Response/Recommendation: Infection following anterior cruciate ligament reconstruction (ACLR) is not a surgical emergency in most cases. Timely urgent surgical treatment is essential, but timing itself is not clearly defined in the literature for treatment of infection following ACLR. Most authors do agree that surgical intervention should take place without delay, on a prompt basis, or on the same day as the clinical presentation of an ACLR infection.
A protocol for patient optimization prior to surgery has not been clearly established. Optimization of information leading to surgery is important to assist in the surgical treatment. Clinical examination and aspiration of the knee joint is recognized as the first step in diagnosis at initial patient presentation with a suspected post-operative ACLR infection. It is also generally reported that broad-spectrum antibiotics, preferably cephalosporins should be started as soon as possible after aspirations are taken. Antibiotic therapy should be modified as soon as culture results identify the pathogen. Blood tests for infectious and inflammatory markers
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state that the surgery should be performed on the day of admission.19 Mouzopoulos et al. state that the infection should be treated without delay.20 Wang et al. report a summary of various authors by stating a recommendation for immediate operative treatment.21 Torres et al. also report that the generally accepted treatment is “arthroscopic lavage, performed as soon as possible”.22 It is known that articular cartilage degrades and loses nearly half of its glycosaminoglycan and collagen composition in the first week of a joint infection23,24. Therefore, a significant delay should not be experienced in the initiation of surgical
When discussing the concept of contract law, there exist two bodies of legal rules that may apply to the contract. These bodies are the common law of contracts and Article 2 of the Uniform Commercial Code or the UCC. The common law of contracts is court made and is constantly changing, but the UCC is required in every state within the U.S.A. It is important to know which one to use and when, as well as what the differences between them are.
The incidence and prevalence rate of anterior cruciate ligament (ACL) injuries in female athletes continues to increase over time (Prodromos, Han, Rogowski, Joyce, & Shi, 2007). With the growing rate in the amount of young women participating in sports, data has shown that the rate of ACL injury increases linearly with this participation ("The Relationship Between Static Posture and ACL Injury in Female Athletes," 1996). This epidemic of ACL injuries in female athletes, young or old, continues to be problematic in the athletic world. This problem not only affects the athlete themselves, but also the coaches and the sports medicine community.
The anterior cruciate ligament (ACL) is one of the most important of your four major knee ligaments. The function of the ACL is to provide stability to the knee and minimize stress across the knee joint. It restrains excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur). It also limits rotational movements of the knee. “Greater external knee valgus and internal rotation moments have been shown to increase loading on the ACL in vitro and are thought to be associated with the increased risk of noncontact ACL injury” (Effects 2011). A tear to the anterior cruciate ligament results from overstretching of this ligament within the knee. It’s usually due to a sudden stop and twisting motion of the knee, or a “...
In order for athletes to save their active lifestyles they need understand the ACL. The ACL is the most important ligament in the knee because it provides stability to the knee. Athletes have to be aware of the importance of the ACL and know its functions in order to preserve the ligament. The ACL otherwise know as the anterior cruciate ligament is the ligament in the knee that connects the upper leg bone which is the femur to the lower leg bone which is the tibia. The anterior cruciate ligament crosses with the posterior cruciate ligament inside the center of the knee joint to stabilize to the knee in movement.
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
In November of 2010, I was playing basketball in the fifth game of my senior season. It was just like any other game. However, I would soon find out otherwise. It was late in the game; I drove into the lane and got fouled hard. I was knocked so off-balance that I speared the floor with my knee. As soon as my knee hit the floor I heard a “snap” that I will never forget for the rest of my life. Little did I know at the time, that would be the last shot of my high school basketball career. Not long after my injury, I consulted a doctor. After getting an x-ray and an MRI, the doctor informed me that I had completely torn my ACL and would need to have surgery. An ACL tear can be a very devastating injury. The anterior cruciate ligament (ACL) is one of the four major ligaments within the knee. The ACL is one of the most commonly injured ligaments, injured by an estimated 200,000 patients each year. Of the 200,000 annual ACL injuries, surgery is performed in approximately 100,000 cases. There are many types of reconstructive surgery on the ACL. However, there is an alternative to surgery in the form of physical therapy.
The Anterior Cruciate Ligament (ACL) attaches the femur, which is the thighbone, and the tibia, which is the shin, together (northstar). A torn ACL is one of the most excruciating experiences in an athlete’s life. It is the first thing that comes to mind when they hurt their knee on the field; for many it is their greatest fear. A torn ACL can sometimes mean the end of an athlete’s career. It can mean losing the chance to get that scholarship for young athletes, and it can also mean the end of those million dollar paychecks for those who have gone professional. A torn ACL can result in numerous surgeries, months of vigorous exercise and rehabilitation, and a sufficient amount of pain. It requires complete patience, for pushing too hard can result in further, more painful injury. Even after all that, an athlete is not guaranteed he or she will ever be able to play sports again.
