Medial Meniscotibial Ligament of the Knee: A Step by-Step Dissection / Ligamento meniscotibial medial do joelho: Uma dissecção passo a passo

Abstract Objective Considerable attention has been paid to meniscotibial ligaments (MTLs), also known as coronary ligaments, especially after the "Save the Meniscus" initiative gained importance among knee surgeons. Technically challenging, the diagnosis and treatment of ramp lesion show the importance of MTLs. These ligaments were discovered long ago, but their contribution to knee stability has only recently been studied and still lacks information. Thus, the aim of the present study was to describe step-by-step an dissection technique of the medial MTL, efficient, reproducible and that may lead to further research. Method Twenty fresh cadaver knees were used, with no preference for sex or age. The knees were dissected using the same technique standardized by our team. Each dissection step was recorded digitally. Results The medial MTL was found in all 20 knees studied using the aforementioned technique. In our sample, the medial MTL exhibited an average length of 70.0 ± 13.4 mm and width of 32.25 ± 3.09 mm, thickness of 35.3 ± 2.7 mm and weight of 0.672 ± 0.134 g. In all the cases, the medial MTL originated proximally and deeply to the deep MTL in the tibia. Conclusion We describe a simple effective and reproducible medial MTL dissection technique that makes it possible to identify the ligament over the entire medial extension of the knee.

Resumo Objetivo Considerável atenção tem sido dada aos ligamentos meniscotibiais (LMT), também conhecidos como ligamentos coronários, especialmente depois que a iniciativa "Salve o Menisco" ganhou importância entre os cirurgiões de joelho. Tecnicamente desafiadores, o diagnóstico e o tratamento da lesão em rampa são importantes nos LMTs. Esses ligamentos foram descobertos há muito tempo, mas sua contribuição para a estabilidade do joelho foi recentemente estudada e ainda carece de informações. Assim, o objetivo deste estudo foi descrever passo a passo uma técnica de dissecção medial do LMT que é eficiente, reprodutível e que possa levar a novas pesquisas. Métodos Foram utilizados 20 joelhos de cadáveres frescos, sem preferência por sexo ou idade. Os joelhos foram dissecados com a mesma técnica padronizada por nossa equipe. Cada etapa da dissecação foi gravada digitalmente. Resultados O LMT medial foi encontrado em todos os 20 joelhos estudados com a técnica supracitada. Em nossa amostra, o LMT medial apresentou comprimento médio de 70,0 ± 13,4 mm e largura de 32,25 ± 3,09 mm, além de espessura de 35,3 ± 2,7 mm e peso de 0,672 ± 0,134 g. Em todos os casos, a origem do LMT medial era proximal e profunda em relação ao LMT profundo na tíbia. Conclusão Descrevemos uma técnica de dissecção simples do LMT medial que é eficaz, reprodutível e permite a identificação do ligamento em toda a extensão medial do joelho.

Resultados funcionales de pacientes con menisco discoide intervenidos quirúrgicamente en una clínica de ortopedia infantil / Functional results of patients with discoid meniscus undergoing surgery in a children's orthopedics clinic

Introducción: El menisco discoide es una malformación del menisco que puede generar sintomatología en niños y adolescentes, se han desarrollado técnicas artroscópicas logrando mejorar la funcionalidad en la gran mayoría de pacientes con menisco discoide y lesiones asociadas. El objetivo es mostrar los resultados clínicos y funcionales de pacientes intervenidos por artroscopia en un centro de referencia en ortopedia infantil durante un periodo de 3 años. Materiales y métodos: Se analizaron los resultados de una cohorte retrospectiva de pacientes menores de 18 años intervenidos quirúrgicamente por menisco discoide sintomático en un período de 3 años, a través de revisión de historias clínicas, evaluando los resultados clínicos mediante la escala de Tegner-Lysholm. Resultados: Se intervinieron 25 rodillas en 21 pacientes con un promedio de edad de 8,9 años. El tiempo de seguimiento promedio fue de 8,3 meses, donde 60% de las rodillas tenía inestabilidad del anillo periférico. El 92% de los pacientes tuvo puntaje excelente (>90) en la escala Tegner-Lysholm y el 8% restante, un puntaje bueno. El 88% de los casos no presentaron dolor postoperatorio y el 12%, dolor leve. El regreso al deporte se dio en los primeros 4 meses en 19 pacientes. Conclusión: El tratamiento artroscópico del menisco discoide sintomático con remodelación meniscal y estabilización del anillo periférico tiene buenos resultados funcionales a corto y mediano plazo, permitiéndole a los pacientes retornar a sus actividades deportivas en un lapso corto de tiempo.

Introduction: The discoid meniscus is a malformation of the meniscus that can generate symptoms in children and adolescents. Arthroscopic techniques have been developed to improve functionality in the vast majority of patients with discoid meniscus and associated injuries. The objective is to show the clinical and functional results of patients undergoing arthroscopy in a reference center for children's orthopedics over a period of 3 years. Materials and methods: The results of a retrospective cohort of patients under 18 years of age who underwent surgery for symptomatic discoid meniscus in a period of 3 years were analyzed through a review of medical records, evaluating clinical results using the Tegner-Lysholm scale. . Results: 25 knees were operated on in 21 patients with an average age of 8.9 years. The average follow-up time was 8.3 months, where 60% of the knees had peripheral annulus instability. 92% of the patients had an excellent score (>90) on the Tegner-Lysholm scale and the remaining 8% had a good score. 88% of cases did not present postoperative pain and 12% had mild pain. Return to sport occurred in the first 4 months in 19 patients. Conclusion: Arthroscopic treatment of symptomatic discoid meniscus with meniscal remodeling and stabilization of the peripheral annulus has good functional results in the short and medium term, allowing patients to return to their sports activities in a short period of time.

