In-office needle arthroscopic assessment after primary ACL repair. Short-term results in 15 patients

Purpose: In-office needle arthroscopy has been reported as a diagnostic tool for different knee pathologies. In addi- tion, ACL repair has seen a resurgence with the advent of innovative orthopedic devices. The aim of this study was to assess clinical, radiological, and in-office needle arthroscopic findings in 15 adult patients who underwent acute (within 14 days from injury) anterior cruciate ligament (ACL) repair. Methods: Fifteen patients voluntarily participated in the study. A second-look arthroscopy was performed with an in-office needle arthroscopy at an average of 7.2 months after the primary repair. The parameters included in the investigation were the continuity of the anatomical footprint of the repaired ACL, subjective assessment of the ACL tension with the probe, and synovial coverage of the ACL. All patients had a Magnetic Resonance Imaging (MRI) at 6 months after repair and an arthrometric evaluation with the KT-1000. Clinical evaluation with the scores, Tegner Lysholm Knee Scoring Scale (TLKSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) was performed at the final follow-up of 2 years. Moreover, a correlation between the characteristics of ACL appearance at the time of the second look in-office needle arthroscopy, MRI and KT-1000 was performed. Results: The mean TLKSS was 97.86, the mean KOOS was 98.08 and the mean subjective IKDC was 96.71. The objec- tive IKDC was A in 10 patients and B in 5 patients. ACL healing was graded as A in 11 patients and B in 4 patients. Synovial coverage was graded as good in 10 patients and fair in 5 while MRI assessment showed a type I ACL in 10 patients, type II in 4 patients and type III in 1 patient. Conclusion: In-office needle arthroscopy is a reliable tool to assess the condition of a repaired ACL. In addition, ACL repair performed in acute proximal tears demonstrated excellent clinical results

Midneb

Ġabra ta’ poeżiji u proża li tinkludi: Il-ħajja u jien ta’ Ġużè Chetcuti – Fil-palk tal-ħajja ta’ Ġużè Chetcuti – Għaliex tħobbni, Ġesù tiegħi? ta’ Dun Karm Farrugia – Għall-ordinazzjoni saċerdotali ta’ Dun Ġużepp Abela fil-Katidral ta’ St. Patrick Melbourne, Awstralja, f’għeluq il-festi ċentinarji ta’ San Pawl f’Malta 24 ta’ Lulju, 1960 ta’ K. Vassallo – Il-Milied it-tajjeb ta’ Ġużè Borg Pantalleresco – Met’inti tmutli ta’ Patri Valentin V. Barbara – Bla mitmum ta’ Karmenu Mallia – Baqa’ f’wiċċhom ta’ Joseph L. Pace – Midneb ta’ Patri A. M. Previ.peer-reviewe

The 3.3. MW-peal photovoltaic power station at Serre

Biblioteca Centrale CNR / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Definitions and clinical impact of revascularization completeness

The completeness of revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy. However, the clinical impact of CR is different in particular clinical subsets, such as diabetes, ST-segment elevation myocardial infarction, cardiogenic shock, ischemic heart failure. The CR is a desirable objective, but it is not mandatory and sometimes a reasonable incomplete revascularization (IR) offers comparable results. Clinical variables, including patient's age, life expectancy, the severity of symptoms at presentation, comorbidities (particularly diabetes mellitus), left ventricular function and myocardial viability, as well as coronary anatomy should be considered in the decision making whether to attempt CR or to follow a reasonable IR strategy, for both percutaneous coronary intervention and coronary artery bypass graft surgery, in patients with multivessel CAD

Impella: pumps overview and access site management

The Impella left ventricular support system consists of two main components: a family of different ventricular support catheters with a microaxial pump to be placed across the aortic valve and a single external controller which is connected to activate and control the pump function. Four Impella left ventricular support catheters are available: Impella 2.5, Impella CP, Impella 5.0 and Impella LD. Impella 2.5 and Impella CP are designed for percutaneous peripheral insertion, have respectively a 12F and 14F maximal diameter at the pump level and are capable of providing up to 2.5 and 4.1 liters per minute, respectively. Impella 5.0 and Impella LD have 21F maximal diameter at the pump level and are designed for surgical insertion through, respectively, a peripheral artery (femoral or axillary) or the aorta. The Impella CP or 5.0 are commonly selected for cardiogenic shock patients. The femoral approach represents the most adopted access site for percutaneous Impella insertion. Yet, it requires the presence of suitable aorto-iliac-femoral arterial axis for retrograde advancement of the Impella pump. The axillary artery is usually the main alternative approach for surgical insertion in the patients with unfavorable peripheral anatomy or for patients requiring prolonged assistance. When adopting Impella pumps, maximal attention should be paid to the access site management before, during and after cardiac assistance in order to minimize the risk of vascular complications