Double and Single Bundle in Athletes: A Comparison in Medium and Long-Term Rates to Return to Sport and Re-Injury.

Objectives: Compare, retrospectively, the medium- and long-term of return to sport rates and re-injury of the anterior cruciate ligament (ACL) in patients submitted to single-bundle (SB) compared to double-bundle (DB) technique reconstruction. Methods: Athletes operated by SB or DB ACL reconstruction, with at least five years of follow-up at a single center, were included. The following data were collected: demographic data; competitive sports practice before the injury; previous surgery; injury/surgery to the contralateral knee; return to sports and level of the return; re-injury (time of the re-injury after the first surgery; mechanism of trauma for the re-injury; necessity of operative treatment); signs and complaints related to the knee the last clinical consultation. Results: Seventy-six athletes (27 SB and 49 DB) were included. The return to sport rate (98%) was the same for both groups, and the return to the previous level rate showed an improvement in the DB group but without statistical significance (63% vs. 79%; P = 0.173). However, other outcomes showed higher results for the DB group: lower re-injury rate throughout the follow-up period (41% vs. 18%; P = 0.034) and during the first year of follow-up (22% vs. 4%; P = 0.021), and less stiffness (0% vs. 22%, P = 0.001). While in primary reconstruction cases, there was not a higher re-injury rate using SB (P = 0.744), in the revision cases, SB was correlated with more re-injuries than DB (P = 0.002). Conclusion: The overall re-injury in the medium- and long-term and the return to practice sports at the same level as before surgery in athletes submitted to DB reconstruction were slightly better than those submitted to SB reconstruction, especially in the cases that were asecond time lesion ( revisioned knees).

Arthroscopic Coracoid Bone Block for Posterior Glenohumeral Instability: Description of Surgical Technique and a Case Report.

This case report describes the surgical technique of posterior arthroscopic bone block using the coracoid graft to treat recurrent posterior dislocations and describes preliminary results. Performance of coracoid transfer as a graft for posterior arthroscopic bone block in one patient (two shoulders) with recurrent posterior glenohumeral instability refractory to clinical treatment for six months, excluding volition dislocation. The patient was followed up weekly for the first three weeks when the stitches were removed. Postoperative computed tomography was performed before the patient was authorized to practice contact and aquatic sports (3-4 months after surgery). Patient returned to previous activities without complaints or limitations. There were no neurovascular complications. The initial results using coracoid as a bone graft for posterior instability were positive, and the technique requires reproduction to investigate possible complications. To date, no study has been found in the literature that reports an open or arthroscopic coracoid bone block technique.

Rotational Stability of the Knee in a Comparative Study of Anterior Cruciate Ligament Reconstruction Using the Double-Bundle and Single-Bundle Techniques.

Background: The purpsose of this study was to evaluate the biomechanical outcomes of patients who underwent ACL reconstruction either with the DB or SB technique. We hypothesized that the DB technique would provide better rotation control of the knee following ACL reconstruction. Methods: The study included seventy-five participants (26 DB, 22 SB, and 27 healthy volunteers). Only cases with at least one year of postoperative follow-up were included. The participants performed three different demand tasks: walk task, walk and change direction, and stair descent and change direction, which was tracked using a three-dimensional 4-camera optoelectronic system. The following kinematic data were analyzed: tibial rotation amplitude and maximal internal and external rotation. Knees with ACL reconstruction were compared to contralateral knees with intact ACL and healthy knees. Clinical outcomes were determined using the subjective and objective International Knee Documentation Committee (IKDC) questionnaire and a manual arthrometer (KT 1000). Results: Both surgical groups exhibited similar clinical outcomes (mean subjective IKDC 91 SB vs. 90 DB, P=0.815; KT 1000 difference: 2mm in both groups, P=0.772). The vertical component of the ground force reaction revealed no differences between the surgical and control groups (P>0.05). Tibial rotation amplitude and maximal internal and external rotation were similar between the control, SB, and DB groups in all three different demand tasks (P>0.05). Conclusion: ACL reconstruction using either the SB or DB technique can restore rotational control to the level of a healthy knee. No clinical or functional differences were found between the SB and DB surgical options.

Return to Sport and Re-Injury Rate after Double-Bundle Anterior Cruciate Ligament Reconstruction with at least Five Years of Follow-Up.

