IntroductionMeniscal tears represent one of the most frequent knee injuries and are the most common cause of knee surgery. Historically, age has been considered an independent factor contraindicating meniscal repair due to the assumption that meniscal injuries in this population are frequently chronic tears, mostly with a degenerative tear pattern, and low healing potential. However, recent literature has questioned this paradigm with studies reporting successful outcomes with meniscal repair in older patients. Our study aimed to evaluate and compare the short-term clinical outcomes of meniscal repair versus partial meniscectomy in patients aged ≥40 years old. MethodsA retrospective study was conducted that included patients over the age of 40 years, diagnosed with meniscal tears, that underwent arthroscopically assisted meniscal repair or partial meniscectomy between 01 January and 31 December 2020. The patients were divided into two groups: Group 1-partial meniscectomy (PM) and Group 2-meniscal repair (MR). The clinical evaluation was performed 24 months after the surgery, and the studied variables were: function (Tegner Lysholm Knee Scoring Scale), pain (Visual Analogue Scale), patient satisfaction, and failure rate. ResultsFifty-one patients met the inclusion criteria, and 7 were excluded due to loss of follow-up during telephone contact. Thus, the final sample consisted of 44 patients (mean age 52.18y), both groups with 22 patients. In both groups, we found an improvement in pain 2 years after the surgery, with a decrease in the VAS value between the pre and post-surgery. On average, the VAS score decreased from 7.9 to 4.5 in the group subjected to partial meniscectomy, and from 7.5 to 3.2 in the meniscal repair. This was statistically significant in both groups, with a p-value <0.01, but not between them (p-value = 0.363). Comparing the degree of satisfaction between both groups, we found no statistically significant difference between them (p=0.167). Regarding the functional outcome (Tegner Lysholm Knee Scoring Scale), the group that underwent the meniscal repair obtained a statistically superior score compared to the partial meniscectomy group (77.55 vs. 64.77; p-value 0.033). The failure rate was exactly equal in both groups (4.5%), therefore no statistically significant difference was found in this variable. ConclusionAge, as an independent factor, should not be considered a contraindication for meniscus repair. In fact, if technically possible, meniscal repair should always be performed as it is associated with better functional outcomes, similar failure rates, and may be protective against the development and progression of arthritis.

Lisfranc injury is extremely rare in the pediatric population and little evidence exists to guide the treatment at this age.We present a clinical case of a rare Lisfranc fracture-dislocation at pediatric age. An 11-year-old male was admitted to the emergency department, in October 2020, after a motorcycle incident. He was diagnosed with a Lisfranc fracture-dislocation of the right foot: Myerson type B2. Fourteen days after the injury, he underwent surgical treatment with open reduction and internal fixation with 3.5 mm solid fully threaded screws.At 18 months postoperative, the patient was asymptomatic, didn't present any limitations, presented an American Orthopedic Foot and Ankle Score (AOFAS) midfoot score of 93%, and excellent results of the 12-Item Short Form Survey (SF-12) -PCS-12 (Physical Score): 52.52277 and MCS-12 (Mental Score): 62.12820. The foot maintained a good configuration without significant malalignment, however, a screw breakage occurred before the implant removal, and a premature physeal arrest developed on the base of the first metatarsal bone.Clinical and radiographic evaluation of Lisfranc injuries may be challenging in the pediatric population. Regarding the treatment, anatomical alignment is mandatory, and good or excellent outcomes have been achieved with anatomical reduction and internal fixation. We recommend early implant removal to avoid screw breakage and avoid the use of screws in the first metatarsal physis, due to the risk of premature physeal arrest.

Surgical treatment of calcaneal fractures continues to be a challenge for surgeons owing to the high risk of complications. The aims of this study were to analyze the results of percutaneous locking nail fixation, including radiologic and functional outcomes, complications, time to surgery and to hospital discharge. This is a retrospective study, that assessed calcaneal fractures treated with a percutaneous locking nail (Calcanail, FH Orthopedics). The fractures were classified according to Sanders. Pain, function and range of motion were evaluated at final follow up, according to the visual analogue scale (VAS), the foot and Ankle Outcome Score (FAOS) and the American Orthopaedic Foot and Ankle Society Ankle-Hind foot Score (AOFAS-AHS), respectively. Between July 2016 and May 2018, 12 patients and 13 fractures were identified. The mean time to surgical procedure was 10.5 days, with 1 day of hospital stay. The average AOFAS and FAOS scores were 87.8 and 79.2% respectively, at a mean final follow-up of 16 months, and the mean VAS was 1.83/10. Böhler and Gissane angles improved from 18º and 132º to 28º and 122º respectively. The mean improve of calcaneal height was 0.5 cm. The mean time to return to daily activity level was 3.3 months and to work 4 months. 8% of the patients had complications severe enough to require a new intervention, and we had no skin complications. Percutaneous calcaneal fracture fixation with locking nail appears to be an effective and reliable procedure. It is a surgical option in selected patients.

<p>Bilateral patellar tendon rupture is a rare injury, usually associated with systemic disease or chronic medication side effect. Early diagnosis and prompt surgical repair are essential to achieve good functional outcomes. The authors report a case of a 44-year-old male with history of multiple urinary tract infection treated with fluoroquinolones who sustained spontaneous simultaneous bilateral patellar tendon rupture. Patient underwent bilateral transosseus tendon repair with autologous semitendinosus augmentation. Nine months after surgery, the patient was able to walk without pain and unassisted, had a normal range of motion in both knees and performed his daily activities without limitation. Surgical treatment of patellar tendon rupture is recommended to allow prevention of extensor mechanism disfunction sequelae. Transosseus tendon repair with autologous semitendinosus augment plasty is a valid surgical technique for treatment of this pathology with biomechanical and literature support.</p>