Osteotomies about the knee for tibiofemoral malalignment in the athletic patient.

Osteotomies have a role in the active patient with degenerative joint disease of the medial or lateral knee who, for reasons of age or activity level, is not yet a good candidate for prosthetic arthroplasty. Recognition and treatment of malalignment associated with ligamentous instability is essential if long-term good outcomes are to be expected from ligamentous reconstruction. Also, treatment of concomitant malalignment and the unloading of the operative site is now recognized as an important adjunct to any cartilage-preserving surgery. This review examines the use of osteotomies about the knee in the athletic patient. Indications, contraindications, preoperative planning, surgical techniques, and complications are reviewed.

[Open surgical treatment in post-traumatic elbow stiffness]. / Tratamiento quirúrgico a cielo abierto de la rigidez postraumática de codo.

PURPOSE: To show how open treatment of the elbow stiffness offers an improvement in the range of motion, pain control, and patient's satisfaction. METHODS: We present a case series analysis of patients who suffer elbow stiffness and were treated with open surgery. We analyzed the range of motion (ROM), visual analogue scale (VAS) for pain and satisfaction, and the Mayo Score. Statistical analysis was performed using Student's t-test, Fisher's exact and Pearson correlation coefficient. RESULTS: 33 patients were included mean, age was 30.3 +/- 13.4. Twenty patients were male and 13 female, 32 patients had an articular fracture of the elbow and 1 with ectopic ossification. In 90.9% the column procedure was the option and in 9.1% open reduction and internal fixation was made. Compared with preoperative ROM was 58.8 degrees +/- 28.6 degrees, postoperative 96.10 +/- 25.5 (p < 0.001). Pain versus registered 5.06 points in the Preoperative 1.7 points in the postoperative period (p = 0.001). 75% of the patients were satisfied. Preoperative Mayo score was 47.2 +/- 17.8 versus 89.2 +/- 13.4 in the postoperative (p < 0.0001). CONCLUSION: The open treatment of the stiff elbow offers the patient pain relief; increased motion and most patients report final results as satisfactory.

Actualidades en la cirugía de reconstrucción articular de rodilla / Update in joint reconstructive surgery of the knee

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Las alteraciones del eje mecánico, las secuelas de lesiones traumáticas y la osteoartritis son las causas que más frecuentemente requieren reconstrucción quirúrgica de la rodilla. Según el grado de alteración, se efectúan diferentes procedimientos quirúrgicos, entre los que se encuentran la artroscopia, las osteotomías alineadoras del eje mecánico, las prótesis que sustituyen un solo compartimento y las prótesis totales de rodilla. Las indicaciones para cada uno de estos procedimientos dependen del tipo y el grado de la lesión. Hasta ahora no se considera que estos tratamientos sean definitivos o curativos de la osteoartritis y principalmente buscan mejorar las condiciones clínicas del paciente y disminuir en lo posible el proceso evolutivo de degeneración articular. Incluso la artroplastia total de rodilla, que se considera un procedimiento quirúrgico definitivo, es temporal por su tendencia natural a aflojarse y desgastarse (AU)

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Alterations in the mechanical axis, complications of traumatic injuries and osteoarthritis are the leading causes for surgical reconstruction of the knee. According to the degree of the alteration, different surgical procedures are carried out, among which we find arthroscopy, mechanical axis aligning osteotomy, single compartment prosthesis, or total knee prosthesis. Indications for each one of these procedures depend on the type and degree of lesion. These treatments are not currently considered definitive or curative for osteoarthritis and their aim is mainly to improve the clinical conditions of the patient and to reduce as much as possible the evolution of the joint degenerative process. Even total knee arthroplasty, considered a definitive surgical procedure, is temporary due to its natural tendency to loosen and wear out (AU)

[Update in joint reconstructive surgery of the knee]. / Actualidades en la cirugía de reconstrucción articular de rodilla.

Alterations in the mechanical axis, complications of traumatic injuries and osteoarthritis are the leading causes for surgical reconstruction of the knee. According to the degree of the alteration, different surgical procedures are carried out, among which we find arthroscopy, mechanical axis aligning osteotomy, single compartment prosthesis, or total knee prosthesis. Indications for each one of these procedures depend on the type and degree of lesion. These treatments are not currently considered definitive or curative for osteoarthritis and their aim is mainly to improve the clinical conditions of the patient and to reduce as much as possible the evolution of the joint degenerative process. Even total knee arthroplasty, considered a definitive surgical procedure, is temporary due to its natural tendency to loosen and wear out.