Purpose The Anterior cruciate ligament (ACL) remnant has been pointed out as a ligamentization enhancer. Nonetheless, the remaining tissue can be functional if it still provides some stability or nonfunctional. This study intends to compare the clinical results and knee stability of functional vs. nonfunctional remnant preservation ACL reconstruction (ACLR). Methods One hundred and seventy-ive patients with ACL injuries were included and underwent remnant preservation ACLR. They were divided into two groups accordingly to remnant tissue functionality: functional (Group F) and nonfunctional (Group NF). Primary outcome was deined as patient reported outcomes measured with Lysholm, IKDC and Tegner continuous scales and improvements. Secondary outcomes comprised of Lachman test, anterior drawer test, pivot shift test, extension and lexion deicit, graft coverage by remnant preserved tissue and failure rate (persistent instability or new ACL lesion). Menisci lesions, cartilage lesions and time to surgery were also recorded for each group.
The objective of this study was to evaluate trochlear morphology in patients with trochlear dysplasia using a new oblique trochlear magnetic resonance imaging (MRI) view (OTV) in comparison with standard axial MRI sequences. MRI exam of 73 patients with patellofemoral instability (PFI) and the same number of controls were retrospectively reviewed. The oblique trochlear sequence was acquired by inclining the axial plane parallel to the intercondylar roof of the sagittal image, showing the anterior cruciate ligament (ACL) in its entire length. Trochlear morphology was assessed on axial and oblique trochlear sequences at three levels: level 1 at 25%, level 2 at 50%, and level 3 at 75% of the length of the trochlear groove. Trochlear sulcus angle and sulcus depth were measured at these three levels and compared between the new trochlear and standard axial sequences. Trochlear sulcus angle and sulcus depth were statistically different between axial and oblique trochlear views at all three levels (p < 0,05). Additionally, OTV displayed more uniform sulcus angle and depth along the trochlea. The oblique trochlear view on the MRI can more accurately evaluate trochlear morphology and also better characterize trochlear dysplasia in patients with PFI. This is Level III, retrospective comparative study.
Resumo Objetivo Realizar a tradução para a língua portuguesa falada no Brasil e a adaptação transcultural do questionário Banff para Instabilidade Patelar. Métodos A tradução e adaptação transcultural seguiu o processo de validação linguístico proposto por diretrizes internacionais, que consiste em seis etapas: tradução, síntese, retrotradução, revisão pelo comitê de especialistas, pré-teste, e apresentação do relatório final aos autores do questionário original. Foram incluídos no estudo pacientes alfabetizados, com diagnóstico de instabilidade patelar recorrente, com mais de 12 anos de idade, que assinaram ou tiveram o termo de consentimento livre e esclarecido assinado por um responsável legal. Foram excluídos do estudo pacientes portadores de comorbidades neurológicas ou sistêmicas. Resultados Um total de 62 pacientes (18 homens e 44 mulheres) foram incluídos no estudo. Durante os processos de tradução e harmonização das retrotraduções, foram observadas discrepâncias, que foram modificadas sem necessidade de reformulação. Não foram necessárias substituições na versão do pré-teste. Conclusão O Questionário Banff para Instabilidade Patelar foi traduzido e adaptado transculturalmente para a língua portuguesa falada no Brasil com sucesso, podendo ser utilizado para a avaliação de pacientes portadores de instabilidade patelar falantes desta língua.
Objective To determine the relationship between cartilage lesion etiology and clinical outcomes after second-generation autologous chondrocyte implantation (ACI) in the patellofemoral joint (PFJ) with a minimum of 2 years’ follow-up. Methods A retrospective review of all patients that underwent ACI in the PFJ by a single surgeon was performed. Seventy-two patients with a mean follow-up of 4.2 ± 2.0 years were enrolled in this study and were stratified into 3 groups based on the etiology of PFJ cartilage lesions: patellar dislocation (group 1; n = 23); nontraumatic lesions, including chondromalacia, osteochondritis dissecans, and degenerative defects (group 2; n = 28); and other posttraumatic lesions besides patellar dislocations (group 3; n = 21). Patient’s mean age was 29.6 ± 8.7 years. Patients in group 1 were significantly younger (25.4 ± 7.9 years) than group 2 (31.7 ± 9.6 years; P = 0.025) and group 3 (31.5 ± 6.6 years; P = 0.05). Body mass index averaged 26.2 ± 4.3 kg/m2, with a significant difference between group 1 (24.4 ± 3.2 kg/m2) and group 3 (28.7 ± 4.5 kg/m2; P = 0.005). A clinical comparison was established between groups based on patient-reported outcome measures (PROMs) and failure rates. Results Neither pre- nor postoperative PROMs differed between groups ( P > 0.05). No difference was seen in survivorship between groups (95.7% vs. 82.2% vs. 90.5%, P > 0.05). Conclusion Cartilage lesion etiology did not influence clinical outcome in this retrospective study after second generation ACI in the PFJ. Level of Evidence Level III, retrospective comparative study.
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