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Above knee amputation

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https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#1
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29217448/perioperative-outcomes-after-regional-versus-general-anesthesia-for-above-knee-amputations
#2
Andrew J B Pisansky, Ethan Y Brovman, Christine Kuo, Alan D Kaye, Richard D Urman
INTRODUCTION: Non-traumatic lower extremity amputation (LEA) remains a common procedure among patients who frequently have significant comorbidities. Patients undergoing above knee amputation (AKA) have the highest rates of mortality in this cohort, yet there is little evidence to support selection between peripheral nerve block or neuraxial regional anesthesia (RA) versus general anesthetic (GA) techniques. OBJECTIVE: To determine whether regional anesthesia (neuraxial or peripheral nerve block) techniques were associated with more favorable outcomes versus general anesthesia among patients undergoing AKA...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#3
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29175037/results-from-a-multicenter-registry-of-heparin-bonded-expanded-polytetrafluoroethylene-graft-for-above-the-knee-femoropopliteal-bypass
#4
Gabriele Piffaretti, Walter Dorigo, Patrizio Castelli, Carlo Pratesi, Raffaele Pulli
OBJECTIVE: The aim of the study was to retrospectively analyze early and follow-up results of above-the-knee femoropopliteal bypasses (AKb) performed with a bioactive heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) graft in patients with peripheral arterial obstructive disease in a multicentric retrospective registry involving seven Italian vascular centers. METHODS: During a 14-year period ending in March 2016, an HB-ePTFE graft was used in 1401 interventions performed for peripheral arterial obstructive disease...
November 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#5
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29132347/knee-arthrodesis-versus-above-the-knee-amputation-after-septic-failure-of-revision-total-knee-arthroplasty-comparison-of-functional-outcome-and-complication-rates
#6
Sven Hungerer, Martin Kiechle, Christian von Rüden, Matthias Militz, Knut Beitzel, Mario Morgenstern
BACKGROUND: After septic failure of total knee arthroplasty (TKA) and multiple revision operations resulting in impaired function, bone and/or soft-tissue damage a reconstruction with a revision arthroplasty might be impossible. Salvage procedures to regain mobility and quality of life are an above-the-knee amputation or knee arthrodesis. The decision process for the patient and surgeon is difficult and data comparing arthrodesis versus amputation in terms of function and quality of life are scarce...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29128877/the-location-of-the-medial-parapatellar-arthrotomy-influences-intraoperative-patella-tracking
#7
Scott R Nodzo, Maximilian Kasparek, Kilian Rueckl, Friedrich Boettner
PURPOSE: The medial parapatellar arthrotomy (MPPA) is a commonly utilized surgical approach; however, the placement of the arthrotomy and its influence on intraoperative patellar tracking has not been evaluated. METHODS: Six knees from three fresh frozen cadavers with transthoracic amputations were operated on. All underwent standard posterior stabilized total knee arthroplasty using a medial parapatellar approach placed at the border of the vastus medialis oblique (VMO)-quadriceps junction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29127251/looking-beyond-the-indication-bone-scan-for-trauma-providing-unsuspected-initial-diagnosis-of-acute-critical-lower-limb-arterial-compromise
#8
Fathima Fijula Palot Manzil, Samuel E Almodovar, Pradeep Bhambhvani
We report a case of rare incidental initial detection of unsuspected arterial supply compromise to the right lower extremity on a bone scan done to rule out fracture in a patient with right hip pain following a fall. Follow up CT angiogram confirmed near complete occlusion of right lower extremity arteries for which patient underwent above knee amputation.
November 10, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/29126767/the-quality-of-life-analysis-of-knee-prosthesis-with-complete-microprocessor-control-in-trans-femoral-amputees
#9
Yavuz Saglam, Baris Gulenc, Fevzi Birisik, Ali Ersen, Ebru Yilmaz Yalcinkaya, Onder Yazicioglu
OBJECTIVE: The aim of this study was to analyze the patient demographics, etiology of limb loss as well as reporting SF-36 scores for microprocessor prosthesis users in Turkish population. METHODS: We reviewed 72 patients (61 male and 11 female; mean age: 37.7 ± 10.7) with uni-lateral, above knee amputation and a history of regular and microprocessor prosthesis use. All patients were called back for a last follow-up and they were asked to fill a self-administered general health status questionnaire (SF-36)...
November 7, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29121845/improving-outcomes-for-lower-extremity-amputations-using-intraoperative-fluorescent-angiography-to-predict-flap-viability
#10
Andrew E Yang, Charles A Hartranft, Alisha Reiss, Charles R Holden
OBJECTIVES: Nearly 25% of vascular surgery patients operated on for peripheral vascular disease are readmitted within 30 days. Development of adjuncts to minimize wound complications remains an area of great interest. Here, we present our experience with intraoperative fluorescent angiography (IFA) as a tool to predict skin flap viability following lower extremity amputations (LEAs). METHODS: Experience with IFA using indocyanine green (ICG) dye was reviewed retrospectively at a single institution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#11
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29101423/risk-of-lower-limb-amputation-in-a-national-prevalent-cohort-of-patients-with-diabetes
#12
Jason K Gurney, James Stanley, Steve York, Dieter Rosenbaum, Diana Sarfati
AIMS/HYPOTHESIS: Lower limb amputation is a serious complication of diabetes mellitus. Understanding how amputation risk differs by population subgroups is crucial in terms of directing preventive strategies. In this study, we describe those factors that impact amputation risk in the entire prevalent diabetic population of New Zealand. METHODS: A national prevalent cohort of 217,207 individuals with diabetes in 2010 were followed up until the end of 2013 for lower limb amputations, and 2014 for mortality...
