Posterolateral Corner Reconstruction: Modification of the LaPrade Technique Using Autologous Hamstring Tendon Grafts: "The Popliteofibular Loop".

Posterolateral corner (PLC) injury is a significant cause of knee instability. In recent years, a better understanding of the anatomy and biomechanics of the PLC structures has led to significant advancements in the surgical treatment of this injury. Anatomical reconstruction techniques, particularly the LaPrade technique, have shown promising results.

Importance of computed tomography in posterior malleolar fractures: Added information to preoperative X-ray studies.

Background: Ankle fractures are common lesions of the lower limbs. Approximately 40% of ankle fractures affect the posterior malleolus (PM). Historically, PM osteosynthesis was recommended when PM size in X-ray images was greater than 25% of the joint.

Diagnostic Contradictions in Carpal Tunnel Syndrome.

 Given the divergence of opinions on the need for complementary tests such as ultrasonography (US) and electroneuromyography (ENMG) for the diagnosis of carpal tunnel syndrome (CTS), we aimed to elucidate which of them presents greater accuracy for the confirmation of the presence or not of this condition.  A total of 175 patients from a hand surgery outpatient clinic were clinically evaluated, and the results of clinical trials (Tinel, Phalen and Durkan), US (normal or altered), and ENMG (normal, mild, moderate and severe) were noted, crossed, and submitted to a statistical analysis to verify the agreement between them.  with the sample had a mean age of 53 years, with a prevalence of female patients (159 cases).

Causes of knee pain evaluated by arthroscopy after knee arthroplasty: a case series.

Background: The origin of persistent pain and joint limitation after knee arthroplasty are controversial and difficult to diagnose. Knee arthroscopy is indicated when the results of routine evaluation tests are not clear. The purpose of this study was to determine through arthroscopy the cause of post-knee-arthroplasty pain symptoms in patients without a prior diagnosis of cause of pain.

Update on Patellar Instability.

Patellar instability is a multifactorial clinical condition that affects a significant number of patients and occurs due to morphological variations of the joint and patellofemoral alignment. The present literature review study aimed to identify and summarize current concepts on patellar instability, in relation to associated risk factors, diagnostic criteria, and the benefits and risks of conservative and surgical treatments. For this purpose, a search was conducted in the following electronic databases: MEDLINE (via Pubmed), LILACS and Cochrane Library.

Evaluation of Histological Properties of Human Meniscal Grafts Stored in a Tissue Bank.

 The present paper aims to evaluate and compare the histological features of fresh and frozen menisci stored in a tissue bank for 1 month and for 5 years.  The meniscal grafts were subjected to a histological study. A total of 10 menisci were evaluated; 2 were frozen for 5 years, 4 were frozen for 1 month, and 4 were fresh, recently harvested specimens.

Difference in Articular Degeneration Depending on the Type of Sport.

 To determine whether type-II collagen degradation is determined by the type of sport. Carboxy-terminal telepoptide of type-II collagen (CTX-II), a serum biomarker of collagen degradation, was measured in athletes who play different sports, and was compared with matched controls.  The sample size consisted of 70 female participants aged between 18 and 25 years, 15 of whom were members of a soccer team, 10 of a (a variant of association football played on a hard court) team, 10 of a handball team, 18 of a volleyball team, and 7 of a swimming team.

A novel device for greater precision and safety in open-wedge high tibial osteotomy: cadaveric study.

Introduction: The complications of the open-wedge osteotomy technique (slope, hypo- and hypercorrection and fractures) are related to difficulties in the control of the open-wedge angle during surgery.

Materials And Methods: In this cadaveric study, we evaluated the safety and precision of a novel system, the Realignment High Control System (RHC), in the correction of knee mechanical axis and slope. The RHC has a fixation plate coupled to a dynamic device that opens the osteotomy continuously, allowing plate fixation before osteotomy wedge opening.

What is the Prognosis of Triple Arthrodesis in the Treatment of Adult Acquired Flatfoot Deformity (AAFD)?

 The present study aims to evaluate the ability of triple arthrodesis in eliminating the main complaints presented by patients with adult acquired flatfoot deformity (AAFD): 1) disabling hindfoot pain; 2) major deformities, such as medial arch collapse, valgus, abduction, and supination.  A total of 17 patients (20 feet) with advanced AAFD who underwent surgical correction by triple arthrodesis were evaluated after a mean follow-up period of 43 months (range: 18-84 months). The average age of the patients at surgery was 62 years old (range: 38-79 years old).

