Artroplastia total de cadera tipo Charnley : Estudio retrospectivo descriptivo de 595 casos de prótesis primarias durante 25 años

L'artroplastia total de maluc cimentada, descrita per Charnley, és reconeguda per ser una de les intervencions més exitoses. Analitzem retrospectivament 595 artroplasties primàries tipus Charnley del nostre centre, durant 1986 i 2011. Com a punt final de supervivencia considerem el recanvi protèsic (afluixament asèptic, infecció o luxació), èxitus o pèrdua de seguiment. Els anàlisis de supervivència a llarg plaç, han sigut similars als obtinguts per altres autors. Aquest estudi identifica grups poblacionals que podrien beneficiar-se dels nous implants i tècniques que millorin aquesta exitosa pròtesi, i reafirma els bons resultats d'aquesta cirurgia, inclús a hospitals generals.La artroplastia total de cadera cementada, descrita por Charnley, es reconocida por ser una de las intervenciones con más éxito. Analizamos retrospectivamente 595 artroplastias primarias tipo Charnley de nuestro centro, durante 1986 y 2011. Como punto final de supervivencia consideramos el recambio protésico (aflojamiento aséptico, infección o luxación), éxitus o pérdida de seguimiento. Los análisis de supervivencia a largo plazo, demostraron ser similares a los obtenidos por otros autores. Este estudio identifica grupos poblacionales que podrían verse beneficiados por nuevos implantes y técnicas que mejoren esta exitosa prótesis, y reafirma los buenos resultados de esta cirugía, incluso en hospitales generales

Artroplastia total de cadera tipo Charnley: Estudio retrospectivo descriptivo de 595 casos de prótesis primarias durante 25 años.

L’artroplastia total de maluc cimentada, descrita per Charnley, és reconeguda per ser una de les intervencions més exitoses. Analitzem retrospectivament 595 artroplasties primàries tipus Charnley del nostre centre, durant 1986 i 2011. Com a punt final de supervivencia considerem el recanvi protèsic (afluixament asèptic, infecció o luxació), èxitus o pèrdua de seguiment. Els anàlisis de supervivència a llarg plaç, han sigut similars als obtinguts per altres autors. Aquest estudi identifica grups poblacionals que podrien beneficiar-se dels nous implants i tècniques que millorin aquesta exitosa pròtesi, i reafirma els bons resultats d’aquesta cirurgia, inclús a hospitals generals.La artroplastia total de cadera cementada, descrita por Charnley, es reconocida por ser una de las intervenciones con más éxito. Analizamos retrospectivamente 595 artroplastias primarias tipo Charnley de nuestro centro, durante 1986 y 2011. Como punto final de supervivencia consideramos el recambio protésico (aflojamiento aséptico, infección o luxación), éxitus o pérdida de seguimiento. Los análisis de supervivencia a largo plazo, demostraron ser similares a los obtenidos por otros autores. Este estudio identifica grupos poblacionales que podrían verse beneficiados por nuevos implantes y técnicas que mejoren esta exitosa prótesis, y reafirma los buenos resultados de esta cirugía, incluso en hospitales generales

Artroplastia total de cadera tipo Charnley : Estudio retrospectivo descriptivo de 595 casos de prótesis primarias durante 25 años

L'artroplastia total de maluc cimentada, descrita per Charnley, és reconeguda per ser una de les intervencions més exitoses. Analitzem retrospectivament 595 artroplasties primàries tipus Charnley del nostre centre, durant 1986 i 2011. Com a punt final de supervivencia considerem el recanvi protèsic (afluixament asèptic, infecció o luxació), èxitus o pèrdua de seguiment. Els anàlisis de supervivència a llarg plaç, han sigut similars als obtinguts per altres autors. Aquest estudi identifica grups poblacionals que podrien beneficiar-se dels nous implants i tècniques que millorin aquesta exitosa pròtesi, i reafirma els bons resultats d'aquesta cirurgia, inclús a hospitals generals.La artroplastia total de cadera cementada, descrita por Charnley, es reconocida por ser una de las intervenciones con más éxito. Analizamos retrospectivamente 595 artroplastias primarias tipo Charnley de nuestro centro, durante 1986 y 2011. Como punto final de supervivencia consideramos el recambio protésico (aflojamiento aséptico, infección o luxación), éxitus o pérdida de seguimiento. Los análisis de supervivencia a largo plazo, demostraron ser similares a los obtenidos por otros autores. Este estudio identifica grupos poblacionales que podrían verse beneficiados por nuevos implantes y técnicas que mejoren esta exitosa prótesis, y reafirma los buenos resultados de esta cirugía, incluso en hospitales generales

