Analysis of Synovial Fluid Metabolic Profile in Patients with Knee Osteoarthritis Using Spectroscopic Magnetic Resonance Metabolomics.

 The present study aimed to evaluate the metabolic profile of synovial fluid in patients with knee osteoarthritis (KOA) and its correlation with clinical data.  We collected synovial fluid samples from the knees of 50 subjects with KOA undergoing total knee arthroplasty from October 2019 to December 2020. For each patient, we evaluated the clinical data from the medical record, the radiographic osteoarthritis grade, and the preoperative fasting blood glucose levels.

Arthroscopy With Adipose-Derived Stromal Vascular Fraction Using a Selective Tissue Engineering Photo-Stimulation Technique for the Treatment of Mild to Moderate Knee Osteoarthritis.

Osteoarthritis (OA) is characterized by articular cartilage degeneration, synovial inflammation, and subchondral bone thickening, affecting the synovial joint as an organ and leading to pain and disability. Subcutaneous stromal vascular fraction is safe and relieves pain, improves function, and repairs cartilage defects in patients with knee OA. Our goal is to describe step-by-step the arthroscopic treatment of mild to moderate knee OA with photo-stimulated stromal vascular fraction harvested from the thigh using a selective tissue engineering photo-stimulation ("One S.

Equal rates of bone healing and reduced surgical time with iliac crest allograft compared to autograft in medial opening wedge high tibial osteotomy: a randomized controlled clinical trial.

Introduction: Iliac crest autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures.

The optimized tourniquet versus no tourniquet in total knee arthroplasty. Analysis of muscle injury, functional recovery, and knee strength.

Background: Tourniquet is widely used in total knee replacement surgery because it reduces intraoperative hemorrhage and provides a comfortable surgical area for the surgeon. It's possible that its use could lead to impaired postoperative functional and motor recovery, as well as local and systemic complications. Our goal was to compare the outcomes of total knee replacement without ischemia using an optimized protocol, consisting of tourniquet inflation before skin incision and deflation after cementing, with a pressure of one hundred millimeters above systolic blood pressure and without postoperative articular suction drains.

Treatment of Chondral Lesions in the Knee.

Articular cartilage injuries are common and lead to early joint deterioration and osteoarthritis. Articular cartilage repair techniques aim at forming a cartilaginous neo-tissue to support the articular load and prevent progressive degeneration. Several techniques are available for this purpose, such as microfracture and chondrocyte transplantation.

Predictive and protective factors for allogenic blood transfusion in total knee arthroplasty. A retrospective cohort study.

Background: This study aimed to identify the predictive and protective factors of blood transfusion in patients undergoing total knee arthroplasty (TKA) and therefore determine the profile of patients with low and high risk of blood transfusion after arthroplasty.

Methods: We conducted a retrospective study with all patients who underwent primary TKA between January 2017 and December 2019 (n = 1.028 patients) in our institution.

Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis - a cross-sectional study.

Objective: This study aimed to compare the functional performance among participants with a neuropathic-like symptoms (NS) and central sensitization related signs and symptoms (CS), and their knee osteoarthritis (OA) counterparts.

Methods: A cross-sectional observational study was conducted with 125 participants with knee OA (94 females, mean age 63.1 ​± ​7.

BRAZILIAN CONSENSUS STATEMENT ON VISCOSUPPLEMENTATION OF THE HIP (COBRAVI-Q).

Objective: The Brazilian Consensus on Hip Viscosupplementation aims to generate a referential and consensual source from the theoretical knowledge and clinical experience of specialists in the field.

Methods: A multidisciplinary panel was formed with 15 specialists (sports medicine, orthopedists, physiatrists and rheumatologists), based on clinical and academic experience in the use of viscosupplementation of the hip. 12 statements were prepared, discussed and voted.

Treatment of Distal Patellar Tendon Chronic Rupture: The X-Wave Technique.