Positioning of the femoral tunnel in anterior cruciate ligament reconstruction: functional anatomical reconstruction.

The aim of this study was to review and update the literature in regard to the anatomy of the femoral origin of the ACL, the concept of the double band and its respective mechanical functions, and the concept of direct and indirect fibres in the ACL insertion. These topics will be used to help determine which might be the best place to position the femoral tunnel and how this should be achieved, based on the idea of functional positioning, that is, where the most important ACL fibres in terms of knee stability are positioned. Low positioning of the femoral tunnel, reproducing more of the posterolateral band, and positioning the tunnel away from the lateral intercondylar ridge, that is, in the indirect fibres, would theoretically rebuild a ligament that is less effective in relation to knee stability.

Comparative study of topical intravenous tranexamic acid regarding blood loss in total knee arthroplasty.

Objective: To compare topical intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion.

Methods: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group).

Should the meniscal height be considered for preoperative sizing in meniscal transplantation?

Purpose And Hypothesis: In preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with the meniscal length and width, (2) whether the heights of the meniscal segments are associated with the individual's anthropometric data, (3) whether the heights of the meniscal segments are associated with each other in the same meniscus, and (4) the degree of symmetry of the meniscal dimensions between the right and left knees.

Methods: In this cross-sectional, observational study, two independent radiologists measured the meniscal length, width and height in knee magnetic resonance imaging scans obtained from 25 patients with patello-femoral pain syndrome.

The influence of femoral tunnel length on graft rupture after anterior cruciate ligament reconstruction.

Background: For ACL reconstruction, the minimum length of the femoral tunnel and the flexor tendon graft length needed within the tunnel for proper integration have not been defined. The aim of this study was to assess whether a short tunnel is a risk factor for poor prognosis and re-rupture by comparing the outcomes of patients with short femoral tunnels to those of patients with longer tunnels.

Materials And Methods: A retrospective observational study of 80 patients who underwent ACL reconstruction using flexor tendons via the medial transportal or transtibial technique was performed.

Which Are the Most Reliable Methods of Predicting the Meniscal Size for Transplantation?

Background: Although the size of the meniscal allograft is crucial during meniscal transplantation, the accuracy of meniscal measurement methods is still under debate. A number of methods based on radiographic and magnetic resonance imaging (MRI) data as well as on anthropometric data have been proposed, but their reproducibility and reliability are still unclear.

Purpose: To compare meniscal length and width as measured by different techniques (anthropometric and plain radiographic) to establish which of these 2 methods is more reliable and cost-effective for determining the meniscal size in comparison to MRI.

Topical vs. intravenous administration of tranexamic acid in knee arthroplasty and prevalence of deep venous thrombosis: a randomized clinical trial.

Background: Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative bleeding. Since TXA inhibits fibrinolysis, there is concern that it may increase the risk of thromboembolic events.

Objectives: To verify the prevalence of deep venous thrombosis (DVT) in patients receiving TXA during total knee arthroplasty and to compare topical with intravenous administration of the drug.

Analysis on the serum levels of the biomarker CTX-II in professional indoor soccer players over the course of one season.

Objective: The aim of this study was to analyze the blood serum levels of CTX-II in professional indoor soccer players, at three different times during one season: at the start of the pre-season, four months later (a time that marks the middle of the season) and at the end of the season.

Methods: Fourteen male soccer players of mean age 19 years were included. Blood samples of 3 mL were collected from each individual.

Total knee arthroplasty with mobile tibial weight-bearing: clinical evaluation after a minimum of five years of postoperative follow-up.

Objective: To evaluate the medium and long term results from total knee arthroplasty with rotating tibial weight-bearing.

Methods: Between January 2000 and July 2007, 162 patients underwent total knee arthroplasty with mobile tibial weight-bearing. Among these, 96 were evaluated in a previous study with a mean follow-up of 4 years.

Anterior cruciate ligament reconstruction: a new cortical suspension device for femoral fixation with transtibial and transportal techniques.

