Medial Patellofemoral Ligament Reconstruction Using the Medial Third of the Patellar Tendon: Camanho's Technique.

The reconstruction of the medial patellofemoral ligament (MPFL) is an essential procedure in the surgical treatment of patellar instability. The medial third of the patellar tendon is a good graft option for this reconstruction, maintaining the insertion of the graft in the patella, with no need for hardware for patellar fixation. The objective of this article is to describe the MPFL reconstruction technique with the patellar tendon graft.

BENEFITS OF A CLINICAL PATHWAY IN TOTAL KNEE ARTHROPLASTY.

Objective: Demonstrate whether a multiprofessional Clinical Pathway Program in Total Knee Arthroplasty (CPPA) contributesto optimizing hospital care.

Method: Retrospective study of medical data of care indicators in 310 patients divided into two groups: A- who underwent arthroplasty in the last biennium before the introduction of the CPPA (n=144) and group B- who underwent TKA in the biennium after the introduction of the CPPA (n=166).

Results: Postoperative showed a significant difference in favor of group B over group A for hospitalization time in days 4.

Patellar Tilt and Patellar Tendon-Trochlear Groove Angle Present the Optimum Magnetic Resonance Imaging Diagnostic Reliability for Patients With Patellar Instability.

Purpose: To describe, in controls and in a population with patellar instability, magnetic resonance imaging values of measurements representing major associated factors for patellar instability (patellar height, trochlear dysplasia, and extensor mechanism alignment), as well as their cutoff values.

Methods: In total, 323 knee magnetic resonance imaging scans, 142 with patellar instability and 181 controls without patellofemoral complaints (anterior cruciate, medial collateral ligament, meniscus ruptures or normal) were evaluated. Means, normality values in the control population, ideal cutoff values through receiver operating characteristic curves analysis, and interobserver reliability (intraclass correlation coefficient) were described for a series of measurements.

The Addition of Either an Anterolateral Ligament Reconstruction or an Iliotibial Band Tenodesis Is Associated With a Lower Failure Rate After Revision Anterior Cruciate Ligament Reconstruction: A Retrospective Comparative Trial.

Purpose: To compare the failure rate in patients who underwent revision anterior cruciate ligament (ACL) reconstruction alone or associated with an extra-articular procedure. Secondary objectives were to compare ACL laxity, patient-reported outcome measures, and complication rates in these patients and, subsequently, to compare the outcomes of patients who underwent revision ACL reconstruction associated with anatomical anterolateral ligament (ALL) reconstruction or lateral extra-articular tenodesis (LET).

Methods: This was a retrospective comparative study.

Functional Complications of Patellar Instability Treatment with Medial Patellofemoral Ligament Reconstruction with the Medial Third of the Patellar Tendon with a Minimum 5-Year Follow-Up.

 To evaluate major complications after a minimum of 5 years of follow-up after acute or recurrent patellar dislocation treated with medial patellofemoral ligament (MPFL) reconstruction with the medial third of the patellar tendon, with or without associated medialization of the tibial anterior tuberosity (TAT).  A total of 50 patients were included, with a minimum follow-up of 5 years. The patients were evaluated regarding complications such as joint stiffness, recurrence of patellar dislocation, subjective instability reported by patients, and inability to return to the previous level of physical activity.

Functional results of multiple revision anterior cruciate ligament with anterolateral tibial tunnel associated with anterolateral ligament reconstruction.

Background: Revision anterior cruciate ligament (ACL) reconstructions are usually complex owing to previous tunnels. The objective of this study is to report the results of a revision ACL reconstruction technique with a tibial tunnel performed from the anterolateral plateau associated with an anterolateral ligament (ALL) reconstruction.

Methods: Patients with at least two ACL reconstructions that failed and who had significant enlargement and confluence of tunnels in the medial tibial plateau and underwent revision ACL reconstruction associated with ALL reconstruction with the tibial tunnel for the ACL performed from the lateral plateau between 2017 and 2019 were evaluated.

The knee in congenital femoral deficiency and its implication in limb lengthening: a systematic review.

Congenital femoral deficiency (CFD) is a rare disorder with several limb anomalies including limb shortening and knee cruciate ligament dysplasia.Limb lengthening is usually performed to correct lower limb discrepancy. However, complications, such as knee subluxation/dislocation, can occur during this treatment.

RESULTS OF TREATMENT OF PLICA SYNDROME OF THE KNEE.

Objective: The synovial fold is an intra-articular structure found in more than 50% of the knees, which can cause symptoms similar to meniscal injuries. These symptoms are mostly related to hypertrophy of the synovial fold resulting from inadequate physical activity. Conservative treatment with readjustment of sports activity and muscle rebalancing solves most cases.

Medial Knee Arthrosis: A Pathology with a Progressive Evolution.

Medial arthrosis of the knee is an evolutionary pathology that occurs due to progressive muscle imbalance. The muscles of the knee region have a large imbalance caused by the difference of power and lever arm. With the progression of life, this imbalance manifests itself more importantly, especially due to the loss of muscle strength due to aging.

UNICOMPARTIMENTAL KNEE ARTHROPLASTY - 15 YEARS FOLLOW UP.

Objective: To evaluate clinically and radiologically the long-term follow-up of patients with anteromedial osteoarthritis who underwent unicompartmental knee arthroplasty surgery.

