Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2013
Purpose: We aimed to analyze how different positions of the tibial and femoral tunnels when used ... more Purpose: We aimed to analyze how different positions of the tibial and femoral tunnels when used for anterior cruciate ligament (ACL) reconstruction affect relations with the posterior cruciate ligament (PCL) at different degrees of knee flexion. Information gained from this study may be helpful in determining optimal placement of the graft in ACL reconstructive surgery. Methods: We divided 10 cadaveric knees into 2 groups of 5 and had either their femoral or tibial ACL insertion detached. For each specimen, 16 different positions were reproduced during ACL reconstruction based on a combination of 4 different tunnels in the tibia for group A (anterior-medial, anterior-lateral, posterior-medial, and posterior-lateral) and 4 in the femur for group B (anterior-proximal, anterior-distal, posterior-proximal, and posteriordistal) with 4 of knee flexion for each (0 , 45 , 90 , and 135 ). We performed a magnetic resonance imaging (MRI) study for each configuration and analyzed the cruciate ligament positioning. Results: We identified 3 different situations: no contact between cruciate ligaments, contact without deformity, and contact with deformity. In group A, the degree of flexion (P ¼ .003) and ligament insertion positioned in the posterior quadrants (P < .05) were statistically significant for the presence of ACL impingement. Ligament contact with deformity was identified in 18 (22.5%) configurations, mostly when the knee was flexed 45 and 90 and the ACL was in the posterior quadrants. For group B, "contact with deformity" was identified in 23 MR images, mostly (12 cases) with the graft position being in the anterior-distal configuration, but it was not significant for the occurrence of cruciate impingement. Conclusions: Impingement with ligament deformity is greater when the graft is fixed at the posterior quadrants of the tibial footprint, regardless of the degree of knee flexion. Although quite common, the ligament position in the femoral footprint was not a primary cause of ACL impingement with deformity. Clinical Relevance: This study helps identify positions of the tibial or femoral tunnels during ACL reconstruction to avoid impingement between cruciate ligaments.
Background: Current literature supports the thought that anesthesia and analgesia administered pe... more Background: Current literature supports the thought that anesthesia and analgesia administered perioperatively for an anterior cruciate ligament (ACL) reconstruction have a great influence on time to effective rehabilitation during the first week after hospital discharge. Purpose: The aim of this study is to answer the research question is there a difference in clinical outcomes between the use of a femoral nerve block with spinal anesthesia versus spinal analgesia alone for people undergoing ACL reconstruction? Methods: ACL reconstruction with spinal anesthesia and patient sedation (Group one); and spinal anesthesia with patient sedation and an additional femoral nerve block (Group two). Patients were re-evaluated for pain, range of motion (ROM), active contraction of the quadriceps, and a Functional Independence Measure (FIM) scoring scale. Results: Spinal anesthesia with a femoral nerve block demonstrates pain relief 6 h after surgery (VAS 0.37; p = 0.007). From the third (VAS = 4.56; p = 0.028) to the seventh (VAS = 2.87; p = 0.05) days after surgery, this same nerve blockage delivered higher pain scores. Patients had a similar progressive improvement on knee joint range of motion with or without femoral nerve block (p b 0.002). Group one and two had 23.75 and 24.29°6 h after surgery and 87.81 and 85.36°of knee flexion after 48 h post op. Conclusion: Spinal anesthesia associated with a femoral nerve block had no additional benefits on pain control after the third postoperative day. There were no differences between groups concerning ability for knee flexion and to complete daily activities during postoperative period. Level of Evidence: Randomized Clinical Trial Level I.
Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The aut... more Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The authors declare that there was no conflict of interest in conducting this work Português e Inglês nos sites: www.rbo.org.br e www.scielo.br/rbort This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort O tratamento das lesões da cartilagem articular permanece um grande desafio nos dias atuais. Isto devido à inerente característica de baixa capacidade de regeneração deste tecido . Trata-se de uma lesão relativamente comum e, em um estudo retrospectivo sobre 31.516 ar-
Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The aut... more Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The authors declare that there was no conflict of interest in conducting this work Este artigo está disponível online nas versões Português e Inglês nos sites: www.rbo.org.br e www.scielo.br/rbort This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort Rev Bras Ortop. 2012;47(2):191-96
4 resumo Objetivo: Definir zona de segurança para evitar possíveis complicações vasculares e liga... more 4 resumo Objetivo: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a recons-trução do ligamento cruzado anterior. Métodos: Reconstru-ção artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. Resultados: A mensuração das distâncias analisadas mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da in-serção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. Conclusão: Per-cebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento cola-teral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecros...
The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal... more The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal following lesions, and surgical reconstruction is the standard treatment among athletes. Some steps of ACL reconstruction remain controversial. It is important to fully understand the anatomy of the ACL to accurately reproduce its anatomy during surgical reconstructions. The purpose of this study was to evaluate the use of anaglyphic images that produce 3D images to better visualize the anatomy of the ACL, and to highlight the anatomical features of this ligament as reported in the literature. We included ten knees in this study. After dissection of the knee structures, pictures were acquired using a camera with Nikon D40, AF-S Nikkor 18-55 mm (1:3.5-5.6 G2 ED), and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images was processed using Callipyan 3D Anabuilder software, which transforms the two images into one anaglyphic image. During the dissection of the knees, nine pictures were a...
Full thickness cartilage defect might occur at different ages, but a focal defect is a major conc... more Full thickness cartilage defect might occur at different ages, but a focal defect is a major concern in the knee of young athletes. It causes impairment and does not heal by itself. Several techniques were described to treat symptomatic full thickness cartilage defect. Recently, several advances were described on the known techniques of microfracture, osteochondral allograft, cell therapy, and others. This article brings an update of current literature on these well-described techniques for full thickness cartilage defect.
A three-dimensional anatomy of the posterolateral compartment of the knee: the use of a new techn... more A three-dimensional anatomy of the posterolateral compartment of the knee: the use of a new technology in the study of musculoskeletal anatomy Background: Recently, an interest has developed in understanding the anatomy of the posterior and posterolateral knee. The posterolateral compartment of the knee corresponds to a complex arrangement of ligaments and myotendinous structures. Undiagnosed lesions in this compartment are the main reason for failure of the anterior and posterior cruciate ligament reconstructions. Understanding the anatomy of these structures is essential to assist in the diagnosis and treatment of these lesions. The aim of this study was to better understand the relationship between these structures of the knee using three-dimensional technology. Methods: Ten knees were included from cadaver lower limbs of adult patients. The skin and subcutaneous tissue were removed leaving only the muscle groups and ligaments. The neurovascular bundles and their ramifications were preserved. Images were acquired from the dissections using a Nikon D40 camera with AF-S Nikkor 18-55 mm (1:3.5 5.6 GII ED) and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images were processed using Callipyan 3D and AnaBuilder software, which transforms the two images into one anaglyphic image. Results: During the dissection of the knees, twelve pictures were acquired and transformed into anaglyphic images. Conclusion: The use of three-dimensional images in this study demonstrates that this technique is useful to improve the knowledge in anatomy of the knee as well as for knee reconstruction surgery.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
The stereoscopic imaging technique is an option for a more realistic understanding of what we nor... more The stereoscopic imaging technique is an option for a more realistic understanding of what we normally see in 2 dimensions on paper or on a screen. To produce a 3-dimensional image of an object, it is necessary to register 2 different images of the same object at the same distance and height with the use of cameras that focus on one particular point. A convergence between the left and right images is required for human vision. The distance between the camera and the images necessary to create the stereo pair should be proportional to the normal distance between the pupils. Stereoscopic or polarization techniques are used to create the images, and special glasses are required to view them. In medicine, 3-dimensional images are an extremely effective resource in the study and teaching of anatomy at both the macroscopic and microscopic levels. With advancements in technology and the emergence of new diagnostic imaging techniques and innovative therapeutic modalities, 3-dimensional images can be an excellent educational tool.
