The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures.
Objective To study the anatomy of the hamstring tendons insertion and anatomical relationships. Methods Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT), tibial plateau (TP) and tibial tuberosity (TT). A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT) was calculated using Image Pro Plus software. Results The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT) was 20.3 ± 4.9°. Conclusion In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.
Objectiveto analyze the effects of hyaluronic acid of different molecular weights in an experimental model of osteoarthritis in rabbits.Methodsforty‐four male California rabbits were divided randomly into three groups and underwent resection of the anterior cruciate ligament in his right knee. After three weeks of the surgical procedure began three weekly intra‐articular injections of hyaluronic acid native (Polireumin®)‐PR, hyaluronic acid branched chain (Synvisc®)‐S and 0.9% saline‐P. All animals were sacrificed after twelve weeks of surgery and tibial plateau infiltrated the knees were dissected. Histological cartilage of the support areas of the tibial plateaus were stained with Alcian Blue pH 1.0, Alcian Blue pH = 2.5 and toluidine blue for research on the amount of proteoglycans. The intensity of staining was quantified on a Zeiss microscope apparatus Imager Z2 MetaSystems and analyzed by software MetaferMsearch.Resultsthe effect of chondroprotetor hyaluronic acids used in the study was confirmed when compared to the control group, but the comparison made between them, there was no statistically significant difference regarding chondroprotetion.Conclusionthe hyaluronic acids tested had chondroprotective effect, with no statistical difference with regard to the different molecular weights.
ObjectiveTo analyze, from the immunohistochemical perspective, the effects of hyaluronic acid of different molecular weights in an experimental model of osteoarthritis in rabbits.MethodsForty-four male California rabbits were randomly assigned to three different groups (PR, S, and P) and submitted to the resection of the anterior cruciate ligament of the right knee. Three weeks after the surgical procedure, three intra-articular weekly injections were carried out with low-molecular-weight native hyaluronic acid (Hyalgan®) to PR group, high molecular weight branched chain hyaluronic acid (Synvisc®) to group S, and saline solution 0.9% to group P. All animals were sacrificed 12 weeks after the surgical procedure, and the tibial plateaus of the infiltrated knees were then dissected. Histological sections of cartilage from the tibial plateau support areas were stained with immunohistochemical markers in order to investigate the amount of metalloproteases (MMPs 3 and 13) and their inhibitors (TIMPs 1 and 3). The staining intensity was quantified on a Zeiss Imager.Z2 Metasystems microscope and analyzed by Metafer4 Msearch software.ResultsThe chondroprotective effect of the hyaluronic acids used in the study was demonstrated when compared to the control group. However, the comparison between them presented no significant statistical difference regarding chondroprotection.ConclusionThe injection of saline solution demonstrated signs of OA development, while adding native hyaluronic acid of low molecular weight (Hyalgan®) and hyaluronic acid of high molecular weight (Synvisc®) protected the articular cartilage in this model of OA.
OBJETIVO: Avaliar a diferença do comportamento mecânico de tendões flexores solidarizados e não solidarizados para verificar se a solidarização tem função efetiva. MÉTODOS: Vinte e quatro tendões digitais bovinos frescos foram usados. Para determinar a área da secção transversal utilizou-se alginato. Dez tendões foram solidarizados seguindo as orientações do fabricante; outros 10 pares não. Foram desenvolvidas garras para fixação dos enxertos à máquina universal para simulação da fixação, sendo a superior bipartida e de passagem controlada dos pinos e a inferior com dentes alternados. RESULTADOS: A carga máxima dos corpos de prova não solidarizados foi de 849,4 N ± 386,8 a área 30,4 mm²± 7,7, tensão de 29 ± 17 Mpa. Os solidarizados obtiveram carga máxima de 871,8 N ± 484,9 área 35 mm²± 5,8, tensão de 24 ± 10 Mpa. Não houve diferença estatística entre os dois grupos (p>0,05). CONCLUSÃO: A distribuição de probabilidade mostra que para 400 N os tendões não solidarizados apresentam confiabilidade de 83,8% e os solidarizados de 78,5%%.
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