Analysis of potential contamination factors in musculoskeletal tissues.

Tissue Banks have become the main source for bone grafts, due to preference for homologous tissues. Notwithstanding the use of aseptic techniques for procurement of tissues and judicious selection of donors, microorganisms are frequently found in procured bones. Purpose of this study is to evaluate the factors that increase safety of procurement and minimize discard of procured tissues. Microbiological contamination was analyzed in 1271 musculoskeletal tissues removed from 138 multi-organ donors over a period extending from 2006 to 2016. Effects of various risk factors related with contamination were estimated using a logistic regression model. Microbiological contamination rate in the tissues was 17.1%; low pathogenic microorganisms were cultivated in 12.9% of the tissues, while highly pathogenic ones were cultivated in 4.2% of the tissues. Evolution of one single team was monitored during that period, verifying a fall in the general contamination level from 22.5 to 9.2%. Absence of antibiotics increased low pathogenic contamination risk. Every additional day in intensive care unit (ICU) increased the risk of highly pathogenic contamination. Time elapsed between death and the beginning of removal procedures was found to be relevant for both low pathogenic and highly pathogenic microorganisms. Among the studied factors, the following contributed for a significant increase in contamination by microorganisms in removed tissues: lack of use of prophylactic antibiotic therapy in donors, quantity of removed tissues, length of admission in ICU and the time elapsed between aortic clamping and beginning of the removal procedure.

Arthroscopic treatment of femoroacetabular impingement: minimum five-year follow-up.

PURPOSE: To evaluate the clinical outcomes of an arthroscopic treatment of femoroacetabular impingement at a minimum of a five-year follow-up. METHODS: A case series with 24 subjects (26 hips) was conducted. Subjects that were submitted to an arthroscopic procedure for the treatment of femoroacetabular impingement, at a minimum of five years, were evaluated. Subjects completed the modified Harris Hip Score (mHHS), the pain numeric rating scale and a general questionnaire accessing sports practice and satisfaction. RESULTS: Twenty-one of the 24 subjects (87.5%) were male and the average age at the time of surgery was 34.6 ± 9.5 years old (range 13-51). Of the 27 subjects submitted to hip arthroscopy, three (11.1%) could not be contacted. Follow-up was 6.1 ± 0.8 years, and at this time the average mHHS was 90.6 ± 11.6. Pain numeric rating scale was 2.6 ± 1.9 and 11 hips (42.3%) reported no pain. Of the 14 subjects that complained of hip pain during sports activities prior to surgery, 10 (71.4%) returned to normal sports activities while four (28.6%) subjects could not return to preoperative activities. Three patients had to be submitted to a new surgical procedure. All 24 subjects were satisfied with their procedure and would repeat it if necessary. CONCLUSIONS: Arthroscopic treatment of femoroacetabular impingement, at five years follow-up, revealed good results in terms of improved function, pain relief and satisfaction.

ARTHROSCOPIC TREATMENT OF FEMOROACETABULAR IMPINGEMENT.

OBJECTIVE: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable. METHODS: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy. The mean age was 34 years, with mean follow-up period of 27 months. Clinical results were graded with the modified Harris hip score, which was measured pre- and postoperatively. Patients had also their internal rotation analyzed. These parameters were calculated by using Wilcoxon's t test for analysis of nonparametric paired samples performed. RESULTS: The mean preoperative Harris Hip Score was 54.2, improving to 94.8 postoperatively (p<0,001). The mean increase was 37.5 points. We had 4 good results (15%) and 24 excellent results (85%). Preoperatively, the patients had a mean internal rotation of 17°, and, postoperatively, 36°. The average internal rotation increase was 19° (p<0,001). CONCLUSIONS: The arthroscopic treatment of femoroacetabular impingement presents satisfactory results.

Tratamento artroscópico do impacto femoroacetabular / Arthroscopic treatment of femoroacetabular impingement

OBJETIVOS: O propósito deste estudo é avaliar os resultados em curto prazo do tratamento artroscópico do impacto femoroacetabular. A hipótese é a de que os resultados do tratamento artroscópico são favoráveis. MÉTODOS: Entre agosto de 2003 e agosto de 2007, 28 quadris foram submetidos ao tratamento do impacto femoroacetabular pela via artroscópica. A idade média dos pacientes foi de 34 anos, com média de seguimento de 27 meses. Quanto à melhora clínica, os pacientes foram avaliados pré e pósoperatoriamente pelo Harris Hip Score (HHS) modificado por Byrd. Os pacientes foram avaliados pré e pós-operatoriamente em relação à rotação interna do quadril acometido. Os valores obtidos nos índices acima foram analisados estatisticamente através do método de Wilcoxon para a avaliação de variáveis não paramétricas. RESULTADOS: O Harris Hip Score médio pré-operatório foi de 54,2 e o pós-operatório, de 94,8 (p < 0,001). O aumento médio do HHS foi de 37,5 pontos. Houve quatro resultados bons (15 por cento) e 24 excelentes (85 por cento). Pré-operatoriamente os pacientes apresentavam rotação interna do quadril média de 17º e pós-operatoriamente, de 36º. O aumento médio de rotação interna foi de 19º (p < 0,001). CONCLUSÃO: O tratamento artroscópico do impacto femoroacetabular tem resultados satisfatórios.

OBJECTIVE: The purpose of this study is to evaluate the short-term follow-up results of arthroscopic treatment of femoroacetabular impingement. Our hypothesis is that arthroscopic treatment results are favorable. METHODS: Between August 2003 and August 2007, 28 hips had femoroacetabular impingement treated by hip arthroscopy. The mean age was 34 years, with mean follow-up period of 27 months. Clinical results were graded with the modified Harris hip score, which was measured pre-and postoperatively. Patients had also their internal rotation analyzed. These parameters were calculated by using Wilcoxon's t test for analysis of nonparametric paired samples performed. RESULTS: The mean preoperative Harris Hip Score was 54.2, improving to 94.8 postoperatively (p<0,001). The mean increase was 37.5 points. We had 4 good results (15 percent) and 24 excellent results (85 percent). Preoperatively, the patients had a mean internal rotation of 17º, and, postoperatively, 36º. The average internal rotation increase was 19º (p<0,001). CONCLUSIONS: The arthroscopic treatment of femoroacetabular impingement presents satisfactory results.