Failure rate, return-to-sports and magnetic resonance imaging after meniscal repair: 119 patients with 7 years mean follow up.

BACKGROUND: One of the most important factors to consider in relation to meniscal repair is the high failure rate reported in the existing literature. AIM: To evaluate failure rates, return to sports (RTS) rate, clinical outcomes and magnetic resonance image (MRI) evaluation after meniscus suture repair for longitudinal tears at a minimum 2-year-follow-up. METHODS: We conducted a retrospective review of meniscal repairs between January 2004 and December 2018. All patients treated for longitudinal tears associated or not with an anterior cruciate ligament reconstruction (ACL-R) were included. Meniscal ramp lesions, radial and root tears, associated with multiligament injuries, tibial fracture and meniscal allograft transplants were excluded. Surgical details and failure rate, defined as symptomatic patients who underwent a revision surgery, were analyzed. As isolated bucket handle tears (BHTs) were usually associated with higher failure rates, we compared BHTs and not BHTs associated or not with an ACL-R. Since 2014, the inside-out technique using cannulas and suture needles with 2-0 Tycron began to predominate. In addition, the number of stitches per repair was increased. In view of differences in surgical technique, we compared two different cohorts: before and after 2014. We recorded the RTS according to the level achieved and the time to RTS. Lysholm and IKDC scores were recorded. Patients were studied with x-rays and MRI as standard postoperative control. RESULTS: One hundred and nineteen patients were included with a mean follow up of 7 years (SD: 4.08). Overall failure rate was 20.3% at a mean 20.1 mo. No statistically significant differences were found when comparing failure for medial and lateral meniscal repair (22.7% and 15.3%, P = 0.36), BHTs and not BHTs (26% and 17.6%, P = 0.27), isolated or associated with an ACL-R (22.9% and 18%, P = 0.47), or when comparing only BHTs associated with an ACL-R (23% and 27.7%, P = 0.9) or not. When comparing cohorts before and after 2014, we found a significant decrease in the overall failure rate from 26% to 11% (P < 0.03). Isolated lesions presented a decrease from 28% to 6.6% (P = 0.02), BHTs from 34% to 8% (P = 0.09) and those associated with an ACL-R from 25% to 10% (P = 0.09). Mean RTS time was 6.5 mo in isolated lesions and 8.64 mo when associated with an ACL-R. Overall, 56% of patients returned to the same sport activity level. Mean pre and postoperative Lysholm scores were 64 and 85 (P = 0.02), and IKDC 58 and 70 (P = 0.03). Out of 84 asymptomatic patients evaluated with MRI, 39% were classified as "not healed" and 61% as "healed". CONCLUSION: Even though the overall failure rate of our series was 20.3%, we found a statistically significant decrease from 26% to 11%, not only for isolated lesions, but also for BHT's and those associated with an ACL-R when comparing our series in two different cohorts, most probably due to improvements in surgical technique.

Arthroscopic Treatment of Bucket-Handle Triangular Fibrocartilage Complex Injury.

Bucket-handle injury to the triangular fibrocartilage complex is a rare and poorly described condition in the literature that is not included in the Palmer classification. A young man presented with right wrist torsional trauma while playing sports. He progressed with local pain and limited range of motion with a supination block. Magnetic resonance imaging revealed a bucket-handle injury to the central portion of the triangular fibrocartilage complex with a volar flap, measuring 0.6 cm × 0.6 cm. The patient underwent wrist arthroscopy with debridement, removal of a loose body, and resection of the bucket-handle lesion. In the postoperative period, pain alleviation and a considerable gain in range of motion occurred. The patient was able to resume his participation in sporting activities 3 months after surgery. There is no consensus about the treatment of bucket-handle injuries to the triangular fibrocartilage complex because of the small number of cases described in the literature.

Evaluation and interpretation of the bucket test in healthy individuals.

OBJECTIVE: To determine and interpret the range of normal deviation of the bucket test in healthy subjects Subjects and methods: Study design: Cross-sectional study in a secondary care center. INCLUSION CRITERIA: subjects ≥18 years old with no otologic or neurologic symptoms and normal complete neuro-otological examination. The subjective visual vertical was evaluated binocularly using the bucket test. Five measurements were made on the clockwise direction and five on the counterclockwise direction. The examiner selected the starting point, the patient then manipulated the bucket and it stopped when the volunteer considered the line reached the vertical position. RESULTS: Fifty healthy volunteers were included, 16 (32%) were men, and 34 (68%) women with a mean age of 34 years. The mean value found clockwise was 1.93° ± 2.26° and counterclockwise sense was of 0.86° ± 2.44°. Mean normal values ranged from 1.4° ± 1.9°. CONCLUSIONS: The bucket test is easy and quick to perform; we recommend to use a range of -1.0° to +3.0° as normal values in the healthy population.

