Background Residual laxity remains after ACL reconstruction in patients with combined chronic ACL and medial instability. The question arises whether to correct medial capsular and ligament injuries when Grade II and III medial laxity is present. Description of Technique We developed a mini-invasive medial ligament plasty to repair the medial collateral ligament to correct residual medial valgus and rotatory laxity after ACL reconstruction. Patients and Methods We prospectively followed 36 patients with an ACL deficiency combined with chronic Grade II or III valgus and rotatory medial instability. The mean age was 37 years (range, 15-70 years).

Purpose: this study was conducted to identify the most effective method of postoperative pain management, comparing the intravenous opiate infusion protocol with the use of a single periarticular local anesthetic infiltration (LAi) in patients undergoing total knee arthroplasty (tKA) surgery. Methods: 50 patients submitted to tKA surgery between 2013 and 2015 were divided into two groups. Buprenorphine was administered intravenously to the patients in Group A, while the Group B patients received a single periarticular LAi (ropivacaine and ketorolac) during surgery. Pain was assessed using a visual analog scale (VAs) and the knee injury and osteoarthritis outcome score. Hemoglobin and hematocrit were measured in the early postoperative period and at 40 days post-surgery. Range of motion and inflammatory markers were also assessed. statistical analysis was performed using student's t-test. Results: student's t-test showed no significant difference between the groups in functional outcomes or blood values, but a difference in VAs score on the day of surgery was found (p < 0.0001), in favor of Group B. Conclusions: LAi considerably reduces postoperative pain, allowing rapid mobilization and accelerating functional recovery. Level of evidence: Level i, prospective single-blind randomized trial.