Características morfométricas de los discos articulares de la rodilla en imágenes de resonancia magnética de mujeres colombianas / Morphometric features of the knee menisci in magnetic resonance images of Colombian female

RESUMEN: La población femenina de adultos mayores suele presentar daños de los discos o meniscos articulares de la rodilla (DAR) generalmente derivados de procesos degenerativos de cartílago ocurridos en osteoartritis. Conocer patrones morfológicos estándares de los DAR en una población demográfica específica permite tener claridad de las características autóctonas de dicha población. Una forma de caracterizar estos patrones es a través del diseño de Modelos de Elementos Finitos (MEF) que permiten predecir anormalidades clínicas y radiológicas. Hasta el momento es escasa la evidencia sobre las características morfométricas de los DAR en la población colombiana. Por esta razón, el objetivo del presente estudio fue describir la morfometría de DAR en imágenes por resonancia magnética (IRM) de mujeres colombianas saludables. En este estudio se tomaron 25 IRM de la rodilla de mujeres colombianas con normo-peso, sin antecedentes de patología de la rodilla, ni historia de trauma o cirugía de esta, y con edades entre los 18 y 60 años. El análisis del ancho del cuerno posterior del DAR medial (12,73 ± 2,42) comparado con el lateral (8,04 ± 1,52) arrojó diferencia estadísticamente significativa (p<0,05). Por otra parte, el DAR medial presentó un diámetro antero-posterior aumentado (38,52 ± 2,71) en comparación con el del DAR lateral (29,18 ± 2,75) cercano a la significancia estadística (p=0.051). De igual manera, la altura del cuerno anterior se encontró aumentada en el DAR medial (4,42 ± 0,79) en comparación con el lateral (3,66 ± 0,76), con tendencia a la significancia estadística (p=0,063). Anatómicamente se reconoce que los DAR medial y lateral se adaptan a la forma y tamaño de los cóndilos femorales, lo que concuerda con las medidas resultantes de la población estudiada, donde se evidencia un DAR medial más largo (diámetro antero-posterior) y menos alto que el lateral.

SUMMARY: The elderly female population usually presents damage to the articular discs or menisci of the knee (ADK), generally derived from degenerative cartilage processes that occur in osteoarthritis. Knowing the standard morphological patterns of ADKs in a specific demographic population allows clarity of the indigenous characteristics of that population. One way to characterize these patterns is through the design of Finite Element Models (FEM) that would enable predicting clinical and radiological abnormalities. So far, there is little evidence on the morphometric characteristics of ADKs in the Colombian population. Thus, the objective of the present study was to describe the morphometry of ADK in magnetic resonance imaging (MRI) of healthy Colombian women. In this study, 25 MRIs of the knee of Colombian women with normal weight were taken, with no history of knee pathology, trauma, or surgery, and with ages between 18 and 60 years. The analysis of the width of the posterior horn of the medial ADK (12.73 ± 2.42) compared to the lateral (8.04 ± 1.52) showed a statistically significant difference (p <0.05). On the other hand, the medial ADK presented an increased anteroposterior diameter (38.52 ± 2.71) compared to that of the lateral ADK (29.18 ± 2.75) close to statistical significance (p = 0.051). Similarly, the height of the anterior horn was found to be increased in the medial ADK (4.42 ± 0.79) compared to the lateral (3.66 ± 0.76), with a trend towards statistical significance (p = 0.063). Anatomically, it is recognized that the medial and lateral ADK adapt to the shape and size of the femoral condyles, which is in agreement with the results of the studied population where measurements show that medial ADK has a longer (anterior to posterior diameter) and a shorter height than the lateral ADK.

Evaluation of Histological Properties of Human Meniscal Grafts Stored in a Tissue Bank / Avaliação das propriedades histológicas de enxertos meniscais humanos armazenados em banco de tecido

Abstract Objectives The present paper aims to evaluate and compare the histological features of fresh and frozen menisci stored in a tissue bank for 1 month and for 5 years. Methods The meniscal grafts were subjected to a histological study. A total of 10 menisci were evaluated; 2 were frozen for 5 years, 4 were frozen for 1 month, and 4 were fresh, recently harvested specimens. Histological properties were evaluated in sections stained with hematoxylin and eosin and Masson trichrome methods. Results The menisci frozen for 1 month showed partially preserved collagen fiber structure and no significant hydropic tissue degeneration. The menisci frozen for 5 years presented an evident dissociation of collagen fibers and multiple foci of hydropic degeneration. Discussion Degeneration was much more significant in menisci stored for 5 years, indicating that a long freezing period results in substantial progression of tissue deterioration. This may suggest that the 5-year period, considered the maximum time for graft storage before transplant, is too long. Conclusion Grafts stored for 1 month showed a slight degenerative change in collagen fibers, whereas menisci frozen for 5 years presented significant tissue degeneration.

Resumo Objetivos Avaliar e comparar as características histológicas de meniscos frescos e meniscos congelados armazenados em banco de tecidos por 1 mês e por 5 anos. Métodos Foi feito um estudo histológico com enxertos meniscais. Avaliamos 10 meniscos, sendo 2 que ficaram armazenados sob congelamento por 5 anos, 4 armazenados congelados por 1 mês, e 4 frescos, recém captados. Foram feitos cortes histológicos corados com hematoxilina e eosina e Tricrômico de Masson, para avaliação das propriedades histológicas. Resultados Os meniscos congelados por 1 mês apresentaram preservação parcial da estrutura das fibras colágenas, sem degeneração hidrópica significativa do tecido. Nos meniscos congelados por 5 anos, observamos dissociação evidente das fibras colágenas, com presença de múltiplos focos de degeneração hidrópica. Discussão Encontramos degeneração bem mais significativa nos meniscos armazenados por 5 anos, o que indica que o longo período de congelamento leva à progressão significativa da degeneração do tecido. Isto pode sugerir que o período de 5 anos, considerado período máximo que o enxerto pode permanecer armazenado antes de ser transplantado, é um período muito longo. Conclusão Nos enxertos armazenados por 1 mês, existiu apenas discreta alteração degenerativa das fibras colágenas, enquanto que nos meniscos com 5 anos de congelamento foi observada degeneração significativa do tecido. Tibiais

Meniscal Ossicle Diagnosed by Magnetic Resonance Imaging: A Case Report / Osso meniscal diagnosticado através de ressonância magnética: Relato de caso

Abstract Meniscal ossicle is a rare condition, which is occasionally symptomatic. Even though it has a low incidence, its diagnosis is important, because it may mimic other lesions. Magnetic resonance imaging (MRI) is a sensitive and specific method for its diagnosis. Its clinical behavior is benign and its conservative management is almost always successful, without any need for diagnostic and therapeutic procedures, such as arthroscopy. This report was able to demonstrate the correct diagnosis by MRI.

