Minimally invasive Chevron-Akin (MICA) osteotomies without Akin fixation in hallux valgus correction: a case series with 2-year follow-up.

PURPOSE: The minimally invasive Chevron-Akin (MICA) is considered the third generation of minimally invasive hallux valgus (HV) surgery, and its original description included fixation of the Akin osteotomy with a screw. The aim of this study is to evaluate a series of patients undergoing HV correction using the MICA technique without screw fixation of the Akin osteotomy. METHODS: We retrospectively evaluated 58 consecutive patients who underwent surgical correction for HV between August 2018 and March 2020. A total of 69 feet were evaluated with a minimum follow-up of 2 years. Clinical outcomes such as pain (VAS), function (AOFAS), range of movement, criteria personal satisfaction and complications were evaluated. RESULTS: The AOFAS score (mean ± standard deviation) significantly improved from 57.0 ± 8.6 preoperatively to 93.9 ± 8.7 postoperatively (p < .001) with a minimum follow-up of 2 years. The VAS score improved from 6.0 ± 1.8 preoperatively to 0.6 ± 1.4 at 2-year follow-up (p < .001), and the hallux valgus angle reduced from 39.7 ± 6.9 to 8.9 ± 9.0 (p < .001). The majority of patients (95.6%) reported the result as excellent or good, and the most common complication was the need to remove the screw (7.2%). CONCLUSIONS: The use of MICA without Akin osteotomy fixation resulted in successful correction of hallux valgus with improvements in clinical and radiographic parameters. LEVEL OF EVIDENCE: IV, case series.

Plantar Vein Thrombosis in a Patient with COVID-19: Case Report.

Plantar thrombophlebitis is a rare abnormality with few cases reported in the literature. Coexistence with severe acute respiratory syndrome coronavirus 2 infection increases its relevance. The disease is generally classified as idiopathic, and it is suggested that it is attributed to conditions that lead to hypercoagulability. We present the case of a 68-year-old female patient with thrombosis of the lateral plantar veins and a diagnosis of coronavirus disease of 2019. The plantar vein thrombosis diagnosis was made by means of Doppler ultrasonography and magnetic resonance imaging. Severe acute respiratory syndrome coronavirus 2 infection was suspected per clinical information and confirmed with reverse-transcriptase polymerase chain reaction technique. Treatment was successful using rivaroxaban and nonsteroidal antiinflammatory drugs.

ARTHROSCOPIC FOOT AND ANKLE SURGERY: BRAZILIAN SURGEON PROFILE.

Objective: To study the profile of the practice of arthroscopy among ankle and foot surgeons in Brazil and its evolution in recent years. Methods: Observational, cross-sectional study, using a survey sent to all members of the Associação Brasileira de Medicina e Cirurgia do Tornozelo e Pé (ABTPé) in 2017 and 2019. Results: In total, 75 surgeons participated in 2017 and 82 in 2019 and most had over 10 years of experience. Of these, 56 participants in 2017 (75%) and 68 in 2019 (82%) used arthroscopy. The number of specialists with no to five years of experience (p = 0.027) and who learned the technique during fellowship (p = 0.007) increased. The use of the 4.0 mm optics and 30° optics (p = 0.040) increased whereas the routine use of traction (p = 0.049) and radiofrequency (p = 0.002) decreased. The main pathology treated with anterior ankle arthroscopy was bone injury. The most frequent complication was neuropraxia. Conclusion: Most of the foot and ankle surgeons who use arthroscopy have more than 10 years of experience, performed anterior access, and are concentrated in the Southeast region of the country. The number of younger surgeons who learned the technique during fellowship increased. Level of Evidence III, Cross-Sectional Comparative Study.

