RESUMO
BACKGROUND: Hip arthroscopy has become an increasingly used technique in orthopedic surgery; the learning curve of this procedure has been discussed recently. The purpose of this study is to assess the learning curve of arthroscopic hip surgery using the complications occurred during the surgery as an objective parameter to measure the outcomes. METHODS: Hip arthroscopic surgeries were performed. Patients were divided into two groups, group A corresponded to the learning curve of the first surgeon and group B includes the remaining surgeries. The demographic, surgical, functional and complications data for both groups were collected. RESULTS: Group A: 30 patients were included, the traction time during surgery was a mean of 75 minutes (range: 45-120). Five complications occurred (16.6%), all of them related to transient neuropraxia of the pudendal nerve. Group B: 67 patients were included, traction time during surgery was a mean of 63 minutes (range: 35-90), 2 complications (2.9%) occurred. CONCLUSIONS: Before performing hip arthroscopy it is necessary to have knowledge of arthroscopic surgery and the regional anatomy, and to have received specific training, given that this technique involves a long learning curve.
Assuntos
Artroscopia , Competência Clínica , Luxação do Quadril/cirurgia , Adulto , Artroscopia/efeitos adversos , Endoscopia/educação , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos ProspectivosRESUMO
BACKGROUND: The cystic lesions seen around the knee are usually meniscal or popliteal cysts. Cysts inside the articular cavity of the knee are rare and they are usually detected as incidental MRI findings. The ganglions originating in the cruciate ligaments or the infrapatellar fat have rarely been reported. We are reporting the cases of three intraarticular ganglions. The clinical diagnosis was made with magnetic resonance imaging. All patients were treated With arthroscopic surgery using the synovial shaver to remove the tissue. The three patients were reported as asymptomatic during the follow-up, with full range of motion. CONCLUSIONS: The literature review shows that the origin of ganglions is controversial. The three reported cases show that this is a pathology that should be suspected, as it is difficult to diagnose. MRI is essential to make the diagnosis and the arthroscopic treatment of intraarticular ganglions is effective.
Assuntos
Cistos Glanglionares , Articulação do Joelho , Adolescente , Feminino , Cistos Glanglionares/diagnóstico , Cistos Glanglionares/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: The allogeneic meniscal transplantation (AMT) has received much attention lately for the treatment of young, active patients with painful knees previously subjected to meniscectomy. OBJECTIVE: Show the current concepts on AMT as well as the methods for meniscal harvesting, processing and preservation that the Tissue Bank must implement. CONCLUSIONS: Based on the results of the short- and medium-term studies, the AMT has proven to relieve pain and improve function in patients with symptomatic knees and a history of meniscectomy. To respond to the requests from surgeons, the Tissue Bank should supply grafts that assure the appropriate processing and quality of the meniscus.
Assuntos
Meniscos Tibiais/transplante , Preservação de Tecido/métodos , Coleta de Tecidos e Órgãos/métodos , Humanos , Meniscos Tibiais/cirurgiaRESUMO
BACKGROUND: Despite the many studies on chondral injury repair, no outcomes have been evaluated with the Western Ontario and McMaster (WOMAC) Universities osteoarthritis index, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Oxford Knee Score, all of which are specific for evaluating the presence of osteoarthritis. MATERIALS AND METHODS: We evaluated the clinical progress of patients following autologous chondrocyte implantation (ACI) performed by our Bone and Tissue Bank using a technique in which cells, instead of being introduced to the articular defect in a liquid form, are implanted into a tridimensional matrix of semisolid collagen (Condrograft((R))). A total of 22 patients underwent the procedure, 15 of whom were available for a 1-year follow-up that included clinical evaluation by WOMAC score before and after surgery and KOOS and the Oxford Knee Score after surgery. RESULTS: The results were improved WOMAC score from 56.4 before surgery to 16.2 after surgery (P < 0.002), average KOOS score of 83.6, and average Oxford Knee Score of 18.8. CONCLUSIONS: These results indicate that our tridimensional matrix technique effectively improved patients' quality of life, at least in the short term, and delayed any subsequent procedure. Long-term assessment is necessary to determine the true value of this technique.