Resumo O osso meniscal é uma condição rara, ocasionalmente sintomática. Apesar de sua baixa incidência, é importante seu reconhecimento, uma vez que pode mimetizar outras lesões. A ressonância magnética (RM) é um método sensível e específico para seu diagnóstico. A evolução é de curso benigno e favorável ao tratamento conservador, não necessita de procedimentos diagnósticos e terapêuticos, como artroscopia, na grande maioria dos casos. No presente trabalho, foi demonstrado como o diagnóstico correto pode ser feito por RM.

Lesiones de la raíz posterior de los meniscos / Posterior meniscal root tears

Las raíces son fundamentales para la función meniscal debido a que son el punto de anclaje en el platillo tibial y permiten la adecuada función de los mismos. Sus lesiones deben ser motivo de alta sospecha diagnóstica para evitar daños condrales precoces. El tratamiento debe ser la reinserción de la lesión ya que el seguimiento a corto plazo ha demostrado buenos resultados. El trasplante meniscal está reservado como cirugía de salvamento cuando no es posible realizar el reparo.

The meniscal roots are essential for their proper functioning. They are the meniscal anchorage point into the tibial plateau maintaining their normal function. Diagnosis of these lesions requires a high degree of suspicion to prevent early development of chondral injuries. Surgical root repair should be attempted, for short-term follow-up has evidenced good outcomes. Meniscal transplantation is reserved for salvage situations when a meniscus cannot be repaired.

Reparación transtibial de la raíz posterior del menisco lateral en lesiones agudas: técnica quirúrgica y seguimiento clínico a corto plazo / Transtibial repair of posterior root of the lateral meniscus in acute lesions: surgical technique and short-term clinical follow-up

Introducción Las lesiones de la raíz posterior del menisco lateral (RPML) afectan la transferencia de la carga axial de la rodilla, lo cual genera una sobrecarga con el posterior deterioro del cartílago articular. Se han descrito numerosas técnicas quirúrgicas en la literatura para su tratamiento, pero aún no se ha demostrado superioridad de alguna, por ende, existen controversias sobre cual técnica es la más indicada para estas lesiones. El objetivo del estudio es describir la técnica quirúrgica y la evolución clínica de pacientes intervenidos con fijación transtibial de la RPML en una clínica especializada, durante el periodo 2016-2017. Materiales & Métodos Se realizó una descripción de la técnica quirúrgica y una serie de casos retrospectiva. Se incluyeron pacientes con lesiones agudas en la RPML, los cuales fueron intervenidos quirúrgicamente utilizando una nueva variación a técnica transtibial. Para determinar la evolución cínica de los pacientes se realizaron las escalas Lysholm e IKDC, antes y después de la cirugía. Resultados Se intervinieron seis pacientes con lesión aguda de la RPML, cuatro de sexo masculino. El tiempo entre el trauma y la cirugía fue en promedio 2,5 meses. Todos los pacientes presentaron lesión concomitante de ligamento cruzado anterior. Al comparar el estado inicial de los pacientes y el postoperatorio mediante las escalas de Lysholm e IKDC, se encontraron diferencias estadísticamente significativas (p<0,05). Asimismo, no se realizaron reintervenciones durante el seguimiento. Discusión La reparación de la RPML con la nueva variación de la fijación transtibial proporciona una mejoría en la función, el dolor y el nivel de actividad de los pacientes, lo que puede ayudar a retrasar la progresión de la osteoartrosis en la rodilla. Igualmente, este procedimiento se puede realizar de forma segura aún en casos de lesiones ligamentarías concomitantes. Nivel de evidencia: IV

Background injuries of posterior lateral meniscus root (PLMR) affect the transfer of the axial load of the knee. Several surgical techniques have been described for it treatment, but still none has demonstrated superiority. Consequently, there are controversies about which technique is most indicated for these injuries. The aim is to describe the a surgical technique and the clinical follow up of patients operated with transtibial fixation of PLMR in a specialized clinic, during the 2016-2017. Methods Retrospective case series and description of the surgical technique. We included patients with acute injuries in the PLMR, who were operated using a new variation to the transtibial technique. For the clinical follow-up, the IKDC and Lysholm scores were performed before and after surgery. Results Six patients with acute lesion in the PLMR were intervened, four were male. The time between trauma and surgery was on average 2.5 months. All the patients presented a concomitant lesion of the anterior cruciate ligament. When comparing the initial state of the patients and the postoperative period, statistically significant differences were found (p <0.05). Likewise, reinterventions were not performed during follow-up. Discussion The repair of PLMR with the new variation of the transtibial fixation provides an improvement in the function, the pain and the level of activity of the patients, which can help to delay the progression of osteoarthrosis in the knee. Likewise, this technique can be performed safely even in cases of concomitant ligament injuries. Level of clinical evidence: Level IV

Meniscectomía artroscópica en 100 pacientes / Arthroscopic meniscectomy in 100 patients

Fundamento: las lesiones del menisco en la articulación de la rodilla son una de las enfermedades más frecuentes debido a causas traumáticas y degenerativas, el cuadro clínico se caracteriza por la presencia de síntomas y signos mecánicos y el tratamiento por lo general es quirúrgico por la vía artroscópica que es de gran utilidad. Objetivo: evaluar la efectividad de la meniscectomía por vía artroscópica en un grupo de pacientes con lesión de menisco. Métodos: se realizó un estudio cuasi experimental modalidad antes y después, en 100 pacientes operados por meniscectomía mediante la vía artroscópica, la investigación tiene un nivel de evidencia III, recomendación B y fue realizada en el hospital Universitario Manuel Ascunce Domenech de la ciudad de Camagüey desde febrero de 2013 a enero de 2017. El universo estuvo compuesto por 158 pacientes de los cuales 100 fueron seleccionados para integrar la muestra no probabilística. Resultados: el promedio de edades fue de 46,95 años, predominó el sexo femenino, la rodilla derecha y el menisco medial. El desgarro de tipo degenerativo se observó en el 50 % de los casos, la plica sinovial se detectó en 41 enfermos y las lesiones de cartílago en 78. El dolor en la línea articular y la maniobra de McMurray presentaron el mayor porcentaje de positividad. La meniscectomía parcial fue el procedimiento quirúrgico más empleado. Se observó significación entre un antes y después al emplear las escalas de WOMET y KOOS abreviada. Conclusiones: la meniscectomía artroscópica es un procedimiento quirúrgico efectivo en pacientes con lesiones de menisco, tanto de causa degenerativa como traumática.

