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  • Serrano Rosa posted an update 10 months, 2 weeks ago

    Spinal deformity may compensate for hip changes.Objective  Coracoid osteolysis has been described as a possible complication after the Latarjet procedure. The aim of the present study was to investigate the incidence and risk factors associated to coracoid graft osteolysis and to correlate them with clinical results. Methods  A retrospective review of 38 Latarjet procedures was conducted. Computed tomography (CT) scans were obtained from all of the patients before and at least 1 year after the surgery. Coracoid osteolysis was evaluated and correlated to preoperative factors, namely age, smoking status, and preoperative glenoid bone loss. The patients were divided into 2 groups A (no or minor bone resorption) and B (major or total bone resorption). The functional outcome was determined by the Rowe score. Results  Coracoid graft osteolysis occurred in 22 cases (57.8%). The mean preoperative glenoid defect was 22.8% in group A, and 13.4% in group B ( p  = 0.0075). The mean ages of the subjects in both groups were not significantly different. Smoking did not seem to affect the main outcome either, and no correlation was found between graft osteolysis and postoperative range of motion, pain, or Rowe score. There were no cases of recurrent dislocations in our sample, although four patients presented with a positive anterior apprehension sign. Conclusion  Bone resorption of the coracoid graft is present in at least 50% of the patients submitted to the Latarjet procedure, and the absence of significant preoperative glenoid bone loss showed to be the only risk factor associated with severe graft osteolysis, even though this did not influence significantly the clinical outcome.Objectives  To analyze the functional outcomes in patients submitted to videoarthroscopic surgical treatment for compleat rotator cuff tears of the shoulder, with a minimum follow-up of 10 years. Methods  A total of 63 patients (63 shoulders) underwent videoarthroscopic surgical repair for compleat rotator cuff tears with a minimum follow-up of 10 years. The postoperative functional outcomes of these patients were evaluated using the Constant and University of California at Los Angeles (UCLA) scores. Results  The functional evaluation revealed mean UCLA and Constant scores of 26 and 93 points, respectively. Ninety-one percent of the subjects had satisfactory Constant scores, whereas 62% presented satisfactory UCLA scores. Conclusion  The arthroscopic repair of rotator cuff complete tear was effective even in the long term (minimum follow-up period of 10 years). 2,4-Thiazolidinedione in vitro The age of the patients before surgery, size of the lesion, the degree of fatty infiltration, and evaluation of muscle trophism are important predictors of prognosis.Objective  To demonstrate the clinical outcomes and complication rates of the surgical release with a single posterior approach in the treatment of post-traumatic elbow stiffness. Methods  A prospective study with patients submitted to surgery between May 2013 and June 2018 in a single center. The access to the elbow was made through the posterior approach. The patients were followed up by an occupational therapy team, and were submitted to a standardized rehabilitation protocol, with static progressive orthoses and dynamic orthoses. The primary outcome was the range of flexion-extension of the elbow after 6 months. Results  A total of 26 patients completed the minimum follow-up of 6-months. The mean range of flexion-extension of the elbow at the end of 6 months was of 98.3 ± 22.0°, with an amplitude gain of 40.0 ± 14.0° in relation to the pre-operative period ( p   less then  0.001). The average flexion-extension gain at the end of 6 months was of 51.7% ± 17.1% ( p   less then  0.001). The mean pronosupination at the end of 6 months was of 129.0 ± 42.7° ( p   less then  0.001). Half of the cases had moderate and severe stiffness in the pre-operative period, compared with 7.7% at 6 months post-operatively ( p   less then  0.001). The mean score for the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) instruments was 74.4 ± 16.8 points and 31.7 ± 21.9 points respectively ( p   less then  0.001 for both). The visual analogue scale (VAS) score presented no statistically significant difference compared to the pre-operative period ( p  = 0.096). Complications were observed in 6 (23%) patients, and no new surgical procedures were necessary. Conclusions  The surgical release of the elbow associated with a rehabilitation protocol is a safe technique, with satisfactory results and low rate of complications.Objective  To verify if the subjective elbow value (SEV) scale presents similar results to those of the Patient-rated Tennis Elbow Evaluation (PRTEE) scale in the evaluation of patients with lateral elbow epicondylitis (LEE). Methods  Thirty-seven patients were diagnosed with LEE in the outpatient service of our hospital through clinical history, physical examination, X-ray, and ultrasonography. The SEV and PRTEE scales were used and their results were compared using a significance level ≥ 5% ( p ≥0.05). Results  A statistically significant relationship was found between the values of SEV and PRTEE in the group of patients studied ( p  = 0.017). Conclusion  Subjective elbow value presented similar results to PRTEE in the evaluation of patients with diagnosis of LEE.Objective  To perform an anatomical study of the location of the infrapatellar branch of the saphenous nerve in relation to the structures of the knee. Methods  An anatomical study was performed by dissection of 18 humans knees (9 right and 9 left knees). After exposure of the infrapatellar branch and its direct and indirect branches, they were then measured. We adopted a quadrant in the medial region of the knee delimited by two transversal planes as a parameter of the study. Results  In 17 of the 18 knees (94.4%) studied, a single infrapatellar branch was observed. The infrapatellar branch emerged as fibers of the womb of the sartorius muscle in 17 of the 18 knees (94.4%). In relation to the branch, we observed that in 100% of the knees the infrapatellar branch had at least one primary branch, resulting in a superior branch and an inferior branch. In 9 limbs (50% of the cases) this branch occurred outside the proposed quadrant, and, in the remaining limbs, it occurred within the quadrant. Conclusion  The infrapatellar saphenous nerve branch was found in all dissected knees, and, in 94.