Objetivo: Mostrar o perfil da prática da artroscopia entre cirurgiões de tornozelo e pé no Brasil e sua evolução nos últimos anos. Métodos: Estudo observacional, transversal, realizado por meio de questionário eletrônico enviado para todos os membros da Associação Brasileira de Medicina e Cirurgia do Tornozelo e Pé (ABTPé) em 2017 e 2019. Resultados: Obtivemos 75 respondentes em 2017 e 82 em 2019; a maioria tinha mais de 10 anos de experiência. Dos respondentes, 56 realizavam artroscopia em 2017 (75%) e 68 em 2019 (82%). Foi observado aumento no número de especialistas com até 5 anos de experiência (p = 0,027) e que aprenderam a técnica durante o estágio de especialização (p = 0,007). Houve aumento no uso da ótica de 4,0 mm e 30° de angulação (p = 0,040), e diminuição do uso rotineiro de tração (p = 0,049) e de radiofrequência (p = 0,002). A principal patologia tratada com artroscopia anterior do tornozelo foi o impacto ósseo, e a complicação mais frequente foi a neuropraxia. Conclusão: A maioria dos cirurgiões de pé e tornozelo que utiliza artroscopia tem mais de 10 anos de experiência, usa o acesso anterior e concentra-se na região Sudeste do país. Foi observado aumento no número de cirurgiões mais novos e que aprenderam a técnica durante o estágio de especialização. Nível de Evidência III, Estudo Transversal Comparativo.

Treatment of Morton's neuroma with minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) and percutaneous release of the deep transverse metatarsal ligament (DTML): a case series with minimum two-year follow-up.

BACKGROUND: The optimal treatment of symptomatic Morton's neuroma remains unclear; conservative methods are sometimes ineffective and neurectomy has significant rates of patient dissatisfaction. The aim of this study was to evaluate the outcome of minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) and percutaneous release of the deep transverse metatarsal ligament (DTML) in patients with Morton's neuroma. METHODS: Between January 2018 and November 2019, 27 patients (29 feet) diagnosed with Morton's neuroma after clinical and radiological evaluation underwent DMMO and percutaneous DTML release. The primary clinical outcomes were pain (VAS) and function (AOFAS score). Secondary outcomes included patient satisfaction, complications, and radiographic outcomes. Patients were followed up for a minimum of two years. RESULTS: The median age of the participants was 66 years (range 48-79) and the follow-up time was 28 months (24-47). There was a decrease of 5.7 points in the VAS for pain (p < .001) and an increase of 19.9 in AOFAS (p < .001) after the surgical procedure. There was one case of superficial infection and one patient required resection of the neuroma (neurectomy). The majority of patients (89.7%) were satisfied and considered the procedure outcome as excellent or good. CONCLUSION: Treatment of Morton's neuroma with minimally invasive distal metatarsal metaphyseal osteotomy and percutaneous release of the deep transverse metatarsal ligament showed significant improvement in pain and function with a low incidence of complications and a high rate of personal satisfaction.

Arthroscopic foot and ankle surgery: brazilian surgeon profile / Cirurgia artroscópica do pé e tornozelo: perfil do cirurgião brasileiro

ABSTRACT Objective: To study the profile of the practice of arthroscopy among ankle and foot surgeons in Brazil and its evolution in recent years. Methods: Observational, cross-sectional study, using a survey sent to all members of the Associação Brasileira de Medicina e Cirurgia do Tornozelo e Pé (ABTPé) in 2017 and 2019. Results: In total, 75 surgeons participated in 2017 and 82 in 2019 and most had over 10 years of experience. Of these, 56 participants in 2017 (75%) and 68 in 2019 (82%) used arthroscopy. The number of specialists with no to five years of experience (p = 0.027) and who learned the technique during fellowship (p = 0.007) increased. The use of the 4.0 mm optics and 30° optics (p = 0.040) increased whereas the routine use of traction (p = 0.049) and radiofrequency (p = 0.002) decreased. The main pathology treated with anterior ankle arthroscopy was bone injury. The most frequent complication was neuropraxia. Conclusion: Most of the foot and ankle surgeons who use arthroscopy have more than 10 years of experience, performed anterior access, and are concentrated in the Southeast region of the country. The number of younger surgeons who learned the technique during fellowship increased. Level of Evidence III, Cross-Sectional Comparative Study.