Background: meniscal lesions of the knee due to degenerative and traumatic causes are common. Patients usually complain of mechanical symptoms and signs. Treatment is usually surgical by arthroscopy because of several advantages. Objective: the aim of this study was to evaluate the use of arthroscopic meniscectomy in patients with meniscal lesions. Methods: a quasi experimental study before and after modality with a level of evidence III and recommendation grade B in Manuel Ascunce Domenech hospital in Camaguey city from February 2013 to January 2017 was performed in 158 patients diagnosed with meniscal lesions, but 100 of them were selected as a non-probabilistic sample, based on selected criteria. Results: average age was 46,95 years. Female sex, right knee and medial meniscus prevailed. Degenerative tears were detected in 50 % of the cases. Synovial plica and cartilage lesions were found in 41 and 78 patients respectively. Joint line tenderness and McMurray test were positive in a huge number of patients. Partial arthroscopic meniscectomy was the common used surgical procedure. There were significant statistical differences between before and after while using WOMET and short KOOS scales. Conclusions: arthroscopic meniscectomy is an effective surgical procedure in patients with meniscal lesions.

Anatomia microscópica e ultraestrutura do joelho da paca (Cuniculus paca Linnaeus, 1766) / Microscopic anatomy and ultrastructure of paca stifle (Cuniculus paca Linnaeus, 1766)

A paca (Cuniculus paca), um dos maiores roedores da fauna brasileira, possui características inerentes à sua espécie que podem contribuir como uma nova opção de animal experimental; assim, considerando-se que há crescente busca por modelos experimentais apropriados para ortopedia e pesquisas cirúrgicas, foram analisados e descritos em detalhes a anatomia microscópica e ultraestrutural do joelho desse roedor. Os ligamentos colaterais são constituídos por feixes de fibras colágenas arranjadas paralelamente e com trajeto ondulado. Os fibroblastos formavam fileiras paralelas às fibras colágenas; quanto aos ligamentos colaterais, estes apresentaram citoplasma imperceptível à avaliação por microscopia de luz, entretanto, em análise ultraestrutural verificou-se vários prolongamentos citoplasmáticos. Microscopicamente, as estruturas presentes no joelho da paca assemelham-se às dos animais domésticos, roedores e lagomorfos.(AU)

Paca (Cuniculus paca), one of the largest rodent of the Brazilian fauna, has characteristics inherent to the species that can contribute as a new experimental animal; so, considering that there is a growing search for experimental models suitable for orthopedic and surgical research, it was analyzed and described in detail the microscopic and ultrastructural anatomy of the stifle in this rodent. The collateral ligaments are composed of bundles of collagen fibers arranged in parallel and in wavy path. Fibroblasts formed parallel rows to the collagen fibers; concerning the collateral ligaments, they presented imperceptible cytoplasm at light microscopy, but at ultrastructure analysis they presented several cytoplasmic processes. At the microscopic level, the stifle of paca resembles the domestic animals, rodents and lagomorphs.(AU)

Understanding posterior meniscal roots lesions: from basic science to treatment / Compreendendo as lesões das raízes posteriores dos meniscos: da ciência básica ao tratamento

ABSTRACT The variability of symptoms and the fact that they are not easily recognized in imaging studies make the diagnosis and treatment of posterior meniscal roots lesions a challenging task to the orthopedist. In recent years, a more precise understanding of the anatomy and biomechanical impair of the knee joint in these cases has enabled great advances in therapeutic approaches. Well-documented studies have shown that the repair of these lesions presents superior functional and clinical improvement when compared with meniscectomy. However, the progression of degenerative joint changes in the long-term still exhibits conflicting results.

RESUMO A variabilidade da sintomatologia e o fato de não serem facilmente reconhecidas nos exames de imagem tornam o diagnóstico e o tratamento das lesões das raízes posteriores dos meniscos tarefas desafiadoras para o ortopedista. Nos últimos anos, uma compreensão mais precisa da anatomia e do comprometimento biomecânico da articulação do joelho nessas lesões têm possibilitado grandes avanços nas abordagens terapêuticas. Estudos bem documentados demonstram que o reparo dessas lesões oferece uma melhoria clínica e funcional superior à meniscectomia. Entretanto, os resultados da progressão das alterações degenerativas articulares em longo prazo ainda são conflitantes.

Avaliação da previsibilidade da sutura de menisco através da ressonância magnética / Predictability of meniscal suture by magnetic resonance imaging

The prediction of meniscus reparability is quite useful for surgeons to optimize surgical planning. The main objective of this study was to evaluate the ability of magnetic resonance imaging (MRI) to predict the suture of meniscal lesions. This was an unicentric retrospective study that included 104 patients who underwent knee joint ligament reconstruction and / or arthroscopy for the treatment of meniscal injury at knee joint level. The MRI images of the meniscus were evaluated and later the arthroscopic findings were used as the gold standard. After the operative procedure, the cases were allocated into two groups according to the necessity of meniscus suture: Sutured Group "MSu" (n = 58) and Non sutured Group "MNSu" (n = 150). Considering the lesion detection capacity in the medial meniscus, the sensitivity, specificity and accuracy of MR were 85.3%, 63.9% and 77.9%, respectively. The positive predictive value (PPV) was 81.7% and the negative predictive value (NPV) was 69.7%. The agreement between MRI and arthroscopy was moderate. For the lateral meniscus, sensitivity, specificity and accuracy of MRI were 80.6%, 89.0% and 86.5%, respectively, with PPV of 75.7% and NPV of 91.5% and a substantial agreement. Regarding suture predictability, the sensitivity, specificity and accuracy were respectively 60.3%, 66.7% and 64.9% with PPV of 41.2% and NPV of 81.3%, with weak agreement. According to the arthroscopy, the 58 meniscal lesions of the MSu group were more frequent in the posterior horn, had the longitudinal pattern and were located in the red-red vascular zone. In our study, MRI was not a good predictor of meniscal suture, although it is an useful tool for the diagnosis of medial and lateral meniscal lesions

Análisis de técnicas artroscópicas y osteotomía tibial alta en gonartrosis primaria / Analyses of arthroscopic techniques and high tibial osteotomy for primary osteoarthritis of the knee