BACKGROUND: This study retrospectively evaluated the medium- and long-term results of patients submitted to double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. METHODS: A retrospective study of case series at a single center. Cases submitted to isolated ACL reconstruction with at least five years of follow-up were included. The following data were collected: demographic data; practice of competitive sport before the injury; previous surgery; injury/surgery in the contralateral knee; return to the practices of sports and level; re-injury (postoperative time; mechanism; need for surgery); and symptoms at the last clinical follow-up visit. Descriptive and sub-group analyses were performed. RESULTS: Sixty-nine patients were included; 52 men (75%), 49 athletes (71%), 47 (68%) with primary injury, mean age of 30 years (SD 10). The patients were followed up for an average of 8.7 years (minimum 5, maximum 11.8) after surgery. After the reconstruction, 67 (97%) returned to the sport; 75% at the same level as before the injury. Ten patients (14%) suffered re-injury after an average of 32 months (between 9 and 50 months). Regarding the outcome of re-injury, no statistically significant differences were found between subgroups of athletes vs non-athletes or primary injury vs revision surgery, despite a significant tendency towards increased re-injury levels in athletes. However, this tendency was not statistically significant. CONCLUSION: In our series of patients operated on with the double-bundle technique and with a long follow-up time, 14% presented re-injury, with no differences between primary and revision cases, and with a trend towards higher re-injury levels among the athletes in relation to the non-athletes. The rate of return to sport was satisfactory, with 97%, of which 75% were playing at the same level as before the injury.

Arthroscopic Latarjet: Technique Description and Preliminary Results. Study of the First 30 Cases.

Objective Arthroscopic Latarjet has been performed with the aim to be an accurate technique with a low incidence of complications. The aim of the present study was to briefly describe the technique and to evaluate the shot-term complications following arthroscopic Latarjet procedure to correct anterior shoulder dislocation with glenoid bone loss. Methods Retrospective study with 30 subjects with anterior shoulder instability, submitted to arthroscopic Latarjet. Intraoperative and short-term postoperative complications were recorded, as well as the rate of revision surgery. Results Five cases had complication (16.7%), and in the last 10 cases no complication occurred. In 1 case (3.3%), it was required to reverse for open surgery due to a fracture of the coracoid process during fixation in the glenoid. No other intraoperative complication occurred. No infection was observed. Two cases (6.7%) evolved with temporary neuropraxia of the musculocutaneous nerve, totally reversed with physiotherapy. With a follow-up from 6 to 26 months, 2 patients (6.7%) required a new intervention for graft/screws removal and release of the joint due to excessive limitation in external rotation. There was no case of recurrence. Conclusion Even in an initial learning curve, arthroscopic Latarjet demonstrated a low rate of short-tem complications and was a safe procedure for treating anterior dislocation of the shoulder with glenoid bone loss.

Arthroscopic Latarjet: Technique Description and Preliminary Results. Study of the First 30 Cases / Latarjet artroscópico: Descrição de técnica cirúrgica e resultados preliminares. Estudo de 30 primeiros casos

Abstract Objective Arthroscopic Latarjet has been performed with the aim to be an accurate technique with a low incidence of complications. The aim of the present study was to briefly describe the technique and to evaluate the shot-term complications following arthroscopic Latarjet procedure to correct anterior shoulder dislocation with glenoid bone loss. Methods Retrospective study with 30 subjects with anterior shoulder instability, submitted to arthroscopic Latarjet. Intraoperative and short-term postoperative complications were recorded, as well as the rate of revision surgery. Results Five cases had complication (16.7%), and in the last 10 cases no complication occurred. In 1 case (3.3%), it was required to reverse for open surgery due to a fracture of the coracoid process during fixation in the glenoid. No other intraoperative complication occurred. No infection was observed. Two cases (6.7%) evolved with temporary neuropraxia of the musculocutaneous nerve, totally reversed with physiotherapy. With a follow-up from 6 to 26 months, 2 patients (6.7%) required a new intervention for graft/screws removal and release of the joint due to excessive limitation in external rotation. There was no case of recurrence. Conclusion Even in an initial learning curve, arthroscopic Latarjet demonstrated a low rate of short-tem complications and was a safe procedure for treating anterior dislocation of the shoulder with glenoid bone loss.

