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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Expanding its angioplasty product portfolio, Medtronic, Inc. (NYSE: MDT), announced today the U.S. market launch of the Sprinter Legend (semicompliant) and the NC Sprinter (noncompliant) balloon dilatation catheters on a rapid exchange delivery system. Recently approved by the U.S.

 

In a development that researchers say is likely to quell concerns about the value of costly computed tomography (CT) scans to diagnose coronary artery blockages, an international team led by researchers at Johns Hopkins reports solid evidence that the newer, more powerful 64-CT scans can easily and correctly identify people with major blood vessel disease and is nearly as accurate as invasive coronary angiography. Reporting in the New England Journal of Medicine online Nov.

 

Mentice proudly announces the launch of two new products for endovascular simulation training - the Mentice VIST 7.7 enhanced training modules for Carotid and Coronary interventions. New features such as vital signs, complications, medication management and measurement functionality add to the clinical realism and enhance the educational value of simulation training.

 

Sorin Group, (MIL:SRN), a global company and a leader in the treatment of cardiovascular diseases, announced today the commercial market release and first implant of its new-generation PARADYM™ CRT 8750 cardiac resynchronization therapy defibrillator (CRT-D). Together with the new SITUS™ BW 28D left ventricle pacing lead and lead delivery system, PARADYM CRT forms a complete new CRT system for heart failure (HF) patients.

 

Ventricular assist devices, or VADs - surgically-placed mechanical pumps that can support failing hearts or buy time to transplant - are associated with high hospital costs and high rates of early death among Medicare recipients, say researchers at Duke University Medical Center. Their study, appearing in the November 26 issue of the Journal of the American Medical Association, found that only half of all patients who received a VAD were alive one year later.

 

As presented by Frank J. Criado, M.D., Chief of Vascular Surgery and Endovascular Intervention and Vascular Surtery at the Union Memorial Hospital - MedStar Health in Baltimore, Maryland, CAS represents undoubtedly a significant advancement and one that will clearly have a role in the management of patients with carotid artery stenosis. The extent of that role, however, remains somewhat unclear at present.

 

Thomas O. McNamara, M.D., Professor of Radiological Sciences at the UCLA Medical Center, Member of the Section of Vascular Interventional Radiology, and a full-time faculty member of the UCLA School of Medicine, reported at the VEITHsymposium that cryoplasty therapy is a safe and effective method of treating advanced below the knee lesions with marked critical limb ischemia (CLI), yielding excellent acute outcomes and a high rate of limb salvage at both 6 and 12 months.

 

First aiders and users of Medtronic Physio-Control LIFEPAK CR Plus automatic external defibrillators (AED) are being told today to test their device by the Medicines and Healthcare products Regulatory Agency (MHRA) following advice from the manufacturer over concerns that the defibrillator could fail to turn on and work due to a faulty internal cable.

 

The use of remote pressure sensors can eliminate the risks associated with cross-sectional imaging, while still ensuring appropriate exclusion after the residual aneurysm sac after endovascular aortic repair (EVAR). The issue in one of the many heated debates at the VEITHsymposum, was the value of pressure sensing in detecting which abdominal aortic aneurysms (AAA) are excluded long-term.

 

Iliac injury may be the most frequent fatal complication with endovascular stent graft therapy, and associated hypotension can precipitate neurologic complications. Strategies have been developed to predict, prevent, and manage these problems. Jon S. Matsumura, M.D.




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