La gonartrosis es una enfermedad frecuente enla actualidad. Existen diversos factores que son consideradosde mal pronóstico para pacientes tratados por la víaartroscópica, uno de estos factores es la deformidad angularen varo, para la cual se necesita de la realización deosteotomía correctora. Objetivo: Analizar las ventajas ydesventajas de las técnicas de intervención de artroscopia yosteotomía en pacientes con artrosis del compartimentotibiofemoral medial y deformidad angular en varo. Materialesy metodología de búsqueda: Se realizó una búsqueda en lasbases de datos Pubmed, Hinari, Scielo y Medline mediante elgestor de búsqueda y administrador de referencias EndNoteutilizando los términos “arthroscopy of the knee”,“arthroscopy and osteotomy of the knee” y “osteotomy of theknee”, obteniendo un total de 350 artículos de los cuales seutilizaron 59 citas seleccionadas para realizar la revisión, 49de ellas de los últimos cinco años donde se incluyeron treslibros y ocho citas del propio autor. Resultados: Se encontróuna relación existente entre lesiones y deformidad angular,especialmente en el compartimento tibiofemoral medial. Ladeformidad en varo como factor de mal pronóstico enpacientes tratados por artroscopia quedó demostrada en unestudio realizado por el autor con anterioridad. Conclusiones:La artroscopia y osteotomía tibial alta abierta simultánea conla artroscopia, ofrecen más ventajas para el paciente respectoa otras intervenciones, en el tratamiento de pacientes conartrosis del compartimento tibiofemoral medial y deformidadangular en varo entre las que se encuentran un solo tiempoanestésico, la corrección de la deformidad, el funcionamientoadecuado de las articulaciones y el alivio del dolor...

Osteoarthritis of the knee is a common disease,there are a lot of poor prognosis factors in patients treatedwith arthroscopy alone and one of them is varus deformityand for that reason a corrective osteotomy should beperformed. Objective: to analyze the advantages ofsimultaneous arthroscopy and osteotomy in patients sufferingfrom medial tibiofemoral osteoarthritis of the knee associatedwith varus deformity. Methodology: a search in the databasesPubmed, Hinari, Scielo and Medline was done through theinformation locator EndNote by using the words arthroscopyof the knee, arthroscopy and osteotomy of the knee, yosteotomy of the knee, resulting in a total of 350 articleswhich 59 of them selected for review, 49 of them in the lastfive years, including three books and eight own references.Results: the relationship between intrarticular lesions andangular deformity was found, especially those locatedat the medial tibiofemoral compartment. The author statedthat varus deformity is associated to poor prognosis, takeninto account a previous investigation. Conclusions:arthroscopy and high tibial osteotomy combined offers moreadvantages over other interventions in the treatment ofpatients with knee osteoarthritis of the medial tibiofemoralcompartment and varus angular deformity, such asdeformity correction, proper joint function and pain relief...

Reducción asistida por artroscopia en pacientes con fractura de la meseta tibial / Reduction assisted by arthroscopy in patients with tibial plateau fractures

Fundamento: las fracturas de la meseta tibial pueden ser de bajo o alto grado; las de bajo grado, que se corresponden con los tipos I al III de la clasificación de Schatzker J., pueden ser tratadas mediante reducción asistida por artroscopia. Métodos: se realizó un estudio observacional descriptivo en el Hospital Universitario Manuel Ascunce Domenech de la ciudad de Camagüey desde el 1ro de enero de 2013 al 31 de marzo de 2014. El universo estuvo conformado por 32 pacientes de los cuales 11 reunieron los criterios de selección. Resultados: el promedio de edades fue de 46, 3 años; la razón sexo masculino-femenino fue de 1, 75 a 1. Predominó el tipo de fractura tipo II en el 54, 4 % de los pacientes estudiados. Las lesiones de menisco asociadas predominaron al ser encontradas en el 54, 5 % de los pacientes. Se encontró significación estadística entre las evaluaciones hechas antes de la cirugía y las de 12 meses después, según las escalas de Rasmussen PS y Lysholm J. Conclusiones: la reducción asistida por artroscopia en pacientes con fractura de la meseta tibial de los grados I al III es un método efectivo desde el punto de vista funcional y para aliviar el dolor.

Background: tibial plateau fractures can be of low or high degree. Fractures of low degree, corresponding to types I to III of Schafzker J classification, can be treated by means of reduction assisted by arthroscopy. Methods: an observational, descriptive study was conducted in Manuel Ascunce Domenech Teaching Hospital, Camagüey city from January 1st, 2013 to March 31st, 2014. The universe was composed of 32 patients, 11 of which matched the selection criteria. Results: the average age was of 46, 3 years. The ratio of male to female sex was 1, 75 to 1. Associated lesions of the meniscus predominated being present in the 54, 5 % of the patients. A statistical significance was found between the presurgical evaluations and the ones made 12 months later, according to Rasmussen PS and Lyshol J scales. Conclusion: reduction assisted by arthroscopy in patients with tibial plateau fractures type I to III, is an effective method from the functional point of view and to relieve pain.

Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy / Diagnóstico das lesões do joelho: comparação entre o exame físico e a ressonância magnética com os achados da artroscopia

To ascertain the sensitivity, specificity, accuracy and concordance of the physical examination (PE) and magnetic resonance imaging (MRI) in comparison with arthroscopy, in diagnosing knee injuries. METHODS: Prospective study on 72 patients, with evaluation and comparison of PE, MRI and arthroscopic findings, to determine the concordance, accuracy, sensitivity and specificity. RESULTS: PE showed sensitivity of 75.00%, specificity of 62.50% and accuracy of 69.44% for medial meniscal (MM) lesions, while it showed sensitivity of 47.82%, specificity of 93.87% and accuracy of 79.16% for lateral meniscal (LM) lesions. For anterior cruciate ligament (ACL) injuries, PE showed sensitivity of 88.67%, specificity of 94.73% and accuracy of 90.27%. For MM lesions, MRI showed sensitivity of 92.50%, specificity of 62.50% and accuracy of 69.44%, while for LM injuries, it showed sensitivity of 65.00%, specificity of 88.46% and accuracy of 81.94%. For ACL injuries, MRI showed sensitivity of 86.79%, specificity of 73.68% and accuracy of 83.33%. For ACL injuries, the best concordance was with PE, while for MM and LM lesions, it was with MRI ( p < 0.001). CONCLUSIONS: Meniscal and ligament injuries can be diagnosed through careful physical examination, while requests for MRI are reserved for complex or doubtful cases. PE and MRI used together have high sensitivity for ACL and MM lesions, while for LM lesions the specificity is higher. Level of evidence II - Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard).

