We reviewed 19 patients (24 knees) with patellofemoral instability treated surgically with antero-medialisation of the tibial tubercle and lateral retinacular release. Twenty-two knees had recurrent patellar dislocation and two patellar subluxation. Lateral retinacular release was performed arthroscopically in 15 knees. Average follow-up was 52 (16-86) months. There was one postoperative haemarthrosis and one failed fixation, which needed surgical revision. The average Lysholm score improved from 63.3 to 98 and only one knee had persistent patello-femoral pain postoperatively. The patellar tilt angle improved from 9.4 degrees to 5.5 degrees . There were no redislocations. We find that the surgical technique produces a consistent correction of patellar instability, but long-term studies are needed to confirm whether it can prevent arthritic degeneration.

Intertrochanteric fracture is the most frequent type of fracture in the proximal femur and the compressive hip screw is one of the most popular methods of treatment. The reduction criteria for this type of fracture are ill-defined. The purpose of this study was to validate 3 reduction criteria: displacement, alignment in the anteroposterior and in the lateral plane. We reviewed a cohort of 430 intertrochanteric fractures treated with a compression hip screw. The type of fracture, quality of reduction and technical complications were noted. We observed a relationship between accuracy of reduction and the incidence of complications, even among fractures of the same severity. A displacement bigger than 4mm and failure to accomplish correct alignment (a neck-shaft angle over 125º and less than 20° angulation on the lateral view) was considered a poor reduction and was associated with more complications.

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O ligamento colateral medial superficial é a estrutura ligamentar do joelho mais frequentemente lesionada. Este encontra-se inserido numa unidade funcional que engloba estabilizadores ativos e dinâmicos da articula é o e que se designa complexo medial do joelho. Curiosamente, durante décadas a literatura debruçou-se quase exclusivamente sobre a lesão do ligamento colateral medial superficial, sendo genericamente aceite que a abordagem conservadora é a estratégia ideal para todos os casos. Isto conduziu a uma simplificação da complexidade das lesões e ao aparecimento de casos de instabilidade residual, dor crónica ou falência do tratamento de outros ligamentos. Nos últimos anos, parece ser crescente o interesse de diversos grupos de investigação sobre aquele que qualificam como “o lado esquecido do joelho”. Este artigo procura transmitir de forma sucinta os conceitos sobre o tema à luz da literatura atual.

No abstract