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Mestriner MB, Hirosse FE, Rabelo NDDA, Santos Netto AD, Oliveira VMDE, Cury RDEPL. POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: ARE THE RESULTS SIMILAR TO ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION? Acta Ortop Bras 2023; 31:e260740. [PMID: 37151723 PMCID: PMC10158965 DOI: 10.1590/1413-785220233102e260740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/06/2022] [Indexed: 05/09/2023]
Abstract
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. To compare groups, objective IKDC and Lysholm scores and assessment via a KT-1000 arthrometer were considered. Results Intragroup analysis showed improved results for all variables (p < 0.001) in both groups. Comparisons between groups showed a significant difference in objective IKDC scores (p < 0.001), but no such disparities for Lysholm ones (p = 0.052), clinical tests (p = 0.058) or evaluation by KT-1000 (p = 0.129). Conclusion Treatment restored knee stability and function in both groups. Comparisons between groups showed that PCL reconstructions had inferior results than ACL ones according to patients' objective IKDC scores. Level of Evidence II, Retrospective Study.
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Affiliation(s)
- Marcos Barbieri Mestriner
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
| | - Fábio Eidi Hirosse
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Sao Paulo, SP, Brazil
| | - Nayra Deise Dos Anjos Rabelo
- Universidade Nove de Julho, Departamento de Ciências da Reabilitação, Laboratório de Análise do Movimento Humano, Sao Paulo, SP, Brazil
| | - Alfredo Dos Santos Netto
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
| | - Victor Marques DE Oliveira
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
| | - Ricardo DE Paula Leite Cury
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
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Fernandes LS, Yagi AJ, Santos Netto AD, Salles MJ, Oliveira VMDE, Cury RDEPL. S. AUREUS IS ASSOCIATED WITH A GREATER NEED FOR REOPERATION IN SEPTIC ARTHRITIS OF THE KNEE. Acta Ortop Bras 2023; 31:e260592. [PMID: 37151729 PMCID: PMC10158961 DOI: 10.1590/1413-785220233102e260592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/30/2022] [Indexed: 05/09/2023]
Abstract
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. Tests for equality of two proportions, chi-square, and multivariate logistic regression analysis were performed, defining a significance level at 0.05, with 95% confidence interval. Results A total of 50% of the cases underwent reoperation, with an average number of required debridement of 2.02 and a mortality rate of 10.5%. Patients with infection caused by Staphylococcus aureus were more likely to need a reoperation compared to patients with positive cultures for other agents (OR 6.0). Conclusion In 50% of cases, an average of 2.02 debridements were necessary and the mortality rate was 10.5%. Staphylococcus aureus infection is associated with a 6 times greater chance of additional surgeries. / Level of Evidence IV, Case Series.
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Affiliation(s)
- Lucas Saade Fernandes
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Departamento de Ortopedia e Traumatologia, Sao Paulo, SP, Brazil
| | - Alexandre Joji Yagi
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Departamento de Ortopedia e Traumatologia, Sao Paulo, SP, Brazil
| | - Alfredo Dos Santos Netto
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
| | - Mauro José Salles
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Departamento de Medicina, Sao Paulo, SP, Brazil
- Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Grupo de Infecção Musculoesquelética, Sao Paulo, SP, Brazil
| | - Victor Marques DE Oliveira
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
| | - Ricardo DE Paula Leite Cury
- Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil
- Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Sao Paulo, SP, Brazil
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Mestriner MB, Cury RDPL, Dos Santos Netto A, de Oliveira VM, de Camargo OPA, Belloti JC. Double-bundle posterior cruciate ligament reconstruction: No differences between two types of autografts in isolated or combined lesions. Knee 2020; 27:140-150. [PMID: 31806509 DOI: 10.1016/j.knee.2019.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/12/2019] [Accepted: 09/20/2019] [Indexed: 02/02/2023]
Abstract
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. The criteria for outcome evaluation were: objective International Knee Documentation Committee (IKDC) score, Lysholm score, posterior stability (posterior drawer test and KT-1000TM), and rate of complications, comparing the two types of grafts and comparing isolated PCL and combined lesions. The minimum follow-up was two years. RESULTS Significant improvements were found in all evaluation methods between the pre- and postoperative periods (all P < .05), with no observed differences between the graft type that was used (all P > .05). The whole sample had the following results: objective IKDC score, 96.2% classified as A/B; Lysholm score, 98.1% rated as good or excellent; and KT-1000, 98.1% with a side-to-side difference of up to five millimeters (65.4% with 0 to two millimeters). The complication rate was 9.6%, with no differences between the graft type that was used (P = .585). No significant difference was observed when comparing the results between isolated PCL injuries and combined injuries (all P > .05). CONCLUSIONS The proposed PCL reconstruction technique presented satisfactory results in both isolated and combined PCL lesions, and there were no differences between different types of autografts used. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Marcos Barbieri Mestriner
- Knee Surgery Division, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCMSP) Medical School, São Paulo, SP, Brazil.
| | - Ricardo de Paula Leite Cury
- Knee Surgery Division, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCMSP) Medical School, São Paulo, SP, Brazil
| | - Alfredo Dos Santos Netto
- Knee Surgery Division, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCMSP) Medical School, São Paulo, SP, Brazil
| | - Victor Marques de Oliveira
- Knee Surgery Division, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCMSP) Medical School, São Paulo, SP, Brazil
| | - Osmar Pedro Arbix de Camargo
- Knee Surgery Division, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCMSP) Medical School, São Paulo, SP, Brazil
| | - João Carlos Belloti
- Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (UNIFESP) Medical School, São Paulo, SP, Brazil
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Netto ADS, de Brito MBS, Severino FR, Campos LRA, Nico MAC, de Oliveira VM, Severino NR. STUDY ON THE PATELLOFEMORAL JOINT USING MAGNETIC RESONANCE IMAGING: MORPHOLOGICAL VARIATION OF THE MEDIAL PATELLOFEMORAL LIGAMENT. Rev Bras Ortop 2015; 47:204-9. [PMID: 27042622 PMCID: PMC4799380 DOI: 10.1016/s2255-4971(15)30087-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 09/22/2011] [Indexed: 01/17/2023] Open
Abstract
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. RESULTS The average length of the MPFL was 46.4 mm, while the average thicknesses of its patellar insertion, middle third and femoral insertion were, respectively, 1.7 mm, 1.4 mm and 1.2 mm. The thickness of the MPFL correlated positively with the lateral condyle and interepicondylar distance measurements, and negatively with the patients' ages. CONCLUSION The morphology of the MPFL varies with the interepicondylar distance and the lateral condyle distance, and with patients' ages.
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Affiliation(s)
- Alfredo Dos Santos Netto
- Resident Physician in the Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Botelho Soares de Brito
- Resident Physician in the Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Fabrício Roberto Severino
- Trainee Physician in the Knee Surgery Group, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Leila Rodrigues Andrade Campos
- Resident Physician in the Musculoskeletal Radiology Group, Department of Imaging Diagnostics, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Astolfi Caetano Nico
- Attending Physician in the Musculoskeletal Radiology Group, Department of Imaging Diagnostics, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Victor Marques de Oliveira
- Attending Physician in the Knee Surgery Group, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Nilson Roberto Severino
- Physician and Head of the Knee Surgery Group, Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
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