Expurgo de grãos de trigo em câmara de lona / Scouring of wheat in camera bag

O objetivo deste trabalho foi determinar o menor período de fumigação necessário para promover a mortalidade total de insetos adultos do gênero Sitophilus, em grãos de trigo submetidos à fumigação em câmara de lonas. O experimento foi implantado em uma unidade armazenadora de grãos, em Ponta Grossa - PR. O delineamento experimental foi inteiramente casualizado, contendo seis tratamentos e dez repetições. Os tratamentos consistiram de diferentes períodos de exposição dos grãos de trigo à fumigação: 0; 12; 36; 60; 84 e 108h, dispostos em caçambas de caminhão envoltas em lonas (formando a câmara de lonas). Empregou-se o produto comercial Fertox(r) na forma de pastilhas, atendendo à dosagem de 6g m-3em câmaras de 35m³ cada. As repetições foram representadas por recipientes telados contendo 10 insetos adultos vivos do gêneroSitophilus, inseridos na massa de grãos da caçamba em diversos pontos e profundidades. A equação de regressão ajustada para descrever o comportamento da mortalidade de insetos (M) em função do período de fumigação (T) foi M=6,6867+93,4694(1-e0,1645T)26,9607. A equação demonstra que 58,9h após a aplicação do fumegante a mortalidade dos insetos foi de 100%.(AU)

The objective of this study was to determine the shortest time of fumigation to promote the total mortality of adult insects of the genus Sitophilus, in grains of wheat, undergoing fumigation in chamber of tarpaulin. The experiment was carried out in a grain storage unit in Ponta Grossa - PR. The experimental design was completely randomized, with six treatments and ten replications. Treatments consisted of times of exposure of wheat grain fumigation: zero; 12; 36; 60; 84 and 108 hours, in bucket trucks wrapped in tarpaulin (forming the chambers of tarpaulin). It was applied the commercial product Fertox(r) in tablets form, with the dosage of 6g m-³ in each chamber of 35m³. Repetitions were composed by cages with ten live adult insects of the Sitophilus genus each one, inserted into the grain mass in bucket trucks and arranged at various points and depths. The fitted regression model to describe the insect mortality behavior (M) according to the fumigation time (T) was M=6.6867+93.4694 (1-e0.1645T)26.9607. Equation shows that 58.9h after application of the steam product the insect mortality is of 100%.(AU)

Expurgo de grãos de trigo em câmara de lona / Scouring of wheat in camera bag

O objetivo deste trabalho foi determinar o menor período de fumigação necessário para promover a mortalidade total de insetos adultos do gênero Sitophilus, em grãos de trigo submetidos à fumigação em câmara de lonas. O experimento foi implantado em uma unidade armazenadora de grãos, em Ponta Grossa - PR. O delineamento experimental foi inteiramente casualizado, contendo seis tratamentos e dez repetições. Os tratamentos consistiram de diferentes períodos de exposição dos grãos de trigo à fumigação: 0; 12; 36; 60; 84 e 108h, dispostos em caçambas de caminhão envoltas em lonas (formando a câmara de lonas). Empregou-se o produto comercial Fertox(r) na forma de pastilhas, atendendo à dosagem de 6g m-3em câmaras de 35m³ cada. As repetições foram representadas por recipientes telados contendo 10 insetos adultos vivos do gêneroSitophilus, inseridos na massa de grãos da caçamba em diversos pontos e profundidades. A equação de regressão ajustada para descrever o comportamento da mortalidade de insetos (M) em função do período de fumigação (T) foi M=6,6867+93,4694(1-e0,1645T)26,9607. A equação demonstra que 58,9h após a aplicação do fumegante a mortalidade dos insetos foi de 100%.

