[Incidence and effect of leg length discrepancy after total hip arthroplasty]. / Incidencia y efecto de la discrepancia en la longitud de la pierna después de la artroplastía total de cadera.

INTRODUCTION: In coxarthrosis pain relief and the restoration of function including leg length are achieved with total hip arthroplasty. Sometimes achieving stability makes it impossible to achieve equal leg length. OBJECTIVE: To determine the incidence of pelvic limb length discrepancy, its effect on function and its emotional effect in a group of patients who underwent total hip arthroplasty. MATERIAL AND METHODS: A total of 252 patients with a diagnosis of grade IV coxarthrosis were assessed. They underwent unilateral primary total hip arthroplasty with a direct lateral approach; 190 were uncemented and 162 hybrid. Limb length was measured from the anterosuperior iliac crest to the medial malleolus of both legs. Patients were divided into four groups depending on leg length discrepancy: A) equal length; B) less than 10 mm; C) more than 10 mm, and D) more than 20 mm. RESULTS: A total of 252 arthroplasties were performed in 252 patients; 194 females (76.98%) and 58 males (23.01%). In 115 patients (45.63%) had a discrepancy < 10 mm; 71 patients (28.17%) > 10 mm; 60 patients (23.80%) did not have length discrepancy, and six patients had > 20 mm of discrepancy with lengthening of the operated limb. CONCLUSIONS: Length discrepancy of the operated limb is reported in the literature. It is a common outcome of primary total hip arthroplasty, and is usually < 10 mm, as reported in world literature.

[Knee gouty monoarthritis. An arthroscopic view]. / Monoartritis gotosa de rodilla "una vista artroscópica". Reporte de un caso clínico.

INTRODUCTION: Gout is the symptom caused by the response to monosodium urate crystals that develop due to hyperuricemia; it is the most frequent inflammatory arthropathy in males over age 40. OBJECTIVE: To demonstrate the diagnosis as an arthroscopic finding. MATERIAL AND METHODS: The case of a male, 39 year-old patient without a relevant medical history whose illness started with left knee trauma consisting of rotation and forced valgus. He initially had pain and inflammation and was treated with immobilization for two weeks. Pain and inflammation persisted so plain films and MRI were ordered and they showed a lesion of the medial meniscus. Arthroscopy of the left knee was performed. RESULTS: The nuclear MRI showed a lesion of the medial meniscus and a chondral lesion of the medial condyle. Preoperative tests showed a uric acid level within the upper normal limit. The arthroscopy showed a transverse lesion of the medial meniscus that was repaired as usual; lesions were found throughout the articular surface, with crystal deposits, as well as an important synovial inflammatory reaction and medial condyle chrondropathy. DISCUSSION: Arthroscopy of a gouty knee shows urate deposits that partially cover the synovial, the anterior cruciate ligament, the menisci and lesion zones in the articular surfaces. Removal of gouty collections and a thorough articular lavage improve the local symptoms of the disease. No synovectomy was performed, as is recommended in the literature.