Purpose For many years, the anatomy of the medial knee corner has been reported. However, it is n... more Purpose For many years, the anatomy of the medial knee corner has been reported. However, it is not exactly clear how all these structures function together. The purpose of this study is to identify and try to understand the relationship between the posteromedial corners of the knee using three-dimensional visualization techniques. Materials and methods This study comprises of 10 knees from adult corpses. Images were acquired from the dissection of different layers of the posteromedial compartment of the knee using a camera Nikon D40 and AF-S Nikkor 18-55 mm (Nikon Corp., Japan) placed on a slide bar. The pair of images was processed using Callipyan 3D or Anabuilder software (Ana builder, France) that trans-forms the two different images of the same structure with the intrapupillary distance proportion into one anaglyphic image. Results During knee dissection, pictures were taken and transformed into three-dimensional images that become more realistic with the use of special glasses. The images were made during the dissection of the three layers of the posteromedial compartment of the knees. Conclusions Posteromedial corner ligament structures are quite complex and are not always clearly described in the literature. Three-dimensional images of these structures can help better understanding its anatomy.
Background: The patella is the largest human sesamoid bone and often sustains chondral injury. Th... more Background: The patella is the largest human sesamoid bone and often sustains chondral injury. There is no consensus on how to treat a full-thickness, symptomatic articular cartilage injury of the patella. We analyzed the clinical and functional outcomes of patients with symptomatic full-thickness patellar chondral lesions treated with autologous osteochondral transplantation and evaluated osteochondral autograft bone-plug integration through magnetic resonance imaging.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
The stereoscopic imaging technique is an option for a more realistic understanding of what we nor... more The stereoscopic imaging technique is an option for a more realistic understanding of what we normally see in 2 dimensions on paper or on a screen. To produce a 3-dimensional image of an object, it is necessary to register 2 different images of the same object at the same distance and height with the use of cameras that focus on one particular point. A convergence between the left and right images is required for human vision. The distance between the camera and the images necessary to create the stereo pair should be proportional to the normal distance between the pupils. Stereoscopic or polarization techniques are used to create the images, and special glasses are required to view them. In medicine, 3-dimensional images are an extremely effective resource in the study and teaching of anatomy at both the macroscopic and microscopic levels. With advancements in technology and the emergence of new diagnostic imaging techniques and innovative therapeutic modalities, 3-dimensional images can be an excellent educational tool.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2012
Purpose: To evaluate the posterior septum of the knee and determine the presence of a safe zone t... more 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. Results: The posterior septum of the knee is rich in type II and type IV mechanoreceptors and blood vessels. The superior half has a greater number of blood vessels (21.52 Ϯ 6.36 v 12.05 Ϯ 4.1, P Ͻ .001), higher-caliber vessels (2.2 Ϯ 0.89 m v 1.41 Ϯ 0.45 m, P Ͻ .006), and a greater number of mechanoreceptors per field (type II, 1.8 Ϯ 1.8 v 0.42 Ϯ 1, P ϭ .04; type IV, 22.6 Ϯ 14 v 14.5 Ϯ 9.4, P ϭ .04) than the inferior half of the septum. Conclusions: This study has shown that the posterior septum of the knee is highly vascularized and has a great number of type II and IV mechanoreceptors. The presence of these structures is significantly higher in the superior half of the septum. Clinical Relevance: If debridement of the posterior septum is necessary, it should be done at the inferior aspect so that a greater number of blood vessels and mechanoreceptors can be preserved.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
Posterolateral compartment of the knee. A new perspective to understand its complex anatomy. 3D i... more Posterolateral compartment of the knee. A new perspective to understand its complex anatomy. 3D images are two-dimensional images prepared in order to provide the illusion of having three dimensions. With the ability to visualize important structures in great detail, 3D visualization methods are a valuable resource for the diagnosis and surgical treatment of many pathologies. 3D glasses available.
Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first ... more Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2013
Purpose: We aimed to analyze how different positions of the tibial and femoral tunnels when used ... more Purpose: We aimed to analyze how different positions of the tibial and femoral tunnels when used for anterior cruciate ligament (ACL) reconstruction affect relations with the posterior cruciate ligament (PCL) at different degrees of knee flexion. Information gained from this study may be helpful in determining optimal placement of the graft in ACL reconstructive surgery. Methods: We divided 10 cadaveric knees into 2 groups of 5 and had either their femoral or tibial ACL insertion detached. For each specimen, 16 different positions were reproduced during ACL reconstruction based on a combination of 4 different tunnels in the tibia for group A (anterior-medial, anterior-lateral, posterior-medial, and posterior-lateral) and 4 in the femur for group B (anterior-proximal, anterior-distal, posterior-proximal, and posteriordistal) with 4 of knee flexion for each (0 , 45 , 90 , and 135 ). We performed a magnetic resonance imaging (MRI) study for each configuration and analyzed the cruciate ligament positioning. Results: We identified 3 different situations: no contact between cruciate ligaments, contact without deformity, and contact with deformity. In group A, the degree of flexion (P ¼ .003) and ligament insertion positioned in the posterior quadrants (P < .05) were statistically significant for the presence of ACL impingement. Ligament contact with deformity was identified in 18 (22.5%) configurations, mostly when the knee was flexed 45 and 90 and the ACL was in the posterior quadrants. For group B, "contact with deformity" was identified in 23 MR images, mostly (12 cases) with the graft position being in the anterior-distal configuration, but it was not significant for the occurrence of cruciate impingement. Conclusions: Impingement with ligament deformity is greater when the graft is fixed at the posterior quadrants of the tibial footprint, regardless of the degree of knee flexion. Although quite common, the ligament position in the femoral footprint was not a primary cause of ACL impingement with deformity. Clinical Relevance: This study helps identify positions of the tibial or femoral tunnels during ACL reconstruction to avoid impingement between cruciate ligaments.
Background: Current literature supports the thought that anesthesia and analgesia administered pe... more Background: Current literature supports the thought that anesthesia and analgesia administered perioperatively for an anterior cruciate ligament (ACL) reconstruction have a great influence on time to effective rehabilitation during the first week after hospital discharge. Purpose: The aim of this study is to answer the research question is there a difference in clinical outcomes between the use of a femoral nerve block with spinal anesthesia versus spinal analgesia alone for people undergoing ACL reconstruction? Methods: ACL reconstruction with spinal anesthesia and patient sedation (Group one); and spinal anesthesia with patient sedation and an additional femoral nerve block (Group two). Patients were re-evaluated for pain, range of motion (ROM), active contraction of the quadriceps, and a Functional Independence Measure (FIM) scoring scale. Results: Spinal anesthesia with a femoral nerve block demonstrates pain relief 6 h after surgery (VAS 0.37; p = 0.007). From the third (VAS = 4.56; p = 0.028) to the seventh (VAS = 2.87; p = 0.05) days after surgery, this same nerve blockage delivered higher pain scores. Patients had a similar progressive improvement on knee joint range of motion with or without femoral nerve block (p b 0.002). Group one and two had 23.75 and 24.29°6 h after surgery and 87.81 and 85.36°of knee flexion after 48 h post op. Conclusion: Spinal anesthesia associated with a femoral nerve block had no additional benefits on pain control after the third postoperative day. There were no differences between groups concerning ability for knee flexion and to complete daily activities during postoperative period. Level of Evidence: Randomized Clinical Trial Level I.
Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The aut... more Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The authors declare that there was no conflict of interest in conducting this work Português e Inglês nos sites: www.rbo.org.br e www.scielo.br/rbort This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort O tratamento das lesões da cartilagem articular permanece um grande desafio nos dias atuais. Isto devido à inerente característica de baixa capacidade de regeneração deste tecido . Trata-se de uma lesão relativamente comum e, em um estudo retrospectivo sobre 31.516 ar-
Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The aut... more Os autores declaram inexistência de conflito de interesses na realização deste trabalho / The authors declare that there was no conflict of interest in conducting this work Este artigo está disponível online nas versões Português e Inglês nos sites: www.rbo.org.br e www.scielo.br/rbort This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort Rev Bras Ortop. 2012;47(2):191-96
4 resumo Objetivo: Definir zona de segurança para evitar possíveis complicações vasculares e liga... more 4 resumo Objetivo: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a recons-trução do ligamento cruzado anterior. Métodos: Reconstru-ção artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. Resultados: A mensuração das distâncias analisadas mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da in-serção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. Conclusão: Per-cebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento cola-teral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecros...
The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal... more The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal following lesions, and surgical reconstruction is the standard treatment among athletes. Some steps of ACL reconstruction remain controversial. It is important to fully understand the anatomy of the ACL to accurately reproduce its anatomy during surgical reconstructions. The purpose of this study was to evaluate the use of anaglyphic images that produce 3D images to better visualize the anatomy of the ACL, and to highlight the anatomical features of this ligament as reported in the literature. We included ten knees in this study. After dissection of the knee structures, pictures were acquired using a camera with Nikon D40, AF-S Nikkor 18-55 mm (1:3.5-5.6 G2 ED), and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images was processed using Callipyan 3D Anabuilder software, which transforms the two images into one anaglyphic image. During the dissection of the knees, nine pictures were a...
Full thickness cartilage defect might occur at different ages, but a focal defect is a major conc... more Full thickness cartilage defect might occur at different ages, but a focal defect is a major concern in the knee of young athletes. It causes impairment and does not heal by itself. Several techniques were described to treat symptomatic full thickness cartilage defect. Recently, several advances were described on the known techniques of microfracture, osteochondral allograft, cell therapy, and others. This article brings an update of current literature on these well-described techniques for full thickness cartilage defect.
A three-dimensional anatomy of the posterolateral compartment of the knee: the use of a new techn... more A three-dimensional anatomy of the posterolateral compartment of the knee: the use of a new technology in the study of musculoskeletal anatomy Background: Recently, an interest has developed in understanding the anatomy of the posterior and posterolateral knee. The posterolateral compartment of the knee corresponds to a complex arrangement of ligaments and myotendinous structures. Undiagnosed lesions in this compartment are the main reason for failure of the anterior and posterior cruciate ligament reconstructions. Understanding the anatomy of these structures is essential to assist in the diagnosis and treatment of these lesions. The aim of this study was to better understand the relationship between these structures of the knee using three-dimensional technology. Methods: Ten knees were included from cadaver lower limbs of adult patients. The skin and subcutaneous tissue were removed leaving only the muscle groups and ligaments. The neurovascular bundles and their ramifications were preserved. Images were acquired from the dissections using a Nikon D40 camera with AF-S Nikkor 18-55 mm (1:3.5 5.6 GII ED) and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images were processed using Callipyan 3D and AnaBuilder software, which transforms the two images into one anaglyphic image. Results: During the dissection of the knees, twelve pictures were acquired and transformed into anaglyphic images. Conclusion: The use of three-dimensional images in this study demonstrates that this technique is useful to improve the knowledge in anatomy of the knee as well as for knee reconstruction surgery.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
The stereoscopic imaging technique is an option for a more realistic understanding of what we nor... more The stereoscopic imaging technique is an option for a more realistic understanding of what we normally see in 2 dimensions on paper or on a screen. To produce a 3-dimensional image of an object, it is necessary to register 2 different images of the same object at the same distance and height with the use of cameras that focus on one particular point. A convergence between the left and right images is required for human vision. The distance between the camera and the images necessary to create the stereo pair should be proportional to the normal distance between the pupils. Stereoscopic or polarization techniques are used to create the images, and special glasses are required to view them. In medicine, 3-dimensional images are an extremely effective resource in the study and teaching of anatomy at both the macroscopic and microscopic levels. With advancements in technology and the emergence of new diagnostic imaging techniques and innovative therapeutic modalities, 3-dimensional images can be an excellent educational tool.
