The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2010
Intermediate to long-term results following the bernese periacetabular osteotomy and predictors of clinical outcome: surgical technique.
The Bernese periacetabular osteotomy is a commonly used non-arthroplasty option to treat developmental hip dysplasia in symptomatic younger patients. Predicting which hips will remain preserved and which hips will go on to require arthroplasty following periacetabular osteotomy is a major challenge. In the present study, we assessed the intermediate to long-term results following periacetabular osteotomy to demonstrate the clinical outcomes for patients with varying amounts of dysplasia and arthritis. From these results, a probability-of-failure analysis was conducted to predict the likelihood of hip preservation and to improve surgical decision-making. ⋯ The Bernese periacetabular osteotomy can be effective for the treatment of painful hip dysplasia, but complications may be expected in as many as 15% of cases. The ideal candidate is the patient who is less than thirty-five years of age and who has good or excellent hip joint congruency.
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J Bone Joint Surg Am · Sep 2010
Commercial liquid bags as a potential source of venous air embolism in shoulder arthroscopy.
Venous air embolism is a rare but potentially fatal complication of arthroscopy. Fatal venous air embolism has been reported with as little as 100 mL of air entering the venous system. During liquid-only arthroscopy, avenues for air introduction into the joint are limited. Therefore, we hypothesized that commercially prepared 3-L saline-solution bags are a source of potentially fatal amounts of gas that can be introduced into the joint by arthroscopic pumps. ⋯ Because a saline-solution arthroscopic pump is theoretically a closed system, venous air embolism has not been a concern. However, this study shows that it is possible to pump a fatal amount of air from 3-L saline-solution bags into an environment susceptible to the creation of emboli. Evacuation of air from the 3-L bags prior to use may eliminate this risk.