The objective of this study was to determine the shortest time of fumigation to promote the total mortality of adult insects of the genus Sitophilus,in grains of wheat, undergoing fumigation in chamber of tarpaulin. The experiment was carried out in a grain storage unit in Ponta Grossa - PR. The experimental design was completely randomized, with six treatments and ten replications. Treatments consisted of times of exposure of wheat grain fumigation: zero; 12; 36; 60; 84 and 108 hours, in bucket trucks wrapped in tarpaulin (forming the chambers of tarpaulin). It was applied the commercial product Fertox(r) in tablets form, with the dosage of 6g m-³ in each chamber of 35m³. Repetitions were composed by cages with ten live adult insects of the Sitophilusgenus each one, inserted into the grain mass in bucket trucks and arranged at various points and depths. The fitted regression model to describe the insect mortality behavior (M) according to the fumigation time (T) was M=6.6867+93.4694 (1-e0.1645T)26.9607. Equation shows that 58.9h after application of the steam product the insect mortality is of 100%.

Como um balde pode contribuir no diagnóstico neurológico? / How a bucket can contribute to neurological diagnosis?

Moedas, chaves e copos são objetos simples que podem ser utilizadosem uma avaliação neurológica de rotina. Recentemente, um balde de plástico tornou-se parte desse arsenal como instrumento para testar a vertical visual subjetiva à beira do leito. O principal empenho deste manuscrito é ressaltar a utilidade do teste do balde no exame à beira do leito visando demonstrar desvios da percepção da verticalidade em doenças comuns na prática neurotológica tais como: acidente vascular cerebral, doença de Parkinson, parkinsonismo, lesão vestibular unilateral e enxaqueca.

Coins, keys or glasses are simple objects that can be used in a routineneurological evaluation. Recently, a plastic bucket became part of the arsenal as a tool for bedside test of the subjective visual vertical. The main effort of this manuscript is to emphasize the usefulness of the bedside bucket test seeking to show verticality perception deviations in common neurologic diseases such as: stroke, Parkinson disease, parkinsonism, unilateral vestibular lesion, and migraine.

Spontaneous healing of bucket handle tear of the medial meniscus associated with ACL tear / Resolução espontânea da lesão alça de balde do menisco medial associado com rotura de LCA

We report a case of injury of the medial bucket handle meniscal tears (BH), which resolved spontaneously, in association with anterior cruciate ligament (ACL) injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treatment and physiotherapy, in an interval of one year, later examinations showed that there was spontaneous healing of AB.

Neste trabalho é relatado um caso de lesão do menisco medial do tipo em alça de balde (AB), que se resolveu espontaneamente, em associação com lesão de ligamento cruzado anterior (LCA). O paciente torceu o joelho esquerdo durante uma luta em artes maciais, evoluindo com dor e bloqueio articular e sensação de falseamento. Na RMN havia rotura em alça de balde do menisco medial com deslocamento do fragmento para a região intercondilar, rotura do menisco lateral e rotura do LCA. Após tratamento clínico e fisioterápico, em um intervalo de um ano, o exame de controle demonstrou que havia ocorrido resolução espontânea da AB.

Spontaneous healing of bucket handle tear of the medial meniscus associated with ACL tear.

We report a case of injury of the medial bucket handle meniscal tears (BH), which resolved spontaneously, in association with anterior cruciate ligament (ACL) injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treatment and physiotherapy, in an interval of one year, later examinations showed that there was spontaneous healing of AB.

Comparison of different systems for milk feeding of kids for meat production / Comparação entre diferentes sistemas de aleitamento de cabritos para abate

A study was conducted at Itapetininga (SP), to compare three systems of milk feeding of kids. Twenty-seven cross-bred Anglonubian kids were randomly assigned to three groups of nine kids, five males and four females. All animals received coloctrum during at least the first 48 hours after birth. The kids were confined to individual pens. The treatments were, does milk: (A) bottle-fed until 60 days; (B) bucket-fed until 60 days and (C) bucket-fed until 45 days of age. The milk kept at ambient temperature was offered twice a day. Kids had free access to water and grass hay (8.7% crude protein). Seven days after birth kids were offered a diet with 17% crude protein and a mineral-salt mix. A completely randomized design in fatorial scheme was used to analyse the data. Variables studied were: body weight at 45,60 and 120 days; body weight gain from 1 to 45days, from 46 to 60 days and from 61 to 120 days of age and labor required to milk feed the kids during the first 60 days. There were no differences in body weight at 60 and 120 days between kids fed from bouttle or fed from bucket until 60 days of age but kids fed from bucket until 45 days of age showed the longest values. The same was observed for body weight gain. Kids from system A and B presented more higher milk intake Levels than kids from system C but had lowest concentrate intake levels. Bucket-fed system reduced labor requ

