ABSTRACT
Las lesiones condrales y osteondrales afectan a sectores del cartílago articular. Producen dolor, inflamación e impotencia funcional que evolucionan a osteoartritis. Los factores de crecimiento presentes en el plasma rico en plaquetas (PRP) son señales bioquímicas capaces de modificar las respuestas de las células al crecimiento y la diferenciación celular, lo que interviene en la curación de los tejidos. Material y métodos. Estudio experimental, aleatorizado, abierto, de 1 año de duración. Objetivo. Evaluar la eficacia clínica del PRP. Incluimos a 324 pacientes con lesiones grado I, II y III, divididos en 2 grupos mediante aleatorización simple. El grupo Tratamiento fue tratado con PRP (3 ml intraarticular) cuya aplicación fue repetida a los 90 días, fisiokinesioterapia y glucosamina. El grupo Control fue tratado con fisiokinesioterapia y glucosamina, durante 90 días. Los resultados fueron evaluados mediante el cuestionario WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Resultados. 81% (n = 262) de los pacientes fue del sexo femenino; 19% (n = 62), masculino. La edad promedio fue 59 años (rango de 41 a 86). Todos los casos correspondieron a rodilla: 73% (n = 237) bilateral, 27% (n = 87) unilateral, 14% (n = 45) derecha, 13% (n = 42) izquierda. No se obtuvieron diferencias significativas entre ambos grupos en el primer control postratamiento. La mejoría clínica del grupo Control disminuyó luego del día 90, y se mantuvo en el grupo Tratamiento, lo que representa un resultado significativo desde el punto de vista estadístico (p < 0,05). Conclusiones. El tratamiento con PRP mostró mejor resultado clínico en el tiempo. No hubo efectos adversos. Nivel de evidencia: 1. (AU)
Chondral and ostechondral injuries affect sectors of articular cartilage. They cause pain, inflammation and functional impairment that can lead to osteoarthritis. The growth factors present in platelet-rich plasma (PRP) are biochemical signals capable of modifying cell responses to growth and differentiation, which play a role in tissue healing. Material and methods. Experimental, randomized, open-label study. Objective. To evaluate the clinical efficacy of PRP. We included 324 patients with grade I, II and III injuries, divided into 2 groups through simple randomization: Treatment group was treated with PRP (3 ml intraarticular) repeated at 90 days, physio-kinesiotherapy and glucosamine. Control group was treated with physio-kinesiotherapy and glucosamine for 90 days. Results were evaluated using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Results. 81% (n = 262) were female, 19% (n = 62) were male. The mean age was 59 years (range 41 to 86). All cases involved the knee: 73% (n = 237) bilateral, 27% (n = 87) unilateral, 14% (n = 45) right, 13% (n = 42) left. No significant differences were found between both groups in the first post-treatment assessment. Clinical improvement of the Control group decreased after day 90, while it was maintained in the Treatment group, representing a statistically significant result (p < 0.05). Conclusions. Treatment with PRP showed better clinical results over time. There were no adverse effects observed. Evidence level: 1. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Cartilage, Articular/physiology , Chondrogenesis/physiology , Platelet-Rich Plasma/metabolism , Knee Joint , Physical Therapy Modalities , Glucosamine/therapeutic use , Knee Injuries/therapyABSTRACT
Abstract Objective To evaluate if there is a significant difference in the outcomes of isolated anterior cruciate ligament (ACL) reconstruction in patients with or without associated anterolateral ligament (ALL) injury. Methods We conducted a retrospective cross-sectional study through the analysis of medical records and the application of the questionnaires of the Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) Subjective Knee Form to patients undergoing isolated ACL reconstruction. Results The 52 participants included were divided into two groups: 19 with associated ALL injury and 33 with no associated ALL injury. None of the patients with associated ALL injury suffered an ACL rerupture, and 21.1% presented injuries to other knee structures after surgery. Among the patients with no associated injury, 6.1% suffered ACL rerupture, and 18.2% presented injuries to other structures after surgery (p = 0.544). Return to activities at the same level as that of the preoperative period occurred in 60% of the patients with associated ALL injury and in 72% of those with no associated injury (p = 0.309). The mean score on the Lysholm Knee Scoring Scale was of 81.6 points in patients with associated ALL injury, and of 90.1 in those with no associated injury (p = 0.032). The mean score on the IKDC Subjective Knee Form was of 70.3 points in patients with associated ALL injury and of 76.7 in those with no associated injury (p = 0.112). Conclusion There was no statistically significant difference regarding graft injuries or new injuries to other structures, satisfaction with the operated knee, or the score on the IKDC Subjective Knee Form. Return to activity was similar in the groups with and without associated ALL injuries. The scores on the Lysholm Knee Scoring Scale were better, with a statistically significant difference in the group with no associated ALL injuries.
Resumo Objetivo Avaliar se há diferença significativa nos resultados da reconstrução isolada do ligamento cruzado anterior (LCA) em pacientes com e sem lesão associada do ligamento anterolateral (LAL). Métodos Foi realizado um estudo transversal retrospectivo com análise de prontuários e aplicação dos questionários da Escala de Pontuação do Joelho de Lysholm e do Formulário Subjetivo de Joelho do International Knee Documentation Committee (IKDC) a pacientes com reconstrução isolada do LCA. Resultados Os 52 participantes incluídos foram separados em 2 grupos: 19 com lesão associada do LAL e 33 sem lesão associada. Nenhum paciente com lesão associada do LAL sofreu rerruptura do LCA, e 21,1% tiveram lesões em outras estruturas do joelho após a cirurgia. Entre os pacientes sem lesão associada, 6,1% sofreram rerruptura do LCA, e 18,2% tiveram lesões em outras estruturas após a cirurgia (p = 0,544). O retorno às atividades no mesmonível do quenopré-operatóriofoi observadoem60% dos pacientes com lesão associada do LAL e em 72% daqueles sem lesão associada (p = 0,309). Na Escala de Pontuação do Joelho de Lysholm, os pacientes com lesão associada do LAL obtiveram média de 81,6 pontos, e os sem lesão associada, média de 90,1 pontos (p = 0,032). No Formulário Subjetivo de Joelho do IKDC, os pacientes com lesão associada do LAL obtiveram média de 70,3 pontos, e os sem lesão associada, média de 76,7 pontos (p = 0,112). Conclusão Não foi observada diferença estatística significativa quanto a lesões do enxerto ou novas lesões de outras estruturas, satisfação com o joelho operado ou pontuação no Formulário Subjetivo de Joelho do IKDC. Oretorno às atividades foi semelhante nos grupos com e sem lesão associada do LAL, e os resultados na Escala de Pontuação do Joelho de Lysholm foram melhores, com diferença estatística significativa no gruposem lesãoassociada do LAL.