Purpose For many years, the anatomy of the medial knee corner has been reported. However, it is n... more Purpose For many years, the anatomy of the medial knee corner has been reported. However, it is not exactly clear how all these structures function together. The purpose of this study is to identify and try to understand the relationship between the posteromedial corners of the knee using three-dimensional visualization techniques. Materials and methods This study comprises of 10 knees from adult corpses. Images were acquired from the dissection of different layers of the posteromedial compartment of the knee using a camera Nikon D40 and AF-S Nikkor 18-55 mm (Nikon Corp., Japan) placed on a slide bar. The pair of images was processed using Callipyan 3D or Anabuilder software (Ana builder, France) that trans-forms the two different images of the same structure with the intrapupillary distance proportion into one anaglyphic image. Results During knee dissection, pictures were taken and transformed into three-dimensional images that become more realistic with the use of special glasses. The images were made during the dissection of the three layers of the posteromedial compartment of the knees. Conclusions Posteromedial corner ligament structures are quite complex and are not always clearly described in the literature. Three-dimensional images of these structures can help better understanding its anatomy.
Background: The patella is the largest human sesamoid bone and often sustains chondral injury. Th... more Background: The patella is the largest human sesamoid bone and often sustains chondral injury. There is no consensus on how to treat a full-thickness, symptomatic articular cartilage injury of the patella. We analyzed the clinical and functional outcomes of patients with symptomatic full-thickness patellar chondral lesions treated with autologous osteochondral transplantation and evaluated osteochondral autograft bone-plug integration through magnetic resonance imaging.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
The stereoscopic imaging technique is an option for a more realistic understanding of what we nor... more The stereoscopic imaging technique is an option for a more realistic understanding of what we normally see in 2 dimensions on paper or on a screen. To produce a 3-dimensional image of an object, it is necessary to register 2 different images of the same object at the same distance and height with the use of cameras that focus on one particular point. A convergence between the left and right images is required for human vision. The distance between the camera and the images necessary to create the stereo pair should be proportional to the normal distance between the pupils. Stereoscopic or polarization techniques are used to create the images, and special glasses are required to view them. In medicine, 3-dimensional images are an extremely effective resource in the study and teaching of anatomy at both the macroscopic and microscopic levels. With advancements in technology and the emergence of new diagnostic imaging techniques and innovative therapeutic modalities, 3-dimensional images can be an excellent educational tool.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2012
Purpose: To evaluate the posterior septum of the knee and determine the presence of a safe zone t... more 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. Results: The posterior septum of the knee is rich in type II and type IV mechanoreceptors and blood vessels. The superior half has a greater number of blood vessels (21.52 Ϯ 6.36 v 12.05 Ϯ 4.1, P Ͻ .001), higher-caliber vessels (2.2 Ϯ 0.89 m v 1.41 Ϯ 0.45 m, P Ͻ .006), and a greater number of mechanoreceptors per field (type II, 1.8 Ϯ 1.8 v 0.42 Ϯ 1, P ϭ .04; type IV, 22.6 Ϯ 14 v 14.5 Ϯ 9.4, P ϭ .04) than the inferior half of the septum. Conclusions: This study has shown that the posterior septum of the knee is highly vascularized and has a great number of type II and IV mechanoreceptors. The presence of these structures is significantly higher in the superior half of the septum. Clinical Relevance: If debridement of the posterior septum is necessary, it should be done at the inferior aspect so that a greater number of blood vessels and mechanoreceptors can be preserved.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
Posterolateral compartment of the knee. A new perspective to understand its complex anatomy. 3D i... more Posterolateral compartment of the knee. A new perspective to understand its complex anatomy. 3D images are two-dimensional images prepared in order to provide the illusion of having three dimensions. With the ability to visualize important structures in great detail, 3D visualization methods are a valuable resource for the diagnosis and surgical treatment of many pathologies. 3D glasses available.
Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first ... more Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.
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