Resumo Objetivo A realização da cirurgia de Latarjet por via artroscópica tem sido possível pelo desenvolvimento de instrumentais adequados e um protocolo para cirurgia estabelecido e reprodutível, que promete uma técnica mais precisa e com menor incidência de complicações. O objetivo do presente estudo foi fazer uma breve descrição de técnica cirúrgica e avaliar as complicações de curto prazo após a cirurgia de Latarjet por via artroscópica para correção de luxação anterior do ombro com perda óssea glenoidal. Método Estudo retrospectivo com 30 pacientes com instabilidade anterior do ombro, operados com a técnica de Latarjet por via artroscópica. Foram feitas avaliação das complicações intraoperatórias e pós-operatório de curto prazo e documentação de necessidade de reintervenções. Resultados Cinco casos tiveram complicação (16,7%), sendo que nos últimos 10 casos nenhuma complicação foi observada. Em 1 caso (3,3%) foi necessária conversão para cirurgia aberta por fratura do processo coracoide no momento de fixação na glenoide. Nenhum outro caso apresentou complicação intraoperatória. Não houve infecção nos casos operados. Dois casos (6,7%) evoluíram com neuropraxia temporária do musculocutâneo, revertida com fisioterapia. Em tempo de seguimento de 6 a 26 meses, 2 pacientes (6,7%) necessitaram de nova intervenção para retirada do material de síntese e liberação articular por excessiva limitação da rotação externa. Não houve caso de recidiva. Conclusão O procedimento de Latarjet artroscópico se mostrou seguro e com baixa incidência de complicações de curto prazo para correção da luxação anterior no ombro com perda óssea na glenoide mesmo em curva inicial de aprendizagem.

SHOULDER ISOKINETIC PERFORMANCE IN HEALTHY PROFESSIONAL JUDO ATHLETES: NORMATIVE DATA.

OBJECTIVE: To evaluate normative data of shoulder isokinetic strength in healthy professional judo athletes. METHODS: Cross-sectional study with 20 professional male and female athletes (10 female), evaluated with an isokinetic dynamometer. The strength assessment was carried out in external and internal rotation, flexion, extension, adduction and abduction. All data collected on muscle torque were normalized with body mass index. RESULTS: Athletes demonstrated higher peak torque and joint work in shoulder adduction, abduction, flexion, and extension for the dominant limb compared to the non-dominant limb (p <0.05), with most of these deficits below 10%. Shoulder internal/external rotation ratios for male and female athletes had no significant differences between dominant and non-dominant sides, demonstrating values at 60°/s of 49.4 ± 7.2 on the dominant side of males and 49.1 ± 4.9 for females. CONCLUSION: The normative data are described to assist during treatment, return to sport and injury prevention. Level of evidence IV, cross-sectional study.

OBJETIVO: Avaliar dados normativos da força isocinética do ombro de judocas profissionais, saudáveis. MÉTODOS: Estudo transversal com 20 atletas profissionais de ambos os sexos (dez mulheres) avaliados com dinamômetro isocinético. A avaliação da força foi realizada em rotação externa e interna, flexão, extensão, adução e abdução. Todos os dados coletados do torque muscular foram normalizados com o índice de massa corporal. RESULTADOS: Os atletas demonstraram maior pico de torque e trabalho articular em adução, abdução, flexão e extensão do ombro para o membro dominante, comparado ao contralateral (p < 0,05), com a maioria desses défices abaixo de 10%. As razões de rotação interna/externa do ombro para atletas de ambos os sexos não apresentaram diferenças significativas entre o lados dominante e não dominante, demonstrando valores a 60°/s de 49,4 ± 7,2 no lado dominante dos homens e 49,1 ± 4,9 no das mulheres. CONCLUSÃO: Os dados normativos são descritos para auxiliar durante o tratamento, o retorno ao esporte e a prevenção de lesões. Nível de evidência IV, estudo transversal.