Subject(s)
Humans , Adult , Anterior Cruciate Ligament Reconstruction , Knee Injuries , Ligaments, ArticularABSTRACT
Purpose: Osteoarthritis (OA) is a degenerative joint disease which is categorized via destruction of joint cartilage and it also affects the various joints, especially knees and hips. Sinomenine active phytoconstituents isolated from the stem of Sinomenium acutum and already proof anti-inflammatory effect against the arthritis model of rodent. In this experimental protocol, we scrutinized the anti-osteoarthritis effect of sinomenine against monosodium iodoacetate (MIA) induced OA in rats. Methods: MIA (3 mg/50 µL) was used for inducing the OA in the rats, and rats received the oral administration of sinomenine (2.5, 5 and 7.5 mg/kg body weight) up to the end of the experimental study (four weeks). The body and organs weight were estimated. Aggrecan, C-terminal cross-linked telopeptide of type II collagen (CTX-II), glycosaminoglycans (GCGs), monocyte chemoattractant protein-1 (MCP-1), Interferon gamma (IFN-γ), antioxidant, inflammatory cytokines, inflammatory mediators and matrix metalloproteinases (MMP) were analyzed. Results: Sinomenine significantly (P < 0.001) boosted the body weight and reduced the heart weight, but the weight of spleen and kidney remain unchanged. Sinomenine significantly (P < 0.001) reduced the level of nitric oxide, MCP-1 and improved the level of aggrecan, IFN-γ and GCGs. Sinomenine remarkably upregulated the level of glutathione, superoxide dismutase and suppressed the level of malonaldehyde. It effectually modulated the level of inflammatory cytokines and inflammatory mediators and significantly (P < 0.001) reduced the level of MMPs, like MMP-1, 2, 3, 9 and 13. Conclusions: Sinomenine is a beneficial active agent for the treatment of OA disease.
Subject(s)
Animals , Rats , Osteoarthritis , Iodoacetic Acid , Hip Injuries , Inflammation , Knee InjuriesABSTRACT
Introducción: Las epifisiólisis de la tuberosidad anterior de la tibia en adolescentes representan el 1% de las lesiones fisarias y el 3% de las fracturas de la tibia proximal, y pueden comprometer la fisis; por lo tanto, ameritan un diagnóstico y un tratamiento correctos para evitar complicaciones. El objetivo de este artículo es comunicar un caso clínico, compararlo con casos similares publicados, analizar las diferencias y, sobre la base de la experiencia, llegar a una conclusión para su resolución. Presentamos a un varón de 13 años que consultó tras sufrir un traumatismo directo en la rodilla derecha, durante la carrera en la práctica deportiva, un mes atrás. La radiografía mostró epifisiólisis por avulsión de la tuberosidad anterior de la tibia (Ogden IIIA, Jones III), por lo que fue sometido a reducción abierta y fijación. Como la recuperación y el retorno a la actividad habitual fueron rápidos, se tomaron un par radiográfico para el diagnóstico y una tomografía para la planificación quirúrgica. Conclusión: Si bien no hay un consenso sobre el diagnóstico y el tratamiento por la baja cantidad de casos publicados, es conveniente sospechar este cuadro en pacientes jóvenes que sufren un traumatismo en la rodilla que limita la extensión. Nivel de Evidencia: IV
Epiphysiolysis of the anterior tibial tubercle in adolescents accounts for 1% of physeal injuries and 3% of proximal tibial fractures, and it may involve the physis, necessitating diagnosis and treatment to prevent complications. Objective: To present a case, compare it existing literature, analyze differences, and propose resolutions based on our experience. A 13-year-old male consulted after suffering direct trauma to his right knee while running in sports practice one month earlier. Radiography revealed epiphysiolysis due to avulsion of the anterior tibial tubercle (Odgen IIIA and Jones III), prompting open reduction and internal fixation with two partially-threaded cannulated screws and washers. After six weeks of cast immobilization, he began rehabilitation. Given his swift recovery, AP and lateral radiographs were obtained for diagnosis and a CT scan for surgery planning, leading to a second surgery involving open reduction and internal fixation with two cannulated screws surrounding the physis, although the patellar tendon was explored first to mitigate the risk of invagination within the fracture line. Conclusion: Despite the scarcity of reported cases, a rising trend due to increased youth sports participation underscores the importance of considering this injury in young patients presenting with knee trauma and restricted extension. Level of Evidence: IV
Subject(s)
Child , Tibial Fractures , Fractures, Avulsion , Knee InjuriesABSTRACT
Abstract Objective The present systematic review aimed to investigate the influence of high physical demand on the increase in muscle and ligament injuries in professional soccer athletes. Methods We analyzed scientific publications to determine the incidences of the main injuries, their causes and mechanisms, and their association with high physical demand. We compared amateur and professional players and assessed the effectiveness of FIFA11+ as a prevention alternative. Searches occurred on Scielo, Pubmed, and Google Scholar databases. The filters were the topic, publication date (last 5 years), and study relevance. The indexing terms were the following: Overuse, Calendar, Injuries, Muscular, Ligament, Athletes, Soccer, Football. We described the main data obtained to compare and analyze the results. This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Results The query resulted in 24 articles published from 2019 to 2023. The high physical demand increased the risk of injuries. Most injuries occurred in the lower limbs. The most common injuries were strains, sprains, contractures, and ligament ruptures. FIFA11+ presented itself as a viable prevention alternative. Conclusion We concluded that high physical demand increases the most frequent muscle and ligament injuries in professional soccer players, that is, strains, sprains, contractures, and ligament rupture, suggesting the FIFA11+ program as a prevention alternative.
