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Introduction: therapeutic equivalence has been established in the effectiveness of peripheral nerve blocks in the management of pain in the postoperative period of anterior cruciate ligament reconstruction. However, it is unknown whether this effect is modulated by the anesthesiologist's experience. The objective was to describe the effectiveness of peripheral nerve blocks during the first 24 hours of the postoperative period, considering patient characteristics and the anesthesiologist's experience., Material and Methods: a retrospective cohort study was conducted from 2015 to 2017. Patients who received a femoral canal block, femoral nerve block, or spinal anesthesia were included. All data were obtained from the patient's medical records, with pain assessed using a visual analog scale recorded in the medical records. A robust, non-parametric kernel regression model was generated to estimate the effect of the variables., Results: out of 480 clinical records, 168 were included in the analysis. The period of greatest pain was between eight and 12 hours, with a non-success rate of up to 22.9%. No differences were found between peripheral nerve blocks. The anesthesiologist's experience did not influence the analgesic effect, while the use of a bone-tendon-bone graft determined greater postoperative pain., Conclusion: in minimally invasive procedures, good pain management outcomes could be observed independently of the anesthesiologist's experience.

Background and aim Meniscal tears are often associated with articular surface damage, which could be an important factor in the clinical outcome. However, these concomitant lesions are usually reported as binary variables. Reports of the severity/extent of the concomitant lesions and stratification by meniscal tear are scarce in the literature; in addition, sample sizes of previous reports are limited. This study aimed to characterize meniscal lesions, determine the prevalence of articular surface lesions and their severity, and correlate these lesions with meniscal injury characteristics. Methods A cross-sectional study of patients undergoing meniscal surgery between 2017 and 2023 was conducted. Patient characteristics and arthroscopic findings on the location and type of meniscal injury as well as the degree of chondral lesion (sICRS score) were recorded by the surgeon. Statistical analysis included frequency reporting for patient characteristics and study variables, including the median and interquartile range of the sICRS classification of articular surface lesions. Meniscal tear types were categorized as degenerative or non-degenerative to explore associations with chondral injury. Chi-square test and univariate and multivariate logistic regression models were employed to analyze relationships between variables. Results A total of 758 surgeries were analyzed, with a mean age of 39.56 years (SD: 12.71) and 67.90% male participants. Medial meniscus injuries accounted for 57.52%, lateral meniscus 36.02%, and both menisci 6.64%. Significant differences were found in vascular area, topography, and lesion type between isolated medial and lateral meniscus lesions (p<0.01). Chondral lesions were present in 35.22% of cases, with significant differences among meniscal injury types (p<0.01). Degenerative tears showed higher rates of chondral damage compared to non-degenerative tears, particularly in lateral meniscus injuries (p<0.01). Regression analysis identified age, gender, meniscal injury characteristics, and meniscectomy percentage as risk factors for articular surface injuries. Conclusion Articular surface injuries frequently accompany meniscal lesions, with associations between affected menisci and articular damage extent. Femoral condyles show greater involvement corresponding to compartment-specific meniscal lesions, unlike tibial plateaus. Meniscal degeneration is present in about half of articular cartilage injury cases. Some meniscal tear types may relate to more severe articular lesions, but larger studies are needed to confirm these findings and explore other tear patterns., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Clínica Indisa Scientific Ethical Committee issued approval #0012021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Valderrama et al.)

Objectives: This study aims to synthesize health state utility values (HSUVs) of type 2 diabetes mellitus (T2DM) and its related complications published in the literature, conducting a meta-analysis of the data when possible., Methods: We conducted a systematic search in MEDLINE and School of Health and Related Research Health Utilities Database repository. Studies focused on T2DM and its complications reporting utility values elicited using direct and indirect methods were selected. We categorized the results according to the instrument to describe health and meta-analyzed them accordingly. Data included in the analysis were pooled in a fixed-effect model by the inverse of variance mean and random-effects DerSimonian-Laird method. Two approaches on sensitivity analysis were performed: leave-one-out method and including data of HSUVs obtained by foreign population value sets., Results: We identified 70 studies for the meta-analysis from a total of 467 studies. Sufficient data to pool T2DM HSUVs from EQ-5D instrument, hypoglycemia, and stroke were obtained. HSUVs varied from 0.7 to 0.92 in direct valuations, and the pooled mean of 3-level version of EQ-5D studies was 0.772 (95% confidence interval 0.763-0.78) and of 5-level version of EQ-5D 0.815 (95% confidence interval 0.808-0.823). HSUVs of complications varied from 0.739 to 0.843, or reductions of HSUVs between -0.014 and -0.094. In general, HSUVs obtained from 3-level version of EQ-5D and Health Utility Index 3 instruments were lower than those directly elicited. A considerable amount of heterogeneity was observed. Some complications remained unable to be pooled due to scarce of original articles., Conclusions: T2DM and its complications have a considerable impact on health-related quality of life. 5-level version of EQ-5D estimates seems comparable with direct elicited HSUVs., (Copyright © 2022 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)