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PURPOSE: The hamstrings muscles are innervated by sciatic nerve branches. However, previous studies assessing which and how many branches innervate each muscle have yielded discrepant results. This study investigated the innervation patterns of hamstrings. MATERIALS AND METHODS: Thirty-five cadaver limbs were investigated. The average age of subjects was 78.6 ± 17.2 years, with 48.6% male and 51.4% female, while 57.1% were right limbs and 42.9% left. The sciatic nerve, hamstrings and associated structures were dissected. The number of nerve branches for each muscle and the level where they penetrated the muscle were recorded. RESULTS: The sciatic nerve was connected by a fibrous band to the long head of the biceps femoris. This muscle was innervated by either one or two branches, which penetrated the muscle into its superior or middle third. The short head of the biceps femoris was innervated by a single nerve that usually penetrated its middle third, but sometimes inferiorly or, less commonly, superiorly. The semitendinosus was always innervated by two branches, the superior branch penetrating its upper third, the inferior mostly the middle third. The semimembranosus usually was innervated by a single nerve branch that penetrated the muscle at its middle or lower third. Four specimens revealed common nerves that innervated than one muscle. CONCLUSIONS: We have characterized hamstring innervation patterns, knowledge that is relevant to neurolysis, surgery of the thigh, and other procedures. Moreover, a mechanical connection between the sciatic nerve and biceps femoris long head was identified that could explain certain neuralgias.

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PURPOSE: The purpose of this study is to compare the patient-reported outcomes and return to sports of the conservative and surgical treatment of distal hamstring tendon injuries. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers searched PubMed, Scopus and Virtual Health Library databases in January 2023. Clinical studies evaluating conservative or surgical management outcomes of distal hamstring tendon injuries were considered eligible for this systematic review if predefined criteria were fulfilled: (1) published in English or Spanish; (2) evaluated any of the following: patient-reported outcomes, return-to-sports rate (RTS-R) or return-to-sports time (RTS-T). Data were presented in tables using absolute values from individual studies and derived pooled percentages. RESULTS: Eighteen studies were included for 67 patients and 68 distal hamstring tendon injuries. Initially, 39 patients (58.2%) underwent surgical treatment, whereas 28 (41.8%) were treated conservatively. Among conservative treatment patients, 15 failed and had to be operated on (53.6%), all with distal semitendinosus tendon injuries. Anchor fixation was the technique of choice in 20 lesions (36.4%), tenodesis in 16 (29.1%), tenectomy in 14 (25.5%) and sutures were preferred in five (9%). Thirteen out of 28 patients (46.4%) undergoing initial conservative treatment returned to sports at a mean of 3.6 months (range 1 week to 12 months), in contrast to surgical treatment, in which 36 out of 39 patients (92.3%) returned at a mean of 4.2 months (range 6 weeks to 12 months). Additionally, 14 of 15 patients (93.3%) converted to surgical treatment after failed conservative treatment returned to sports at a mean of 7.6 months after injury. CONCLUSION: Initial surgical treatment of distal hamstring tendon injuries yields a high RTS-R (92.3%) at a mean of 4.2 months. Furthermore, 15 out of 28 patients (53.6%) initially treated conservatively had to be operated on, delaying the RTS-T (mean 7.6 months after injury) without affecting their RTS-R. LEVEL OF EVIDENCE: IV.

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El Ligamento Colateral Medial Superficial y otros estabilizadores estáticos de la rodilla, como el fascículo profundo del LCM y el Ligamento Posterior Oblicuo, presentan una alta frecuencia de lesiones, comprometiendo principalmente a la población joven y deportista. El mecanismo lesional suele involucrar un movimiento de valgo forzado, rotación externa en flexión o semiflexión de rodilla o combinación de ambos, que pueden ser producto de actividades como el ski, patinaje y fútbol. El trabajo se realizó en pacientes del Hospital Clínicas y particulares desde enero 2017 a diciembre 2018, como muestra se tiene a 11 pacientes internados con el diagnostico de Inestabilidad medial crónica de rodilla ; se escogieron mediante un muestro no probabilístico. Investigación de tipo comparativo, observacional, longitudinal, prospectivo , se realizó un seguimiento de 6 a 1 año post quirúrgico en paciente que se sometieron a la reconstrucción anatómica monofascicular con injerto autólogo semitendinoso monofascicular. Cumplían los criterios de inclusión 11 pacientes. El 95 % de los pacientes fueron hombres . Pacientes operados con injerto autólogo semitendinoso con reconstrucción anatómica , teniendo resultados del 92%Grado A y B escala objetiva IKDC post quirúrgica. Los resultados de este estudio demuestran la efectividad , sencillez de reproducir la técnica empleada en estabilizar la rodilla en casos de lesiones crónicas grado III del LCMs y el LPO