Resumo Objetivo Esta é uma revisão sistemática que objetivou investigar a influência da alta demanda física no aumento de lesões musculares e ligamentares em atletas profissionais de futebol. Métodos Tratou-se de buscar, por meio da análise de publicações em meios científicos, as incidências das principais lesões, abordando suas causas e mecanismos bem como sua relação com a alta demanda física. Comparamos jogadores amadores (categorias de base) com jogadores profissionais e avaliamos a eficácia do FIFA11+ como alternativa de prevenção. As buscas foram realizadas nas plataformas Scielo, Pubmed e Google Scholar. Os filtros foram de acordo com o tema, data de publicação (últimos 5 anos) e relevância para o estudo. Foram utilizados os seguintes termos de indexação: Overuse, Calendar, Injuries, Muscular, Ligament, Athletes, Soccer, Football. Os principais dados obtidos foram descritos, objetivando a comparação e análise dos resultados. Foram aderidas as recomendações da declaração de Principais Itens para Relatar Revisões Sistemáticas e Metanálises (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA). Resultados A pesquisa resultou em 24 artigos, publicados entre 2019 e 2023. Quanto à influência da alta demanda física, observou-se o aumento do risco de lesões. Em relação à incidência, constatou-se a prevalência de lesões nos membros inferiores. Quanto aos tipos de lesões, nota-se que as mais comuns são estiramento, entorse, contratura e rompimento ligamentar. Quanto ao FIFA11 + , apresentou-se como alternativa viável de prevenção. Conclusão Concluiu-se que a alta demanda física aumenta a ocorrência das lesões musculares e ligamentares mais frequentes em futebolistas profissionais, que são estiramento, entorse, contratura e rompimento ligamentar, sugerindo-se o programa FIFA11+ como prevenção.
Subject(s)
Humans , Soccer/injuries , Wounds and Injuries , Athletes , Knee Injuries , Musculoskeletal Physiological PhenomenaABSTRACT
Abstract The lateral collateral ligament (LCL) is the strongest lateral stabilizer of the knee. It provides support against varus stress and posterolateral rotation of the knee. Lateral collateral ligament injuries mostly occur together with anterior and/or posterior cruciate ligament injuries. While grades 1 and 2 injuries are treated conservatively since they are partial injuries, total ruptures, as in grade 3, require surgical treatment. In conventional LCL reconstruction methods, hamstring grafts are used, and bioscrews are used in bone-tendon fixation. Lateral collateral ligament reconstruction is usually performed as a component of multiple ligament surgery. Therefore, there is a need for a contralateral hamstring tendon or allograft. The present article aims to define a technique that does not require tendon grafts and bioscrews in fibular fixation.
Resumo O ligamento colateral lateral (LCL) é o estabilizador lateral mais forte do joelho. Ele fornece suporte contra o estresse varus e a rotação de posterolateral do joelho. As lesões de LCL ocorrem principalmente com lesões do ligamento cruzado anterior e/ou posterior. Enquanto as lesões grau 1 e 2 são tratadas de forma conservadora, uma vez que são lesões parciais, rupturas totais, como no grau 3, requerem tratamento cirúrgico. Utilizam-se enxertos isquiotibiais nos métodos convencionais de reconstrução da LCL e bioscrews na fixação do tendão ósseo. A reconstrução do LCL é geralmente realizada como um componente de cirurgia de ligamento múltiplo. Portanto, há necessidade de um tendão contralateral ou aloenxerto. O presente artigo tem como objetivo definir uma técnica que não exija enxertos tendíneos e bioscrews na fixação fibular.
Subject(s)
Humans , Athletic Injuries , Collateral Ligaments , Anterior Cruciate Ligament Reconstruction , Joint Instability , Knee InjuriesABSTRACT
Abstract Objective This study aimed to identify the main knee complaints and injuries associated with baseball and their prevalence in the state of São Paulo, Brazil. Methods This epidemiological study analyzed data from an online questionnaire sent to baseball athletes from the state of São Paulo, Brazil, from 2019 to 2022. Results Ninety-eight athletes participated in the study. Their average age was 24.3 years, and 85.72% of the subjects were men. The most prevalent ethnicities were yellow (50%) and white (42.86%). Most athletes had incomplete or complete higher education (75.5%). Most (88.77%) have been training for over 1 year, and 40.82% played in more than 1 position. More than half also practiced another sport. Most (66.32%) athletes present knee complaints or symptoms, and 37.75% had suffered a knee injury playing baseball, with several mechanisms (contact with the ground, contact with another player, or no contact). More than half (59.45%) of the athletes required time away from baseball due to complaints, symptoms, or injuries. Conclusion Among the athletes interviewed, 66.32% had a knee complaint, and 37.75% had already had a knee injury, especially meniscal and ligament injuries. The injury rate was highest in the first year of practice.
Resumo Objetivo Identificar as principais queixas e lesões de joelho associadas ao beisebol, e sua prevalência em atletas de beisebol no estado de São Paulo. Métodos Estudo epidemiológico desenvolvido por meio da análise de dados obtidos por um questionário online, entre os anos de 2019 e 2022, distribuído entre atletas de beisebol do estado de São Paulo. Resultados Noventa e oito atletas participaram do estudo, com média de 24,3 anos de idade, sendo que 85,72% eram homens. As etnias mais prevalentes foram os amarelos (50%) e brancos (42,86%), e a maioria dos atletas possuía ensino superior incompleto ou completo (75,5%). Um total de 88,77% treinava há mais de 1 ano e 40,82% atuavam em mais de uma posição. Mais da metade praticava simultaneamente outro esporte. Um total de 66,32% dos atletas apresentava queixas ou sintomas no joelho e 37,75% já haviam sofrido alguma lesão no joelho associada à prática do beisebol através de diversos mecanismos (contato com solo, contato com outro jogador, sem contato). Um total de 59,45% dos atletas precisou ser afastado da prática devido às queixas, sintomas ou lesões apresentadas. Conclusão Dos atletas entrevistados, 66,32% apresentaram alguma queixa no joelho e 37,75% já tiveram alguma lesão diagnosticada nessa articulação, sendo as mais prevalentes as lesões meniscais e as ligamentares. A taxa de lesões foi maior no primeiro ano de prática.
