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Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

Journal of Clinical Orthopaedics | Vol 9 | Issue 1 | January-June 2024 | page: 57-60 | Made Winatra Satya Putra, Anak Agung Gde Yuda Asmara DOI: https://doi.org/10.13107/jcorth.2024.v09i01.636 Author: Made Winatra Satya Putra [1], Anak Agung Gde Yuda Asmara [1] [1] Department of Orthopaedics and Traumatology, General Hospital Prof. IGNG Ngoerah, Faculty of Medicine Udayana […]

Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

Journal of Clinical Orthopaedics | Vol 9 | Issue 1 | January-June 2024 | page: 22-27 | Jamie C Heimroth, Max L Willinger, Nipun Sodhi, B A Ariel Henig, Alain E Sherman, Jonathan R Danoff DOI: https://doi.org/10.13107/jcorth.2024.v09i01.626 Author: Jamie C Heimroth [1], Max L Willinger [1], Nipun Sodhi1, B A Ariel Henig [2], Alain E […]

Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

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Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.636

Author: Made Winatra Satya Putra [1], Anak Agung Gde Yuda Asmara [1]

[1] Department of Orthopaedics and Traumatology, General Hospital Prof. IGNG Ngoerah, Faculty of Medicine Udayana University, Bali, Indonesia

Address of Correspondence

Dr. Made Winatra Satya Putra,
JL. Diponegoro, Dauh Puri Klod, Bali, Indonesia.
E-mail: borthopaedi@gmail.com

Abstract

Neglected elbow dislocations pose a challenge to orthopedic surgeons, leading to contracture and functional limitations. This case involves a 51-year-old female patient experiencing pain and stiffness in her left elbow for the past 5 months due to neglected dislocation. Previous traditional treatment showed no improvement. Disuse atrophy was suspected, prompting open reduction, ligament reconstruction, and a 3-week temporary pinning. The intervention aimed to address the late-presenting unreduced elbow, utilizing autograft for ligament reconstruction. The subsequent supervised physiotherapy played a crucial role in restoring functional, stable, and painless elbow movement. This case underscores the importance of timely intervention in neglected elbow dislocations to prevent disability and enhance the quality of life for affected individuals.
Keywords: Neglected elbow dislocation, ligament reconstruction, autograft.

References

1. Kone SG, Bana A, Dogba EG. Neglected elbow dislocation with conservation of elbow function, concerning a case in Abidjan (Ivory Coast). Open J Orthop 2018;8:127-31.
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3. Agarwal S, Patel RK. A prospective study of 9 cases of neglected posterior dislocation of elbow treated by open reduction and V-Y tricepsplasty of speed. J Bone Jt Dis 2016;31:26-9.
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How to Cite this article: Putra MWS, Asmara AAGY. Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report. Journal of Clinical Orthopaedics 2024;January-June:9(1)57-60.

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Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

June 30, 2024/in Vol 9 | Issue 1 | Jan-June 2024 /by editor.jcorth

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.626

Author: Jamie C Heimroth [1], Max L Willinger [1], Nipun Sodhi1, B A Ariel Henig [2], Alain E Sherman [3], Jonathan R Danoff [1]

[1] Department of Orthopedic Surgery, Long Island Jewish Medical Center, New York, USA,
[2] Department of Orthopedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra, New York, USA,
[3] Department of Orthopedic Surgery, Lenox Hill Hospital, New York, USA.

Address of Correspondence

Dr. Jonathan Danoff,
Department of Orthopedic Surgery, Long Island Jewish Medical Center, New York, USA.
Email: jdanoff@northwell.edu

Abstract

Introduction: Risk stratification is used in total joint arthroplasty (TKA) to optimize outcomes and minimize complications. Modifiable risk factors such as surgical duration can be influenced by surgeons; however, under certain circumstances, prolonged surgery cannot be avoided. While previous studies have investigated the impact of surgical duration on post-operative complications, we felt that research was lacking in comparing both surgical duration and tourniquet time and the rate of infection following a TKA. Our learning objective was to investigate the risk of surgical site infections (SSIs) and periprosthetic joint infections (PJIs) from prolonged (1) surgical duration or (2) tourniquet time during primary TKAs.
Materials and Methods: A multicenter health-care system database consisting of 15 hospitals was queried for all patients undergoing TKA between March 2020 and December 2020. Patient demographics, comorbidities, and infection data were collected. The surgical duration and tourniquet time were calculated for each patient undergoing a TKA and compared against the rate of PJI or SSI rate. PJI was defined based on the 2018 musculoskeletal infection society (MSIS) criteria, and superficial SSI was defined as any infection that did not meet MSIS criteria.
Results: Of the 2511 patients who underwent primary TKA, 19 were found to have an infection. Average surgical duration of 126.17 min for patients with an infection compared to 103.44 min without infection (P = 0.02). There was a significantly increased infection rate with increased surgical duration after univariate analysis. Patients who developed any infection had an average tourniquet time of 78.5 min, whereas those without infections had an average of 62.14 min (P = 0.004). Infection rate began to increase once the surgical duration reached 70 min; however, the infection rate increase per 10-min increments was not statistically significant (P = 0.09). The infection rate began to increase at 50 min of tourniquet time and significantly increased as tourniquet time increased (P = 0.004).
Conclusion: Surgical duration is associated with an increased risk of infection following TKA. Our study demonstrated tourniquet time had a greater impact on infection. There are many circumstances that lead to increased surgical and tourniquet duration, including increased body mass index, and severe deformity. Surgeons should consider deflating the tourniquet as soon as the critical parts of the surgery are complete to decrease the risk of post-operative infections.
Keywords: Total knee replacement, infection, knee joint, tourniquets.

References

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5. Gold PA, Garbarino LJ, Anis HK, Neufeld EV, Sodhi N, Danoff JR, et al. The cumulative effect of substance abuse disorders and depression on postoperative complications after primary total knee arthroplasty. J Arthroplasty 2020;35:S151-7.
6. Naranje S, Lendway L, Mehle S, Gioe TJ. Does operative time affect infection rate in primary total knee arthroplasty? Clin Orthop Relat Res 2015;473:64-9.
7. Scigliano NM, Carender CN, Glass NA, Deberg J, Bedard NA. Operative time and risk of surgical site infection and periprosthetic joint infection: A systematic review and meta-analysis. Iowa Orthop J 2022;42:155-61.
8. Anis HK, Sodhi N, Klika AK, Mont MA, Barsoum WK, Higuera CA, et al. Is operative time a predictor for post-operative infection in primary total knee arthroplasty? J Arthroplasty 2019;34:S331-6.
9. Badawy M, Espehaug B, Fenstad AM, Indrekvam K, Dale H, Havelin LI, et al. Patient and surgical factors affecting procedure duration and revision risk due to deep infection in primary total knee arthroplasty. BMC Musculoskelet Disord 2017;18:544.
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How to Cite this article: Heimroth JC, Willinger ML, Sodhi N, Henig BAA, Sherman AE, Danoff JR. Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty. Journal of Clinical Orthopaedics 2024;January-June:9(1):22-27.

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Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

Full Sized Blog Element (Big Preview Pic)

Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

Author: Made Winatra Satya Putra [1], Anak Agung Gde Yuda Asmara [1]

Abstract

References

Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

Author: Jamie C Heimroth [1], Max L Willinger [1], Nipun Sodhi1, B A Ariel Henig [2], Alain E Sherman [3], Jonathan R Danoff [1]

Abstract

References

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