ObjectiveThe aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients.MethodThis is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Patients with open physis who had more than two episodes of recurring patellar dislocation were included. No patients underwent additional procedures. The distance from the anterior tibial tuberosity to the trochlea grove (TT-TG) was measured in all patients. On physical examination, the inverted J-sign, the apprehension sign, and the knee range of motion parameters were used in the pre- and post-operative period. In addition, the Kujala and Lysholm scores were applied before and 12 months after surgery. The results were analyzed with the Wilcoxon test.ResultsThe mean age of the patients was 11.28 in both genders. Comparing the data of the pre- and post-operative period, the inverted J-sign was present in six patients (85.7%) vs. absent in one (14.3%). The apprehension sign was absent in cases in the postoperative period; the range of motion was 117.85 ± 8.09 vs. 148.57 ± 3.77. The Kujala score was 42.57 ± 8.9 vs. 88.57 ± 5.09 and the Lysholm scores were classified as excellent or good in 28.6% and 71.4%, respectively.ConclusionThe combined reconstruction of the medial patellofemoral ligament combined with the medial patellotibial ligament in skeletally immature patients with predisposing factors, presents satisfactory results without episodes of recurrence or residual subluxation; according to these preliminary results, it should be considered as a treatment option.

Objective:Clubfoot is one of the most common congenital deformities affecting the musculoskeletal system. The main conservative treatment for clubfoot includes the Ponseti's and Kite's methods. This study aimed to perform a comparative evaluation of the effectiveness of the Ponseti and Kite approaches for the conservative treatment of clubfoot.Methods:One hundred children with clubfoot abnormality, visiting the Martagão Gesteira Hospital, were divided in two groups. The first group received conservative treatment using the Kite method and the second group received conservative treatment using the Ponseti method. At the end of the treatment, both groups were evaluated based on the Pirani classification to verify whether there had been an adequate correction of the deformity. The variables studied included correction of deformity, age, sex, and laterality.Results:The effectiveness of the Kite and Ponseti methods of conservative treatment showed significant statistical differences.Conclusion:The present study shows that the efficacy of conservative treatment using the Ponseti method was 18% higher than that of the Kite method. Level of evidence II, randomized clinical trial.

BackgroundThere are several reports on anatomical differences of the meniscus. However, there are only a few reports on abnormalities in both menisci and anatomical differences in anterior cruciate ligament insertions.Case presentationThis is a case report of a 36-year-old Hispanic man presenting symptoms, including knee pain, locking, and effusion, with an anatomical abnormality of the menisci corresponding to the fusion of the posterior horns of the menisci in tandem with the insertion of the posterior meniscus fibers in the anterior cruciate ligament.ConclusionsThis is the first study describing a meniscus anatomical variant with isolated posterior junction of the posterior horn with an anomalous insertion to the anterior cruciate ligament. The recognition of meniscus variants is important as they can be misinterpreted for more significant pathology on magnetic resonance images.

ObjectiveUsing biomechanical studies, this research aims to compare hip capsulorrhaphy in rabbits, carried out with two different techniques: capsulorrhaphy with simple sutures and with anchors.MethodThirteen New Zealand Albino (Oryctolaguscuniculus) male rabbits, twenty-six hip joints, were used. First, a pilot project was performed with three rabbits (six hip joints). This experiment consisted of ten rabbits divided into two groups: group 1 underwent capsulorrhaphy on both right and left hips with simple suture using polyglycolic acid absorbable thread, and group 2 underwent capsulorrhaphy with titanium anchors. After a four-week postoperative period, the animals were euthanized and the hip joints were frozen. On the same day of the biomechanical studies, after the hip joints were previously unfrozen, the following parameters were evaluated: rigidity, maximum force, maximum deformity and energy.ResultsThere was no relevant statistical difference in rigidity, maximum force, maximum deformity and energy between the simple suture and anchor groups.ConclusionThrough biomechanical analyses, using parameters of rigidity, maximum force, maximum deformity and energy, it has been shown that capsulorrhaphy with simple suture and with anchors has similar results in rabbit hip joints. Level of Evidence II, Prospective Comparative Study.

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