Regenerative effect of platelet-rich plasma in the murine ischemic limbs.

Aims: The purpose of this study was to investigate the effect of PPRP (pure PRP) and LPRP (PRP with leukocytes) on recovery from limb ischemia and on expression of growth factors involved in angiogenesis, myogenesis and fibrogenesis.

Material And Methods: PPRP and LPRP prepared by centrifugation were added to cultures of C2C12 and NIH3T3 cells (1 or 10% PRPs) to evaluate alterations in cell metabolism and expression of growth factors by MTT, ELISA and RT-qPCR, respectively. To evaluate in vivo regenerative effects, PRPs were injected into the ischemic limbs of BALB/c mice and muscle mass/strength and histomorphometry were evaluated after 30 days.

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique.

 The present paper evaluates the resuming of physical activities by young, active patients who practiced some sport modality and underwent a high tibial osteotomy (HTO) using the opening wedge technique.  A total of 12 patients submitted to HTO using the opening wedge technique were prospectively analyzed. All patients were not playing sports at that time.

A Hamstring-Based Anatomic Posterolateral Knee Reconstruction With Autografts Improves Both Radiographic Instability and Functional Outcomes.

Purpose: To report the subjective outcomes and objective stability in a series of chronically grade III posterolateral injured knees treated with a hamstring-based anatomic posterolateral corner (PLC) reconstruction technique using autografts.

Methods: An outcome study of patients with a chronic complete tear of all ligamentous structures of the PLC (>5 mm of varus gapping at 30, ≥10° of external tibial rotation during the dial test, ≥4 mm of increased lateral compartment opening during varus stress radiographs) was performed. The patients were evaluated subjectively with Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores and objectively with varus stress radiographs at 20° of knee flexion, IKDC objective scores, and recurvatum evaluation.

Anteromedial Tibial Tubercle Osteotomy Improves Results of Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability in Patients With Tibial Tuberosity-Trochlear Groove Distance of 17 to 20 mm.

Purpose: To compare the midterm clinical outcomes of anteromedialization tibial tubercle osteotomy combined with medial patellofemoral ligament reconstruction (TTO+MPFLR) with MPFLR alone (MPFLRa) for the treatment of recurrent patellar instability (RPI) in patients with a tibial tuberosity-trochlear groove (TT-TG) of 17 to 20 mm.

Methods: From January 2008 to August 2013, patients with RPI and a TT-TG of 17 to 20 mm were divided into 2 groups: TTO+MPFLR or MPFLRa. Subjects were evaluated for J sign classification (1-4+); patellar glide (1-4+); the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores.

Bicruciate lesion biomechanics, Part 2-treatment using a simultaneous tensioning protocol: ACL fixation first is better than PCL fixation first to restore tibiofemoral orientation.

Purpose: An uncommon technique for bicruciate ligament reconstruction involving simultaneous tensioning of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) grafts with ACL graft fixation first has been pointed out as superior to the "gold-standard" PCL graft fixation first. The purpose of this study was to compare tibiofemoral biomechanics between ACL fixation first and PCL fixation first in a simultaneous tensioning protocol for bicruciate ligament reconstruction.

Methods: 12 fresh-frozen cadaveric knees (six matched pairs) were tested using a custom testing system.

Total knee and hip arthroplasty: the reality of assistance in Brazilian public health care.

Objective: To analyze the number of hospital permits for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in Brazil between 2008 and 2015, and correlate them with regional, national, and international demographic and epidemiological aspects.

Methods: Data on demographics, economic level, and TKA and THA were obtained from the website of the Ministry of Health/DATASUS, Brazilian Institute of Geography and Statistics, and the National Health Agency to assess the assistance provided by the Public Health Care System in arthroplasties for elderly Brazilian population without private health care.

Results: The South and Southeast had the best care, with 8.

Bicruciate lesion biomechanics, Part 1-Diagnosis: translations over 15 mm at 90° of knee flexion are indicative of a complete tear.

Purpose: Understanding the pathomechanics of a bicruciate injury (BI) is critical for its correct diagnosis and treatment. The purpose of this biomechanical study aims to quantify the effects of sequential sectioning of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) bundles on knee laxity.

Methods: Twelve cadaveric knees (six matched pairs) were used.

Forgotten Joint Score - Portuguese translation and cultural adaptation of the instrument of evaluation for hip and knee arthroplasties.

Objective: To translate and adapt culturally to Brazilian Portuguese the Forgotten Joint Score (FJS) patient-reported outcome questionnaire.

Methods: Forty-five patients in the postoperative period (3-12 months) of total knee and hip arthroplasty were asked to answer the Br FJS questionnaire, translated into Portuguese based on the guidelines of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Results: Twenty-three patients completed the questionnaire correctly, suggesting changes when pertinent.

Anatomic Posterolateral Corner Reconstruction With Autografts.

Anatomic posterolateral corner reconstruction reproduces 3 main structures: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. The LaPrade technique reproduces all 3 main stabilizers. However, it requires a long graft, limiting its indication to clinical settings in which allograft tissue is available.

Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level.

Background: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR).

Hypotheses: Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not.

Magnetic resonance imaging-based morphological and alignment assessment of the patellofemoral joint and its relationship to proximal patellar tendinopathy.

Objective: To assess the differences in morphology and alignment of the knee between patients with proximal patellar tendinopathy (PPT) and a control group, using MRI and focusing on the patellofemoral joint.

Methods: We retrospectively included 35 patients with clinically diagnosed and unequivocal findings of PPT on knee MRI, the case group. For the control group, we included 70 patients who underwent knee MRI for other reasons, with no clinical or MRI evidence of PPT.

Parylene scaffold for cartilage lesion.

Evaluate parylene scaffold feasibility in cartilage lesion treatment, introducing a novel paradigm combining a reparative and superficial reconstructive procedure. Fifteen rabbits were used. All animals had both knees operated and the same osteochondral lesion model was created bilaterally.

Relationship Between the Middle Genicular Artery and the Posterior Structures of the Knee: A Cadaveric Study.

Background: The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA.

Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

Platelet-Rich Plasma in a Murine Model: Leukocytes, Growth Factors, Flt-1, and Muscle Healing.

Background: It is well known that platelet-rich plasma (PRP) preparations are not the same and that not all preparations include white blood cells, but the part that leukocytes play on the healing role of PRP is still unknown.

Purpose: The primary aim of this study was to evaluate the influence of leukocytes in different PRP preparations with a special emphasis on growth factor concentrations. The secondary aim was to evaluate the influence of PRP on muscle healing.

Anterolateral ligament anatomy: a comparative anatomical study.

Purpose: Some anatomical studies have indicated that the anterolateral ligament (ALL) of the knee is distinct ligamentous structure in humans. The purpose of this study is to compare the lateral anatomy of the knee among human and various animal specimens.

Methods: Fifty-eight fresh-frozen knee specimens, from 24 different animal species, were used for this anatomical study.

Surgical treatment for muscle injuries.

Muscle injury causes functional impairment. The healing process takes time and fibrotic tissue can result. Recurrence and delayed recovery remain as unsolved problems.

A simple method to minimize vascular lesion of the popliteal artery by guidewire during transtibial posterior cruciate ligament reconstruction: a cadaveric study.

Purpose: To compare the outside-in transtibial lateral and medial approaches for posterior cruciate ligament (PCL) reconstruction regarding the guidewires and popliteal artery integrity.

Methods: Twenty-two human cadaveric knees were used. A PCL tibial aimer was arthroscopically placed within the PCL footprint through the anteromedial portal for the medial approach and through the anterolateral portal for the lateral approach.

Updates in biological therapies for knee injuries: anterior cruciate ligament.

There have been many advances in anterior cruciate ligament reconstruction (ACLR) techniques incorporating biological treatment. The aim of this review is to discuss the recent contributions that may enlighten our understanding of biological therapies for anterior cruciate ligament (ACL) injuries and improve management decisions involving these enhancement options. Three main biological procedures will be analyzed: bio-enhanced ACL repair, bio-enhanced ACLR scrutinized under the four basic principles of tissue engineering (scaffolds, cell sources, growth factors/cytokines including platelet-rich plasma, and mechanical stimuli), and remnant-preserving ACLR.

A manual method to obtain platelet rich plasma.

Objective: This study is to report a manual method to obtain platelet rich plasma (PRP).

Methods: For this study 61 ml of peripheral blood was obtained and submitted to centrifugation at 541g for 5 min. The centrifugation separates the blood into three components: red blood cells, buffy coat and platelet rich plasma.

An anatomic study of the posterior septum of the knee.

Purpose: To evaluate the posterior septum of the knee and determine the presence of a safe zone that could be removed, without significant damage to blood vessels and nerves.

Methods: Nineteen fresh unpaired adult human cadaveric knees, with no macroscopic degenerative or traumatic changes, were used in this study. Microscopic evaluation was performed by analysis of H&E, CD-34, and S-100 staining.

Bupivacaine injection leads to muscle force reduction and histologic changes in a murine model.

Objective: To evaluate the effect of bupivacaine on muscle force and histology. We hypothesize that bupivacaine will worsen the muscle's physiological activity.

Setting: Controlled laboratory experiment.

Low-intensity pulsed ultrasound accelerates healing in rat calcaneus tendon injuries.

Study Design: Controlled laboratory study.

Objective: To evaluate the effect of low-intensity therapeutic ultrasound on the murine calcaneus tendon healing process.

Background: Therapeutic ultrasound promotes formation and maturation of scar tissue.

A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome.

Study Design: Cross-sectional study.

Objective: To compare the hip strength of sedentary females with either unilateral or bilateral patellofemoral pain syndrome (PFPS) to a control group of sedentary females of similar demographics without PFPS.

Background: It has been suggested that hip muscle weakness may be an important factor in the etiology of young female athletes with PFPS.