RESUMO
The Technical Note aims to present an arthroscopic capsular closure technique at the end of the hip arthroscopy. The technology employs a dual-channel approach and modified shoelace suture technique to continuously suture the hip capsule. Recent studies have indicated that routine intraoperative repair of the articular capsule at the end of the hip arthroscopy is advocated. However, the majority of the hip capsular closure techniques are relatively complex, time-consuming, and bring many complications, which has hindered their widespread use in clinical practice. Herein, we provide an arthroscopic capsular closure technique using the modified shoelace continuous suture in combination with a dual cannula for correcting hip instability during hip arthroscopic surgery of femoroacetabular impingement.
RESUMO
A rare case of coronary artery involvement in a child with Systemic Juvenile Idiopathic Arthritis (sJIA) complicated by Macrophage Activation Syndrome (MAS) is reported. The patient initially received an inaccurate diagnosis of Kawasaki Disease, sepsis, and mycoplasma infection and showed no improvement after Intravenous Immune Globulin (IVIG) treatment. Upon admission, symptoms included diffuse red rash, swelling of the limbs, lymph node enlargement, and hepatosplenomegaly. Post investigations, a diagnosis of sJIA and MAS was confirmed, and treatment involved a combination of hormones (methylprednisolone) and immunosuppressive drugs (methotrexate). The revealed widened coronary artery diameter was managed with a disease-specific treatment plan and prophylactic plus low-dose aspirin anti-coagulation therapy. Under this management, MAS was well controlled, and follow-ups showed normalization of the child's coronary artery structure and function. This case and the associated literature review underscore the importance of early recognition, diagnosis, treatment, and long-term monitoring for children presenting with sJIA and MAS complicated by coronary artery involvement.
