Epidemiology of Knee Injuries in Baseball Players from the State of São Paulo.

 This study aimed to identify the main knee complaints and injuries associated with baseball and their prevalence in the state of São Paulo, Brazil.  This epidemiological study analyzed data from an online questionnaire sent to baseball athletes from the state of São Paulo, Brazil, from 2019 to 2022.  Ninety-eight athletes participated in the study.

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.

S. AUREUS IS ASSOCIATED WITH A GREATER NEED FOR REOPERATION IN SEPTIC ARTHRITIS OF THE KNEE.

Objective: To determine the frequency of reoperations in the treatment of adult patients diagnosed with septic arthritis of the knee, the average number of debridements needed to control the infection, the mortality rate, and to assess factors associated with a greater need for reoperation and mortality.

Methods: Retrospective cohort study evaluating 38 adult patients diagnosed with septic arthritis who underwent arthrotomy via a medial parapatellar approach for joint cleaning and debridement. Demographic, clinical, surgical, and microbiological variables of the cases were analyzed by review of medical records.

POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: ARE THE RESULTS SIMILAR TO ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION?

Objective: To report and compare the results of posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) reconstructions.

Methods: In total, 42 patients were retrospectively evaluated, 20 with isolated PCL injuries (group 1) and 22 with isolated ACL ones (group 2) who were subjected to arthroscopic ligament reconstruction with autologous grafts and followed up for at least two years. To evaluate the results in group 1, objective IKDC and Lysholm scores, posterior drawer tests, and evaluations by a KT-1000 arthrometer were used, whereas for group 2, subjective IKDC and Lysholm score and the Lachman test were employed.

The proximal posterior cartilage of the lateral femoral condyle can be used as a reference for positioning the femoral tunnel in ACL reconstruction.

Purpose: To describe the femoral insertion of the ACL using the posterior proximal cartilage of the lateral femoral condyle as the anatomical reference.

Methods: Twenty knees were dissected. The X-axis (deep-shallow) and Y-axis (high-low) were determined using the femoral diaphysis and the proximal cartilage of the lateral femoral condyle (point C) as a reference, which were easily identified by direct visualization through the anteromedial portal.

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.

Prospective and Randomized Clinical Evaluation of Hamstring Versus Patellar Tendon Autograft for Anterior Cruciate Ligament Reconstruction in Soccer Players.

Background: Anterior cruciate ligament (ACL) reconstruction is usually performed with autologous bone-patellar tendon-bone (PT) or hamstring tendon (HT) graft. There has been only 1 randomized clinical trial examining ACL reconstruction with these grafts specifically in soccer players, and more studies comparing these graft types within a homogenous cohort such as soccer athletes may better highlight differences in outcomes.

Purpose: To compare the results of ACL reconstruction with PT versus HT autograft in soccer players and to evaluate objective and subjective outcomes.

The impact of sonication cultures when the diagnosis of prosthetic joint infection is inconclusive.

Background: In the absence of a gold standard criterion for diagnosing prosthetic joint infections (PJI), sonication of the removed implant may provide superior microbiological identification to synovial fluid and peri-implant tissue cultures. The aim of this retrospective study was to assess the role of sonication culture compared to tissue cultures for diagnosing PJI, using different consensus and international guidelines for PJI definition.

Methods: Data of 146 patients undergoing removal of hip or knee arthroplasties between 2010 and 2018 were retrospectively reviewed.

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.

Correction to: Anteromedial positioning of the femoral tunnel in Anterior Cruciate Ligament reconstruction is the best option to avoid revision: a single surgeon registry.

An amendment to this paper has been published and can be accessed via the original article.

Anteromedial positioning of the femoral tunnel in anterior cruciate ligament reconstruction is the best option to avoid revision: a single surgeon registry.

Purpose: The aim of the study is to compare the risk of revision of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial, transtibial and outside-in techniques.

Methods: This cohort study was based on data from a single surgeon's registry. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendon using the anteromedial portal, transtibial and outside-in technique, operated between 1 November 2003 to 31 December 2016, were eligible for inclusion.

Double-bundle posterior cruciate ligament reconstruction: No differences between two types of autografts in isolated or combined lesions.