Patellar tendon lengthening: rescue procedure for patella baja

Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritis-even more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar tendon with allograft, and proximalization of the tibial tubercle. A combination of 2 or more of these treatments may be recommended in cases of significant patella baja. We present a simple and reproducible technique to address patella baja that combines a partial transposition of the tibial tubercle and patellar tendon lengthening using a subperiosteal patellar flap in continuity with the patellar tendon

Femoral Tunnel Drilling Angles for Posteromedial Corner Reconstructions of the Knee

PURPOSE: To determine the best angle to drill the femoral tunnels of the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) with concomitant posterior cruciate ligament (PCL) reconstruction to avoid either short tunnels or tunnel collisions. METHODS: Eight cadaveric knees were studied. Double-bundle PCL femoral tunnels were arthroscopically drilled. Drilling of the sMCL and POL tunnels was performed in 4 different combinations of 0° and 30° axial (anteriorly directed) and coronal (proximally directed) angulations. Specimens were scanned with computed tomography to document the relations of the sMCL and POL tunnels to the intercondylar notch and PCL tunnels. A minimum tunnel length of 25 mm was required. RESULTS: When the sMCL femoral tunnel was drilled at 0° axial and 30° coronal (proximally directed) angulations or 30° axial (anteriorly directed) and 0° coronal angulations, the risk of tunnel collision with the PCL tunnels increased in comparison with the remaining evaluated angulations (P < .001). No POL tunnels collided with either PCL tunnel bundle with the exception of tunnels drilled at 0° axial and 30° coronal (proximally directed) angulations, which did so in 3 of 8 cases (P < .001). The minimum required tunnel length was obtained in all the sMCL and POL tunnels (P < .001 and P = .02, respectively). However, some of those angled at 0° on the axial plane violated the intercondylar notch. CONCLUSIONS: When one is performing posteromedial reconstructions with concomitant PCL procedures, the sMCL and POL femoral tunnels should be drilled anteriorly and proximally at both 30° axial and 30° coronal angulations. The POL femoral tunnel may also be angled 0° in the coronal plane. Tunnels at 0° axial angulations showed a shorter distance to the intercondylar notch and a higher risk of collision with the PCL tunnels. CLINICAL RELEVANCE: Specific drilling angles are necessary to avoid short tunnels or collisions between the drilled tunnels when sMCL and POL femoral tunnels are placed with concomitant PCL reconstruction

Does anatomic single-bundle ACL reconstruction using hamstring autograft produce anterolateral meniscal root tearing?

To determine if tibial tunnel reaming during anatomic single-bundle anterior cruciate ligament (ACL) reconstruction using hamstring autograft can result in anterolateral meniscal root injury, as diagnosed by magnetic resonance imaging (MRI). A case series of 104 primary anatomic single-bundle ACL reconstructions using hamstring autograft was retrospectively reviewed. Pre- and post-operative (>1 year) MRIs were radiologically evaluated for each patient, with a lateral meniscus extrusion > 3 mm at the level of the medial collateral ligament midportion on a coronal MRI, to establish anterolateral meniscal root injury. No patients presented radiological findings of anterolateral meniscal root injury in this case series. Examining a single-bundle ACL reconstruction technique using hamstring autograft that considered tibial tunnel positioning in the center of the tibial footprint, this case series found no evidence of anterolateral meniscal root injury in patient MRIs, even more than 1-year post-operation

MRI evaluation of the peripheral attachments of the lateral meniscal body: the menisco-tibio-popliteus-fibular complex

Data de publicació electrònica: 17-06-2021Purpose: To determine, identify and measure the structures of the menisco-tibio-popliteus-fibular complex (MTPFC) with magnetic resonance imaging (MRI) in knees without structural abnormalities or a history of knee surgery. Methods: One-hundred-and-five knees without prior injury or antecedent surgery were analyzed by means of MRI. The average age was 50.1 years ± 14.8. All the measurements were performed by three observers. The peripherical structures of the lateral meniscus body were identified to determine the location, size, and thickness of the entire MTPFC. The distance to other "key areas" in the lateral compartment was also studied and compared by gender and age. Results: The lateral meniscotibial ligament (LMTL) was found in 97.1% of the MRIs, the popliteofibular ligament (PFL) in 93.3%, the popliteomeniscal ligaments (PML) in 90.4% and the meniscofibular ligament (MFL) in 39%. The anteroposterior distance of the LMTL in an axial view was 20.7 mm ± 3.9, the anterior thickness of the LMTL was 1.1 mm ± 0.3, and the posterior thickness of the LMTL 1.2 mm ± 0.1 and the height in a coronal view was 10.8 mm ± 1.9. The length of the PFL in a coronal view was 8.7 mm ± 2.5, the thickness was 1.4 mm ± 0.4 and the width in an axial view was 7.8 mm ± 2.2. Conclusions: The MTPFC has a constant morphological and anatomical pattern for three of its main ligaments and can be easily identified and measured in an MRI; the MFL has a lower prevalence, considering a structure difficult to identify by 1.5 T MRI