The superficial medial collateral ligament and other static stabilizers of the knee, such as the LCM deep fasciculus and the oblique posterior ligament, present a high frequency of injuries, compromising mainly the young population and athletes. The mechanism of injury usually involves forced valgus movement, external rotation in knee flexion or semi-flexion, or a combination of both, which may be the result of activities such as skiing, skating and soccer. The work was carried out in patients of the Hospital Clínicas and private from January 2017 to December 2018, as sample shows 11 patients interned with the diagnosis of chronic medial instability of the knee; they were chosen through a non-probabilistic sampling. Comparative, observational, longitudinal, prospective research was carried out 6 to 1 year post-surgical follow-up in a patient who underwent monofascicular anatomic reconstruction with monofascicular semitendinosus autologous graft. 11 patients met the inclusion criteria. 95% of the patients were men. Patients operated with autologous semitendinous graft with anatomical reconstruction, having 92% Grade A and B results after IKDC objective scale. The results of this study demonstrate the effectiveness, simplicity of reproducing the technique used to stabilize the knee in cases of chronic injuries grade III of LCMs and LPO.

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The physicochemical characteristics of the meat from lambs fed diets containing whole or disintegrated cottonseed, associated or not with calcium lignosulfonate (LignoCaSO3), were evaluated. Thirty non-castrated Dorper x Santa Inês lambs, with an average of 24.9 ± 3.6 kg and four months of age were confined for 60 days in collective stalls and distributed in a completely randomized design with six replications. After slaughter, by means of contrasts, the averages of the parameters of the semimembranous and semitendinosus muscles were analyzed. The cottonseed increased cooking loss and ash, and reduced muscle weight, water holding capacity and red intensity. The disintegration of the cottonseed reduced the shear force in diets without LignoCaSO3, increased the protein and the loss by cooking and reduced the pH in the diets with the additive. The luminosity values increased with the disintegration of the cottonseed in diets with and without LignoCaSO3. The addition of LignoCaSO3increased the weight of the muscle, protein, ash, pH, shear strength and the intensity of red. Moisture, lipids and yellow intensity were not influenced by the diets. Even changing the physical-chemical characteristics, the cottonseed with or without LignoCaSO3does not change the quality of the meat.(AU)

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Hamstring muscle injuries are the most prevalent among athletes who engage in sprinting activities. Their most frequent location is where the long head of the biceps femoris joins with the semitendinosus muscle to form the conjoint hamstring tendon. Just distal to this area, an additional group of fibers of the semitendinosus originate from medial aspect of biceps femoris. The objective of this study was to analyze the morphological characteristics of this union and to discuss its potential role in hamstring tears. Anatomical dissection was performed on 35 thighs. Samples obtained from this region were sectioned and stained with Masson's trichrome for further histological evaluation. A group of fibers from the semitendinosus muscle originating from the long head of the biceps femoris were observed in all 35 specimens. This origin was located 67 ± 12 mm from the ischial tuberosity and was 32 ± 14 mm in length. This group of muscle fibers had a width of 10.9 ± 5.3 mm and a thickness in the anteroposterior axis of 3.2 ± 1.4 mm. Its pennation angle was 9.2 ± 1.5 degrees. Microscopic examination showed muscle cells from both muscles contacting interposed tendinous tissue. In conclusion, fibers of the semitendinosus muscle consistently arise from the proximal aspect of the long head of biceps femoris. The morphological characteristics of this junction have functional implications. The horizontal component of the semitendinosus vector could pull the long head of the biceps femoris medially during its shortening-lengthening cycle, rendering it an intrinsic risk factor for hamstring injuries.

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SUMMARY: The injury of Biceps Femoris long head (BFlh) and Semitendinosus (ST) is caused by over-stretch of the muscles at the back of the thigh. This condition encompasses almost one third of sports-related injuries and has severe consequences, such as pain and weakness of the muscles. This injury is related namely to quick and demanding activities, such as short distance sprinting in a limited time period. The Common Origin Tendon (COT) for these two muscles is affected in these injuries. This tendon is formed by the BFlh and ST muscles which together have a common origin in the ischial tuberosity. Given the lack of complete knowledge about the detailed structure of the COT, we dissected cadaveric limbs, describing their morphological characteristics, and discussing its functional and clinical implications.: Thirty-five human cadaveric lower limbs were dissected after fixation to analyze the morphology of the COT, focusing on their volume and muscular/tendinous proportion. We identified two subtypes of COT. The most frequent was the musculotendinous type, in which the origin of the BFlh was mainly tendinous, while the ST muscle was mainly muscular (91.4%). In the tendinous type both muscles had a tendinous origin (8.6%). In the musculotendinous type, the ST muscle ends with a microscopic connective tissue that extend into the ischial tuberosity. We conclude that there is a variability in the anatomical presentations of the COT, and we propose that this will correspond with biomechanical differences in the risks and the response to regional injuries. The connective tissue between the COT and the neighbouring structures could be a risk factor for adhesion tearing.