Subject(s)
Humans , Male , Female , Baseball , Tendinopathy , Athletes , Tibial Meniscus Injuries , Knee Injuries/epidemiologyABSTRACT
Abstract A middle-aged female patient with a tibial plateau fracture combined with an avulsion of the tibial eminence was treated with a combination of medial plate fixation for the plateau and an arthroscopic aided nonabsorbable suture of the eminence. Our technique for tibial eminence avulsion fractures has no interference with tibial plateau osteosynthesis materials and has proven, once again, to have good results in the treatment of combined and complex injuries of the knee.
Resumo Uma paciente de meia-idade com fratura do platô tibial e avulsão da eminência tibial foi tratada com uma combinação de fixação do platô com placa medial e sutura da eminência com fio não absorvível auxiliada por artroscopia. Nossa técnica para fraturas com avulsão da eminência tibial não interfere nos materiais de osteossíntese do platô tibial e, mais uma vez, teve bons resultados no tratamento de lesões combinadas e complexas do joelho.
Subject(s)
Humans , Female , Middle Aged , Arthroscopy , Tibial Fractures , Fracture Fixation, Internal , Knee InjuriesABSTRACT
Objetivo: Evaluar los efectos del uso de plasma rico en plaquetas (PRP), ácido hialurónico (AH), o su combinación, en la analgesia y funcionalidad en pacientes femeninas operadas por artroscopía por lesiones condrales en la rodilla. Materiales y métodos: estudio de cohorte prospectivo, participaron dieciséis pacientes femeninas con una edad promedio de 52.7 años (DE = 2.84). Las exposiciones evaluadas fueron inyección intraarticular de plasma rico en plaquetas (12.5%), ácido hialurónico (37.5%) y su combinación (50.0%). Todas las pacientes fueron seguidas durante cuatro semanas postquirúrgicas. Se evaluaron el dolor, la funcionalidad en términos de distancia caminada y capacidad para subir y bajar escaleras, y los resultados de maniobras clínicas (Appley, McMurray, cajón anterior y posterior). Resultados: se observó que el dolor promedio disminuyó significativamente de 3 (DE = 1) a 2 (DE = 1) (p = 0.015). En la escala funcional de subir y bajar escaleras, se constató una mejoría clínica significativa (p = 0.004), con un aumento del 12.5% al 62.5% en las pacientes que realizaban esta actividad sin asistencia. Las maniobras de Appley y McMurray positivas al dolor mostraron disminución, siendo significativa la segunda (p = 0.072 y p = 0.023).Conclusiones: a la fecha, la evidencia que apoya o rechaza la inyección de ortobiológicos es escasa y controversial. Los resultados de este estudio sugieren que estas intervenciones pueden ser efectivas para la rehabilitación postquirúrgica en pacientes con lesiones condrales en la rodilla, aunque se necesitan trabajos con mayores muestras y seguimiento a largo plazo para reforzar estos hallazgos. Nivel de evidencia: II
Objective: to evaluate the effects of using platelet-rich plasma (PRP), hyaluronic acid (HA), or their combination on analgesia and functionality in female patients post-operated by arthroscopy for chondral lesions in the knee.Materials and methods: this was a prospective cohort study involving sixteen female patients with an average age of 52.7 years (SD = 2.84). The exposures evaluated were intra-articular injection of platelet-rich plasma (12.5%), hyaluronic acid (37.5%), and their combination (50.0%). All patients were followed for four weeks post-surgery. Pain, functionality in terms of walking distance and ability to climb and descend stairs, and the results of clinical maneuvers (Appley, McMurray, anterior and posterior drawer) were evaluated.Results: the average pain decreased significantly from 3 (SD = 1) to 2 (SD = 1) (p = 0.015). In the functional scale of climbing and descending stairs, a significant clinical improvement was observed (p = 0.004), increasing from 12.5% to 62.5% of patients performing this activity without assistance. Positive Appley and McMurray maneuvers for pain showed a decrease, with the latter being significant (p = 0.072 and p = 0.023).Conclusions: to date, the evidence supporting or rejecting the injection of orthobiologics is scarce and controversial. The results of this study suggest that these interventions may be effective for post-surgical rehabilitation in patients with chondral lesions in the knee, although studies with larger samples and long-term follow-up are needed to reinforce these findings. Level of Evidence: II
Subject(s)
Knee InjuriesABSTRACT
La rotura del tendón rotuliano es infrecuente y aún más lo es su re-rotura. La integridad de este tendón es fundamental para una adecuada movilidad de la rodilla y una marcha apropiada. El tratamiento se basa en diferentes técnicas quirúrgicas: reparación y aumentación tendinosa usando autoinjertos o aloinjertos. En el presente artículo se describe una alternativa en el posicionamiento de los autoinjertos del tendón de gracilis y tendón de semitendinoso, preservando su inserción en el caso de tener mala calidad de tejidos blandos. A los seis meses postoperatorios se logra un adecuado mecanismo extensor íntegro, con arcos de movilidad en el plano sagital de 0 a 90°, con un buen patrón de marcha sin dolor.
