[Study of the feasibility of lateral meniscal repair including the popliteal tendon with a knee simulator]. / Estudio de la viabilidad de la reparación meniscal lateral incluyendo el tendón poplíteo con simulador de rodilla.

BACKGROUND: Although the indications for lateral meniscal repair are well established, some aspects are still controversial. The classic recommendation is to avoid going through the popliteal tendon with sutures, even though this is at times difficult to achieve. The purpose of this paper was to assess the feasibility of a meniscal repair that included the popliteal tendon. METHODS: To this end, nine human fresh frozen knees were used, in which a bucket handle lesion of the lateral meniscus was inflicted. The knees were divided into three groups: Group A (control): meniscal repair was performed with 5 vertical sutures, 2 posterior and 3 anterior to the popliteal fossa; Group B: one stitch was added between the lateral meniscus and the popliteal tendon, and Group C: the additional stitch included the meniscus, the popliteal tendon and the articular capsule. In all cases a lateral condyle osteotomy was performed to access the lateral compartment of the knee. Once the osteotomy had been fixed, the knees underwent 1000 gait cycles and a rotational test using an experimental gait simulator. Then a macroscopic assessment of the meniscal repair and the popliteal tendon was performed. RESULTS: No differences were seen in the previous situation in any of the groups. CONCLUSIONS: In this experimental model the repair of the lateral meniscus including the popliteal tendon did not seem to have any repercussions on suture viability.

Basic science in digital imaging: digital dynamic radiography, multimedia, and their potential uses for orthopaedics and arthroscopic surgery.

In this article, we discuss the different types of up-to-date tools available to understand multimedia and its applications, imaging manipulation, digital video, and new approaches to surgical planning, digital dynamic radiography, and patient education aided by digital technology.

Trivalent reconstruction for posterolateral and lateral knee instability.

Chronic posterolateral rotatory and lateral instability of the knee is approached from multiple anatomic and functional points of view. Traditional surgical techniques provide one-directional stabilization using autologous tendon transplantation and the split-tendon biceps procedure. Both of these resolve the lateral opening of the joint but do not secure the rest of the anatomic structures that are very important, such as the arcuate ligament and the capsule. This new approach to solving an old problem acts by tightening the fibular collateral ligament, arcuate ligament, the capsule (partially), and biceps tendon in 1 step by performing an oblique fibular-head osteotomy and pulling down these structures with good results. We report 2 cases in which this technique was used. The first was a 26-year-old man who hit the dashboard in an automobile accident and presented 1 week later with posterolateral instability associated with a tear of the posterior cruciate ligament. The second was a case of pure chronic lateral instability of the knee in a 32-year-old man who sustained a fall that caused a rupture of his lateral collateral ligament. This was repaired using a trivalent reconstruction at 3 months. Both patients successfully achieved good stability after reconstruction.

Cirugía artroscópica en la liberación de adherencias post fractura intra-articular de tobillo. Reporte de un caso / Arthroscopy surgery for fibrosis release after intra-artidular fractures of the ankle jount. case report

Se reporta un caso de paciente masculino con antecedentes de fractura intra-articular de tobillo de 15 años de evolución el cual desarrolló artrosis y limitación de movimiento con dolor importante en la articulación. El tratamiento de elección fue debridación artroscópica de adherencias intra-articulares con buenos resultados disminuyendo el dolor y aumentando la movilización en el postoperatorio inmediato