Verificar a sensibilidade, especificidade, acurácia e concordância entre o exame físico (EF) e a ressonância magnética (RM) em comparação com a artroscopia, no diagnóstico das lesões do joelho. MÉTODOS: Estudo prospectivo com 72 pacientes avaliados quanto ao EF, à RM e aos achados artroscópicos. Foram comparados os achados entre si e observaram-se a concordância, acurácia, sensibilidade e especificidade. RESULTADOS: O EF demonstrou sensibilidade de 75%, especificidade de 62,50% e acurácia de 69,44% para as lesões meniscais mediais (MM). Para o menisco lateral (ML) encontraram-se sensibilidade de 47,82%, especificidade de 93,87% e acurácia de 79,16%. O EF demonstrou, para lesões do ligamento cruzado anterior (LCA), sensibilidade de 88,67%, especificidade de 94,73% e acurácia de 90,27%. As lesões do MM, às imagens de RM, apresentaram sensibilidade de 92,50%, especificidade de 62,50% e acurácia de 69,44%. As lesões do ML apresentaram sensibilidade de 65%, especificidade de 88,46% e acurácia de 81,94%. A RM evidenciou para as rupturas do LCA sensibilidade de 86,79%, especificidade de 73,68% e acurácia de 83,33%. Para o LCA, a melhor concordância foi com o EF; e para MM e ML, com a RM (p < 0,001). CONCLUSÕES: O exame físico cuidadoso diagnostica as lesões meniscais e ligamentares. A RM é reservada para casos complexos ou duvidosos. Associados, EF e a RM têm alta sensibilidade para as lesões do LCA e do MM, porém para o ML é a especificidade que é maior. Nível de Evidência II - Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com padrão de referencia "ouro" aplicado).

Evaluación geométrica de meniscos frescos y conservados en glicerina al 98%: Estudio en conejos (Oryctolagus cuniculus) / Geometric Evaluation of Fresh Menisci and Menisci Preserved in 98% Glycerin: Study in Rabbits (Oryctolagus cuniculus) / Avaliação geométrica de meniscos frescos e conservados em glicerina em 98%: Estudo em coelhos (Oryctolagus cuniculus)

Los aloimplantes de meniscos se han utilizado como fuente de tejido a la hora de sustituirlos por roturas o daños irreparables. Para determinar posibles cambios o no por conservación se planteó como objetivo evaluar geométricamente meniscos frescos y conservados en glicerina al 98%. Se utilizaron 15 meniscos mediales, provenientes de ocho conejos de raza nueva zelanda albina, separados en tres grupos: cinco meniscos frescos (GI), cinco meniscos conservados por ocho meses en glicerina al 98% (GII) y cinco meniscos conservados por ocho meses en glicerina al 98% y rehidratados en solución salina 0,9%, por 24 horas (GIII). Todos los meniscos se midieron con pie de rey en siete puntos de su estructura geométrica. El estudio estableció que no hubo diferencias estadísticas en las medidas estudiadas de GII y GIII con relación a GI y al comparar las medidas de GIII con GII tampoco las hubo, por lo que se podría considerar innecesaria a la rehidratación por 24 horas en solución salina antibiótica.

Meniscus alloimplants have been used as a source of tissue for replacement in case of breakage or irreparable damage. To determine possible changes by conservation, the study proposed to geometrically evaluate fresh menisci and menisci preserved in 98% glycerin. 15 medial menisci from eight albino rabbits of New Zealand breed were used, divided into three groups: five fresh menisci (GI); five menisci preserved in 98% glycerin for eight months (GII), and five menisci preserved in 98% glycerin for eight months and then rehydrated in 0.9% saline solution for 24 hours (GIII). All menisci were measured with vernier caliper at seven points of their geometric structure. The study established that there were no statistical differences in the measurements of GII and GIII when compared to GI; there was no difference either in the measurements of GIII when compared to GII, thus rehydration in antibiotic saline solution for 24 hours can be considered unnecessary.

Os alo implantes de meniscos se utilizaram como fonte de tecido na hora de substituí-los por rupturas ou danos irreparáveis. Para determinar possíveis mudanças ou não por conservação se propôs como objetivo avaliar geometricamente meniscos frescos e conservados em glicerina a 98%. Utilizaram-se 15 meniscos mediais, provenientes de oito coelhos de raça Nova Zelândia albina, separados em três grupos: cinco meniscos frescos (GI), cinco meniscos conservados por oito meses em glicerina a 98% (GII) e cinco meniscos conservados por oito meses em glicerina em 98% e reidratados em solução salina 0,9%, por 24 horas (GIII). Todos os meniscos se mediram com paquímetro em sete pontos de sua estrutura geométrica. O estudo estabeleceu que não houvesse diferenças estatísticas nas medidas estudadas de GII e GIII com relação a GI e ao comparar as medidas de GIII com GII tampouco as houve, razão pela que se poderia considerar desnecessária na reidratação por 24 horas em solução salina antibiótica.

A história natural da instabilidade anterior do joelho por radiografia em estresse / The natural history of anterior knee instability by stress radiograph

Analisar o deslocamento anteroposterior do joelho pormeio de radiografias de estresse em indivíduos com instabilidadeunilateral anterior do joelho e correlacionar com o tempo de instabilidade.Métodos: Sessenta indivíduos com joelhos íntegros (grupocontrole) e 125 pacientes com instabilidade unilateral anterior dojoelho (grupo Al) concordaram em participar do estudo. Sexo,idade, peso, altura, idade por ocasião da lesão, tempo entre alesão e testes, e resultados cirúrgicos foram estudados. Ambos osgrupos foram submetidos a radiografias de stress anterior e posteriorde ambos os joelhos. Diferenças de deslocamento anterior(DDA) e posterior (DDP) foram calculadas. Resultados: No grupocontrole DDA e DDP são, em média, zero. No grupo AI, ADD é emmédia 9,8 mm e PDD 1,92 mm. Sexo, idade, peso, altura, idadeem trauma e presença de lesões de meniscos não interviram nosvalores da DDA e DDP. Lesões do menisco aumentaram com otempo. DDA e DDP não se correlacionaram com a presença ounão de com lesões meniscais. DDA e DDP mostraram correlaçãoentre sí e com o tempo de lesão. Conclusão: Há uma sub-luxaçãopermanente anterior do joelho lesionado que está relacionada coma quantidade de deslocamento anterior, que, por sua vez, aumentacom o tempo. Nivel de Evidência III, Estudo de Caso-controle...

