of 10 min and a maximum dose 240 microg kg(-1) h(-1). At the end of Surgery ketoprofen 100 mg i.v. was given and continued orally three times a day. Patients were assessed for pain with a visual analogue scale (VAS) at rest and during activity, side effects and satisfaction at 3, 9 and 20 h. RESULTS Both epidural infusions (F10, F5) provided better analgesia than epidural saline plus i.v. PCA (S) (P

A. J. Foster - One of the best experts on this subject based on the ideXlab platform.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    Purpose All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Methods Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Results Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p  = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p  = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p  = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). Conclusions All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. Level of evidence IV.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery.
    Knee surgery sports traumatology arthroscopy : official journal of the ESSKA, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. IV.

M. J. Risebury - One of the best experts on this subject based on the ideXlab platform.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery
    Knee Surgery Sports Traumatology Arthroscopy, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    Purpose All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Methods Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Results Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p  = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p  = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p  = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). Conclusions All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. Level of evidence IV.

  • Excellent medium-term survival of an all-inside tensionable knotted suture device justifies repair of most meniscal tears encountered during reconstructive Knee Ligament Surgery.
    Knee surgery sports traumatology arthroscopy : official journal of the ESSKA, 2020
    Co-Authors: A. D. Shearman, A. J. Foster, A. J. Wilson, M. J. Risebury, S. K. Yasen
    Abstract:

    All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive Ligament Surgery using a particular meniscal repair device. Patients were identified using a single-site prospectively maintained patient registry. Primary outcome was failure, defined as return to Surgery with documented failure of repair. Complication rates and functional scores were also recorded. Patients in whom meniscal repair failure was identified were further assessed, to identify any common features. Over an 8-year period, 323 patients underwent meniscal repair at the time of Ligament reconstruction, compared to 244 meniscectomies. Of these, 286 patients underwent repair using an all-inside suture device. One-hundred and twenty-seven repairs were to the medial meniscus only, 124 were lateral, and in 35 patients both menisci were repaired. Follow-up was to a median of 51.5 months. There were 31 (9.7%) failures reported at a median of 22 months post-operatively (IQR 13.5–41.5). Medial repair failures were seen more frequently than lateral (13.6% versus 5.6% OR 2.62 95% CI 1.17–5.88 p = 0.022). Failure of ACL reconstruction was associated with meniscal repair failure (OR 5.83 95% CI 1.55–21.95 p = 0.0039). Multi-Ligament reconstruction was undertaken in 70/286 patients receiving meniscal repair and was not associated with failure (OR 1.3 95% CI 0.57–2.98 p = 0.51). Mode number of all-inside sutures used was 3 in both medial and lateral repairs (Range 1–9 lateral; 1–7 medial). All-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during Ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction. IV.