RESUMEN: Los desgarros de los músculos bíceps femoral cabeza larga (BFcl) y semitendinoso (ST) son causados por una tensión excesiva durante actividades que implican amplios rangos de movimiento en velocidad. Alcanzan casi a un tercio de las lesiones deportivas y tienen graves consecuencias competitivas, además generan dolor y debilidad muscular. El tendón de origen común (TOC) de estos dos músculos se ve afectado en estas lesiones. Este tendón se encuentra formado por el BFcl y el ST, originándose juntos en la tuberosidad isquiática. Debido a la falta de conocimiento completo y detallado de este tendón, se realizó un estudio cadavérico, describiendo sus características morfológicas y discutiendo sobre sus implicaciones funcionales y clínicas. Se practicó la disección anatómica de 35 miembros inferiores, lo que permitió describir la morfología del TOC, focalizando en su volumen y proporciones musculo-tendinosas. La conformación morfológica del TOC fue de 2 tipos: la musculotendinosa, donde el BFcl tenía una estructura tendinosa y el ST tenía una estructura muscular (91,4 %). La conformación tendinosa, donde ambos músculos tenían estructuración tendinosa (8,6 %). Cuando la conformación era musculotendinosa, el ST terminaba con un tejido conjuntivo microscópico, que se extendía hasta la tuberosidad isquiática. La conformación morfológica del TOC del BFcl y ST tuvo una presentación variable, lo cual podría tener implicación en su comportamiento biomecánico, y ser un factor de riesgo de lesiones. Además el tejido conjuntivo situado entre este tendón y las estructuras anatómicas vecinas podría ser un factor de riesgo de lesiones por adherencia.

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Resumen La ruptura espontánea de un tendón secundario al uso de una quinolona es un efecto adverso poco común, pero que con el paso de los años se ha venido documentado con mayor frecuencia. A pesar de lo anterior, aún no hay estudios clínicos que permitan aclarar su fisiopatología, qué estrategias pueden disminuir el riesgo de desarrollar una ruptura espontánea o a qué dosis de las diferentes quinolonas se aumenta el riesgo de presentar una ruptura espontánea. Adicionalmente, varías guías de práctica clínica incentivan el uso de las quinolonas como primera línea para el manejo de infecciones respiratorias o de vías urinarias sin hacer consideraciones sobre este efecto adverso. Por lo anterior, presentamos a continuación el caso de un paciente de 31 años que posterior al inicio de ciprofloxacina para el manejo de una diarrea aguda presento una ruptura espontánea del tendón del semitendinoso secundario al uso de la quinolona. (Acta Med Colomb 2019; 44: 115-118).

Abstract The spontaneous rupture of a tendon secondary to the use of a quinolone is an uncommon adverse effect, but over the years has been documented more frequently. Despite this, there are still no clini cal studies to clarify its pathophysiology, nor which strategies can reduce the risk of developing a spontaneous rupture or at what dose of the different quinolones the risk of presenting a spontaneous rupture increases. In addition, several clinical practice guidelines encourage the use of quinolones as the first line for the management of respiratory or urinary tract infections without considering this adverse effect. Therefore, the case of a 31 year old patient who after the start of ciprofloxacin for the management of acute diarrhea had spontaneous semitendinosus tendon rupture secondary to the use of quinolone, is presented. (Acta Med Colomb 2019; 44: 115-118).

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Los aspectos morfológicos del componente tendomuscular del compartimiento posterior han sido descritos en algunos grupos poblacionales. Se evaluó mediante disección directa las características morfológicas y biométricas del compartimento posterior de 50 muslos de especímenes cadavéricos, en una muestra de población colombiana. El 2 % los músculos isquiotibiales se originaron en un tendón común, 58 % presentó un tendón común para el musculo semitendinoso (MSt) y cabeza larga del músculo bíceps femoral (MBF). El 40 % de la cabeza larga del MBF se originó en el margen lateral de la tuberosidad isquiática (TI) y el MSt en su superficie posterior. En el 98 % de los casos el músculo semimembranoso (MSm) se originó en el margen medial de la TI y se dispuso como una estructura medial del muslo. No se observaron variaciones en el lugar de inserción de los músculos isquiotibiales. El MSt presentó la mayor longitud (419,5 DE 33,2 mm); el tendón distal con mayor espesor fue el del MBF (8,5 DE 5,6 mm), mientras que el músculo semimembranoso (MSm) presentó el componente miotendinoso más ancho (22,4 DE 6,5 mm). No hubo diferencias morfométricas estadísticamente significativas con relación al lado de presentación. Los hallazgos obtenidos enriquecen los conceptos morfológicos de la región posterior del muslo, aportan a la cualificación de procedimientos de cirugía plástica, ortopédica y al diseño de programas de entrenamiento muscular específico en diferentes disciplinas deportivas.

