Conservative treatment of closed subtalar dislocation: a case report and 2 years follow-up.

We report a case of a closed subtalar dislocation without any related fractures treated with closed reduction and conservative treatment with a cast immobilization. Pure subtalar dislocation without any fractures is extremely rare and hardly reported in the literature. Such injuries are more likely to be open and associated with fractures of the surrounding foot bones such as malleoli, talus or fifth metatarsal fractures. In the examined case, closed reduction was followed by cast immobilization for 3 weeks. Six months post-injury, the patient had a full range of motion without any pain while there were no signs of residual instability or early post-traumatic osteoarthritis. Subjective clinical testing using a valid health instrument revealed an excellent outcome. We discuss in details the mechanism of such an injury and highlight the importance of prompt closed reduction and early mobilization to ensure a satisfactory long term outcome.

ACL injury and reconstruction: Clinical related in vivo biomechanics.

Several researchers including our group have shown that knee joint biomechanics are impaired after anterior cruciate ligament (ACL) injury, in terms of kinematics and neuromuscular control. Current ACL reconstruction techniques do not seem to fully restore these adaptations. Our research has demonstrated that after ACL reconstruction, excessive tibial rotation is still present in high-demanding activities that involve both anterior and rotational loading of the knee. These findings seem to persist regardless of the autograft selection for the ACL reconstruction. Our results also suggest an impairment of neuromuscular control after ACL reconstruction, although muscle strength may have been reinstated. These abnormal biomechanical patterns may lead to loading of cartilage areas, which are not commonly loaded in the healthy knee and longitudinally can lead to osteoarthritis. Muscle imbalance can also influence patients' optimal sports performance exposing them to increased possibility of knee re-injury. In this review, our recommendations point towards further experimental work with in vivo and in vitro studies, in order to assist in the development of new surgical procedures that could possibly replicate more closely the natural ACL anatomy and prevent future knee pathology.

Intraarticular synovial lipoma of the knee located in the intercondylar notch, between ACL and PCL: a case report and review of the literature.

This report presents a 16 year old girl with persistent left knee pain caused by an intra-articular synovial lipoma (IASL) of the knee. Arthroscopy revealed a lipoma arising from the posterior aspect of the synovial membrane, extending in the femoral intercondylar notch, between the femoral attachments of anterior cruciate ligament and posterior cruciate ligament. Histological examination confirmed the diagnosis of IASL. IASL is a rarely described situation. There are only a few references in the literature. One IASL found in an adolescent and one more located in the intercondylar notch have been described.