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Above knee amputation

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https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#1
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#2
Nobuya Abe, Tomoko Tomita, Miyuki Bohgaki, Hideki Kasahara, Takao Koike
RATIONALE: Crystalglobulinemia is a rare disease caused by monoclonal immunoglobulins, characterized by irreversible crystallization on refrigeration. It causes systemic symptoms including purpura, arthralgia, and vessel occlusive conditions to be exacerbated by exposure to cold. We report a patient with crystalglobulinemia associated with monoclonal gammopathy of undetermined significance (MGUS) manifesting as chronic arthralgia and recurrent acute arterial occlusion. PRESENTING CONCERNS: A 61-year-old man, who had been diagnosed with MGUS and who had arthralgia of unknown origin, presented with recurrent acute limb ischemia after surgical thromboembolectomy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#3
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28348796/diagnostic-difficulty-identifying-apophysomyces-trapeziformis-septic-arthritis-in-a-patient-with-multiple-myeloma
#4
J Bradford Bertumen, Wiley A Schell, Maria Joyce, Christopher Alley, Christopher W Woods
INTRODUCTION: Mucormycosis is a rare fungal infection, but can cause substantial morbidity and mortality in both immunocompromised and immunocompetent patients. Apophysomyces is a mucormycetes species ubiquitous in nature, particularly in soil, decaying wood and other organic matter. Apophysomyces is known to cause cutaneous fungal infections, particularly after penetrating trauma. Septic arthritis is a rare clinical manifestation. CASE PRESENTATION: We describe a case of Apophysomyces trapeziformis causing septic arthritis of the knee of a patient with multiple myeloma...
December 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#5
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28291452/slack-reducing-band-improves-combat-application-tourniquet-pressure-profile-and-hemorrhage-control-rate
#6
Dean Nachman, Avi Benov, Amiram Shovali, Yavnai Nirit, Roy Nadler, Yitzhak Avraham, Elon Glassberg
BACKGROUND: The Combat Application Tourniquet (CAT) is the tourniquet of choice in the Israeli defense forces. Applying the device loosely before windlass twisting is a main pitfall in CAT application. This study objective is to assess the effectiveness of a novel design modification of the CAT, aiming to prevent loose applications, by minimizing the slack. METHODS: Using the HapMed leg tourniquet trainer, an above the knee traumatic amputation was simulated. Active duty combatants and Special Forces basic medics were randomly assigned to apply the modified (n = 67) or conventional CAT (n = 65) once...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28242264/association-between-phantom-limb-complex-and-the-level-of-amputation-in-lower-limb-amputee
#7
Bayram Kelle, Erkan Kozanoğlu, Ömer Sunkar Biçer, İsmet Tan
OBJECTIVE: The aim of this study was to evaluate the natural course of phantom limb complex without any treatment after lower limb amputation. METHODS: The study design was consisted of a combination of retrospective review and cross-sectional interview. 101 patients with lower limb amputation were included into the study. Patients were divided into three groups according to the amputation level: i) from hip disarticulation to knee disarticulation (including knee disarticulation) (25 patients, mean age: 55...
February 24, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28236917/outcomes-of-native-superficial-femoral-artery-chronic-total-occlusion-recanalization-after-failed-femoropopliteal-bypass
#8
Mark G Davies, Hosam F El-Sayed
OBJECTIVE: When a bypass fails, the options are lysis, redo bypass, or endovascular intervention. If lysis of the original bypass is not considered an option, which is better-redo bypass or attempts at endovascular recanalization of the native system? This retrospective study examined the outcomes of native superficial femoral artery (SFA) chronic total occlusion (CTO) recanalization compared with redo bypass after failed femoropopliteal bypass. METHODS: Patients presenting with a symptomatic failed femoropopliteal bypass that underwent attempted CTO endovascular (EV) recanalization of the native SFA or a redo femoropopliteal bypass (BP) from 2000 to 2015 were analyzed...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28236080/what-are-the-frequency-associated-factors-and-mortality-of-amputation-and-arthrodesis-after-a-failed-infected-tka
#9
Min-Sun Son, Edmund Lau, Javad Parvizi, Michael A Mont, Kevin J Bozic, Steven Kurtz
BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known. QUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA? METHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9(th) Revision, Clinical Modification codes...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28216364/clinical-outcomes-of-obturator-canal-bypass
#10
Jonathan Bath, Maham Rahimi, Becky Long, Efthymios Avgerinos, Joseph Giglia
