[Clinical and radiographic correlation after anterior cruciate ligament reconstruction]. / Correlación clínica y radiográfica después de reconstrucción de ligamento cruzado anterior.

UNLABELLED: The purpose of this work is to correlate the clinical, functional and radiographic results of the anterior cruciate ligament (ACL) reconstruction with the angulation and orientation of the femoral and tibial tunnels. INTRODUCTION: The ACL is one of the most frequently injured articular structures of the knee. The reason for this being that it is the primary limiting structure of anterior tibial translation; its tear causes kinematic alterations and results in long-term degenerative and functional changes. Repair can restore the kinematics. MATERIAL AND METHODS: 26 patients, 20-50 years old, post-ACL reconstruction with the semitendinous-gracilis technique. From November 2006 to July 2007. Clinical and functional assessments: Tegner and Lysholm. Radiographic assessment: anteroposterior view with knee extension and lateral view with 30 degrees flexion. Pearson correlations (r) were used in the analysis. RESULTS: 26 patients (100%), 20 males (76.92%), 6 females (23.08%). Mean of 2.4 in the Lysholm scale (fair to good); standard deviation 1.2. Bernard-Lysholm quadrant r = -0.772. Tegner quadrant r = 0.790. CONCLUSIONS: The Lysholm and Tegner scale is associated with the graft quadrant. The situation of the tibial implant in the saggital plane is associated with the Lysholm scale. The correlation of patients with an inadequate placement with respect to the quadrants was associated with good-to-excellent results and fair-to-good results. Two patients had a poor clinical outcome; the orientation of the AP angle and the quadrant were within acceptable parameters, with the exception of the lateral angle-shaft axis.

[Clinical association between patellofemoral pain with arthroscopic findings]. / Asociación clínica entre dolor patelofemoral y los hallazgos artroscópicos.

UNLABELLED: The purpose of this study was to associate patellofemoral pain with the findings of arthroscopic procedures. A visual analogue scale was used considering that 1 represented no pain and 10 severe pain, the functional Lysholm scale for function, and the Outerbridge classification to determine the grade of the articular cartilage lesion. MATERIAL AND METHODS: The study population was composed of an heterogeneous group of patients with chondral lesions. This is a retrospective, observational and longitudinal study undertaken for a period of 18 months. Sixty-nine patients had patellofemoral pain, and traumatic knee injuries were excluded. RESULTS: Sixty-eight patients were found to have a chondral lesion, only one patient did not. In the latter only loose body removal was performed. The most frequent procedure was articular lavage, debridement and chondroplasty in 98.5%. Thirty-five patients were found to have knee arthrosis grade IV (50.7%); the broadest functional improvement range occurred in patients with arthrosis grades I and III. DISCUSSION: Patients with mild-to-moderate knee arthrosis grades I to III are the ones with the highest chance of success from the perspective of pain relief and functionality of arthroscopic surgery.

[Clinical and functional course of patients after arthroscopic repair of a Bankart lesion]. / Evolución clínica y funcional en pacientes operados vía artroscópica con inestabilidad unidireccional anterior del hombro.

OBJECTIVE: Show the experience of the Orthopedics Service at Lic. Adolfo López Mateos Regional ISSSTE Hospital, in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of reattaching the labrum in the glenoid with anchored sutures and capsular tightening with radiofrequency. MATERIAL AND METHODS: Twenty-six patients with anterior unidirectional shoulder instability who were operated-on between August 2006 and November 2008 were included. Twelve patients underwent capsular retightening with radiofrequency and in 14 patients the latter was combined with sutured anchors. The patients selected had a history of relapsing glenohumeral dislocations and subluxations with anterior instability, with or without associated Bankart lesions, and all of them were young. RESULTS: The results were assessed basically with the functional UCLA scale and considering the occurrence of any instability-related event during the postoperative follow-up; from this perspective, there were no cases of recurrent instability. Two cases reported severe postoperative pain, and one had irritation of the sutures; 6 patients had residual limitation of combined lateral rotation and abduction movements, with a mean of 10 degrees compared with the sound contralateral limb. The most frequent incident was infiltration of solutions into the soft tissues due to the operative time. CONCLUSIONS: Capsular retightening with radiofrequency, whether combined or not with other repair techniques, has proven highly satisfactory from the perspective of the glenohumeral stabilization for anterior unidirectional instability. The arthroscopic approach offers the known advantages of being less aggressive to the soft tissues and a shorter time to resume work activities when rehabilitation therapy and exercises are followed.