Tag: arthroscopic surgery

Categories : Paediatrics Surgeries & ProceduresTags :

Younger Children at Greater Risk for a Postoperative Knee Surgery Complication

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Discoid lateral meniscus and osteochondritis dissecans in adolescent patients. The black arrow represents DLM and the white arrow represents osteochondritis dissecans. Credit: Osaka Metropolitan University

New research published in Knee Surgery, Sports Traumatology, Arthroscopy has shown that younger age is associated with increased risk of osteochondritis dissecans, a serious complication arising from surgery to correct misshapen knee cartilage.

Growing pains are common in maturing children, but sometimes this growth can be irregular and cause injury. Discoid lateral meniscus (DLM), a misshapen knee cartilage, is one such occurrence that can degenerate into osteochondritis dissecans, a joint disorder where the bone and joint begin to separate from the rest of the bones. It has been reported that osteochondritis dissecans of the femoral condyle occurs in approximately 14.5% of cases of DLM, but there has been little analysis of its treatment to date.

Dr Ken Iida and Specially Appointed Professor Yusuke Hashimoto’s team at Osaka Metropolitan University’s Graduate School of Medicine analysed the incidence of post-surgery osteochondritis dissecans. This analysis consisted of two groups, a pre-osteochondritis group with DLM and osteochondritis dissecans of the outer femoral epicondyle, and a non-osteochondritis dissecans DLM group. They studied 95 cases of DLM patients under the age of 15 who underwent surgery between 2003 and 2017 and had five years of post-surgery records. There were 15 cases in the pre-osteochondritis dissecans group and 80 non-osteochondritis dissecans cases.

Their analysis found that the surgical results for osteochondritis dissecans were good in pre-osteochondritis cases, but 28.5% had a recurrence of the joint disorder. In the non-osteochondritis dissecans group, 8.8% were diagnosed with the disorder after surgery. Additionally, age was found to be a risk factor for relapse or post-surgical osteochondritis dissecans, and surgery on patients ages 9 and under was also involved in the occurrence of osteochondritis dissecans.

“Patients with DLM accompanied by osteochondritis dissecans of the femoral condyle often have difficulty in deciding on a treatment method,” Dr Iida explained. “Based on the results of this study, we believe for patients ages 9 years or younger, it is necessary to consider conservative treatment methods rather than immediate surgery.”

Source: Osaka Metropolitan University

Categories : Medical Research & TechnologyTags :

Telemedicine Is as Satisfactory as In-person Follow-Up for Knee Surgery

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Following arthroscopic knee surgery, patients are as satisfied with telemedicine follow-ups as they are with in-person follow-up, according to a new study published in The Journal of Bone & Joint Surgery.

“Patient satisfaction with overall care is equivalent between telemedicine and office-based follow-up after an arthroscopic meniscal surgical procedure in the immediate postoperative period,” wrote Christina P Herrero, MD, and colleagues of NYU Langone Health.

The study recruited 122 patients who underwent arthroscopic surgery on the meniscus in the knee, which is one of the most common orthopaedic surgical procedures. Of these patients, 88% had a removal of the meniscus (meniscectomy), with the rest undergoing meniscal repair procedures.
Patients were randomly assigned to either office-based or telemedicine follow-up, scheduled for 5 to 14 days postoperatively. During both types of follow-up visits, the surgeon spoke to the patient about the surgical findings, pain the patient might be experiencing, and the postoperative recovery period, as well as performing a physical examination that included range-of-motion testing.

The telemedicine follow-ups were performed using the patient’s home computer or mobile device via a telemedicine program that was compliant with privacy rules. Surgeons of course were unable to physically feel or touch the knee during telemedicine follow-ups. However they could still conduct a visual assessment of wound healing, drainage, and swelling. 

Overall satisfaction ratings were nearly identical between groups. The surveys showed average patient satisfaction scores (on a 0-to-10 scale) were 9.77 in office-based follow-up and 9.79 for telemedicine follow-up. In both groups, only about 20% of patients said they would have preferred the other type of visit. There was also similar improvement observed in pain scores between groups: from about 5 (out of a maximum of 10) on the day of the surgery to 3 at the follow-up visit.

Telemedicine has become all the more crucial in the COVID pandemic to minimise contact, but the levels of satisfaction shown indicate that it may be a promising standard mode of care in the future, especially for cases where access to physical follow-up consultation may be difficult for the patients. 

“Telemedicine may be a reasonable alternative to office-based follow-up after knee arthroscopy,” Dr Herrero and coauthors concluded. “[Our] study only evaluated the first postoperative visit, but future studies may benefit from expanding the use of telemedicine to longer-term follow-ups or to additional surgical procedures.”

Source: News-Medical.Net

Journal information: Herrero, C. P., et al. (2021) Patient Satisfaction Is Equivalent Using Telemedicine Versus Office-Based Follow-up After Arthroscopic Meniscal Surgery. The Journal of Bone & Joint Surgery. doi.org/10.2106/JBJS.20.01413.