Rupture of the patellar tendon is infrequent and even more infrequent re-rupture; the integrity of this tendon is necessary for an adequate knee mobility and a proper gait. The treatment is based on different surgical techniques performing a tendon repair and augmentation using autografts or allografts. The present article describes an alternative in the positioning of autografts of gracilis tendon and semitendinosus tendon, achieving a complete extensor mechanism after a 6-month follow-up, with ranges of mobility in the sagittal plane from 0 to 90°, with an adequate gait pattern without pain
Subject(s)
Patella , Rupture , Tendon Injuries , Autografts , Knee Injuries , Knee JointABSTRACT
Abstract The present study reports a rare case of avulsion fracture of the tibial tuberosity in an adolescent. A 14-year-old male patient sprained his left knee during a soccer match. At the first emergency-room visit, he presented pain in his left knee, 2 +/4+ edema, and inability to walk and flex the affected knee, but no neurovascular changes or signs of compartment syndrome. Radiographs revealed a physeal fracture at the left proximal tibia, classified by Ogden, Tross and Murphy, and modified by Ryu and Debenham, as type IV, and complemented by Aerts et al. as type IV-B. Immobilization was performed with a plaster cast from the inguinal to malleolar regions, followed by analgesia. The patient was operated on the next day, when open reduction and internal fixation using 4.5-mm cannulated screws were performed. The patient was discharged one day after surgery, with plaster cast immobilization and load restraint for four weeks, and bone consolidation was radiologically confirmed three months after the procedure. The patient evolved with a range of motion similar to that of the contralateral limb, no length discrepancy in the lower limbs, and no complaints after one year of follow-up.
Resumo O presente estudo tem como objetivo relatar um caso raro de fratura por avulsão da tuberosidade da tíbia em adolescente. Um paciente de 14 anos, do sexo masculino, sofreu entorse de joelho esquerdo durante partida de futebol. No primeiro atendimento em pronto-socorro, ele apresentava dor no joelho esquerdo, edema 2 +/4 + , incapacidade de deambulação e de flexo-extensão do joelho acometido, sem alterações neurovasculares ou sinais de síndrome compartimental. Nas radiografias, identificou-se fratura fisária na tíbia proximal esquerda, classificada por Ogden, Tross e Murphy, com modificação por Ryu e Debenham, como tipo IV, e complementada por Aerts et al. como tipo IV-B. Foi realizada imobilização com tala gessada inguino-maleolar e analgesia, e o paciente submetido a cirurgia no dia seguinte, com redução aberta e fixação interna utilizando parafusos canulados 4,5 mm. O paciente recebeu alta no dia seguinte à cirurgia, sendo mantida a imobilização com tala gessada e a restrição de carga por quatro semanas, e apresentou consolidação óssea confirmada por radiografia com três meses do pós-operatório. O paciente evoluiu sem discrepância de comprimento dos membros inferiores, arco de movimento igual ao do membro contralateral, e sem queixas no seguimento de um ano.
Subject(s)
Humans , Male , Adolescent , Tibial Fractures , Fractures, Avulsion , Knee InjuriesABSTRACT
Abstract Articular cartilage injuries are common and lead to early joint deterioration and osteoarthritis. Articular cartilage repair techniques aim at forming a cartilaginous neo-tissue to support the articular load and prevent progressive degeneration. Several techniques are available for this purpose, such as microfracture and chondrocyte transplantation. However, the procedural outcome is often fibrocartilage, which does not have the same mechanical resistance as cartilaginous tissue. Procedures with autologous osteochondral graft have a morbidity risk, and tissue availability limits their use. As such, larger lesions undergo osteochondral transplantation using fresh or frozen grafts. New techniques using minced or particulate cartilage fragments or mesenchymal stem cells are promising. This paper aims to update the procedures for treating chondral lesions of the knee.
Resumo As lesões da cartilagem articular são comuns e levam à deterioração precoce da articulação e ao desenvolvimento da osteoartrite. As técnicas de reparo da cartilagem articular visam a formação de um neo-tecido cartilaginoso capaz de suportar carga articular e evitar a progressão da degeneração. Há várias técnicas disponíveis para esse fim, como a microfratura e o transplante de condrócitos. Entretanto muitas vezes o desfecho do procedimento é a formação de fibrocartilagem, que não possui a mesma resistência mecânica do tecido cartilaginoso. Em outros procedimentos, nos quais é realizado enxerto osteocondral autólogo, há risco de morbidade associada ao procedimento, além da disponibilidade limitada de tecido. Por esse motivo, o transplante osteocondral, utilizando enxertos a fresco ou congelados tem sido utilizado para lesões de maior volume. Por fim, novas técnicas utilizando fragmentos de cartilagem picada ou particulada, assim como o uso de células tronco mesenquimais se apresentam como promissores. O objetivo desse artigo é realizar uma atualização dos procedimentos para tratamento das lesões condrais do joelho.
Subject(s)
Humans , Cartilage, Articular/injuries , Fractures, Stress/therapy , Chondrocytes , Transplants , Knee Injuries/therapyABSTRACT
Abstract Objective To evaluate the effects of hydrolyzed collagen and collagen peptide in the treatment of superficial chondral lesions in rats. Method This research employed 18 Rattus norvegicus. A single intraarticular infiltration of sodium iodoacetate (2 mg solution) through the patellar ligament induced joint damage in previously anesthetized animals. We divided the animals into three groups: a control group, a collagen peptide group, and a hydrolyzed collagen group. Treatment consisted of oral administration of collagen peptide or hydrolyzed collagen for 30 days. Afterwards, we euthanized the animals and studied the joint chondral changes. We evaluated the results according to the chondrocyte clusters count and a histological evaluation, as per Pritzker et al. Results There was no statistical significance in injury stages between the control, hydrolyzed collagen, and collagen peptide groups (p= 0.11). Regarding scores, there was a statistical significance between the groups treated with hydrolyzed collagen and collagen peptide (p< 0.05), but not in comparison with the control group. Conclusion The proposed treatments of the induced chondral lesion with the oral administration of hydrolyzed collagen or collagen peptides were effective, resulting in lesion stabilization or regression, and warranting further experimental research to understand and improve the primary outcome of this study.
