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Soft Tissue Injuries Associated with Proximal Tibia Fractures

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Vol. 11 | Issue 1 | January-February 2023 | Page: 13-16 | Lakshith B R, Adarsh U Tuppad, Shashiraj K Shetty, Edward L Nazareth, Kumar Mihir

DOI: https://doi.org/10.13107/jkoa.2023.v11i01.058

Authors: Lakshith B R [1], Adarsh U Tuppad [1], Shashiraj K Shetty [1], Edward L Nazareth [1], Kumar Mihir [1]

[1] Department of Orthopaedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India.

Address of Correspondence

Dr. Lakshith B R
Junior Resident, Department of Orthopaedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India.
E-mail: lakshithgowdajo3014@gmail.com

 

Abstract

The purpose of this study was to document the pattern of ligament and meniscal injuries that occur with proximal tibia fractures due to high energy trauma. Seventy patients with fractures of proximal tibia due to high-energy mechanisms were evaluated with magnetic resonance imaging (MRI) of the knee. All studies were reported by a single musculoskeletal radiologist who was blinded to surgical and physical findings. Of the 70 patients, there were 42 patients with AO/OTA type 41B2 (60%) fractures. On average, 70 % sustained a complete tear or avulsion of one or both cruciates.70% sustained collateral ligament injury.91% had lateral meniscal pathology.40% had medial meniscus tears. Of the 70 patients, 42 patients (60%) had Schatzker type II injuries, in which 90% had lateral meniscus tear, 80% MCL and ACL tear, 66% PCL and LCL tear. We adopted chi-square test to find the association. In our study, we found that there is a significant association between footprint avulsion of PCL and lateral meniscus (p value-0.038), between partial tear of LCL and lateral meniscus (p value-0.048), between partial tear of ACL and medial meniscus (p value-0.023). Also there is a significant association between complete tear of ACL and medial meniscus (p value- 0.019), between partial tear of PCL and medial meniscus (p value-0.007). But there is no significant association between ACL, PCL, MCL, LCL and Schatzker type (p value >0.05). We conclude MRI scanning should be considered for proximal tibia fractures due to high energy mechanism, which would help to identify and treat of associated soft tissue injuries.
Keywords: Soft tissue injury, Proximal tibia fracture, Magnetic resonance imaging, ACL, PCL, LCL, MCL, Medial meniscus and lateral meniscus.

References

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How to Cite this article:  Lakshith BR, Tuppad AU, Shetty SK, Nazareth EL, Mihir K | Soft Tissue Injuries Associated with Proximal Tibia Fractures | Journal of Karnataka Orthopaedic Association | January-February 2023; 11(1): 13-16 | https://doi.org/10.13107/jkoa.2023.v11i01.058

 

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Management of Infection Following Arthroscopic Anterior Cruciate Ligament Reconstruction

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Volume 6 | Issue 1 | Jan-April 2018 | Page 23-27 |  P Anoop, Mathew David, M. Madan Mohan, Rajkumar S Amaravati

Authors: P Anoop [1], Mathew David [1], M. Madan Mohan [1], Rajkumar S Amaravati [1]

[1]Department of Orthopaedics, Division of Arthroscopy & Sports Surgery, St. John’s Medical College, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. P Anoop
Department of Orthopaedics, St. John’s Medical College,
Bengaluru – 560 034, Karnataka, India.
E-mail: dranoopp07@gmail.com

Abstract

Aim: The purpose of this case series is to summarize our experience in the diagnosis and management of septic arthritis after anterior cruciate ligament (ACL) reconstruction. Infection after arthroscopic ACL reconstruction (AACLR) is a relatively rare but potentially a serious complication.
Settings and Design: Case series, prospective study.
Materials and Methods: We present a series of four cases who presented with septic arthritis following AACLR. After initial evaluation and intravenous antibiotics, the patients were subjected to early arthroscopic wash, debridement and graft retention, and antibiotics for 6 weeks. Postoperative rehabilitation protocol was followed and the patients were reviewed for a period of 2 years. Functional evaluation was done and the patients were found to have good to satisfactory results with no complaints of instability.
Statistical Analysis Used: Functional outcome measured with Tegner and Lyshlom scores, IKDC, KOOS score, and X-ray.
Results: At 2-year follow-up, patients had good functional outcome measured with Tegner and Lyshlom scores, KOOS, IKDC scores, and with no evidence of instability.
Conclusion: Infection post-arthroscopic anterior cruciate ligament reconstruction (AACLR) is a relatively rare but potentially devastating complication, early diagnosis in infection following AACLR and prompt treatment is necessary. Diagnosis relies on clinical evaluation, laboratory tests, synovial fluid analysis, and bacterial culture. Our proposed treatment protocol is arthroscopic debridement and irrigation as early as possible with retention of the graft.
Keywords: Septic Arthritis, Knee Arthroscopy, ACL, Management

References

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How to Cite this article: Anoop P, Mathew D, Mohan MM, Amaravati RS. Management of Infection Following Arthroscopic Anterior Cruciate Ligament Reconstruction. J Kar Orth Assoc. Jan-April 2018; 6(1): 23-27.

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