Aims The main objective of this study is to analyze the penetration of bone cement in four different full cementation techniques of the tibial tray. Methods In order to determine the best tibial tray cementation technique, we applied cement to 40 cryopreserved donor tibiae by four different techniques: 1) double-layer cementation of the tibial component and tibial bone with bone restrictor; 2) metallic cementation of the tibial component without bone restrictor; 3) bone cementation of the tibia with bone restrictor; and 4) superficial bone cementation of the tibia and metallic keel cementation of the tibial component without bone restrictor. We performed CT exams of all 40 subjects, and measured cement layer thickness at both levels of the resected surface of the epiphysis and the endomedular metaphyseal level. Results At the epiphyseal level, Technique 2 gave the greatest depth compared to the other investigated techniques. At the endomedular metaphyseal level, Technique 1 showed greater cement penetration than the other techniques. Conclusion The best metaphyseal cementation technique of the tibial component is bone cementation with cement restrictor. Additionally, if full tibial component cementation is to be done, the cement volume used should be about 40 g of cement, and not the usual 20 g. Cite this article: Bone Joint Res 2021;10(8):467–473.

The high prevalence of trapeziometacarpal arthritis has resulted in the development of several surgical techniques intended to treat patients failing conservative treatment. However, there is no scientific evidence of the superiority of one technique over others. Open arthrodesis has up to now been successfully used to treat this condition. We believe that performing the technique using a minimally invasive approach with long and short Shannon burrs together with the tapered burr included in the MIS foot instrument set can yield satisfactory results. This article provides a description of this minimally invasive technique performed on a seventy-year-old woman with rhizarthrosis and an anatomical description of the approach in a human cadaver.

Introduction: One of the most frequent knee injuries and one that is on the increase, especially in sports, is the anterior cruciate ligament injury. Surgical reconstruction is essential to recover the biomechanics of the knee, provide correct stability and pain-free function, as well as toavoid early degenerative changes. The objective of the present study was to assess the functional recovery of patients undergoing reconstruction of the anterior cruciate ligament by means of ligamentoplasty with semitendinosus- internal rectus tendon and Toggelock system. Material and methods: A retrospective descriptive observational study was designed, which included 29 patients who underwent a ligamentoplasty with internal semitendinosus-rectum and Togglelock system in our Center, during the years 2017-2018. Variables obtained from the clinical history and the Lysholm scale were studied to assess the patients. Results: In total, a sample of 29 patients was obtained, 26 men and 3 women with a mean age of 31.13 years (range 19-53). The most frequently injured knee was the right knee in 17 patients out of 29, with 65% presenting associated injuries. One patient had suffered a tibial fracture operated with an intramedullary nail that altered the final results. The postsurgical score on the Lysholm subjective assessment scale was 86. The mobility of the operated knee showed a minimal reduction in flexion of 6º compared to the non-operated knee that was statistically significant. Conclusion: The results obtained after ACL reconstruction with this technique, using the semitendinosus- internal rectum plasty and the Togglelock system were good-excellent, with a high degree of patient satisfaction, few complications, and notable functional results.

We present a bibliographic review and a description of the surgical technique in checkrein deformity of the hallux and lesser toes. This dynamic deformity causes a significant difficulty in walking and prevents patients from practicing any sport, since in the stance phase of gait toes are forced into maximum plantar flexion and end up trapped under the foot. In cases in which this is not associated with a bone fracture, the clinical suspicion causing the injury is a subclinical compartment syndrome. Treatment described in this work consists of a Z-plasty and the application of a pulvertaft suture in the flexor hallux longus. In the rest of the toes, any additional surgical procedure is not needed, as the deformity is corrected at the retromalleolar level.

The isolated instability of the proximal tibiofibular joint (PTFJ) as a cause of pain in a prosthetic knee is a very rare clinical entity, to date we have only found one reference in the bibliography of ATPP instability associated with total knee arthroplasty. We review the bibliography on the different forms of instability and their etiology, as well as the possibilities of conservative and surgical treatment. We present the case of a patient with anterolateral instability PTFJ associated with a primary postero-stabilized (PS) TKA with a mobile tibial polyethylene.