Background: In the field of anterior cruciate ligament (ACL) reconstruction, there is still no consensus regarding the proper fixation method and position of the tunnels. The primary objective of this paper was to describe a new fixation device, the Endo Tunnel Device (ETD®), for both techniques (transtibial and transportal), as well as the associated difficulties and the intraoperative and postoperative intercurrences. The secondary objective was to describe a preliminary clinical evaluation (6 months of follow-up) comparing these techniques.

Bone tunnel enlargement on anterior cruciate ligament reconstruction.

Objective: To assess the presence of tibial bone tunnel enlargement after surgical reconstruction of the anterior cruciate ligament using quadruple graft of the flexor tendons and correlate the functional results in their presence.

Methods: The studied lasted six months and included 25 patients, with ages ranging from 18 to 43 years old. Assessment was based on radiographs taken immediately postoperatively and at the third and sixth month of follow up in the anterior cruciate ligament reconstruction.

Double-bundle PCL reconstruction using autogenous quadriceps tendon and semitendinous graft: surgical technique with 2-year follow-up clinical results.

Objective: The objective of this study was to evaluate the results obtained from posterior cruciate ligament (PCL) reconstruction with the double femoral tunnel technique, using quadriceps tendon and semitendinous autograft, in patients with isolated PCL tears or PCL tears associated with other ligament lesions, 2 years after surgery.

Methods: The study included 14 patients with isolated PCL lesions and 20 with combined ligament lesions, who underwent PCL reconstruction using the double femoral tunnel technique and were evaluated 24 months after surgery using the International Knee Documentation Committee (IKDC) and Lysholm scores, a KT-1000 arthrometer, and the graduation of the posterior drawer test.

Results: Knees were considered normal ("A") or nearly normal ("B") in 92.

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study.

Purpose: This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases.

Methods: In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital.

Results: The two groups were similar for pre-operative mechanical axis (mean 8.

Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study.

Purpose: The objective of this study was to verify whether the correction obtained using a navigation system (NS) corresponds to the wedge calculated by the Dugdale method (DM) in high tibial osteotomy (HTO).

Methods: We included 17 patients with primary varus and HTO indication, consecutively admitted to a public university hospital. All patients underwent panoramic radiography with bipedal load for the wedge calculation by DM.

Reconstruction of chronic lesions in the posterolateral corner of the knee with autologous biceps femoralis and fascia lata grafts.

Objective: The aim of this study was to evaluate the treatment of patients with chronic lesions in the posterolateral corner of the knee with reconstruction of the fibular collateral ligament, popliteus tendon and popliteofibular ligament and with autografts of the biceps femoris and fascia lata.

Method: A total of 129 patients with injuries of the posterolateral corner of the knee that lasted for more than three weeks and were associated with the lesion of at least one of the cruciate ligaments were included. All of the patients were operated on consecutively in the same hospital between March 2004 and April 2009.

STUDY ON THE PATELLOFEMORAL JOINT USING MAGNETIC RESONANCE IMAGING: MORPHOLOGICAL VARIATION OF THE MEDIAL PATELLOFEMORAL LIGAMENT.

Objectives: To study the measurements and anatomical relationships of the patellofemoral joint using magnetic resonance imaging, and to evaluate the variation in the morphology of the medial patellofemoral ligament (MPFL) according to patients' heights and ages and the variation in measurements on other structures that are known to be involved in predisposition to patellar instability.

Method: Twenty-three knees (18 patients) underwent magnetic resonance imaging and their interepicondylar distance, patellar height, trochlear depth, ventral trochlear prominence, trochlear groove angle, lateral facet tilt, lateral patellar tilt and size of the lateral and medial facets and their ratio were measured. These measurements were compared with the length and thickness of the MPFL.

A new technique in double-bundle anterior cruciate ligament reconstruction using implant-free femoral fixation.

Purpose: The study is a prospective case-series analysis to demonstrate a new double bundle technique for anterior cruciate ligament (ACL) reconstruction with the use of hamstring tendons through a single tibial tunnel, a double femoral socket with implant-free femoral fixation and interference screw for tibial fixation.

Materials And Methods: Twenty-one patients were treated with the same technique. Hamstring tendons were not removed from the tibial side, and using a single tibial and a double femoral tunnel of 8 and 6 mm, respectively, anatomic ACL reconstruction was performed.