Combined Reconstruction of the Medial Patellofemoral Ligament and Medial Quadriceps Tendon-Femoral Ligament.

Most patellar dislocations are associated with disruption of the proximal medial patellar restraints (PMPRs). The PMPRs comprise the medial patellofemoral ligament (MPFL) and medial quadriceps tendon-femoral ligament (MQTFL). Although isolated MPFL reconstruction is the most frequently performed procedure for the surgical management of recurrent dislocation, recent studies have shown that the MQTFL has a synergistic role with the MPFL in resisting lateral patellar displacement close to full extension.

Venous Thromboembolism Prevention Protocol: Experience of 2,000 Cases in Total Knee Arthroplasty.

 The objective of the present study is to evaluate the impact evaluate the impact of an institutional protocol on a tertiary hospital for the prevention of venous thromboembolism in 2005 patients submitted to primary total knee arthroplasty (TKA).  Data from medical records of patients submitted TKA before (  = 1,115) and after (  = 890) the implementation of the institutional protocol, totaling 2,005 patients, were retrospectively reported. Demographics, comorbidities, and outcomes were analyzed.

Effect of porous tantalum on the biological response of human peripheral mononuclear cells exposed to Porphyromonas gingivalis.

Aim: To evaluate biological behavior of human peripheral mononuclear cells (PBMC) in contact with porous tantalum (PT) and Porphyromonas gingivalis (Pg).

Methods: Pg was incubated for 8 hours. The groups formed were: PBMC (control), PBMC + PT, PBMC + Pg and PBMC + PT + Pg.

Piriformis Pyomyositis in a Patient with Kikuchi-Fujimoto Disease - A Case Report and Literature Review.

Primary pyomyositis is a deep bacterial infection of the skeletal muscle. If left undiagnosed and untreated, the infection spreads, leading to sepsis, septic shock, and even death. The authors report a 23-year-old female presenting with piriformis pyomyositis during a treatment for Kikuchi-Fujimoto disease.

Hamstring Tendon Autograft Contamination in Anterior Cruciate Ligament Reconstruction: Comparison between two Harvesting Techniques.

Objective: To evaluate the contamination rate of hamstring tendon autografts by comparing two different techniques, and to verify whether intraoperative contamination is associated with the development of clinical infection in patients submitted to reconstruction of the anterior cruciate ligament (ACL).

Methods: A total of 110 hamstring tendon autograft ACL reconstructions were performed and divided into two groups: 1-hamstring tendon retraction technique; and 2 - technique maintaining the tibial insertion of the hamstring tendon. During the preparation, two graft fragments were sent for culturing; the harvesting time, the preparation time, and the total surgery time were measured.

Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury.

Background: Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian jiu-jitsu (BJJ) because of the knee varus-flexion mechanism that frequently occurs during grappling.

Purpose/hypothesis: The purpose of this study was to evaluate the incidence of this injury pattern in a series of BJJ athletes with an acute knee injury and to evaluate clinical and functional outcomes after nonoperative management at a minimum follow-up of 1 year. Our hypotheses were that PLCCALL injuries are common in BJJ and that nonoperative treatment is associated with excellent clinical outcomes and return to the preinjury level of sport.

The femoral tunnel view test during ACL reconstruction can ensure tunnel integrity.

Objective: Violation of the posterior femoral cortex commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament reconstruction (ACLR) and can lead to loss of graft fixation or early graft failure. This study describes and analyzes whether the femoral tunnel view test can ensure the integrity of the femoral tunnel during ACLR.

Methods: Intraoperative femoral tunnel integrity using the 360° arthroscopic view test was performed in 584 ACLR patients between 2014 and 2016.

A Femoral Tunnel View Test During ACL Reconstruction.

Despite technologic advances in the surgical techniques for anterior cruciate ligament (ACL) reconstruction, some patients continue to have violation of the femoral cortex, commonly referred to as wall blowout. These posterior or lateral cortical breaches lead to loss of graft containment and subsequent difficulty with graft fixation. If this intraoperative error is not promptly recognized and treated, the graft is at an increased risk of premature failure.

Clinical Outcomes of Single Anteromedial Bundle Biologic Augmentation Technique for Anterior Cruciate Ligament Reconstruction With Consideration of Tibial Remnant Size.

Purpose: The primary aim of this study was to evaluate the functional outcomes, knee stability, complications, and reoperations associated with anatomic anterior cruciate ligament (ACL) reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique in a consecutive series of 128 patients with a minimum follow-up of 24 months. A secondary aim was to compare larger preserved ACL remnants with smaller preserved remnants.

Methods: Patients who underwent primary anatomic ACL reconstruction using the SAMBBA technique from July 2013 to October 2014 were analyzed.

Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty).

Objective: To propose a multidisciplinary protocol to standardize the care of patients undergoing total hip arthroplasty (THA) and evaluate it effectiveness after implementation.

Methods: Retrospective evaluation of 95 consecutive patients undergoing THA divided into two groups, one group of 47 patients operated before the protocol implementation and 48 after.

Results: Assessing the re-admission rate, among 47 patients evaluated prior to implementation of the protocol, seven (14.

Diffuse pigmented villonodular synovitis in knee joint: diagnosis and treatment.

Pigmented villonodular synovitis is a rare proliferative condition of the synovium. Although the condition can present in any joint, the knee is the most commonly affected site. Despite being a benign condition, pigmented villonodular synovitis is often aggressive, with marked extra-articular extension in some cases.

Three-Dimensional CT Evaluation of Tunnel Positioning in ACL Reconstruction Using the Single Anteromedial Bundle Biological Augmentation (SAMBBA) Technique.