The morphological aspects of tendon and muscle component of the posterior compartment have been described in some population groups. The morphological and biometric characteristics of the posterior compartment of 50 thighs of cadaverous specimens were evaluated by means of a direct design, in a sample of the Colombian population. The 2 % of the hamstring beats originated in a common tendon, 58 % with a common tendon for the Semitendinous muscle (MSt) and long head of the femoral Biceps muscle (MBF). The 40 % of the long head of the MBF were originated on the lateral margin of the Ischial Tuberosity (TI) and the MSt on its posterior surface. In 98 % of the cases the semimembranous muscle (MSm) originated in the middle margin of the IT and dissolved as a medial structure of the thigh. No variation was observed in the place of the hamstring insertion. The longest time (419.5 DE 33.2 mm) the distal tendon with greater thickness was that of the MBF (8.5 OF 5.6 mm), while the semimembranosus muscle (MSm) presented the broadest myotendinous component (22.4 SD 6.5 mm). There weren't statistically significant morphometric differences in relation to the presentation side. The findings obtained enrich the morphological concepts of the posterior thigh region, contribute to the qualification of plastic surgery, orthopedic procedures and the design of muscle training programs in different sports disciplines.

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PURPOSE: Shear modulus (µ) is directly correlated to the tissue stiffness and can predict the tendon ultimate force to failure. With the knee extended 0° (K0), semitendinosus tendon (ST) is tensioned while patellar tendon (PT) is relaxed. At 80o , knee flexion (K80) tendons present an opposite stress pattern; however, the relation between ST and PT µ in both situations was not studied yet. METHOD: We accessed the µ of the ST and PT at 0o and 80o knee flexion by supersonic shear wave imaging (SSI) elastography from 18 healthy males. Relative µ indexes were calculated for relaxed and tensioned conditions. RESULT: The average µ for ST was µST-K0  = 197·62 ± 31·93 kPa and µST-K80  = 77·76 ± 30·08. For TP, values were µTP-K0  = 23·45 ± 5·89 and µTP-K80  = 113·92 ± 57·23 kPa. Relative µ indexes were calculated for relaxed (IR = µST-K80 /µTP-K0 ) and tensioned conditions (IT = µST-K0 /µPT-K80 ). The relative µ indexes were IR = 3·63 ± 1·50 and IT = 2·00 ± 0·96 (P<0·05). CONCLUSION: Semitendinosus tendon µ was significantly higher than PT µ in both tensioned and relaxed positions. This can predict a higher ultimate force to failure and a less elastic behaviour in ST grafts when compared to PT grafts. This new parameter could aid physicians in graft choice previous to anterior cruciate ligament reconstruction.

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PURPOSE: The aim of this study was to evaluate whether the anthropometric and demographic measures of patients under 18 years can be used to predict the diameter of STG autograft in ACL reconstruction surgery. METHODS: Retrospective series of 169 patients under 18 years (112 men, 57 women, average age 15.8 years) underwent ACL reconstruction surgery with STG autograft. We recorded anthropometric measures (weight, height and BMI), demographics (age and gender) and autograft diameter used. Correlation coefficients, linear regression and unpaired t test were used to determine the relationship between anthropometric/demographic variables and the diameter of the graft. p values <0.05 were considered statistically significant. RESULTS: Correlation analysis showed a significant positive relation between height and graft diameter (r = 0.483, p < 0.0001) as well as between weight and graft diameter (r = 0.248, p = 0.001). However, age and BMI did not correlate with graft thickness (r = 0.098 and p = 0.203, r = 0.009 and p = 0.905, respectively). The mean graft diameter in men was 8.2 (range 6-10) and 7.5 in women (range 6-9), a difference that was statistically significant (p < 0.001). CONCLUSIONS: Prediction of the STG graft diameter according to the height of the patient is an easy and reliable method in children and adolescents. These data may provide relevant preoperative information about the need of an alternative graft source and can be useful when counselling patients. LEVEL OF EVIDENCE: IV.

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Las roturas agudas del tendón rotuliano con mala calidad del tejido remanente son un problema de difícil resolución. Se han descrito varias técnicas para reparar o reconstruir el tendón rotuliano. El objetivo de este trabajo es comunicar un caso en el cual se realizó un aumento del tendón rotuliano con injerto autólogo de semitendinoso ipsilateral, con excelentes resultados funcionales.

Ruptures of acute patellar tendon with poor quality tissue are difficult to resolve. Several techniques have been described to repair or rebuild the patellar tendon. The objective of this report is to present a case in which patellar tendon augmentations with ipsilateral semitendinosus autograft was performed, showing excellent functional results.

