The medial open-wegde osteotomy generates progressive intrameniscal integrity changes in the lateral knee compartment: a prospective MR-assessment after valgic osteotomy in the varus gonarthritic knee.

PURPOSE: Meniscal changes in the lateral knee compartment after medial-opening high tibial osteotomy (HTO) with valgic overcorrection have not been investigated clinically with magnetic resonance imaging (MRI). The hypothesis of this study was that HTO with valgic overcorrection affects the lateral compartment due to the change in the bearing axis and the shift in the pressure load from the medial to the lateral compartment. This should lead to an accelerated degeneration of the lateral compartment. METHODS: Twenty-four patients (mean age, 45.7 ± 7.6 years) were prospectively and longitudinally monitored with MRI after medial-opening high tibial osteotomy. The degeneration of the meniscus was assessed at the anterior horn, pars intermedia, and posterior horn using the Stoller classification. The morphological changes were also assessed at the anterior horn, pars intermedia, and posterior horn using the relative vertical and transverse diameters of the examined part of the meniscus, according to the ratio maximal meniscal diameter/maximal tibial width. These parameters were analyzed preoperatively and at follow-up (mean 5.3 ± 1.5 years after surgery). RESULTS: During the follow-up period, there were no significant morphological changes in either the anterior horn, pars intermedia, or posterior horn. Nor were there any correlations between the morphological parameters, bodyweight, and the follow-up period. Despite these findings, an MRI evaluation showed progressive degeneration in every part of the meniscus according to the Stoller classification, and this was significant at the anterior horn (p < 0.01), pars intermedia (p = 0.021), and posterior horn (p < 0.01). CONCLUSION: High tibial osteotomy did not lead to morphological changes in the external meniscus over a follow-up period of 5.3 ± 1.5 years. However, progressive degeneration of the meniscus was observed in the imaging data. Further research is required to confirm the observed degeneration and to evaluate the consequences of the observed degeneration.

Breve percurso histórico acerca da transexualidade / Brief history on transsexuality / Breve historia sobre la transexualidad

Este estudo pretendeu investigar o fenômeno da transexualidade, por meio de registros históricos sobre as manifestações da sexualidade em diferentes épocas e como estas eram explicadas de forma naturalista. Intentamos estudar como eram concebidos o sexo e o gênero nos séculos XV a XIX, e como os discursos científicos vieram, por sua vez, ordenar e especificar o que era próprio ao masculino e ao feminino. Pretendemos averiguar como o aperfeiçoamento das técnicas cirúrgicas e hormonais contribuíram para elevar a transexualidade à categoria de fenômeno social. Apresentamos os estudos Queer com o intuito de compreendermos como se entende a constituição das identidades dentro de uma determinada estrutura social. Discutimos também o posicionamento de Judith Butler em relação aos constructos sexo e gênero fundados nas categorias binárias. Por fim, demonstramos de que modo o conceito de gênero foi introduzido e abordado na psicanálise pelo psicanalista/psiquiatra Robert Stoller.

This study aimed to investigate the phenomenon of transsexuality through historical records on the manifestations of sexuality at different times, and how these were explained in a naturalistic way. We seek to study how sex and gender were conceived in the fifteenth and nineteenth centuries, and how the scientific discourses came, in turn, to order and specify what was proper to the masculine and the feminine. We intend to investigate how the improvement of surgical and hormonal techniques have contributed to elevate transsexuality to the category of social phenomenon. We present the Queer studies in order to understand how one understands the constitution of identities within a social structure. We also discuss Judith Butler’s position on the sex and gender constructs based on the binary categories. Finally, we demonstrate how the concept of gender was introduced and approached in psychoanalysis through the psychoanalyst/psychiatrist Robert Stoller.

Este estudio pretendió investigar el fenómeno de la transexualidad a través de registros históricos sobre las manifestaciones de la sexualidad en diferentes épocas, y como éstas se explicaban de forma naturalista. Buscamos estudiar cómo era concebido el sexo y el género en los siglos XV a XIX y cómo los discursos científicos vinieron a su vez a ordenar y especificar lo que era propio al masculino y al femenino. Pretendemos averiguar cómo el perfeccionamiento de las técnicas quirúrgicas y hormonas contribuyó a elevar la transexualidad a la categoría de fenómeno social. Presentamos los estudios Queer con el propósito de comprender cómo se entiende la constitución de las identidades dentro de una determinada estructura social. También discutimos el posicionamiento de Judith Butler en relación a los constructos sexo y género fundados en las categorías binarias. Finalmente, demostramos de qué modo el concepto de género fue introducido y abordado en el psicoanálisis a través del psicoanalista/psiquiatra Robert Stoller.