To analyze the anteroposterior displacement of theknee by means of stress radiographs in individuals with unilateralanterior knee instability and correlate with time of instability.Methods: Sixty individuals with intact knees (control group) and125 patients with unilateral anterior instability (AI group) agreedto participate in the study. Gender, age, weight, height, age atinjury, time between injury and testing, and surgical findings werestudied. Both groups were submitted to anterior and posteriorstress radiographs of both knees. Anterior (ADD) and posteriordisplacement difference (PDD) were calculated between sides.Results: In the control group ADD and PDD are, in average, zero,whereas in AI group ADD averaged 9.8mm and PDD, 1.92mm.Gender, age, weight, height, age at trauma and presence of meniscallesions did not intervene in ADD and PDD values. Meniscalinjuries increased with time. ADD and PDD did not correlatewith the presence or absence of associated meniscal lesions.ADD and PDD are related to each other and increase with time.Conclusion: There is a permanent anterior subluxation of theinjured knee that is related to the amount of anterior displacementthat, in turn, increases with time. Level of Evidence III,Case-control Study...

Comportamiento de pacientes con fracturas de la meseta tibial / Behavior of patients with fractures of the tibial plateau

La fractura de la meseta tibial es una enfermedad observada con regularidad, para su tratamiento es necesario de su entendimiento en cuanto a mecanismo de producción, grado de depresión articular, estado de los tejidos blandos subyacentes y estabilidad.Objetivo: mostrar el comportamiento de pacientes con fractura de la meseta tibial.Método: se realizó un estudio observacional descriptivo en el servicio de Ortopedia y Traumatología del Hospital Universitario Manuel Ascunce Domenech de la ciudad de Camagüey, desde mayo de 2009 hasta octubre de 2012. La muestra no probabilística quedó conformada por 48 enfermos que reunieron los criterios de selección.Resultados: predominó el sexo masculino en una razón de 1,4 a 1. Las fracturas del cóndilo externo fueron las más encontradas en el 58,3 por ciento. Las fracturas tipo I y V de Schatzker J fueron las más halladas para un 37,5 por ciento y 20,8 por ciento respectivamente. El tratamiento quirúrgico fue el más utilizado en el 56,2 por ciento de los enfermos. Predominaron los resultados de excelente (22,2 por ciento) y bueno (55,5 por ciento) según la escala de Rasmussen PS.Conclusiones: predominó el sexo masculino en enfermos por debajo de 45 años de edad, el cóndilo tibial lateral fue el más afectado, el tratamiento quirúrgico fue el más utilizado. Los resultados de excelentes y bueno fueron los más encontrados...

Tibial plateau fractures are very common. For treating this kind of fracture, it is necessary to know its mechanism of injury, degree of articular depression, state of associated soft tissue and joint stability.Objective: to show the behavior of patients with tibial plateau fractures.Methods: a descriptive, observational study was conducted in the Orthopedics service at Manuel Ascunce Domenech Provincial Teaching Hospital in Camagüey from May, 2009 to October, 2012. The non-probabilistic sample was composed of 48 patients that fitted the selection criteria.Results: male sex predominated in a male-female proportion of 1, 4 to 1. Fractures of the external condyle were the most frequent in the 58, 3 percent of the patients. Fractures type I and V according to Schatzker J. classification were the most common with a 37, 5 percent and 20, 8 percent respectively. Surgical treatment was the most applied, indicated in the 56, 2 percent of the cases. Excellent (22, 2 percent) and good (55, 5 percent ) results according to Rasmussen PS scale predominated.Conclusions: male sex predominated in patients younger than 45 years old. The lateral tibial plateau was the most affected. Surgical treatment was the most used. Excellent and good results were the most frequent...

Repercusión funcional en el rendimiento físico-atlético postoperatorio de pacientes deportistas con lesiones meniscales / Functional repercussions of meniscal injuries on the postoperative physical athletic performance of athletes

La práctica deportiva a la fecha ha tenido un enorme auge en la sociedad mundial. Durante ésta, con frecuencia se generan lesiones de rodilla, específicamente lesiones meniscales que ameritan el tratamiento quirúrgico respectivo pudiendo ser: la remodelación y resección de fragmentos, la reparación meniscal o en casos extremos la práctica de injerto meniscal. En este trabajo prospectivo practicamos la resección fragmentaria y remodelación meniscal en pacientes deportistas y medimos su rendimiento físico-atlético postoperatorio. Métodos: Criterios de inclusión: Pacientes de ambos sexos quienes practicaran algún deporte con nivel amateur o recreativo competitivo y que sufrieran una lesión meniscal. Criterios de exclusión: Pacientes con ruptura total de ligamento cruzado anterior asociada, pacientes con pérdida de seguimiento y pacientes candidatos a reparación de menisco. Cohorte de 23 pacientes, 10 mujeres y 13 hombres captados en nuestro hospital. Se practicó un protocolo diagnóstico a fin de certificar la lesión. Los pacientes fueron intervenidos quirúrgicamente para realizar la resección y remodelación de fragmentos meniscales. Posteriormente fueron rehabilitados por el servicio de fisiatría y finalmente se autorizó regresar a la práctica deportiva. Se aplicó la tabla Tegner Lysholm Knee Scoring Scale para evaluar los resultados postoperatorios. Conclusión: Todos los pacientes fueron capaces de regresar a la práctica deportiva anterior a la lesión aunque con un rendimiento promedio de un 20 a 30% menor al previo. En el sexo femenino se requirió un mayor tiempo de recuperación.

The practice of sports has experienced a huge boom in societies worldwide. It often involves knee injuries, specifically meniscal tears that warrant surgical treatment which may include: fragment remodeling and resection, meniscal repair or, in extreme cases, the use of a meniscal graft. In this prospective study we performed fragment resection and meniscal remodeling in athletes and we measured their postoperative physical-athletic performance. Methods: Inclusion criteria: Patients of both sexes who practice a sport either as amateurs or at a recreational competitive level, who sustained a meniscal injury. Exclusion criteria: Patients with associated total anterior cruciate ligament tear, patients lost to follow-up, and patients eligible for meniscal repair. 23-patient cohort including 10 females and 13 males who presented at our hospital. A diagnostic protocol to certify the injury was applied. Patients underwent surgery to perform meniscal fragment resection and remodeling. They later underwent rehabilitation at the physiatrics service and finally received approval to return to sports. The Tegner Lysholm Knee Scoring Scale was used to assess postoperative results. Conclusion: All patients were able to return to practice their pre-injury sport, but their performance was 20 to 30% lower than before. Recovery took longer in females.