Background: To demonstrate and compare results obtained with the transtibial double-bundle posterior cruciate ligament (PCL) reconstruction technique using two types of autografts in isolated and combined PCL lesions.

Methods: Fifty-two patients with isolated or combined PCL injuries underwent double-bundle PCL reconstruction and were retrospectively evaluated. Among them, 34 were reconstructed using ipsilateral quadriceps and semitendinosus tendon grafts, and 18 were reconstructed using bilateral hamstring tendon grafts.

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.

Histological study of the posterior cruciate ligament femoral insertion.

Objectives: To describe the microscopic anatomy of the posterior cruciate ligament femoral insertion in order to identify and establish differences between the direct and indirect insertions of this ligament.

Methods: Ten cadaveric knees were used for this study. The posterior cruciate ligament femoral insertion was observed microscopically.

Comparative evaluation of the results of three techniques in the reconstruction of the anterior cruciate ligament, with a minimum follow-up of two years.

Objective: To compare the clinical results of the reconstruction of the anterior cruciate ligament by transtibial, transportal, and outside-in techniques.

Methods: This was a retrospective study on 90 patients (ACL reconstruction with autologous flexor tendons) operated between August 2009 and June 2012, by the medial transportal (30), transtibial (30), and "outside-in" (30) techniques. The following parameters were assessed: objective and subjective IKDC, Lysholm, KT1000, Lachman test, Pivot-Shift and anterior drawer test.

Double-bundle PCL reconstruction using autologous hamstring tendons: outcome with a minimum 2-year follow-up.

Objective: To present the outcomes of posterior cruciate ligament (PCL) double-bundle reconstruction using autologous hamstring tendons, with a minimum follow-up of two years.

Methods: Evaluation of 16 cases of PCL injury that underwent double-bundle reconstruction with autogenous hamstring tendons, between 2011 and 2013. The final sample consisted of 16 patients, 15 men and one woman, with a mean age of 31 years (21-49).

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.

Cadaveric study of the secondary medial patellar restraints: patellotibial and patellomeniscal ligaments.

Purpose: To detail the anatomy of the medial patella stabilizers, medial patellotibial (MPTL), and medial patellomeniscal ligaments (MPML), focusing on the points of origin and insertion, length, thickness, width, and fibres orientation to study the frequency of anatomical variations and the anatomy of these ligaments, thereby improving surgical techniques.

Methods: Thirty dissected knees were analysed. A digital caliper was used to measure the length, thickness, and width, as well as the mid-point of the ligaments insertion and the distance from the MPTL insertion to the articular surface of the tibia.

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.

Study on the relationship between the thickness of the anterior cruciate ligament, anthropometric data and anatomical measurements on the knee.

Objectives: To ascertain thickness measurements on the anterior cruciate ligament (ACL) in its middle third on magnetic resonance imaging (MRI) scans and to assess whether there is any association between variations in ligament thickness and patients' heights and ages, along with variations in the anatomical measurements on the knee.

Methods: MRI scans on 48 knees were evaluated. The anteroposterior size of the femoral condyles, interepicondylar distance, intercondylar distance and anteroposterior and mediolateral thicknesses of the ACL were measured.

TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY.

Objectives: To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores.

Methods: We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1(st), 2008 to December 31(st), 2010.

Results: In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure.

Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial.

Purpose: The objective of this study was to evaluate whether women with knee osteoarthritis performing a rehabilitation programme consisting of low-load exercises combined with PVO exhibited the same results in changes in quadriceps strength, pain relief, and functional improvement when compared to women receiving a programme consisting of high-load exercises without PVO.

Methods: Thirty-four women (mean age, 61 years) with a diagnosis of knee osteoarthritis were randomly assigned to a conventional or occlusion group. The women in the conventional group (n = 17) performed a 6-week quadriceps strengthening and stretching programme using a load around 70 % of the 1-repetition maximum (RM).

Concentration of Sonication Fluid through Centrifugation Is Superior to Membrane Filtration for Microbial Diagnosis of Orthopedic Implant-Associated Infection.

Microbial identification of orthopedic implant-associated infections using sonication fluid (SF) submitted to a concentration step by membrane filtration (SMF) was compared with the standard centrifugation (SC) method. Among 33 retrieved infected implants, sonication identified microorganisms in 26 (78.8%).