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El objetivo de este estudio fue evaluar si las medidas antropométricas y demográficas de pacientes con esqueleto inmaduro pueden ser utilizadas para predecir el diámetro del autoinjerto semitendinoso-gracilis (ST-G) en la cirugía de reconstrucción del ligamento cruzado anterior (LCA). Métodos: Serie retrospectiva de 169 pacientes con esqueleto inmaduro (112 hombres, 57 mujeres, edad media 15,8 años) que se sometieron a cirugía de reconstrucción del LCA con autoinjerto ST-G. Se registraron las medidas antropométricas (peso, talla e índice de masa corporal [IMC]), datos demográficos (edad y sexo) y diámetro del autoinjerto ST-G utilizados. Se utilizaron coeficientes de correlación, regresión lineal y t de Student para determinar la relación entre variables antropométricas-demográficas y el diámetro del injerto. Los valores de p < 0,05 fueron considerados estadísticamente significativos. Resultados: El análisis estadístico mostró una correlación positiva significativa tanto para la talla y el peso con el diámetro del injerto (r = 0,483, p < 0,0001; r = 0,248, p = 0,001, respectivamente). Sin embargo, la edad y el IMC no se correlacionaron con el diámetro del injerto (r = 0,098 y p = 0,203, r = 0,009 y p = 0,905, respectivamente). La media del diámetro del injerto en los hombres fue de 8,2mm (rango 6-10) y 7,5mm en las mujeres (rango 6-9), diferencia que fue estadísticamente significativa (p < 0,001). Conclusiones: La predicción del diámetro del injerto ST-G según la talla del paciente es un método fácil y fiable en pacientes con esqueleto inmaduro. Estos datos pueden proporcionar información preoperatoria relevante sobre la necesidad de una técnica para aumentar el injerto ante un eventual diámetro insuficiente de este...

The aim of this study was to evaluate whether the anthropometric and demographic measures of patients under 18 years old can be used to predict the diameter of semitendinosus-gracilis (ST-G) autografts in anterior cruciate ligament (ACL) reconstruction surgery. Methods: A study was conducted on retrospective series of 169 patients under 18 years (112 men, 57 women, average age 15.8 years) who underwent to ACL reconstruction surgery with ST-G autograft. The anthropometric measurements were recorded (weight, height and body mass index), demographics (age and gender) and the diameter of the ST-G used. Correlation coefficients, linear regression and unpaired t-test were used to determine the relationship between anthropometric/demographic variables and the diameter of the graft. P values <.05 were considered statistically significant. Results:Correlation analysis showed a significant positive relationship between height and graft diameter (r=0.483, P<.0001), as well as between weight and graft diameter (r=0.248, P=.001). However, age and body mass index (BMI) did not correlate with graft thickness (r=0.098 and P=.203, r=0.009 and P=.905, respectively). The mean graft diameter in men was 8.2 (range 6-10) and 7.5 in women (range 6-9), a difference that was statistically significant (P<.001). Conclusions:Prediction of the ST-G graft diameter according the height of the patient is an easy and reliable method in children and adolescents. These data can provide relevant preoperative information on the need for an alternative graft source for an eventual insufficient diameter of the latter...

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Objetivou-se avaliar o emprego da rédea Pessoa no treinamento de equinos atletas, como auxiliar de condicionamento físico, sobre a biometria avaliada pela ultrassonografia das musculaturas epaxial (Longíssimus Dorsi, Gluteus Medius e Musculus Multifidus) e pélvica (Biceps Femoris e Semitendinosus). Foram utilizadas oito éguas da raça Quarto de Milha, com idade média de cinco anos, 400kg de peso vivo, treinadas com a rédea Pessoa duas vezes por semana, durante dois meses. As variáveis foram mensuradas, antes e após o treinamento, consistindo das avaliações de espessura (cm) do Longíssimus Dorsi e área transversal (cm2) dos músculos, Gluteus Medius, Biceps Femoris, Semitendinosus e Musculus Multifidus. Observou-se efeito significativo do treinamento com rédea Pessoa sobre os músculos Biceps Femoris (P 0,01) e Musculus Multifidus (P 0,01), no qual os valores médios da área transversal, na avaliação final, foram de 28,66cm2 e 14,29cm2, respectivamente. Concluiu-se que o treinamento com a rédea Pessoa modifica o funcionamento muscular, promovendo a hipertrofia do Musculus Multifidus e Biceps Femoris de equinos.(AU)

This study aimed to evaluate the use of Pessoa's rein in training equine, as a support in exercise training, on biometry by ultrasonography of the epaxial (Longíssimus Dorsi, Gluteus Medius e Musculus Multifidus) and pelvic musculature (Biceps Femoris e Semitendinosus). Thereby, eight Quarter Horse mares was used, with eight years on average age, 400kg of body weight, trained with the Pessoa's rein twice a week, for two months. Variables were measured before and after training, consisting of assessment thickness (cm) of the Longíssimus Dorsi and cross-sectional area (cm2) of muscles, Gluteus Medius, Biceps Femoris, Semitendinosus and Musculus Multifidus. It observed a significant effect of training with Pessoa's rein, on the Biceps Femoris (P 0.01) and Musculus Multifidus (P 0.01), which the average cross-sectional area at the final evaluation were of 28.66cm2 and 14.29cm2, respectively. Thus it can be conclude that training with Pessoa's rein modifies muscular function, promoting hypertrophy Musculus Multifidus and Biceps Femoris of horses.(AU)

