RESUMO
BACKGROUND: The natural history of a knee subjected to total meniscectomy leads to poor outcomes, so we should be careful with these lesions. Meniscal transplantation may be a proper treatment for these patients as it involves a good medium-term survival. MATERIAL AND METHOD: We report the case of a 52 year-old male who underwent meniscal transplantation and developed left gonarthrosis. The surgical approach consisted of medial longitudinal arthrotomy and implantation of a posterior stabilized prosthesis after releasing the soft tissues, which were very retracted. RESULTS: At the one year follow-up the operated knee had an articular range of 0-110 degrees, with no gap and no pain; no external support was required for walking. CONCLUSIONS: Despite the fact that most case series report good short- and medium-term results, some patients do not have good results and need a total knee prosthesis.
Assuntos
Artroplastia do Joelho , Meniscos Tibiais/transplante , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: We are currently observing an increase in the incidence of acetabular fractures in elderly patients due to the increase in this population age group. These fractures represent a challenge to the traumatologist because in some cases there is the surgical alternative of combining fixation with total acute hip arthroplasty. In this paper we explore the use of trabecular metal combining the stability provided by a cage with potential bone incorporation, applying the principles of revision surgery to speed-up the healing process without the limitations resulting from the restrictions in the load of the operated limb. MATERIAL AND METHODS: We assessed the clinical and radiological results, with a 2-year follow-up, after total hip arthroplasty for the acute treatment of an acetabular fracture of the anterior column, with involvement of the quadrilateral lamina in an elderly 85 year-old patient. RESULTS: Important pain relief occurred, with functional improvement and an appropriate range of motion using the Merle d'Aubigné system. Radiologically, the graft areas in the particles surrounding the acetabular component were uniformly integrated. No loosening, screw rupture or implant migration occurred. CONCLUSIONS: This indication using a revision technique based on a trabecular metal reconstruction cage should be considered as an alternative to bear in mind in these patients.