Shoulder isokinetic performance in healthy professional judo athletes: normative data / Desempenho isocinético do ombro de atletas profissionais de judô saudáveis: dados normativos

ABSTRACT Objective: To evaluate normative data of shoulder isokinetic strength in healthy professional judo athletes. Methods: Cross-sectional study with 20 professional male and female athletes (10 female), evaluated with an isokinetic dynamometer. The strength assessment was carried out in external and internal rotation, flexion, extension, adduction and abduction. All data collected on muscle torque were normalized with body mass index. Results: Athletes demonstrated higher peak torque and joint work in shoulder adduction, abduction, flexion, and extension for the dominant limb compared to the non-dominant limb (p <0.05), with most of these deficits below 10%. Shoulder internal/external rotation ratios for male and female athletes had no significant differences between dominant and non-dominant sides, demonstrating values at 60°/s of 49.4 ± 7.2 on the dominant side of males and 49.1 ± 4.9 for females. Conclusion: The normative data are described to assist during treatment, return to sport and injury prevention. Level of evidence IV, cross-sectional study.

RESUMO Objetivo: Avaliar dados normativos da força isocinética do ombro de judocas profissionais, saudáveis. Métodos: Estudo transversal com 20 atletas profissionais de ambos os sexos (dez mulheres) avaliados com dinamômetro isocinético. A avaliação da força foi realizada em rotação externa e interna, flexão, extensão, adução e abdução. Todos os dados coletados do torque muscular foram normalizados com o índice de massa corporal. Resultados: Os atletas demonstraram maior pico de torque e trabalho articular em adução, abdução, flexão e extensão do ombro para o membro dominante, comparado ao contralateral (p < 0,05), com a maioria desses défices abaixo de 10%. As razões de rotação interna/externa do ombro para atletas de ambos os sexos não apresentaram diferenças significativas entre o lados dominante e não dominante, demonstrando valores a 60°/s de 49,4 ± 7,2 no lado dominante dos homens e 49,1 ± 4,9 no das mulheres. Conclusão: Os dados normativos são descritos para auxiliar durante o tratamento, o retorno ao esporte e a prevenção de lesões. Nível de evidência IV, estudo transversal.

Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture.

OBJECTIVE: To investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture. MATERIALS AND METHODS: We evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments. RESULTS: Using the region of interest technique, we obtained a quantitative evaluation index, comparing affected and unaffected legs. The mean uptake of 99mTc-MDP was significantly higher in the TSF group than in the control group (2.54 ± 0.77 vs. 1.05 ± 0.11; p < 0.001). CONCLUSION: In our sample of athletes, determining the bone scintigraphy uptake indices provided an objective method to estimate the appropriate recovery time after a tibial stress fracture.

Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture / Valor prognóstico dos achados focais na cintilografia óssea em pacientes suspeitos de fratura por estresse na tíbia

Abstract Objective: To investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture. Materials and Methods: We evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments. Results: Using the region of interest technique, we obtained a quantitative evaluation index, comparing affected and unaffected legs. The mean uptake of 99mTc-MDP was significantly higher in the TSF group than in the control group (2.54 ± 0.77 vs. 1.05 ± 0.11; p < 0.001). Conclusion: In our sample of athletes, determining the bone scintigraphy uptake indices provided an objective method to estimate the appropriate recovery time after a tibial stress fracture.

Resumo Objetivo: Analisar a correlação entre a captação da cintilografia óssea e o tempo para recuperação de pacientes com fraturas de estresse na tíbia. Materiais e Métodos: Foram avaliados 21 atletas com suspeita clínica e o diagnóstico radiológico de fratura por estresse na tíbia (grupo 1) e 10 atletas assintomáticos (grupo 2). Todos os sujeitos submeteram-se a cintilografia óssea e ressonância magnética com intervalo máximo de sete dias entre as avaliações. Resultados: Índice quantitativo foi obtido usando a técnica da região de interesse, comparando pernas afetadas com não afetadas. A média de captação do 99mTc-MDP nos membros afetados foi significativamente diferente no grupo 1 (2,54 ± 0,77), comparado com o grupo 2 (1,05 ± 0,11) (p < 0,001). Conclusão: Em nossa amostra de atletas, os índices de captação obtidos pela cintilografia óssea proporcionaram um método objetivo para estimar o tempo de recuperação apropriado após uma fratura de estresse na tíbia.

Bioabsorbable suture anchor migration to the acromioclavicular joint: how far can these implants go?