November 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/29082050/a-case-of-rituximab-induced-necrotizing-fasciitis-and-a-review-of-the-literature
#13
Abdullateef Abdulkareem, Ryan S D'Souza, Oluwaseun Shogbesan, Anthony Donato
Necrotizing fasciitis is a fulminant soft tissue infection characterized by rapid progression and high mortality. Rituximab is a generally well-tolerated immunosuppresive medication used for B-cell malignancies and some rheumatological disorders. We report a case of a 69-year-old male with chronic lymphocytic leukemia who suffered necrotizing fasciitis of his left lower extremity secondary to Clostridium septicum 7 weeks after treatment with rituximab. Despite immediate intravenous antimicrobial therapy and emergent fasciotomy with extensive debridement, his hospital course was complicated by septic shock and he required an above-the-knee amputation...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29079006/risk-factors-for-unplanned-readmission-and-stump-complications-after-major-lower-extremity-amputation
#14
John Phair, Charles DeCarlo, Larry Scher, Issam Koleilat, Saadat Shariff, Evan C Lipsitz, Karan Garg
OBJECTIVE: The unplanned 30-day readmission rate is a marker of quality of patient care across many disciplines. Data regarding risk factors for unplanned readmission after major lower extremity amputation (LEA) are limited. We evaluated predictors of readmission at our institution after major LEA. METHODS: We conducted a retrospective review of all patients undergoing above-knee amputation (AKA) or below-knee amputation (BKA) between November 2009 and November 2014...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29077505/rate-of-and-factors-associated-with-ambulation-after-unilateral-major-lower-limb-amputation-at-an-urban-us-tertiary-care-hospital-with-a-multidisciplinary-limb-salvage-team
#15
Laura E Sansosti, Amanda Crowell, Eric T Choi, Andrew J Meyr
BACKGROUND: One relatively universal functional goal after major lower-limb amputation is ambulation in a prosthesis. This retrospective, observational investigation sought to 1) determine what percentage of patients successfully walked in a prosthesis within 1 year after major limb amputation and 2) assess which patient factors might be associated with ambulation at an urban US tertiary-care hospital. METHODS: A retrospective medical record review was performed to identify consecutive patients undergoing major lower-limb amputation...
September 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29069141/intra-arterial-fibrinolysis-for-the-management-of-acute-ischemia-on-a-below-knee-amputation-stump-case-report
#16
Breno Boueri Affonso, Joaquim Maurício da Motta Leal, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion...
October 23, 2017: Einstein
https://www.readbyqxmd.com/read/29067429/association-of-prehospital-blood-product-transfusion-during-medical-evacuation-of-combat-casualties-in-afghanistan-with-acute-and-30-day-survival
#17
Stacy A Shackelford, Deborah J Del Junco, Nicole Powell-Dunford, Edward L Mazuchowski, Jeffrey T Howard, Russ S Kotwal, Jennifer Gurney, Frank K Butler, Kirby Gross, Zsolt T Stockinger
Importance: Prehospital blood product transfusion in trauma care remains controversial due to poor-quality evidence and cost. Sequential expansion of blood transfusion capability after 2012 to deployed military medical evacuation (MEDEVAC) units enabled a concurrent cohort study to focus on the timing as well as the location of the initial transfusion. Objective: To examine the association of prehospital transfusion and time to initial transfusion with injury survival...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29063607/spinal-or-general-anaesthesia-for-lower-limb-amputation-in-peripheral-artery-disease-a-retrospective-cohort-study
#18
M Niskakangas, S Dahlbacka, J Liisanantti, M Vakkala, T Kaakinen
BACKGROUND: The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post-operative analgesic requirements in patients undergoing major limb amputation for lower-limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high-risk patients despite abnormal coagulation profile or use of anticoagulation. METHODS: The study was a retrospective cohort study...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29062347/major-limb-amputations-in-a-tertiary-hospital-in-north-western-nigeria
#19
Chikwendu Nwosu, Misbau O Babalola, Muhammad H Ibrahim, Siyaka I Suleiman
BACKGROUND: Amputation is the removal of whole or part of a limb, often as a life saving measure. It is a mutilating surgical procedure altering the body image and producing severe functional deficit. It is a common orthopedic surgical procedure performed worldwide. AIMS AND OBJECTIVES: The aim of this study was to determine the pattern and indications for amputation in Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria; between January 2008 and December 2014, in a bid to proffer preventive measures...
June 2017: African Health Sciences
https://www.readbyqxmd.com/read/29032478/total-knee-arthroplasty-in-patients-with-a-history-of-illicit-intravenous-drug-abuse
#20
David E Bauer, Andreas Hingsammer, Lukas Ernstbrunner, Alexander Aichmair, Andrea B Rosskopf, Franziska Eckers, Karl Wieser, Sandro F Fucentese
PURPOSE: Injection drug users are at high risk for both infection with blood-borne pathogens, namely, human immune deficiency virus (HIV), hepatitis-B, -C virus, various bacterial infections, as well as early primary and secondary joint degeneration. When total knee arthroplasty (TKA) is anticipated the risk of septic complications is a major concern. The purpose of this study was to assess the clinical and radiographic outcome of patients with a history of intravenous drug use after total knee arthroplasty...
October 14, 2017: International Orthopaedics
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