Methods: This study included 36 patients who underwent unicompartmental knee arthroplasty surgery for medial compartmental osteoarthritis with a minimum of 15-year post-operative follow-up. All surgeries were performed by a single surgeon (G.

Anatomical Risk Factors for Anterior Cruciate Ligament Injury Are Not Important As Patellar Instability Risk Factors in Patients with Acute Knee Injury.

To compare in magnetic resonance imaging the anatomical risk factors for anterior cruciate ligament (ACL) injury and patellar dislocation among patients who suffered acute knee injury, 105 patients with acute knee injury resulting in 38 patellar dislocations (patella group), 35 ACL injuries (ACL group), and 32 meniscus or medial collateral ligament injuries (control group) were included. These groups were compared for risk factors for patellar dislocation (patellar height, trochlear dysplasia, and quadriceps angle of action) and for ACL injury (intercondylar width, posterior inclination of tibial plateaus, and depth of the medial plateau). Univariate analysis found statistically significant differences ( < 0.

The Vastus Medialis Insertion Is More Proximal and Medial in Patients With Patellar Instability: A Magnetic Resonance Imaging Case-Control Study.

Background: The anatomy and function of the quadriceps muscle play a role in patellofemoral stability. Few studies have evaluated anatomic differences in the vastus medialis between patients with and without patellar instability.

Purpose: To compare the anatomy of the vastus medialis using magnetic resonance imaging in patients with patellar instability to a control group.

Combined Reconstruction of the Anterolateral Ligament in Patients With Anterior Cruciate Ligament Injury and Ligamentous Hyperlaxity Leads to Better Clinical Stability and a Lower Failure Rate Than Isolated Anterior Cruciate Ligament Reconstruction.

Purpose: To compare functional outcomes, residual instability, and rupture rates in patients with ligamentous hyperlaxity undergoing isolated anterior cruciate ligament (ACL) reconstruction or combined ACL and anterolateral ligament (ALL) reconstruction.

Methods: Two groups of patients were evaluated and compared retrospectively. Both groups consisted of patients with ACL injuries and associated ligamentous hyperlaxity, defined based on the modified Beighton scale with a minimum score of 5.

Clinical Outcomes of Posterolateral Complex Reconstruction Performed with a Single Femoral Tunnel.

The objective of this study is to report the functional outcomes, complications, and reconstruction failure rate of patients undergoing posterolateral complex reconstruction with a single femoral tunnel technique. Patients with posterolateral complex injuries associated with injury of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), or both undergoing surgical treatment with the single femoral tunnel technique were included in the study. The International Knee Documentation Committee (IKDC) and Lysholm's scales were evaluated, in addition to age, gender, time between trauma and surgery, trauma type, range of motion (ROM) restrictions, peroneal nerve injury, and reconstruction failure.

PROTOCOL FOR TREATING ACUTE INFECTIONS IN CASES OF TOTAL KNEE ARTHROPLASTY.

Objective: To retrospectively evaluate the results after applying a protocol for treating acute infections in cases of total knee arthroplasty and to establish factors predictive of success or failure.

Methods: Thirty-two patients who were diagnosed with acute infection of the knee following total arthroplasty between 2004 and 2009 were retrospectively evaluated. Infections following arthroplasty were treated in accordance with the protocol for acute infections following arthroscopy recommended at our institution.

Clinical results of pulsed signal therapy on patellofemoral syndrome with patellar chondropathy.

This study was designed to evaluate the effect of pulsed signal therapy (PST) on patellofemoral pain syndrome associated with patellar chondropathy. A prospective randomized double-blind placebo controlled trial included 25 patients (41 knees) between 20 and 50 years with pain due to isolated patellofemoral syndrome with chondropathy. PST group received nine 60-min daily sessions of PST treatment.

Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerations and functional results.

Background: To report the functional outcomes and complications from reconstructing the knee posterolateral complex (PLC), associated with one-stage opening-wedge tibial valgus osteotomy, and discuss the technical feasibility of this procedure.

Methods: Five patients with chronic PLC injuries and varus deviation of the mechanical axis, associated with central pivot injuries or not, underwent medial opening-wedge high tibial osteotomy combined with PLC reconstruction. The lateral collateral ligament, popliteal tendon, and popliteofibular ligament were reconstructed using a single femoral tunnel.

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report.

Osteochondral fracture after acute patellar dislocation in teenagers is relatively common (up to 60% of cases of patellar dislocation), but poorly diagnosed. There are several treatments proposed for this type of injury, but none well defined in the literature. A male patient, 13 years old, with a diagnosis of osteochondral fracture of the lateral femoral condyle after acute dislocation of the right patella.

Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions.

Objective: To present the indications, technical aspects, and initial results of the first cases using Endo-Model™ implants in Brazil.

Methods: A prospective study was conducted. It included nine patients submitted to a total knee arthroplasty, of which six were primary and three were revisions, using exclusively the Endo-Model™ implant.

Combined reconstruction of the anterolateral ligament in chronic ACL injuries leads to better clinical outcomes than isolated ACL reconstruction.

Purpose: To evaluate the results of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction in patients with chronic ACL injury. It was hypothesized that patients who underwent combined ACL and ALL reconstruction would exhibit less residual laxity and better clinical outcomes.

Methods: Two groups of patients were evaluated and compared retrospectively.