Objective: The objective of this study was to verify the effects of resisted and proprioceptive exercises program for the treatment of patients diagnosed with patellofemoral pain syndrome (PFPS). Design method: Randomized Controlled Trial e level of evidence, II. Methods: Sixty female patients, clinically diagnosed with PFPS, were allocated into two experimental groups. The exercise group (ExG) underwent 6 weeks of a resisted and proprioceptive exercises for the trunk muscles, abductors and lateral hip rotators and knee extensors. The Guidance Group (GG) received educational, cognitive and behavioral guidance on healthcare. Before and after the program implementation period, all participants were evaluated in relation to the injured limb for pain assessment, subjective functionality, maximum isometric strength and 2D biomechanical analysis. Results: After a six-week follow-up, ExG showed significant improvement in the Numerical Pain Rating Scale, Anterior Knee Pain Scale and Knee Outcome Survey-Activities of Daily Living Scale when compared to the control group (p 0,05). The ExG also proved superior for increased muscle strength of knee extensors, hip abductors, decreased dynamic knee valgus and pelvic drop in relation to GG (p 0.05). However, when we consider the strength of the hip lateral rotator muscles there was no difference between the two interventions (p > 0.05). Conclusion:Resisted and proprioceptive exercises yielded superior results to those of a treatment focused on educational, cognitive and behavioral guidance in improving pain and lower limb function for women with PFPS.

Background: Lower limb muscle strength symmetry has been suggested as an essential criterion for the safe return to sports after anterior cruciate ligament (ACL) reconstruction. Limited evidence is available regarding the most effective intervention to achieve symmetry after reconstruction with contralateral bone–patellar tendon–bone (BPTB) graft. Purpose: To verify whether unilateral isotonic resistance exercise is more effective than bilateral exercise for obtaining postoperative functional and muscular strength symmetry between the donor limb and reconstructed limb for patients who received BPTB graft. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 88 patients were randomly divided into a control group (n = 44) and an intervention group (n = 44). All participants performed an 8-week exercise program starting at the beginning of the fourth postoperative month and were evaluated before and after the program. The control group performed bilateral exercises, and the intervention group performed unilateral exercises for the donor limb only (the limb with the greatest disability). The primary outcome was muscle strength (peak torque and hamstrings to quadriceps [H:Q] ratio), and the secondary outcomes were range of motion (ROM; goniometry), KT-1000 arthrometer side-to-side difference in anteroposterior knee laxity, and objective (single-leg hop test) and subjective (Lysholm score) functionality. Results: Both groups improved significantly from before to after the exercise program. The improvements were significantly greater in the intervention group regarding peak torque, H:Q ratio, flexion ROM, single-leg hop test, and Lysholm score in the donor limb ( P < .001 for all), and the improvements were significantly greater in the control group regarding peak torque and single-leg hop test in the reconstructed limb ( P < .001 for both). Comparison between the groups showed significantly increased symmetry regarding peak torque, H:Q ratio, and single-leg hop test in the intervention group compared with the control group ( P < .001), with large effect sizes (>0.80) except for the H:Q ratio. Conclusion: Although postoperative, bilateral, isotonic resistance exercise provided better strength gains to the reconstructed limb, unilateral exercise was more effective in obtaining functional and muscle strength between-limb symmetry in patients who underwent ACL reconstruction with contralateral BPTB graft. Registration: Brazilian Registry of Clinical Trials (number RBR-22rnjh).

Objective:To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results. Methods:The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords “anterior cruciate ligament reconstruction” combined with “contralateral” in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative. Results:A total of 755 articles were found initially, and after detailed evaluation of all references, followed by a screening process and assessment of quality, a total of 11 studies were determined to be eligible for inclusion in this systematic review. Of these, 72.72% were level II studies, the most common level of evidence among the results. Positive results for this type of graft were found in 63.63% of the studies. Conclusion:Based on the literature review, most of the included articles (63.63%) presented positive results for the use of contralateral patellar tendon grafts. Level of Evidence III; Systematic review.

Objective  To measure the cost of simultaneous total knee arthroplasty, as well as the costs of total and intensive care unit (ICU) length of stay, perioperative complications and need for blood transfusion compared to the costs of unilateral procedure in a referral hospital, in Federal District, Brazil. Method  The present article is a retrospective study analyzing the medical records of patients admitted for unilateral or bilateral total knee arthroplasty, performed between June 2011 and March 2017. Seventy-four medical records were included in the study for evaluation of data such as total cost of the procedure, comorbidities, complications, days of hospitalization, and need for blood transfusion. Results  A significantly higher incidence of deep vein thrombosis (DVT) was found in unilateral procedures. Compared to the other data, no statistically significant differences were found in the relative costs or in the need for blood transfusion. Conclusion  There was no increase in the cost or in complications when comparing the simultaneous bilateral knee joint replacement procedure with the unilateral procedure, which corroborates most of the literature.

Resultados clínicos e funcionais da cirurgia de reconstrução do lca contralateral em médio prazo Clinical results and functional surgery the aCl reconstruction contralateral in medium term ResumoLesões na articulação do joelho têm grande impacto na vida das pessoas devido à sua alta prevalência e sua repercussão clínica. Estudos com-