Fatores preditivos de resultados desfavoráveis da meniscectomia medial artroscópica em pacientes com mais de 50 anos de idade / Predictors of poor outcomes of arthroscopic medial meniscectomy in patients over 50 years old

A evolução do conhecimento acerca das funções dos meniscos e do tratamento das suas lesões, impulsionada pelo advento da cirurgia artroscópica, consagrou e popularizou a meniscectomia por esta via, por ser uma técnica menos invasiva, com menor morbidade e menores custos hospitalares, a ponto de torná-la, atualmente, a cirurgia ortopédica mais frequentemente realizada no mundo. Embora a maior parte dos pacientes submetidos a esta intervenção cirúrgica tenha resultados favoráveis e resolução rápida dos sintomas, percebe-se que parte considerável dos pacientes, especialmente os mais idosos, não apresenta uma evolução póscirúrgica satisfatória, apresentando piora dos sintomas e, eventualmente, necessitando de nova cirurgia. Partindo da hipótese que em determinados pacientes a meniscectomia, em vez de tratar, precipita e acentua um desequilíbrio biomecânico do joelho, o autor realizou estudo observacional prospectivo não-controlado com 86 pacientes de ambos os gêneros, com idade superior a 50 anos (média de 60,2 ± 7,1 anos), submetidos à meniscectomia artroscópica para tratamento de lesão do menisco medial de natureza degenerativa, com o objetivo de determinar variáveis demográficas, clínicas, anatômicas e cirúrgicas relacionadas aos resultados desfavoráveis. As avaliações funcionais pré e pós-operatórias foram realizadas utilizandose o Índice do KOOS (Knee Injury and Osteoarthritis Outcome Score), aplicado a todos os pacientes antes da cirurgia e 60 meses depois. Após análise estatística dos resultados obtidos, o autor verificou que 10 fatores podem ser considerados preditivos das meniscectomias mediais artroscópicas neste grupo etário, sendo quatro fatores fortemente associados aos resultados desfavoráveis: lesão da raiz posterior do menisco medial, dor pré-operatória intensa, claudicação antes da cirurgia e tempo decorrido entre o início dos sintomas e a cirurgia; dois fatores foram considerados moderadamente associados aos resultados...

The evolution of knowledge concerning meniscal functions and the treatment of their injuries, boosted by the development of arthroscopic surgery, has established and popularized arthroscopic meniscectomy due to its less invasiveness, less post-operative morbidity and lower hospital costs, to the point it has become, nowadays, the most frequently performed orthopedic procedure in the world. Although the majority of patients undergoing this operation is quite pleased with the outcomes and with the prompt resolution of their symptoms, it is noticeable that a considerable amount of patients with meniscal injuries, mainly the older, does not have a satisfactory postoperative outcome, with worsening of symptoms after being operated on and occasionally requiring another surgery. Based on observations of his medical practice and on the assumption that meniscectomy, rather than treat, can hasten and accentuate a biomechanical imbalance of the knee in those patients, the author conducted an observational prospective uncontrolled study with 86 patients of both genders, aged over 50 years old (average 60.2 ± 7.1 years), who underwent arthroscopic meniscectomy for the treatment of degenerative medial meniscal lesions, aiming to determine demographic, anatomical, clinical and surgical variables related to poor outcomes. The functional pre and post-operative evaluations were performed using the KOOS index (Knee Injury and Osteoarthritis Outcome Score) applied to all patients before surgery and 60 months later. After statistical analysis of the results, the author found that 10 factors can be considered predictors of arthroscopic medial meniscectomy in this age group: four factors were strongly associated with unfavorable results - posterior root lesion of the medial meniscus, intense pre-operative pain, claudication before surgery and time elapsed between onset of symptoms and surgery; two factors were moderately associated with unfavorable results - bone marrow...

Propriedades mecânicas de aloenxertos meniscais de coelhos após preservação em glicerina e reidratação em NaCl 0,9% / Mechanical properties of rabbit meniscal allografts after glycerin preservation and rehydration in NaCl 0.9%

Foram avaliadas as propriedades mecânicas, força, deformação e tensão ao limite elástico, tensão ao ponto de ruptura e índice de rigidez, de meniscos frescos e meniscos transplantados por 70 dias em joelhos de coelhos, após preservação em glicerina. O primeiro grupo (tratado) foi formado por seis meniscos mediais do joelho esquerdo, coletados de animais oriundos de criação comercial. Esses meniscos foram armazenados em glicerina 98% por um período de 45-60 dias; em seguida, foram reidratados em solução salina a 0,5% de enrofloxacina, por 12 horas, e implantados em joelhos de outros seis coelhos, submetidos à meniscectomia. Após 70 dias da cirurgia, foi realizada a eutanásia dos animais e retirada dos aloenxertos para avaliação mecânica. O segundo grupo (controle) foi composto por seis meniscos mediais, retirados dos joelhos contralaterais (direito) dos mesmos animais. Para a amostra estudada, não houve diferença estatisticamente significante entre os grupos controle e tratado para nenhuma das variáveis analisadas, demonstrando que a reidratação de aloenxertos meniscais, após preservação em glicerina, mantém as características mecânicas desses, após 70 dias de implantação, semelhantes às de meniscos frescos.

We evaluated the mechanical properties, strength, strain and stress to the elastic limit, the rupture stress point and stiffness index of fresh menisci and menisci transplanted for 70 days in the knees of rabbits after preservation in glycerin. The first group (treated) was formed by six medial menisci of the left knee, collected from these animals for commercial breeding. These menisci were stored in 98% glycerin for a period of 30-60 days, and then rehydrated in a solution in 0.5% saline enrofloxacin for 12 hours, and implanted in the knees of another six rabbits underwent meniscectomy . After 70 days of surgery was performed the euthanasia of animals and removal of allografts for mechanical evaluation. The second group (control) consisted of six medial menisci, removed from the contralateral knees (right) of the same animals. For the sample studied, had no statistically significant difference between control and treated groups for any of the variables analyzed, showing that the rehydration of meniscal allografts after preservation in glycerin keeps the mechanical characteristics of these, after 70 days of implantation, similar to the meniscus fresh.