Few complications regarding the use of bioabsorbable suture anchors in the shoulder have been reported. What motivated this case report was the unusual location of the anchor, found in the acromioclavicular joint which, to our knowledge, has never been reported so far. A 53-year old male with previous rotator cuff (RC) repair using bioabsorbable suture anchors presented with pain and weakness after 2 years of surgery. A suspicion of retear of the RC led to request of a magnetic resonance image, in which the implant was found located in the acromioclavicular joint. The complications reported with the use of metallic implants around the shoulder led to the development of bioabsorbable anchors. Advantages are their absorption over time, minimizing the risk of migration or interference with revision surgery, less artifacts with magnetic resonance imaging, and tendon-to-bone repair strength similar to metallic anchors. Since the use of bioabsorbable suture anchors is increasing, it is important to know the possible complications associated with these devices.

Males still have limb asymmetries in multijoint movement tasks more than 2 years following anterior cruciate ligament reconstruction.

BACKGROUND: More than 2 years after undergoing anterior cruciate ligament (ACL) reconstruction, women still present bilateral asymmetries during multijoint movement tasks. Given the well-known ACL-injury gender bias, the goal of this study was to investigate whether males also present such asymmetries more than 2 years after undergoing ACL reconstruction. METHODS: This study involved 12 participants submitted to ACL reconstruction in the ACL group and 17 healthy participants in the control group. The mean postoperative period was 37 months. The participants executed bilateral countermovement jumps and load squat tasks. The kinematics and ground reaction forces on each lower limb and pelvis were recorded, and used to compute bilateral peak vertical ground reaction forces, peak knee and hip joint powers in the sagittal plane, and the ratio between these powers. RESULTS: For the jump task, the groups had the same performance in the jump height, but for the ACL group the peak knee joint power on the operated side was 13% lower than on the non-operated side (p = 0.02). For the squat task, the hip-knee joint power ratio on the operated side of the ACL group was 31% greater than on the non-operated side (p = 0.02). CONCLUSIONS: The ACL group presented a deficit in the operated knee that had its energy generation over time (joint power) partially substituted by the hip joint power of the same side. The fact that, even after more than 2 years following the ACL reconstruction and returning to regular activity, the ACL group still had neuromuscular asymmetries suggests a need for improvement in the ACL reconstruction surgery procedures and/or rehabilitation protocols.

Reconstrução do ligamento cruzado anterior com a técnica de duplo feixe - avaliação no laboratório de biomecânica / Anterior cruciate ligament reconstruction using the double bundle technique - evaluation in the biomechanics laboratory

OBJETIVO: O objetivo deste estudo é descrever a metodologia da análise da rotação do joelho utilizando instrumentos do laboratório de biomecânica e apresentar os resultados preliminares de um estudo comparativo com pacientes submetidos à reconstrução do ligamento cruzado anterior com a técnica de duplo feixe. MÉTODOS: Descreveu-se o protocolo atualmente utilizado em nosso laboratório e realizou-se a análise cinemática tridimensional e medida da amplitude de rotação do joelho de oito pacientes normais (grupo controle) e 12 pacientes operados com a técnica de duplo feixe em três tarefas no laboratório de biomecânica. RESULTADOS: Não indicam diferenças significativas entre os lados operados e não operados em relação às amplitudes médias da marcha, da marcha com mudança de direção ou da marcha com mudança de direção ao descer a escada (p > 0,13). CONCLUSÕES: Os resultados preliminares não demonstraram diferença da técnica de reconstrução de LCA em duplo feixe em relação ao lado contralateral e ao grupo controle.

OBJECTIVE: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. METHODS: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. RESULTS: No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). CONCLUSION: The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group.

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE - EVALUATION IN THE BIOMECHANICS LABORATORY.

OBJECTIVE: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. METHODS: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. RESULTS: No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). CONCLUSION: The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group.

Discinesia escapular: avaliação clínica e análise cinemática tridimensional / Scapular dyskinesia: clinical evaluation and three-dimensional kinematic analysis