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This study aimed to evaluate the use of Pessoa's rein in training equine, as a support in exercise training, on biometry by ultrasonography of the epaxial (Longíssimus Dorsi, Gluteus Medius e Musculus Multifidus) and pelvic musculature (Biceps Femoris e Semitendinosus). Thereby, eight Quarter Horse mares was used, with eight years on average age, 400kg of body weight, trained with the Pessoa's rein twice a week, for two months. Variables were measured before and after training, consisting of assessment thickness (cm) of the Longíssimus Dorsi and cross-sectional area (cm2) of muscles, Gluteus Medius, Biceps Femoris, Semitendinosus and Musculus Multifidus. It observed a significant effect of training with Pessoa's rein, on the Biceps Femoris (P<0.01) and Musculus Multifidus (P<0.01), which the average cross-sectional area at the final evaluation were of 28.66cm2 and 14.29cm2, respectively. Thus it can be conclude that training with Pessoa's rein modifies muscular function, promoting hypertrophy Musculus Multifidus and Biceps Femoris of horses.

Objetivou-se avaliar o emprego da rédea Pessoa no treinamento de equinos atletas, como auxiliar de condicionamento físico, sobre a biometria avaliada pela ultrassonografia das musculaturas epaxial (Longíssimus Dorsi, Gluteus Medius e Musculus Multifidus) e pélvica (Biceps Femoris e Semitendinosus). Foram utilizadas oito éguas da raça Quarto de Milha, com idade média de cinco anos, 400kg de peso vivo, treinadas com a rédea Pessoa duas vezes por semana, durante dois meses. As variáveis foram mensuradas, antes e após o treinamento, consistindo das avaliações de espessura (cm) do Longíssimus Dorsi e área transversal (cm2) dos músculos, Gluteus Medius, Biceps Femoris, Semitendinosus e Musculus Multifidus. Observou-se efeito significativo do treinamento com rédea Pessoa sobre os músculos Biceps Femoris (P<0,01) e Musculus Multifidus (P<0,01), no qual os valores médios da área transversal, na avaliação final, foram de 28,66cm2 e 14,29cm2, respectivamente. Concluiu-se que o treinamento com a rédea Pessoa modifica o funcionamento muscular, promovendo a hipertrofia do Musculus Multifidus e Biceps Femoris de equinos.

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Neuromuscular compartments are subvolumens supplied by a primary nerve branch with homogeneous fiber characteristics. This muscular organization is important for understanding the muscle function in relation to postural and dynamic implications and also is relevant for appraising meat quality. Current researches associate fiber muscle characteristics with perimortem processes that regulate muscle transformation into meat. It is known that pig muscle has four heavy chain myosin isoforms: I, IIa, IIx and IIb. Castrated male pigs were slaughtered at 100 kg live weight. Semitendinosus muscle samples of each subvolumen determined previously (R1, R2, R3, R4) were frozen in liquid nitrogen and reacted for myofibrillar ATPase and NADH-TR for determining fiber types and oxidative capacity respectively. It were identified I, IIA and IIX/IIB fiber types. The frequency distribution of the I, IIA, and IIX/IIB fiber types were significantly greater in R1- R4, R4 and R3 respectively. The CSA of all fiber types was significantly larger in R1 than other compartments, notwithstanding CSA did not vary significantly among fiber types; oxidative capacity was significantly greater in R4. These results show a heterogeneousness of the muscle which would explain probably the disagreements documented between characteristics of fiber and meat quality traits.

Los compartimientos neuromusculares son subvolúmenes abastecidos por un ramo nervioso primario, los cuales poseen características fibrilares homogéneas. Esta organización muscular es importante para entender la función muscular en relación tanto en la estática y dinámica como en la apreciación de la calidad de la carne. Actuales investigaciones asocian características fibrilares con procesos perimorten que regulan la transformación del músculo en carne. Es conocido que en el músculo del cerdo están presentes cuatro cadenas pesadas de miosina: I, IIa, IIx y IIb. Cerdos machos castrados fueron faenados a los 100K kg de peso vivo. Muestras musculares de cada subvolumen del músculo semitendinoso, previamente determinados (R1, R2, R3, R4), fueron congeladas en nitrógeno líquido y tratadas con las reacciones de ATPasa miofribrilar y NADH-TR para determinar los tipos fibrilares y la capacidad oxidativa, respectivamente. Fueron identificadas los tipos fibrilares I, IIA y IIX/IIB. La frecuencia de distribución de los tipos fibrilares I, IIA, y IIX/IIB fueron significativamente mayores en R1- R4, R4 y R3, respectivamente. La CSA de todos los tipos fibrilares fueron significativamente mayores en R1 que en los otros compartimientos, sin embargo CSA no varía en forma significativa entre los tipos fibrilares; la capacidad oxidativa fue significativamente mayor en R4. Estos resultados evidencian una heterogeneidad muscular la cual podría probablemente explicar los desacuerdos documentados entre las características de las fibras y su relación con la evaluación de la calidad de la carne.

