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Deep gluteal syndrome is characterized by nondiscogenic, extrapelvic sciatic nerve compression presenting with symptoms of pain and dysesthesias in the buttock area, hip, or posterior thigh and/or as radicular pain. The piriformis muscle and tendon are the most common source of extrapelvic sciatic nerve entrapment. However, a number of structures can entrap the sciatic nerve in the deep gluteal space, including bone structures, fibrous scar bands, and muscular structures other than the piriformis. The main differential diagnoses are intra-articular hip pathologies, spine issues, intrapelvic abnormalities, ischiofemoral impingement, hamstring's origin tendinopathy, and pudendal nerve entrapment. A comprehensive history and physical examination is crucial for the diagnosis of deep gluteal syndrome. Guided injections and magnetic resonance imaging are useful complementary diagnostic tools. The nonoperative treatment of deep gluteal syndrome is successful in most patients. Endoscopic sciatic nerve decompression may be indicated in cases of failure of the conservative treatment.

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ObjectivesTo evaluate the results obtained through using an intramedullary or extramedullary guide for sectioning the tibia in total knee arthroplasty procedures, with a view to identifying the accuracy of these guides and whether one might be superior to the other.MethodsThis was a randomized double-blind prospective study on 41 total knee arthroplasty procedures performed between August 2011 and March 2012. The angle between the base of the tibial component and the mechanical axis of the tibia was measured during the immediate postoperative period by means of radiography in anteroposterior view on the tibia that encompassed the knee and ankle.ResultsThere was no demographic difference between the two groups evaluated. The mean alignment of the tibial component in the patients of group A (intramedullary) was 90.3° (range: 84–97°). In group B (extramedullary), it was 88.5° (range: 83–94°).ConclusionIn our study, we did not find any difference regarding the precision or accuracy of either of the guides. Some patients present an absolute or relative contraindication against using one or other of the guides. However, for the other cases, neither of the guides was superior to the other one.

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