Injuries to the patellar tendon (PT) are associated with knee function deterioration and loss of the capacity to perform daily and sports activities. Patellar tendon injury is often misdiagnosed at emergency rooms, leading to chronic proximal retraction and a challenging clinical scenario. Proximal PT injuries are more common, while distal ones, which can involve tibial bone avulsion fractures or direct tendon avulsion, are rarer.

Influence of type I collagen polymorphisms and risk of anterior cruciate ligament rupture in athletes: a case-control study.

Background: Anterior cruciate ligament (ACL) rupture is a common and severe knee injury in sports and occurs mostly due to noncontact injuries. There is an increasing amount of evidence associating ACL rupture to single nucleotide polymorphisms (SNPs), and SNPs in the collagen type I genes can change its expression and tissue mechanical features. This study aimed to investigate the association between SNPs in COL1A1 and COL1A2 with sports-related ACL tears.

Modified Pulvertaft on Weave Technique Restores Full Active Knee Extension in Patients With Large Chronic Quadriceps Tendon Rupture: A Case Series.

Purpose: We aimed to investigate the clinical and functional outcomes, including maximal and explosive strength, after chronic quadriceps tendon rupture repair with Modified Pulvertaft on Weave (MPW) technique METHODS: Knee joint range of motion (ROM), patella height, thigh circumference, and Lysholm and International Knee Documentation Committee (IKDC) scores were assessed preoperatively and postoperatively. The knee extensors maximal (isokinetic peak torque and isometric maximal voluntary contraction (MVC) torque) and explosive strength-rate of torque development (RTD) early [RTD and RTD] and late [RTD]-were performed. We assessed the thigh circumference and vastus lateralis muscle thickness (MT) as indicators of quadriceps muscle mass, and the voluntary quadriceps activation using surface electromyography (EMG).

How to Create an Arthroscopy Training Laboratory Using a Bovine Knee Model.

Orthopaedic surgeries by video arthroscopy have become increasingly popular, as they allow joint treatment through small incisions and minimal tissue damage. However, their execution requires specific skills from the surgeon, different from open surgery, which can only be achieved through practical training. These skills would be ideally performed on human cadaveric anatomical pieces which, however, can be difficult to access for different reasons.

Harvest, Transport, and Storage of Fresh Humeral Head Osteochondral Allograft: Step-by-Step Protocol.

Articular cartilage defects are not common in the glenohumeral joint and are mostly found in patients after shoulder trauma, in patients with recurrent instability, or in patients who underwent previous surgical treatment. Articular cartilage defects lead to pain and loss of motion, consequently causing shoulder function impairment and reducing quality of life. In young patients, the use of osteochondral allografts for the treatment of humeral head defects may avoid well-known complications of shoulder arthroplasty.

Continuous Meniscal Suture in Radial Meniscal Tear: The Hourglass Technique.

The key to preventing early knee osteoarthritis is meniscal preservation. The main functions of the meniscus are impact absorption, mechanical load transmission, lubrication, joint stability, and proprioception. Radial lesions that extend to the joint capsule are called complete radial tears.

Posterior Root Repair of Medial Meniscus Combined With Valgus Opening Wedge Tibial Osteotomy.

The medial meniscal root tear, a particular meniscal injury at the level of its posterior bone insertion, leads to a loss of impact absorption and load distribution capacity, similar to total meniscectomy. Therefore, its repair is fundamental for knee joint longevity. This type of injury often occurs in middle-aged patients with lower limbs varus malalignment, which results in mechanical overloading of the medial compartment and induces premature cartilage wear out.

Bodyweight distribution between limbs, muscle strength, and proprioception in traumatic transtibial amputees: a cross-sectional study.

Objectives: To evaluate how transtibial amputation (TT) affects bodyweight distribution, voluntary knee joint position sense (JPS), and quadriceps (QUA) and hamstrings (HAM) strength in prosthetized patients.