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BACKGROUND: Gluteus maximus strengthening exercises are employed in clinical practice as options for the treatment of low back and sacroiliac disorders. However, no studies were found that investigated which were the best exercises to activate this muscle and justify its employment in physical therapy practice. OBJECTIVE: To quantify the electromyographic (EMG) activity of the gluteus maximus and semitendinosus muscles during four modalities of therapeutic exercises. METHODS: Thirty-one participants (16 men, 15 women) were selected. The EMG activities of the gluteus maximus and semitendinosus was recorded and quantified while the participants performed four modalities of therapeutic exercises, involving active prone hip extension in four positions: knee extension (KE), knee flexion (KF), lateral hip rotation and knee extension (LHRKE), and lateral hip rotation and knee flexion (LHR-KF). RESULTS: Repeated-measures ANOVAs showed that the addition of KF or LHR increased gluteus maximus activity, whereas, KE decreased the activation of this muscle. In contrast, the exercises performed with KE increased semitendinosus activity. CONCLUSIONS: Exercises performed with KF or LHR, or a combination of the two, may be effective choices for gluteus maximus strengthening, however both KF and LHR decreased semitendinosus activity. The exercises performed with KE appeared to be an acceptable choice for semitendinosus activation.

CONTEXTUALIZAÇÃO: Exercícios para fortalecimento do glúteo máximo são empregados na prática clínica para tratamento de disfunções da coluna lombar e sacroilíaca. Entretanto, não foram encontrados estudos que investigaram os melhores exercícios para ativar esse músculo de forma a justificar a sua utilização na prática fisioterapêutica. OBJETIVO: Quantificar a atividade eletromiográgica (EMG) dos músculos glúteo máximo e semitendinoso durante quatro modalidades de exercícios terapêuticos. MÉTODOS: Trinta e um participantes (16 homens, 15 mulheres) foram selecionados. A atividade EMG do glúteo máximo e semitendinoso foi registrada e quantificada enquanto os indivíduos realizaram quatro modalidades de exercícios terapêuticos envolvendo extensão ativa do quadril em prono em quatro posições: joelho em extensão, joelho em flexão, rotação lateral do quadril e extensão do joelho e rotação lateral do quadril e flexão do joelho. RESULTADOS: ANOVA medidas repetidas revelou que a adição de flexão do joelho ou rotação lateral do quadril aumentou a atividade do glúteo máximo, enquanto os exercícios realizados com extensão do joelho resultaram na redução da sua ativação. Por outro lado, os exercícios realizados com extensão do joelho aumentaram a atividade do semitendinoso. CONCLUSÕES: Os exercícios realizados com flexão de joelho e/ou rotação lateral do quadril demonstraram ser opções efetivas para ativação do glúteo máximo, mas resultaram em redução da atividade do semitendinoso. Os exercícios realizados com extensão do joelho demonstraram ser uma boa opção para ativar o semitendinoso.

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Hipótese: Reconstrução do ligamento patelofemoral medial restaura a estabilidade, promove retorno funcional e alívio da dor em pacientes com instabilidade patelar lateral crônica. Design do estudo: Série de casos nível 4 de evidência. Métodos: Vinte e um pacientes com instabilidade lateral crônica foram tratados com reconstrução do ligamento patelofemoral medial usando enxerto do semitendíneo. Todos os pacientes foram avaliados pré-operatoriamente e pós-operatoriamente com questionários de Kujala, Fulkerson, Lysholm, nível de atividade de Tegner e através da Escala Analógica de Dor por um período mínimo de 24 meses. Resultados: Vinte e um pacientes foram avaliados por um período médio de 66,5 meses (variando de 24-130 meses) após a cirurgia. O questionário de Kujala mudou de 55,7 para 82,3, o de Fulkerson mudou de 60,6 para 91,2, o de Lysholm variou de 53,5 para 85,6, a escala de atividade de Tegner variou de 3,5 para 7,1 e a Escala Analógica Visual de Dor variou de 7,4 no pré-operatório para 3,0 na última avaliação. Todos mostraram diferenças estatisticamente significantes (P <.001). Nenhuma diferença estatisticamente significante foi encontrada nas avaliações pós-operatoria dos questionários de Kujala, Lysholm, Fulkerson, Tegner e Escala Analógica Visual de Dor. Existiram 66,59%, 71,42% e 71,41% de bons e excelentes resultados baseados nos questionários de Kujala, Lysholm e Fulkerson, respectivamente. Nenhuma luxação recorrente ocorreu e todos os 21 pacientes estavam satisfeitos com o tratamento cirúrgico. Conclusão: A reconstrução do ligamento patelofemoral medial prove excelente alívio da dor e retorno funcional em pacientes com instabilidade patelar crônica.