O trabalho foi conduzido no Posto de Ovinos e Caprinos, em ltapetininga (SP), vinculado ao Instituto de Zootecnia, comparando-se 3 sistemas de aleitamento de cabritos mestiços anglo-nubianos: (A) leite de cabra em mamadeira até 60 dias de idade; (B) em balde até 60 dias (B) e (C) em balde até 45 dias. O delineamento foi inteiramente casualizado, em esquema fatorial 2x3 (sexos e sistema de aleitamento), com 4 repetições para fêmeas e 5 para machos. Os parámetros analisados foram: peso vivo aos 45, 60 e 120 dias de idade e ganho de peso vivo de 1 a 45, de 46 a 60 e de 61 a 120 dias. Estudou-se ainda, o consumo total de leite e de concentrado, bem como a ocupação estimada de mão-de-obra, para aleitamento, no periodo de 1 a 60 dias. Observou-se que o aleitamento no balde por 60 dias foi semelhante, em peso vivo aos 60 e 120 dias e em ganho diário de peso vivo do desmame até 120 dias, em confronto ao aleitamento na mamadeira. Os menores Índices ponderais foram observados no sistema C. Os animais dos sistemas A e B apresentaram níveis mais elevados de ingestão de leite que os do sistema C, todavia apresentaram um menor consumo de concentrados. O aleitamento em balde reduziu a demanda de mão-de-obra.

Comparison of different systems for milk feeding of kids for meat production / Comparação entre diferentes sistemas de aleitamento de cabritos para abate

A study was conducted at Itapetininga (SP), to compare three systems of milk feeding of kids. Twenty-seven cross-bred Anglonubian kids were randomly assigned to three groups of nine kids, five males and four females. All animals received coloctrum during at least the first 48 hours after birth. The kids were confined to individual pens. The treatments were, does milk: (A) bottle-fed until 60 days; (B) bucket-fed until 60 days and (C) bucket-fed until 45 days of age. The milk kept at ambient temperature was offered twice a day. Kids had free access to water and grass hay (8.7% crude protein). Seven days after birth kids were offered a diet with 17% crude protein and a mineral-salt mix. A completely randomized design in fatorial scheme was used to analyse the data. Variables studied were: body weight at 45,60 and 120 days; body weight gain from 1 to 45days, from 46 to 60 days and from 61 to 120 days of age and labor required to milk feed the kids during the first 60 days. There were no differences in body weight at 60 and 120 days between kids fed from bouttle or fed from bucket until 60 days of age but kids fed from bucket until 45 days of age showed the longest values. The same was observed for body weight gain. Kids from system A and B presented more higher milk intake Levels than kids from system C but had lowest concentrate intake levels. Bucket-fed system reduced labor requ

O trabalho foi conduzido no Posto de Ovinos e Caprinos, em ltapetininga (SP), vinculado ao Instituto de Zootecnia, comparando-se 3 sistemas de aleitamento de cabritos mestiços anglo-nubianos: (A) leite de cabra em mamadeira até 60 dias de idade; (B) em balde até 60 dias (B) e (C) em balde até 45 dias. O delineamento foi inteiramente casualizado, em esquema fatorial 2x3 (sexos e sistema de aleitamento), com 4 repetições para fêmeas e 5 para machos. Os parámetros analisados foram: peso vivo aos 45, 60 e 120 dias de idade e ganho de peso vivo de 1 a 45, de 46 a 60 e de 61 a 120 dias. Estudou-se ainda, o consumo total de leite e de concentrado, bem como a ocupação estimada de mão-de-obra, para aleitamento, no periodo de 1 a 60 dias. Observou-se que o aleitamento no balde por 60 dias foi semelhante, em peso vivo aos 60 e 120 dias e em ganho diário de peso vivo do desmame até 120 dias, em confronto ao aleitamento na mamadeira. Os menores Índices ponderais foram observados no sistema C. Os animais dos sistemas A e B apresentaram níveis mais elevados de ingestão de leite que os do sistema C, todavia apresentaram um menor consumo de concentrados. O aleitamento em balde reduziu a demanda de mão-de-obra.