OBJECTIVE: Infected aortofemoral grafts pose a formidable challenge with a significant risk of limb loss and high mortality. Despite successful reports of obturator canal bypass (OCB) for infected aortofemoral graft and complicated groins, the technique has not gained widespread use. We reviewed our experience with OCB and performed a systematic review of the literature. METHODS: A retrospective review of patients who underwent OCB in our institution between 1995 and 2013 was conducted...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28203511/a-retrospective-look-at-integrating-a-novel-regenerative-medicine-approach-in-plastic-limb-reconstruction
#11
Edgardo R Rodriguez Collazo, Christopher R Rathbone, Brian R Barnes
Full-thickness wounds that have rendered patients candidates for amputation may require techniques that may include a combinatorial approach above traditional standard of care. The purpose of this retrospective study was to evaluate the effectiveness of an innovative approach whereby several therapies were combined to avoid amputation. Patients with full-thickness wounds who were previously recommended for amputation and were treated with the combinatorial approach of muscle flap reconstruction and concentrated bone marrow aspirate, platelet-rich plasma, INTEGRA Wound matrix, vacuum-assisted closure, and split-thickness skin grafts were assessed retrospectively...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#12
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28144581/tourniquets-do-not-increase-the-total-blood-loss-or-re-amputation-risk-in-transtibial-amputations
#13
Christian Wied, Peter T Tengberg, Gitte Holm, Thomas Kallemose, Nicolai B Foss, Anders Troelsen, Morten T Kristensen
AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28074439/corr-insights-%C3%A2-racial-disparities-in-above-knee-amputations-after-tka-a-national-database-study
#14
Paul J Dougherty
No abstract text is available yet for this article.
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050490/renal-cell-carcinoma-with-unusual-skeletal-metastasis-to-tibia-and-ankle-a-case-report-and-review-of-literature
#15
Kiran Shankar, Durgesh Kumar, Kariyanakatte Veeraiah Veerendra Kumar, Chennagiri Premlata
Renal Cell Carcinoma (RCC) accounts for 5% of the epithelial malignancies worldwide with clear cell carcinoma accounting for 85% of these malignancies. One third of these patients experience synchronous metastatic disease and 20-30% of the remaining patients experience metachronous metastatic RCC. Bony metastasis accounts for 20% of metastatic RCC. They most commonly affect the axial skeleton and rarely the long bones or the small bones of the hands and feet. Bone metastases from RCC are predominantly osteolytic in nature, leading to significant patient morbidity due to the associated Skeletal Related Events (SRE)...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#16
Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28004988/biosynthetic-grafts-to-replace-infected-prosthetic-vascular-bypasses-a-single-center-experience
#17
Ingolf Töpel, Theresa Stigler, Isabelle Ayx, Thomas Betz, Christian Uhl, Markus Steinbauer
BACKGROUND: There are only a few options to replace infected infrainguinal synthetic vascular grafts in the absence of suitable autologous veins. To use a biosynthetic vascular graft (Omniflow(®)II) might be a valuable alternative. METHODS: We retrospectively analyzed the clinical course of 29 patients who underwent replacement of an infected infrainguinal vascular prosthesis (Szilagyi 3) by an Omniflow(®)II graft. RESULTS: Because of the lack of suitable autologous veins, 15 above-knee femoro-popliteal, 5 below-knee femoro-popliteal, and 9 femoro-tibial bypasses were replaced with biosynthetic grafts...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27995560/racial-disparities-in-above-knee-amputations-after-tka-a-national-database-study
#18
Jaiben George, Suparna M Navale, Nicholas K Schiltz, Miguel Siccha, Alison K Klika, Carlos A Higuera
BACKGROUND: Above-knee amputation (AKA) is a rare but devastating complication of TKA. Although racial disparities have been previously reported in the utilization of TKA, it is unclear whether disparities exist in the rates of AKA after TKA. QUESTIONS/PURPOSES: (1) Which gender-racial group has the highest rate of AKA from septic and aseptic complications of TKA? (2) Which age groups have higher rates of AKA from septic and aseptic complications of TKA? METHODS: Using National Inpatient Sample data from 2000 to 2011, AKAs resulting from complications of TKA were identified using a combination of International Classification of Diseases, 9th Revision procedure and diagnosis codes...
December 19, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27926681/influence-of-immediate-and-delayed-lower-limb-amputation-compared-with-lower-limb-salvage-on-functional-and-mental-health-outcomes-post-rehabilitation-in-the-u-k-military
#19
COMPARATIVE STUDY
Peter Ladlow, Rhodri Phillip, Russell Coppack, John Etherington, James Bilzon, M Polly McGuigan, Alexander N Bennett
BACKGROUND: Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. METHODS: This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#20
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 2016: Vascular and Endovascular Surgery
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