Methods: Only TT patients who had been prosthetized for more than one year were included, and an age-paired able-bodied group was used as control. The participants stood on force plates with their eyes open to measure bodyweight distribution between the limbs.

BMP-4, TGF-β and Smad3 as Modulators of Synovial Fluid Cells Viability.

 Our goal was to evaluate the modulation of the synovial fluid cells (SFC) from patients with and without osteoarthritis (OA) by bone morphogenetic protein 4 (BMP-4), Smad-3 and (TGF-β).  Synovial fluid was collected from patients submitted to knee arthroscopy or replacement and were centrifuged to isolate cells from the fluid. Cells were cultured for 21 days and characterized as mesenchymal stem cells (MSCs) according to the criteria of the International Society of Cell Therapy.

Stress Radiography for Multiligament Knee Injuries: A Standardized, Step-by-Step Technique.

Physical examination in the presence of a multiligament knee injury can be complex and challenging. Hence, stress radiography is a useful and inexpensive tool that is widely used in the assessment of this type of injury. It guarantees an objective analysis of the magnitude of knee instability, which may reduce the observer's interpretation bias in relation to the physical examination.

Outside-in Continuous Meniscal Suture Technique of the Knee.

The meniscus is largely responsible for the health and longevity of the knee. It has diverse functions, being fundamental in load absorption and distribution and even in joint stability. To preserve meniscal functions and prevent the occurrence of osteoarthritis after meniscectomy, several meniscal repair techniques have been developed.

Vertical Continuous Meniscal Suture Technique.

Meniscal injuries are common in the population, representing the major cause of functional impairment in the knee. Vertical longitudinal injuries of the meniscus can be stable or unstable. When extensive, they are commonly unstable and can lead to clinical signs of significant functional disability.

HIGHER RISK OF COMPLICATIONS AFTER TOTAL KNEE ARTHROPLASTY IN OCTOGENARIANS.

Objective: To evaluate the complication rate of total knee arthroplasty (TKA) in octogenarian patients and identify predictive factors.

Methods: The study comprised 70 octogenarians and 70 non-octogenarian patients as control group, all submitted to TKA. We analyzed the medical records of these patients, seeking for complications during the first postoperative year.

Posterior Meniscal Root Repair Using a Meniscal Suture Device.

A greater understanding of the deleterious consequences that a meniscal root tear brings to the knee joint and how its surgical repair can be advantageous over the previously used treatment strategies brings the need for the development of surgical techniques that make the procedure less complex and more reproducible. When meniscal root rupture occurs, a mechanical overload occurs in the affected compartment similar to a total meniscectomy. Several authors have concluded that meniscal root reinsertion significantly improves postoperative outcomes and patient satisfaction, regardless of age or laterality of the meniscal injury.

Continuous Meniscal Suture Technique of the Knee.

The menisci are fibroelastic structures interposed between the articular surfaces of the femur and tibia. They absorb impact and transmit load. Meniscal injury may compromise function and cause rapid joint degeneration, leading to the development of secondary osteoarthritis.

How to Perform a Giant Parameniscal Cyst Exeresis: Step by Step Technique.

Parameniscal cysts are usually small cystic lesions, less than 2 cm in size, found along the meniscal periphery. They are rarely associated with extra-articular palpable mass. Magnetic resonance imaging is the diagnostic method of choice; giant meniscal cysts (>5 cm at its greatest diameter) are very rare, with few cases described in the literature.

Intraoperative morphometric study of distal femur in Brazilian patients undergoing total knee arthroplasty.

Background: Total knee arthroplasty (TKA) is the treatment option for patients with severe osteoarthritis (OA) of the knee whose symptoms are refractory to conservative management. Unfortunately, the level of patient dissatisfaction is high, reaching up to 25%. The reasons for this dissatisfaction are multifactorial, but bone-implant mismatch significantly increases the chance of pain and functional limitation.