Patellar tendinopathy: late-stage results from surgical treatment.

OBJECTIVE: To evaluate the late-stage results from surgical treatment of patellar tendinopathy (PT), using the Visa score (Victorian Institute of Sport Tendon Study Group) and the Verheyden method. METHODS: This was a retrospective study in which the postoperative results from 12 patients (14 knees) who were operated between July 2002 and February 2011 were evaluated. The patients included in the study presented patellar tendinopathy that was refractory to conservative treatment, without any other concomitant lesions. Patients who were not properly followed up during the postoperative period were excluded. RESULTS: Using the Verheyden method, nine patients were considered to have very good results, two had good results and one had poor results. In relation to Visa, the mean was 92.4 points and only two patients had scores less than 70 points (66 and 55 points). CONCLUSION: When surgical treatment for patellar tendinopathy is correctly indicated, it has good long-term results.

OBJETIVO: Avaliar os resultados tardios do tratamento cirúrgico na tendinopatia patelar (TP) com o uso do escore Visa (Victorian Institute of Sport Tendon Study Group) e o método de Verheyden. MÉTODOS: Estudo retrospectivo que avaliou os resultados pós-operatórios de 12 pacientes, ou 14 joelhos, entre julho de 2002 e fevereiro de 2011. Foram incluídos os pacientes com tendinopatia patelar refratários ao tratamento conservador e que não apresentavam outras lesões cirúrgicas concomitantes. Pacientes que não foram devidamente acompanhados no período pós-operatório foram excluídos. RESULTADOS: Pelo método de Verheyden, nove pacientes foram considerados muito bons, dois bons e um ruim. Em relação ao Visa, a média foi de 92,4 pontos, com apenas dois pacientes abaixo de 70 pontos (66 e 55 pontos). CONCLUSÃO: O tratamento cirúrgico da tendinopatia patelar, quando corretamente indicado, tem bons resultados em longo prazo.

Popliteal artery injury during posterior cruciate ligament reconstruction.

This study reports a case of popliteal artery injury during arthroscopic reconstruction of the posterior cruciate ligament. The evolution of the injury is described and comments are made regarding the anatomy of this artery and potential risks of this surgical technique. This study had the aims of alerting the medical community, especially knee surgeons, regarding a severe surgical complication and discussing the ways of preventing it.

Este trabalho relata uma lesão da artéria poplítea (AP) durante uma reconstrução artroscópica do ligamento cruzado posterior, descreve sua evolução e faz considerações sobre a anatomia dessa artéria e os riscos potenciais dessa técnica cirúrgica. Tem como objetivo alertar a comunidade médica, em especial os cirurgiões de joelho, sobre uma complicação cirúrgica grave e discutir as formas de preveni-la.

Comparative study between physical examination, electroneuromyography and ultrasonography in diagnosing carpal tunnel syndrome.

OBJECTIVE: To evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard. METHODS: In this cross-sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination. RESULTS: Nocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7%-78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0%-100%); and electromyography, 98.6% (95% CI: 95.7%-100%). The presence of atrophy, abnormalities of the sense of touch and longer-duration symptoms increased the sensitivity of ultrasonography and physical examination. CONCLUSION: The sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination.

OBJETIVO: Avaliar a sensibilidade da eletroneuromiografia (ENMG) e da ultrassonografia (USN) no diagnóstico de síndrome do túnel do carpo (STC) comparada com a do exame físico, considerado padrão-ouro. MÉTODOS: Estudo seccional pela análise de prontuários de 56 pacientes com 70 mãos acometidas com STC entre março de 2010 e junho de 2012. A sensibilidade dos exames complementares foi analisada e comparada com a do exame físico. RESULTADOS: Constataram-se sintomas noturnos em 96,4%, hipotrofia tenar em 62,5% e alteração do tato em 50%. A sensibilidade da USG foi de 67,1% (95% IC, 55,7%-78,6%); a da associação dos testes do exame físico, de 95,7 (95% IC, 90,0%-100%); e a da ENMG, de 98,6% (95% IC, 95,7%-100%). A presença de hipotrofia, de alterações no tato e o maior tempo dos sintomas aumentaram a sensibilidade da USG e do exame físico. CONCLUSÃO: A sensibilidade da USG para a STC foi inferior à da ENMG e à do exame físico.

OSTEOID OSTEOMA IN THE ILIAC BONE: REPORT ON TWO CASES.

Osteoid osteoma is a benign bone tumor that generally presents with nighttime pain among young adults and is relieved by rest and salicylates. It can affect any bone, but occurrences in the iliac are unusual. The authors describe two cases of intramedullary osteoid osteoma next to the sacroiliac joint, with symptoms that simulated sciatic pain. The cases were diagnosed late, although the initial radiographs showed sclerotic lesions in both cases. The diagnosis was confirmed by means of CT scan and the nidus was excised surgically through en bloc resection. The definitive diagnosis was given by means of histopathological examination. Over long-term follow-up, both cases remained asymptomatic and complete bone remodeling at the surgical site was observed. The authors highlight the typical characteristics of the tumor, the unusual location, the differential diagnosis and the treatment.