Resumo Objetivo Avaliar os efeitos do colágeno hidrolisado e do peptídeo de colágeno no tratamento de lesões condrais superficiais de ratos. Método Foram utilizados 18 Rattus norvegicus nesta pesquisa. O dano articular foi induzido por uma única infiltração intra-articular de iodoacetato de sódio (solução 2 mg), injetada através do ligamento patelar da articulação dos animais previamente anestesiados. Os animais foram distribuídos em três grupos: grupo controle, grupo peptídeo de colágeno e grupo colágeno hidrolisado. O tratamento foi realizado por 30 dias com a administração via oral do peptídeo de colágeno ou do colágeno hidrolisado. Posteriormente, foi realizada a eutanásia dos experimentos e seguiu-se para o estudo das alterações condrais articulares. Os resultados foram avaliados conforme contagem de condrócitos por cluster e através da avaliação histológica segundo Pritzker et al. Resultados Ao observar os estágios de lesão, não foi observada significância estatística entre os grupos controle, colágeno hidrolisado e peptídeo de colágeno (p= 0,11). Ao observar os escores, houve significância estatística na comparação do grupo tratado com colágeno hidrolisado e o grupo peptídeo colágeno (p< 0,05), porém sem diferença estatística em relação ao grupo controle. Conclusão Os tratamentos propostos da lesão condral induzida com uso de colágeno hidrolisado ou peptídeos de colágeno via oral mostraram-se eficazes, com estabilização ou regressão da lesão apresentada em ratos, merecendo novas pesquisas experimentais com o intuito de compreender e melhorar o desfecho primário deste trabalho.
Subject(s)
Animals , Rats , Collagen , Knee Injuries/therapyABSTRACT
Abstract Objective The aim of the present study is to determine whether previous shoulder and knee injuries were associated with isokinetic fatigue index and agonist/antagonist ratio of shoulder internal/external rotators and knee flexors/extensors in male volleyball athletes. Methods The current study is a cross-sectional investigation of 49 male elite volleyball players competing at a high level in Brazil. Isokinetic fatigue index and agonist/antagonist profiles were assessed during the preseason. Additionally, in order to record previous injuries, the athletes answered a standardized questionnaire. We conducted a receiver operating characteristic (ROC) curve analysis to determine the association strength and the clinically relevant cut-off point for variables presenting statistical significance for the area under the curve (AUC) (α = 0.05). An independent t-test was used to compare isokinetic variables between athletes with and without previous injury (α = 0.05). Results The results of the ROC curve analysis indicated that hamstring fatigue index values at 300o/s were associated with the presence of previous knee injury (area under the curve [AUC] = 73%, p= 0.004), and shoulder external rotators fatigue index values at 360°/s were not associated with the presence of previous shoulder injury (AUC = 68%, p= 0.053). Conclusions Elite volleyball athletes who reported previous knee injuries were prone to a higher fatigue index than those reporting no injuries. Knee flexor resistance training might be useful for those athletes who reported knee injuries in the previous season.
Resumo Objetivo O objetivo deste estudo é determinar se lesões prévias de ombro e joelho estavam associadas ao índice de fadiga isocinética e razão agonista/antagonista dos rotadores internos/externos do ombro e flexores/extensores do joelho em jogadores de voleibol. Métodos Esta é uma investigação transversal com 49 jogadores de voleibol de elite que competem em alto nível no Brasil. O índice de fadiga isocinética e os perfis de agonistas/antagonistas foram avaliados durante a pré-temporada. Além disso, para registro de lesões anteriores, os atletas responderam a um questionário padronizado. Conduzimos uma análise da curva de característica de operação do receptor (receiver operating characteristic, ROC) para determinar a força de associação e o ponto de corte clinicamente relevante de variáveis com significância estatística na área sob a curva (AUC) (α = 0,05). Um teste t independente comparou as variáveis isocinéticas entre atletas com e sem lesão prévia (α = 0,05). Resultados Os resultados da análise da curva ROC indicam que os valores do índice de fadiga dos isquiotibiais a 300o/s foram associados à presença de lesão prévia no joelho (área soba a curva [AUC] = 73%, p= 0,004), enquanto os valores do índice de fadiga dos rotadores externos do ombro a 360°/s não foram associados à presença de lesão prévia no ombro (AUC = 68%, p= 0.053). Conclusões Atletas de voleibol de elite que relataram lesões anteriores no joelho estavam propensos a um índice de fadiga maior do que aqueles que não relataram lesões. O treinamento de resistência de flexores do joelho pode ser útil para atletas com relatos de lesões no joelho na temporada anterior.
Subject(s)
Humans , Muscle Strength , Volleyball , Athletes , Shoulder Injuries , Knee InjuriesABSTRACT
OBJECTIVE@#To investigate effectiveness of suture anchor fixation combined with Nice knot strapping via longitudinal patellar drilling in the treatment of patellar inferior pole fractures.@*METHODS@#A clinical data of 37 patients with unilateral patellar inferior pole fracture who met the selection criteria between June 2017 and June 2021 was retrospectively analyzed. Among them, 17 cases were treated with the suture anchor fixation combined with Nice knot strapping via longitudinal patellar drilling (group A), and 20 cases were treated with the traditional Kirschner wire tension band technique (group B). There was no significant difference in terms of gender, age, body mass index, fracture side, combined medical disease, and preoperative hemoglobin between the two groups ( P>0.05). Operation time, intraoperative blood loss, postoperative complications, fracture healing time, knee range of motion, and knee function Bostman score (range of motion, pain, daily work, muscle atrophy, walking aids, knee effusion, soft leg, and stair climbing) and grading were recorded in both groups at last follow-up.@*RESULTS@#There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). All incisions healed by first intention. All patients were followed up 1-2 years, with an average of 1.7 years. X-ray films reexamination showed that all fractures in group A healed, while 2 cases in group B did not heal. There was no significant difference in bone healing time between the two groups ( P>0.05). At last follow-up, the knee range of motion, the range of motion score of Bostman score, total score and effectiveness grading in group A were significantly better than those in group B ( P<0.05). There was no significant difference in the other items of Bostman scores between the two groups ( P>0.05). During follow-up, 2 cases of internal fixation failure and 1 case of internal fixator irritation occurred in group B, and no complication related to internal fixation occurred in group A. The occurrence of complications was significantly lower in group A than in group B ( P<0.05).@*CONCLUSION@#Compared with the traditional Kirschner wire tension band technique, the suture anchor combined with Nice knot strapping via longitudinal patellar drilling for the patellar inferior pole fractures has the advantages of simple operation, reliable fixation, early flexion and extension activity, and better functional recovery of knee joint.