RESUMO Objetivo: Mostrar o perfil da prática da artroscopia entre cirurgiões de tornozelo e pé no Brasil e sua evolução nos últimos anos. Métodos: Estudo observacional, transversal, realizado por meio de questionário eletrônico enviado para todos os membros da Associação Brasileira de Medicina e Cirurgia do Tornozelo e Pé (ABTPé) em 2017 e 2019. Resultados: Obtivemos 75 respondentes em 2017 e 82 em 2019; a maioria tinha mais de 10 anos de experiência. Dos respondentes, 56 realizavam artroscopia em 2017 (75%) e 68 em 2019 (82%). Foi observado aumento no número de especialistas com até 5 anos de experiência (p = 0,027) e que aprenderam a técnica durante o estágio de especialização (p = 0,007). Houve aumento no uso da ótica de 4,0 mm e 30° de angulação (p = 0,040), e diminuição do uso rotineiro de tração (p = 0,049) e de radiofrequência (p = 0,002). A principal patologia tratada com artroscopia anterior do tornozelo foi o impacto ósseo, e a complicação mais frequente foi a neuropraxia. Conclusão: A maioria dos cirurgiões de pé e tornozelo que utiliza artroscopia tem mais de 10 anos de experiência, usa o acesso anterior e concentra-se na região Sudeste do país. Foi observado aumento no número de cirurgiões mais novos e que aprenderam a técnica durante o estágio de especialização. Nível de Evidência III, Estudo Transversal Comparativo.

RELIABILITY OF WIRELESS INSOLE BAROPODOMETRY OF NORMAL INDIVIDUAL'S GAIT.

OBJECTIVE: The plantar pressure distribution can be assessed quantitatively by computerized baropodometry such as carpet or insole. An insole-type system with wireless transmission was developed and plantar pressure results were previously validated by force platform. However, the reproducibility of the system had not been determined. Our objective was to evaluate the reliability of the results in different gait cycles, clinical characteristics and in different plantar anatomical sites. METHODS: 41 healthy adults (age, 34 ± 13 years; body mass index, 25 ± 5 kg/m2; 26 [63%], male, 26 [63%] practicing physical activity) were evaluated. Baropodometer evaluations were performed in 3 walking cycles with 100 m each, and the reliability between the cycles was examined. Pressure points on the heel, first metatarsal, fifth metatarsal and total plantar pressure were analyzed and compared. RESULTS: Moderate agreement was identified between the second and third cycles (ICC, 0.66; 95% CI, 0.14-0.83). Physical activity practitioners showed higher total plantar pressure (70.8 vs 68.2 Kpa; p = 0.04) and higher pressure in the heel (70.7 vs 68.1 Kpa; p = 0.036) in relation to sedentary ones. CONCLUSION: The insole was able to assess plant pressure with moderate reliability from the adaptation period. Level of Evidence III, Case control study - Investigating a diagnostic test.

OBJETIVO: A distribuição da pressão plantar pode ser avaliada quantitativamente por baropodometria computadorizada tipo tapete ou palmilha. Um sistema tipo palmilha com transmissão sem fio foi desenvolvido, cujos resultados de pressão plantar foram previamente validados por plataforma de força. No entanto, a reprodutibilidade do sistema não havia sido determinada. Nosso objetivo foi avaliar a confiabilidade dos resultados em relação a diferentes ciclos de marcha, características clínicas e em diferentes sítios anatômicos plantares. MÉTODOS: Foram avaliados 41 adultos saudáveis (idade, 34 ± 13 anos; índice de massa corpórea, 25 ± 5 kg/m2; 26 [63%], sexo masculino, 26 [63%] praticantes de atividade física). Avaliações com o baropodômetro foram realizadas em 3 ciclos de marcha com distância de 100 m, e avaliada a concordância entre os ciclos. Pontos de pressão no calcanhar, primeiro metatarsal, quinto metatarsal e a pressão plantar total foram analisados e comparados. RESULTADOS: Houve moderada concordância entre o segundo e terceiro ciclos (CCI, 0,66; IC95%, 0,14-0,83). Praticantes de atividades físicas apresentaram pressão plantar total (70,8 vs 68,2 Kpa; p = 0,04) e no calcanhar (70,7 vs 68,1 Kpa; p = 0,036) aumentada em relação aos sedentários. CONCLUSÃO: A palmilha foi capaz de avaliar a pressão plantar com confiabilidade moderada a partir do período de adaptação. Nível de Evidência III, Estudo diagnóstico - Investigando um teste diagnóstico.