O objetivo deste artigo é descrever um método de análise cinemática tridimensional baseado em marcas superficiais que pode ser combinado com uma análise clínica para avaliar a movimentação da escápula no gradil costal. Para realizar a análise cinemática tridimensional dos membros superiores (braços, escápulas e tronco) cada segmento é modelado como um corpo rígido com seis graus de liberdade. A posição e atitude de cada segmento são quantificadas durante o movimento a partir da mensuração da posição de marcas superficiais sobre locais específicos dos segmentos. Para ilustração do método proposto, é apresentado a avaliação de um paciente que foi diagnosticado com tendinose e bursite do supraespinhal e discinesia escapular Kibler II bilateral. A avaliação cinemática foi capaz de quantificar com sucesso os desvios do movimento da escápula quando comparados à escápula contralateral e a sujeitos sem discinesia escapular. A conclusão a partir do resultado da avaliação cinemática foi equivalente à avaliação clínica, porém apresentou maior detalhe de descrição, o que não seria possível ser feito apenas visualmente. Esta maior riqueza de informação pode ser usada para o desenvolvimento de um protocolo de reabilitação mais específico e individual para cada sujeito, assim como critério de alta ou evolução do tratamento. Dessa forma, a avaliação cinemática tridimensional da escápula pode ser usada como mais uma ferramenta auxiliar para o tratamento do ombro de indivíduos com discinesia escapular.

Neurapraxia do femoral pelo uso do garrote: relato de caso / Femoral neurapraxia due to the use of tourniquet: case report

Os autores descrevem caso de paciente do sexo feminino, com 23 anos de idade, submetida à cirurgia do joelho para realinhamento patelar com uso de garrote pneumático e que desenvolveu neurapraxia femoral. Faz-se breve revisão da literatura sobre as vantagens e desvantagens do uso do garrote em cirurgias do joelho e discute-se a necessidade da sua indicação, considerando-se as complicações acarretadas por seu uso incorreto.

The authors describe the case of a 27 year-old female patient submitted to knee surgery for patellar realignment with the use of a pneumatic tourniquet, who developed femoral neurapraxia. They make a brief literature review about the advantages and disadvantages of using a tourniquet in knee surgeries, and discuss the need for tourniquet indication considering the complications entailed by the incorrect use of the tourniquet.

Sternoclavicular dislocation--reconstruction with semitendinosus tendon autograft: a case report.

Traumatic sternoclavicular dislocation is a rare injury corresponding to less than 5% of all injuries of the scapular belt. It is preferentially treated through reduction of the sternoclavicular joint, symptom relief, a brief period of immobilization and rehabilitation, with the aim of gaining strength and range of motion. In some patients, however, this type of injury may progress with instability and pain, thus causing discomfort and pain. On such occasions, surgical treatment is chosen. The objective of this study was to report the clinical case of a sports player who progressed with chronic traumatic anterior instability of the sternoclavicular joint and underwent reconstruction using the ipsilateral semitendinosus tendon. This was a 16-year-old male patient who was a state-level judo player. Following a fall during a fight, he presented pain, slight deformity and edema in the right sternoclavicular joint, and he underwent conservative treatment for 12 months, without success. In the end, reconstruction of the sternoclavicular joint was carried out using the ipsilateral autologous semitendinosus, with resection of the intra-articular disc and suturing of the costoclavicular ligaments. We have presented a case of dislocation of the sternoclavicular joint in a high-performance judo player who underwent reconstruction using the semitendinosus, with excellent functional results after 1 year of follow-up.

Valor diagnóstico e prognóstico dos métodos de imagem na fratura de estresse da tíbia: correlação clínico-radiológica / Diagnostic and prognostic value of image methods in tibis stress fracture: clinical-radiological correlation

Um grande problema em atletas com fraturas por estresse é o tempo necessário para sua recuperação completa. Nenhum método de imagem tem se mostrado eficaz em apresentar dados objetivos com relação ao tempo de recuperação dos atletas em casos de fraturas por estresse / A major problem in athlets with stress fractures is the length of resting time required for complete recovery. No imaging tool has been capable of offering objective data regarding the apropriate recovery time in our study...

Repercussäo no aparelho locomotor da prática do judô de alto nível: estudo epidemiológico / Impact of high level judo practice in the locomotor apparatus: epidemiologic study

Os autores, analisando os dados constantes em formulários especialmente elaborados para ser preenchidos por 129 atletas praticantes de judô de alto nível (estadual, nacional e internacional), puderam observar considerável incidência de lesoes no aparelho locomotor. Verificaram que houve predominância das lesöes articulares nos atletas de maior nível e de maior peso. Notaram ainda incidência maior de lesöes nos atletas que iniciaram seus treinamentos em idade mais precoce e que permaneceram em atividade competitiva por mais tempo.