Subject(s)
Humans , Male , Female , Blood Loss, Surgical , Bone Wires , Fracture Fixation, Internal/methods , Fractures, Bone/surgery , Knee Injuries , Patella/surgery , Retrospective Studies , Suture Anchors , Treatment OutcomeABSTRACT
OBJECTIVE@#To compare clinical efficacy of No-touch technique and traditional retractor in treating calcaneal fracture.@*METHODS@#Clinical data of 74 calcaneal fracture patients with closed Sanders typeⅡ to Ⅳ were retrospectively analyzed from July 2019 to June 2021. According to different treatment methods, the patients were divided into No-touch group and conventional group, 37 patinets in each group. In No-touch group, there were 25 males and 12 females, aged from 19 to 70 years old with an average of (42.64±14.16) years old;17 patients were typeⅡ, 14 patinets with type Ⅲ, 6 patients with type Ⅳ according to Sanders fracture classification;three 2.0 mm Kirschner wires were implanted into the talus body, talus neck, and cuboid bone, and the flap was turned upward to expose the operation area. In conventional group, there were 30 males and 7 females, aged from 19 to 67 years old with an average of (41.56±11.38) years old;17 patients with typeⅡ, 12 patients with type Ⅲ, 8 patients with type Ⅳ according to Sanders fracture classification;the operation was completed by exposing the operation area with traditional retractor. Operation time, postoperative incision complications, postoperaive American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score at 6 months between two groups were compared.@*RESULTS@#Seventy-four patients were followed up, and follow-up time in No-touch group ranged from 6 to 17 months with an average of(9.57±2.72) months, while in conventional group ranged from 6 to 16 months with an averge of(9.14±2.71) months, and no difference in follow-up between two groups (P>0.05). Operation time in No-touch group (55.67±7.94) min was shorter than that in conventional group (70.16±9.41) min (P<0.05);four patients in No-touch group occurred incision complications, while 8 patients in normal group, and had statistically difference(P<0.05). Daily activities and support, maximum walking distance (block), ground walking, limited degree of flexion, extension and valgus, foot alignment and total score of AOFAS scores in No-touch group was significantly higher than that of conventional group (P<0.05). There were no significant difference in pain degree, abnormal gait and ankle hind foot stability between two groups(P>0.05). According to AOFAS score, 19 patients got excellent result, 16 good and 2 poor in No-touch group;while 9 excellent, 24 good, and 4 poor in conventional group, and no difference between two groups (P>0.05).@*CONCLUSION@#Compared with traditional retractor in treating calcaneal fracture, No-touch technology could significantly shorten operation time, reduce incidence of postopertive complications, while two methods could improve excellent and good rate of ankle joint function recovery after operation.
Subject(s)
Male , Female , Humans , Young Adult , Adult , Middle Aged , Aged , Fracture Fixation, Internal , Retrospective Studies , Calcaneus/surgery , Fractures, Bone/surgery , Ankle Injuries , Treatment Outcome , Ankle Joint , Foot Injuries , Knee Injuries , Postoperative Complications , TalusABSTRACT
OBJECTIVE@#To investigate clinical effect of percutaneous reduction combined with internal fixation of calcaneal nail in treating Sanders typeⅡto Ⅲ calcaneal fractures.@*METHODS@#From July 2017 to August 2019, clinical data of 98 patients with Sanders typeⅡto Ⅲ calcaneal fractures treated were retrospectively analyzed, and divided into observation group and control group according to different surgical methods. In observation group, there were 35 males and 21 females, aged from 23 to 58 years old with an average of (34.50±7.81) years old;29 patients with Sanders typeⅡand 27 patients with Sanders type Ⅲ;30 patients on the left side and 26 patients on the right side;the time from fracture to operation ranged from 1 to 4 days with an average of (3.45±0.54) days;and treated with percutaneous reduction combined with internal fixation of calcaneal nail system. In control group, there were 25 males and 17 females, aged from 25 to 60 years old with an average of (35.27±7.64) years old;23 patients with Sanders type Ⅱ and 19 patients with Sanders type Ⅲ;24 patients on the left side and 18 patients on the right side;the time from fracture to operation ranged from 2 to 5 days with an average of (3.42±0.62) days;and treated with open reduction and internal fixation. Operation time, blood loss, hospital stay, fracture healing time, and postoperative visual analogue scale (VAS) at 1 day, preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Böhler angle, Gissane angle and calcaneus width, and postoperative complications were compared between two groups.@*RESULTS@#All patients were followed up from 13 to 18 months with an average of (15.6±2.2) months. There were significant differences in operation time, blood loss, hospital stay, fracture healing time and postoperative VAS at 1 day between two groups (P<0.05). There was statistical difference in postoperative AOFAS score at 12 months between two groups (P<0.05), and AOFAS score at 12 months after operation was higher than that before operation (P<0.05). According to AOFAS score, 21 patients got excellent result, 30 good and 5 moderate in observation group, and 10 excellent, 22 good, 7 moderate and 3 poor in control group, which had statistical difference between two groups (P<0.05). Postoperative Böhler angle, Gissane angle and calcaneus width at 6 months were better than that before operation between two groups(P<0.05). One patient in observation and 20 patients in control group occurred skin numbness after operation, and 14 patients occurred skin necrosis in control group, there were obvious difference between two groups(P<0.01).@*CONCLUSION@#Compared with open reduction and internal fixation, percutaneous reduction combined with internal fixation system in treating Sanders typeⅡto Ⅲ calcaneal fractures is feasible for fracture repair without waiting for foot deswelling, which could accurately restore normal shape and position of the fractured heel bone, completely eliminate fracture malunion, and reduce postoperative complications. Therefore, it could shorten operation time, hospital stay, fracture healing time, reduce amount of blood loss, promote postoperative recovery, and less complications, high safety, which could be used as a choice of orthopedic surgery for foot and ankle trauma.