Background: Remnant preservation may confer important advantages in the anterior cruciate ligament (ACL)-reconstructed knee. However, the presence of a large remnant may obscure visualization and impair the ability to correctly place tunnels during surgery.

Purpose: To determine whether tunnel placement during anatomic ACL reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique is consistent and precise when a large native remnant is preserved.

A New Technique for Surgical Treatment of Proximal Hamstring Tendinopathy in a Triathlon Athlete.

Introduction: Proximal hamstring tendinopathy (PHT) is the result of chronic overload caused by repetitive eccentric contraction. Surgical treatment becomes an option for patients with chronic symptoms that do not respond to conservative treatment.

Case Report: This report describes a case of a 48-year-old man, an amateur triathlete, with deep gluteal pain in the left hip for 12 months, leading to a decline in sports performance.

Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture.

Objective: To determine the incidence and MRI characteristics of the spectrum of posterolateral corner (PLC) injuries occurring in association with anterior cruciate ligament (ACL) rupture.

Materials And Methods: We carried out a level IV, retrospective case series study. All patients clinically diagnosed with an ACL rupture between July 2015 and June 2016 who underwent MRI of the knee were included in the study.

Range of motion predictability after total knee arthroplasty with medial pivot prosthesis.

Objective: To assess whether there the final range of motion (ROM) results achieved by patients undergoing total knee arthroplasty (TKA) with prosthesis using Medial Pivot design are predictable.

Methods: Between January and August of 2014, 155 patients with primary osteoarthritis of knee who underwent TKA using the prosthesis ADVANCE Medial Pivot were prospectively assessed. All ROM measures were made and recorded before, during, and after surgery.

Anterolateral Ligament Reconstruction Is Associated With Significantly Reduced ACL Graft Rupture Rates at a Minimum Follow-up of 2 Years: A Prospective Comparative Study of 502 Patients From the SANTI Study Group.

Background: Graft failure and low rates of return to sport are major concerns after anterior cruciate ligament (ACL) reconstruction, particularly in a population at risk.

Purpose: To evaluate the association between reconstruction techniques and subsequent graft rupture and return-to-sport rates in patients aged 16 to 30 years participating in pivoting sports.

Study Design: Cohort study; Level of evidence, 2.

Relationship between peri-incisional dysesthesia and the vertical and oblique incisions on the hamstrings harvest in anterior cruciate ligament reconstruction.

Objective: To compare the incidence of peri-incisional dysesthesia according to the skin incision technique for hamstring tendon graft harvest in anterior cruciate ligament reconstruction.

Methods: Thirty-three patients with ACL rupture were separated in two groups: group 1, with 19 patients submitted to the oblique skin incision to access the hamstrings and group 2-14 patients operated by vertical skin incision technique. The selected patients were assessed after surgery.

Effectiveness of Chitosan Films Impregnated With Ciprofloxacin for the Prophylaxis of Osteomyelitis in Open Fractures: An Experimental Study in Rats.

Background: The systemic antimicrobial prophylaxis is the standard treatment in the prevention of osteomyelitis after open fractures, with topical application of antimicrobials as an alternative due to their high concentrations at the site of the fracture, low systemic concentrations and fewer side effects.

Objectives: This study aimed to evaluate the effectiveness of prophylaxis of osteomyelitis through experimental model of open fractures with the use of chitosan films, whether or not impregnated with ciprofloxacin.

Materials And Methods: In this experimental study, 24 Holtzman rats were distributed into 4 groups of 6 rats each.

Synovial Chondromatosis of the Knee in a 2-Year-Old Child: A Case Report and Review of the Literature.

Case: We describe a rare case of synovial chondromatosis of the knee of a 2-year-old child. The diagnosis was based on the history, physical examination, and complementary examinations (radiography and magnetic resonance imaging). Anterior and posterior approaches were used for total synovectomy and resection of loose bodies.

Reconstruction of chronic patellar tendon rupture using graft from contralateral patella graft together with reinforcement from flexor tendons. Case report.

Chronic patellar tendon rupture is a rare disabling injury that is technically difficult to repair. The true prevalence of this injury is unknown. Delayed reconstruction of chronic patellar tendon rupture has yielded suboptimal clinical and functional results.

Reconstruction of chronic patellar tendon rupture with contralateral bone-tendon-bone autograft.

Purpose: To evaluate the clinical and functional outcome following the reconstruction of chronic patellar tendon ruptures using the contralateral bone-tendon-bone (BTB) autograft.

Methods: The records of seven patients who underwent reconstruction of chronic patellar tendon rupture with contralateral patellar BTB were retrospectively reviewed. Chronic tears were defined as a minimum of 3 months from injury to initial clinical evaluation.

Atypical femoral fracture due to chronic use of bisphosphonates: case report.

The causal relationship between chronic use of bisphosphonates and occurrences of atypical femoral fractures has not yet been established. Nonetheless, it is known that their chronic use is more related to fractures with a pattern differing from that of classical osteoporotic fractures. Atypical fractures are still rare events and the benefit from using bisphosphonates remains greater for prevention and treatment of osteoporosis.

Partial tearing of the anterior cruciate ligament: diagnosis and treatment.

Partial tears of the anterior cruciate ligament (ACL) are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process.

Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block.

Objective: the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block.

Materials And Methods: the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not.

Relationship between range of motion and femoral rollback in total knee arthroplasty.

Objective: The aim of this study was to evaluate the relation between femoral rollback and range of motion (ROM) in patients with cruciate retaining (CR) and posterior stabilized (PS) total knee arthroplasty (TKA).

Methods: The study included 38 knees of 31 patients (26 female and 5 male) with primary knee arthrosis who underwent TKA. The posterior cruciate ligament (PCL) was sacrificed in 24 knees in the PS group and preserved in 14 in the CR group.