Results evaluation of the use of intra-articular sodium hyaluronate in the post-operative knee arthroscopy.

OBJECTIVE: to evaluate the efficacy of hyaluronic acid in the post-operative of knee arthroscopy. METHODS: we have evaluated 49 patients undergoing arthroscopic procedure with the use of intra-articular hyaluronic acid (Group 1) and 49 patients undergoing arthroscopic procedure without the use of hyaluronic acid (Group 2). Patients were evaluated based on the Visual Analogue Scale, household analgesia, assessment of the Range of Motion with a goniometer, and the Lysholm questionnaire. RESULTS: there were no substantial adverse effects on either group. CONCLUSION: the use of hyaluronic acid in the post-operative of knee arthroscopy is justified due/because it leads to a decrease in pain in the early stage, enabling faster recovery of the patient.

OBJETIVO: avaliar a eficácia do uso do ácido hialurônico no pós­operatório de artroscopia de joelho. MÉTODOS: foram avaliados 49 pacientes submetidos ao procedimento artroscópico associado ao uso do ácido hialurônico intra­articular (Grupo I) e 49 pacientes submetidos ao procedimento artroscópico sem uso do ácido hialurônico (Grupo II). Os pacientes foram avaliados com base na Escala Visual Analógica de dor (EVA), analgesia domiciliar, amplitude do movimento do joelho com goniômetro e no questionário Lysholm. RESULTADOS: não ocorreram efeitos adversos significativos em nenhum dos dois grupos. CONCLUSÃO: o uso do ácido hialurônico no pós­operatório de artroscopia de joelho é justificado por levar a uma diminuição da dor na fase inicial e possibilitar uma recuperação mais rápida do paciente.

RANDOMIZED PROSPECTIVE STUDY COMPARING TRANSVERSE AND EXTRACORTICAL FIXATION IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

OBJECTIVE: This study had the objective of prospectively comparing transverse fixation (Cross-Pin™) with extracortical fixation (EZLoc™) for the femur, in surgical reconstruction of the anterior cruciate ligament, from a clinical, biomechanical and functional point of view. METHODS: Between April 2007 and November 2009, 50 patients with acute or chronic anterior cruciate ligament injuries underwent arthroscopic reconstruction using the homologous flexor tendons (gracilis and semitendinosus). Randomization of the femoral fixation method was done by means of a draw at the time of the procedure. Patients were excluded if they presented multiple ligament lesions, fractures, previous surgery, autoimmune disease and impairment of the contralateral knee. The Lysholm scale, SF36 quality-of-life questionnaire and KT1000™ arthrometer were used. RESULTS: After a mean follow-up of 18.1 months, there were no statistically significant differences between the groups regarding the Lysholm scale and KT1000™ measurements. However, the SF36 questionnaire showed a statistical difference such that transverse fixation was superior regarding pain and vitality. CONCLUSION: Both techniques were shown to be efficient for transfemoral fixation, but with almost no statistically significant difference between them. We believe that new studies will be necessary for better understanding of these differences.

SURGICAL TREATMENT OF OSTEOCHONDRAL LESIONS OF THE KNEE BY MEANS OF MOSAICPLASTY.

OBJECTIVE: To evaluate the functional results from the technique of mosaicplasty, in the knees of patients with osteochondral lesions. METHODS: Between August 1999 and March 2005, 27 patients underwent mosaicplasty on their knees. Twenty-one were male and six were female. The patients' ages ranged from 16 to 64 years (mean of 38.1 years). Seventeen lesions were located on the right knee and ten on the left knee. The lesion was located on the lateral femoral condyle in four patients (15%), on the medial femoral condyle in 18 patients (66.5%) and on the patella in five patients (18.5%). The lesion sizes ranged from 1 to 8 cm(2) (mean of 2.7 cm(2)). The patients were evaluated before and after the operation using Lysholm's functional scale, with a mean follow-up of 2.5 years. RESULTS: Before the operation, the mean was 62.7 points, and after the operation, the mean was 95.4 points. The patients who underwent mosaicplasty on the lateral femoral condyle presented a mean of 51.5 points before the operation, and a mean of 100 points after the operation. In relation to the medial femoral condyle, the mean before the operation was 64.1 points, and it was 95.4 points after the operation. In relation to the patella, the mean before the operation was 66.4 points, and it was 92 points after the operation. CONCLUSION: Mosaicplasty proved to be a good alternative for treating osteochondral lesions of the knee. It presented better evolution in relation to lesions of the femoral condyles than in relation to lesions located on the patella.