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.

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.

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.

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.

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.

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 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.

Infection after total knee replacement: diagnosis and treatment.

Infection after total knee replacement (IATJ) is a rare complication. It is associated with increased morbidity and mortality increasing the final costs. Gram positive and and are the most common isolated germs (>50% of the cases).

FEMORAL ROLL BACK IN TOTAL KNEE ARTHROPLASTY: COMPARISON BETWEEN PROSTHESES THAT PRESERVE AND SACRIFICE THE POSTERIOR CRUCIATE LIGAMENT.

Unlabelled: To compare the rollback of the contact point between the femoral component and the tibial polyethylene as the knee is flexed, in two types of total knee arthroplasty: one that sacrifices and the other that preserves the posterior cruciate ligament (PCL).

Methods: Under fluoroscopy, 36 knees from 32 patients who underwent total knee arthroplasty were evaluated. Using lateral images, the contact points between the femur and the tibial polyethylene with the knee in complete extension and at 90° of flexion were measured, thereby measuring the percentage rollback of the femur in arthroplasties in which the PCL was sacrificed and in those in which it was preserved.

RELATIONSHIP BETWEEN PATELLAR HEIGHT AND RANGE OF MOTION AFTER TOTAL KNEE ARTHROPLASTY.

Unlabelled: To evaluate whether, after total knee arthroplasty, there is any correlation between patellar height and range of motion (ROM) achieved by patients six months after the operation.

Methods: Forty-five patients who underwent total knee arthroplasty were assessed at least 12 months after the operation (total of 54 knees). The maximum and minimum ROM of all the knees was recorded under fluoroscopy, along with patellar height according to the Blackburne and Peel ratio.

MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION TO TREAT RECURRENT PATELLAR DISLOCATION.

Objective: To present a new technique for reconstruction of the medial patellofemoral ligament (MPFL) in patients with recurrent patellar dislocation and to evaluate the clinical findings from this.

Methods: Between January 2007 and January 2008, 23 patients underwent reconstruction of the MPFL with a free graft from the semitendinosus tendon. After a minimum of 24 months of follow-up, 22 patients were evaluated using the Kujala and Lysholm clinical protocols.

PERI-INCISIONAL DYSESTHESIA FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING CENTRAL THIRD OF PATELLAR TENDON.

Objective: To evaluate the prevalence and type of dysesthesia around the incision used to obtain the patellar tendon for anterior cruciate ligament (ACL) reconstruction surgery.

Methods: Out of a population of 1368 ACL reconstructions using the central third of the patellar tendon, 102 patients (111 knees) were evaluated by means of telephone interview.

Results: The mean follow-up was 52 months (ranging from 12 to 88 months).

TOURNIQUET VERSUS NO TOURNIQUET USE IN KNEE VIDEOARTHROSCOPY: A MULTICENTRIC, PROSPECTIVE, DOUBLE-BLIND, RANDOMIZED CLINICAL TRIAL.

Unlabelled: To evaluate whether, by using an arthropump (irrigation equipment with pressure sensor), pneumatic tourniquet use could interfere with the duration of surgery, recovery of movement and joint volume in patients who underwent knee videoarthroscopy for partial meniscectomy.

Methods: 103 patients divided randomly into two groups regarding use or nonuse of a pneumatic tourniquet were evaluated in five different centers by seven different surgeons. The variables were evaluated during the surgery and seven days after the operation.

RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT WITH THE CENTRAL THIRD OF THE QUADRICEPS MUSCLE TENDON: ANALYSIS OF 10-YEAR RESULTS.

Objective: Assess clinical results using two different protocols, 10 years after ACL reconstruction surgery with the central third of quadriceps muscle tendon (QT).

Method: Between November /1997 and April/1998, 25 patients were submitted to 25 ACL reconstructions with QT by transtibial technique. The bone portion of the graft was fixated on femoral tunnel with interference screw and the tendinous portion of tibial tunnel with screw with washer.