If tenosynovitis is caused by infection, treatment may include antibiotic medicine given through an IV. In some cases, surgery may be needed to drain fluid from the tendon sheath or remove the tendon sheath.
...Havelin, L., Furnes, O., Overgaad, S., & Engesaeter, L. (2012). Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthopaedica, 83(5), 449-458.
Osteoarthritis is a degenerative joint condition that primarily affects the hands, spine and the ankles and hips. It is known to be associated with aging, and is concerned with the cartilage that protects the joints (the meeting place of two bones). Normal cartilage allows for bones to slide over each other uniformly, acting as a shock absorber to any damage. However cartilage in osteoarthritis, located at the ends of the bones erodes and deteriorates, causing friction and hence pain, swelling and restricted movement. Therefore in osteoarthritic both the composition and appearance of the cartilage alters, while the body attempts to repair this damaged cartilage is broken down faster than it can be built up. A defective repair process can cause bone overgrowth, bone spur/osteocytes to form which can be seen at the ends of the joints. In osteoarthritis the bones come in close contact with each other, and wear away leaving the bone exposed and unprotected.
Osteoarthritis (OA) is the most common form of arthritis, affecting more than 27 million Americans (LeMone, Burke, Bauldoff, 2011). It is caused when the cartilage in the joints breaks down, causing the bones of the joint to rub against one another. This causes pain, stiffness, and loss of motion in the joint. Osteoarthritis is most prevalent in those 65 and older, but can affect those of any age. In addition, African Americans and Hispanics report a higher incidence of arthritis than Caucasians (LeMone, Burke, Bauldoff, 2011). Although the cause is unknown, it is believed that the increasing age of the population, prevalence of obesity and injuries add to the progression of the condition. Osteoarthritis can affect any joint in the body; however, those of the hand, hip, and knee are often the most common. This condition may be asymptomatic, or may present symptoms including soreness, stiffness and pain. The symptoms are more common in the older population, those with limited activity levels, and those who are obese. Joint cartilage thins over time, causing an increased risk for symptoms in the elderly, and obesity puts extra pressure on the joints during activity. Osteoarthritis is commonly diagnosed with the use of a physical assessment along with results of radiology testing such as X-Ray and MRI.
The majority of ACL injuries suffered during athletic participation are of the noncontact variety. Three main noncontact mechanisms have been identified planting and cutting, straight-knee landing and one-step stop landing with the knee hyperextended. Pivoting and sudden deceleration are also common mechanisms of noncontact ACL injury. Basketball, soccer, and volleyball consistently produce some of the highest ACL injury rates across various age groups. Other activities with a high rate of injury are gymnastics, martial arts, and running. In most sports, injuries occur more often in games than in practice. Many injuries have occurred during the first 30 minutes of play. One-reason physicians are seeing more ACL injuries in female patients that more women play sports, and they play more intensely. But as they continued to do more studies, they are finding that women's higher rate of ACL is probably due ...
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
A 16-year-old, female high school soccer player, Lindsey Robinson, tore her anterior cruciate ligament (ACL) during a soccer game. Interestingly, she was not the only one in her team who injured her ACL, but several of her teammates have torn the same ligament as well during the soccer season. Lephart (2002) found that women involved in physical activity are more susceptible to acquiring the ACL injuries than men who are involved in the same physical activity (as cited in Ogden, 2002). According to “ACL Injury Prevention” (2004), the numbers of female ACL ruptures have increased for the past ten years. Over 1.4 million women have suffered from the ACL rupture, which is twice the rate of the previous decade.
Orthopedic surgeons are responsible for mending and operating on the musculoskeletal system. “Orthopedics is a medical specialty that focuses on the diagnosis, care, and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin” (Career in Orthopaedics). Depending on the damage the patient has sustained determines how the orthopedic surgeon is able to correct the patient’s injury. In many cases there are multiple ways of correcting the patient’s injury such as; using medical, physical, and rehabilitative techniques to using complex surgical methods. “Typically, as much as 50 percent of the orthopedic surgeon’s practice is devoted to no surgical or medical management of injuries or disease and 50 percent to surgical management” (Career in Orthopaedics). The majority of surgeons, including orthopedic surgeons, prefer to choose the least invasive procedures such as; arthroscopy which is a technological advancement allowing orthopedic surgeons to use special cameras in order to diagnose and treat a joint with minimal cutting and trauma to...