ObjectiveTo ascertain whether the proprioceptive deficit in the sense of joint position continues to be present when patients with a limb presenting a deficient anterior cruciate ligament (ACL) are assessed by testing their active reproduction of joint position, in comparison with the contralateral limb.MethodsTwenty patients with unilateral ACL tearing participated in the study. Their active reproduction of joint position in the limb with the deficient ACL and in the healthy contralateral limb was tested. Meta-positions of 20% and 50% of the maximum joint range of motion were used. Proprioceptive performance was determined through the values of the absolute error, variable error and constant error.ResultsSignificant differences in absolute error were found at both of the positions evaluated, and in constant error at 50% of the maximum joint range of motion.ConclusionWhen evaluated in terms of absolute error, the proprioceptive deficit continues to be present even when an active evaluation of the sense of joint position is made. Consequently, this sense involves activity of both intramuscular and tendon receptors.
r e v b r a s o r t o p . 2 0 1 4;4 9(6):607-612 w w w . r b o . o r g . b r Artigo Original Déficit proprioceptivo em indivíduos com ruptura unilateral do ligamento cruzado anterior após a avaliação ativa do senso de posição articular ଝ informações sobre o artigo Histórico do artigo: Recebido em 12 de junho de 2013 Aceito em 30 de julho de 2013 On-line em 27 de junho de 2014 Palavras-chave: LCA Sistema somatossensorial Joelho r e s u m o Objetivo: Verificar se o déficit proprioceptivo no SPA permanece quando pacientes com um membro LCA deficiente são avaliados por meio do teste de reprodução ativa da posição articular, em comparação com o membro contralateral. Métodos: Participaram do estudo 20 pacientes com ruptura unilateral do LCA. Foi feito o teste de reprodução ativa da posição articular no membro LCA deficiente e contralateral saudável. Foram usadas as posiç ões meta de 20% e 50% da amplitude articular máxima. O desempenho proprioceptivo foi determinado por meio dos valores de erro absoluto (EA), erro variável (EV) e erro constante (EC). Resultados: Diferenças significativas foram encontradas para o EA em ambas as posiç ões avaliadas e para o EC em 50% AAM. Conclusão: O déficit proprioceptivo quando avaliado pelo EA permanece mesmo quando a avaliação do senso de posição articular é ativa e, consequentemente, envolve a atividade de receptores intramusculares e tendíneos.
The medial meniscal root tear, a particular meniscal injury at the level of its posterior bone insertion, leads to a loss of impact absorption and load distribution capacity, similar to total meniscectomy. Therefore, its repair is fundamental for knee joint longevity. This type of injury often occurs in middle-aged patients with lower limbs varus malalignment, which results in mechanical overloading of the medial compartment and induces premature cartilage wear out. The success of meniscal root repair, with meniscal bone reinsertion, depends on the correction and realignment of varus deformities greater than 5 for physiological levels. In this situation, corrective tibial osteotomy combined with meniscal repair is indicated. Our goal is to describe the step-by-step technique of the valgus opening wedge tibial osteotomy combined with the arthroscopic reinsertion of the posterior meniscal root in tibia during the treatment of a patient with varus deformity and medial meniscus root tear.
Patellar fractures, which constitute approximately 1% of bone lesions, may lead to severe impairment of the extensor mechanism. When conservative or surgical treatment fails, the patella may develop pseudoarthrosis. Neglect or delayed treatment of this type of injury may lead to significant diastasis between the patellar fragments. There is no consensus regarding the best treatment for such cases. This study is aimed at describing a rare case of patellar pseudoarthrosis in a patient who underwent two-step surgical treatment comprising transskeletal patellar traction followed by osteosynthesis with a tension band. A 17-year-old male patient presented with a left patellar fracture that resulted from a fall from a standing height 8 years ago. He did not undergo any type of surgical treatment during that time, but the fracture was immobilized for only 2 weeks. The two-step surgical treatment with transskeletal patellar traction and patellar osteosynthesis was performed and provided satisfactory functional clinical results in this patient. This two-step surgical treatment can be performed in cases similar to ours with satisfactory results.
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