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The medial patellofemoral ligament (MPFL) reconstruction is an option for the recurrent patellar instability. We developed a prospective study whose objective was to show the functional results at 6 and 12 months of patients who underwent MPFL reconstruction with semitendinosus (St) autograft. Four patients (5 knees) were treated between May 2006 and May 2008. The Kujala´s test before surgery in all patients was poor (< 50 points); 6 months after the surgery 4 cases turned out to be "good and very good" (only 1 case "poor", but increased her score to 78 points) and after 12 months of follow-up, 5 cases scored "very good and excellent" (score > 90 points). The Tegner´s test showed an increased of activity that was normal for the patients, and with the Insall´s test all patients referred very satisfied 12 months after surgery. Up to this stage, there has been no recurrence. In our local environment, the MPFL reconstruction with St. is a valid treatment to recover the patellofemoral mecanic.

La reconstrucción del ligamento patelofemoral medial (LPFM) es una alternativa en la inestabilidad rotuliana recurrente. Desarrollamos un estudio prospectivo con el objetivo de exponer los resultados funcionales a los 6 y 12 meses de pacientes sometidos a una reconstrucción del LPFM con semitendinoso (St). Son 4 pacientes (5 rodillas) operados entre mayo 2006 y mayo 2008. El test de kujala preoperatorio era "malo" (< 50 pts) en todos, a los 6 meses post op. 4 casos de "bueno y muy bueno" resultado (sólo 1 caso "malo", pero con incremento de su score a 78) y a los 12 meses (5 casos) todos con función "muy bueno y excelente" (score > 90 pts). El test de Tegner mostró un aumento del nivel de actividad considerada de normal en todos los pacientes, y en el test de Insall todos refieren excelente mejoría a los 12 meses. Hasta la fecha no existen recidivas. En nuestro medio local, la reconstrucción del LPFM con St. es una alternativa válida para recuperar la mecánica patelofemoral.

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Introduction: Anterior Cruciate Ligament (ACL) reconstruction is frequently evaluated using Magnetic Resonance Imaging (MRI). In order to do this, it becomes very important to recognize the changes of the graft along the first postoperative months. Objective and Hypothesis: Establish the maturation pattern of the ST-G graft after reconstruction of the ACL on the third and sixth month after surgery by means of MRI. Materials and Methods: 32 ACL reconstructions were evaluated by MRI on the 3rd and 6th month after surgery. The graft was analyzed at the level of the femoral tunnel and the articular segment. The maturation criteria used in this study were a low and homogeneous intrasubstance signal and the absence of ligament-to-bone interface. Results: At the 31d month after surgery, 44 percent of the patients had a low intensity signal in the femoral tunnel and 63 percent articular. The signal was homogeneously low in 6 percent of the patients at the femoral tunnel and in 53 percent of the patients at the articular segment. The absence of a ligament-to-bone interface was found in 44 percent of the patients. Six months after surgery, we found low intensity signals in 78 percent of the patients at the femoral tunnel and in 94 percent of the patients at the articular segment. The signal was homogeneously low in 41 percent of the patients in the femoral tunnel and in 78 percent of the patients within the articular segment. The absence of a ligament-to-bone interface was found in 66 percent of the patients. Conclusions: The graft matured during the period of observation and the number of homogeneous low-intensity signals increased between the third and sixth month, thus our hypothesis is confirmed. According to all the criteria employed in this study, the intrarticular segment matures earlier than the intra-tunnel segment.

Introducción: La evaluación de la reconstrucción de ligamento cruzado anterior (LCA) por medio de la resonancia magnética (RM) es un método frecuentemente utilizado. Resulta por tanto fundamental conocer los cambios evolutivos del injerto en los primeros meses del postoperatorio. Objetivo e Hipótesis: Determinar un patrón de maduración mediante RIVI del injerto semitendinoso-gracilis (ST-G) en la reconstrucción de LCA at tercer y sexto mes postcirugía. Pacientes y Métodos: 32 pacientes sometidos a reconstrucción de LCA, fueron estudiados mediante RM a los 3 y 6 meses postcirugía. Se evaluaron las características del injerto, a nivel del túnel femoral y segmento articular, definiendo como criterios de maduración la obtención de una baja intensidad de señal intra sustancia, de aspecto homogéneo y con ausencia de interfase osteoligamentosa. Resultados: Al tercer mes de la cirugía, encontramos 44 por ciento de señal de baja intensidad a nivel del túnel femoral y 63 por ciento articular. La señal fue homogénea en 6 por ciento de los pacientes a nivel del túnel femoral y 53 por ciento articular. La ausencia de interfase osteoligamentosa se pesquisó en 44 por ciento de los pacientes. Al sexto mes, encontramos 78 por ciento de señal de baja intensidad a nivel del túnel femoral y 94 por ciento articular. La señal fue homogénea en 41 por ciento de los pacientes a nivel del túnel femoral y 78 por ciento articular. La ausencia de interfase osteoligamentosa se pesquisó en 66 por ciento de los pacientes. Conclusiones: Se observa que el injerto evoluciona, madurando entre el tercer y sexto mes de acuerdo a los criterios utilizados, confirmando así la hipótesis de que existe un patrón de maduración definido. El segmento intrarticular, madura más precozmente que el segmento intra-túnel.

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