Subject(s)
Male , Female , Humans , Infant, Newborn , Calcaneus/injuries , Retrospective Studies , Treatment Outcome , Fractures, Bone/surgery , Fracture Fixation, Internal , Ankle Injuries , Bone Screws , Foot Injuries , Knee Injuries , Ankle Joint , Postoperative ComplicationsABSTRACT
OBJECTIVE@#To explore clinical effect of intermittent flap opening technique in L-shaped incision of calcaneal fracture.@*METHODS@#From January 2017 to January 2019, 48 patients with Sanders typeⅡ to Ⅳ calcaneal fractures were treated by open reduction and internal fixation. According to different flap opening techniques, the patients were divided into control group and observation group, 24 patients in each group. In observation group, there were 17 males and 7 females, aged from 20 to 60 years old with an average of(45.12±9.56) years old;7 patients were typeⅡ, 10 patients were type Ⅲ and 7 patients were type Ⅳ according to Sanders classification;3 patients were C0, 16 patients were C1 and 5 patients were C2 according to Tscherne-Gotzen soft-tissue assessment;treated with intermittent flap technique. In control group, there were 19 males and 5 females aged from 20 to 60 years old with an average of (47.32±10.67) years old;7 patients were typeⅡ, 11 patients were type Ⅲ and 6 patients were type Ⅳ according to Sanders classification;2 patients were C0, 18 patients were C1 and 4 patients were C2 according to Tschemc-Gotzen soft-tissue assessment;treated with static flap opening technique. Operation time, flap retraction time, changes of Böhler angle and Gissane angle before and after operation at 3 days, and occurrence of incision complications were observed and compared between two groups.@*RESULTS@#All patients were followed up from 3 to 6 months with an average of(4.52±1.01) months. There were no significant differences in operation time, changes of Böhler angle and Gissane angle before and after operation at 3 days between the two groups(P>0.05);there was statistical difference in flap retraction time between two groups(P<0.05). Occurrence of incision complications in observation group was significantly lower than that in control group (P<0.05).@*CONCLUSION@#Intermittent flap opening technique is superior to static opening technique in reducing incision complications of lateral "L" approach of calcaneus. Single Kirschner wire opening does not affect the exposure, reduction and fixation of fracture during operation.
Subject(s)
Male , Female , Humans , Young Adult , Adult , Middle Aged , Surgical Wound , Treatment Outcome , Fractures, Bone/surgery , Fracture Fixation, Internal/methods , Calcaneus/surgery , Ankle Injuries , Foot Injuries , Knee InjuriesABSTRACT
OBJECTIVE@#To investigate the effectiveness of preemptive analgesia with imrecoxib on analgesia after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#A total of 160 patients with ACL injuries who met the selection criteria and were admitted between November 2020 and August 2021 were selected and divided into 4 groups according to the random number table method (n=40). Group A began to take imrecoxib 3 days before operation (100 mg/time, 2 times/day); group B began to take imrecoxib 1 day before operation (100 mg/time, 2 times/day); group C took 200 mg of imrecoxib 2 hours before operation (5 mL of water); and group D did not take any analgesic drugs before operation. There was no significant difference in gender, age, body mass index, constituent ratio of meniscal injuries with preoperative MRI grade 3, constituent ratio of cartilage injury Outerbridge grade 3, and visual analogue scale (VAS) score at the time of injury and at rest among 4 groups (P>0.05). The operation time, hospitalization stay, constituent ratio of perioperative American Society of Anesthesiologists (ASA) grade 1, postoperative opioid dosage, and complications were recorded. The VAS scores were used to evaluate the degree of knee joint pain, including resting VAS scores before operation and at 6, 24, 48 hours, and 1, 3, 6, and 12 months after operation, and walking, knee flexion, and night VAS scores at 1, 3, 6, and 12 months after operation. The knee injury and osteoarthritis score (KOOS) was used to evaluate postoperative quality of life and knee-related symptoms of patients, mainly including pain, symptoms, daily activities, sports and entertainment functions, knee-related quality of life (QOL); and the Lysholm score was used to evaluate knee joint function.@*RESULTS@#All patients were followed up 1 year. There was no significant difference in operation time, hospitalization time, or constituent ratio of perioperative ASA grade 1 among 4 groups (P>0.05); the dosage of opioids in groups A-C was significantly less than that in group D (P<0.05). Except for 1 case of postoperative fever in group B, no complications such as joint infection, deep vein thrombosis of the lower extremities, or knee joint instability occurred in each group. The resting VAS scores of groups A-C at 6 and 24 hours after operation were lower than those of group D, and the score of group A at 6 hours after operation was lower than those of group C, and the differences were significant (P<0.05). At 1 month after operation, the knee flexion VAS scores of groups A-C were lower than those of group D, the walking VAS scores of groups A and B were lower than those of groups C and D, the differences were significant (P<0.05). At 1 month after operation, the KOOS pain scores in groups A-C were higher than those in group D, there was significant difference between groups A, B and group D (P<0.05); the KOOS QOL scores in groups A-C were higher than that in group D, all showing significant differences (P<0.05), but there was no significant difference between groups A-C (P>0.05). There was no significant difference in VAS scores and KOOS scores between the groups at other time points (P>0.05). And there was no significant difference in Lysholm scores between the groups at 1, 3, 6, and 12 months after operation (P>0.05).@*CONCLUSION@#Compared with the traditional analgesic scheme, applying the concept of preemptive analgesia with imrecoxib to manage the perioperative pain of ACL reconstruction can effectively reduce the early postoperative pain, reduce the dosage of opioids, and promote the early recovery of limb function.
Subject(s)
Humans , Quality of Life , Analgesics, Opioid , Analgesia , Osteoarthritis, Knee , Pain, Postoperative/prevention & control , Anterior Cruciate Ligament Reconstruction , Knee InjuriesABSTRACT
OBJECTIVE@#To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment.@*METHODS@#The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded.@*RESULTS@#Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05).@*CONCLUSION@#BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.