Reliability of wireless insole baropodometry of normal individual's gait / Confiabilidade da baropodometria por palmilha sem fio na marcha de indivíduos normais

ABSTRACT Objective: The plantar pressure distribution can be assessed quantitatively by computerized baropodometry such as carpet or insole. An insole-type system with wireless transmission was developed and plantar pressure results were previously validated by force platform. However, the reproducibility of the system had not been determined. Our objective was to evaluate the reliability of the results in different gait cycles, clinical characteristics and in different plantar anatomical sites. Methods: 41 healthy adults (age, 34 ± 13 years; body mass index, 25 ± 5 kg/m2; 26 [63%], male, 26 [63%] practicing physical activity) were evaluated. Baropodometer evaluations were performed in 3 walking cycles with 100 m each, and the reliability between the cycles was examined. Pressure points on the heel, first metatarsal, fifth metatarsal and total plantar pressure were analyzed and compared. Results: Moderate agreement was identified between the second and third cycles (ICC, 0.66; 95% CI, 0.14-0.83). Physical activity practitioners showed higher total plantar pressure (70.8 vs 68.2 Kpa; p = 0.04) and higher pressure in the heel (70.7 vs 68.1 Kpa; p = 0.036) in relation to sedentary ones. Conclusion: The insole was able to assess plant pressure with moderate reliability from the adaptation period. Level of Evidence III, Case control study - Investigating a diagnostic test.

RESUMO Objetivo: A distribuição da pressão plantar pode ser avaliada quantitativamente por baropodometria computadorizada tipo tapete ou palmilha. Um sistema tipo palmilha com transmissão sem fio foi desenvolvido, cujos resultados de pressão plantar foram previamente validados por plataforma de força. No entanto, a reprodutibilidade do sistema não havia sido determinada. Nosso objetivo foi avaliar a confiabilidade dos resultados em relação a diferentes ciclos de marcha, características clínicas e em diferentes sítios anatômicos plantares. Métodos: Foram avaliados 41 adultos saudáveis (idade, 34 ± 13 anos; índice de massa corpórea, 25 ± 5 kg/m2; 26 [63%], sexo masculino, 26 [63%] praticantes de atividade física). Avaliações com o baropodômetro foram realizadas em 3 ciclos de marcha com distância de 100 m, e avaliada a concordância entre os ciclos. Pontos de pressão no calcanhar, primeiro metatarsal, quinto metatarsal e a pressão plantar total foram analisados e comparados. Resultados: Houve moderada concordância entre o segundo e terceiro ciclos (CCI, 0,66; IC95%, 0,14-0,83). Praticantes de atividades físicas apresentaram pressão plantar total (70,8 vs 68,2 Kpa; p = 0,04) e no calcanhar (70,7 vs 68,1 Kpa; p = 0,036) aumentada em relação aos sedentários. Conclusão: A palmilha foi capaz de avaliar a pressão plantar com confiabilidade moderada a partir do período de adaptação. Nível de Evidência III, Estudo diagnóstico - Investigando um teste diagnóstico.

Which clinical outcome scores are more frequently used in the literature on osteochondral lesions of the talus? a systematic review / Quais escores de desfechos clínicos são usados com mais frequência na literatura lesões osteocondrais do tálus? uma revisão sistemática

ABSTRACT Objective: This study aimed to identify the most used scales in the assessment of the clinical outcomes for the treatment of osteochondral lesions of the talus. Methods: We performed a systematic review of the PubMed/MEDLINE databases from September 1999 to September 2019, based on the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research strategy was: osteochondral [All Fields], AND ("talus" [MeSH Terms] OR "talus" [All Fields]) AND lesion [All Fields]. Of the 364 articles found in the literature, 166 (45%) were included in the study and 198 (55%) excluded. In total, 23 clinical assessment tools were used in the studies. Results: We found 49.4% of the studies to use the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS Ankle-Hindfoot Scale) and 29.5% the Visual Analogue Scale (VAS). Conclusion: The use of AOFAS increased in relation to VAS in the last 6 years (p = 0.046), and these two scales, either alone or combined, were the most used for studying osteochondral lesions of the talus. Level of Evidence III, Systematic Review of Level II studies.

RESUMO Objetivo: Este estudo propõe revisar sistematicamente a literatura para identificar as escalas mais utilizadas da avaliação clínica de resultados do tratamento das LOTs. Métodos: Foi realizada revisão sistemática das bases de dados do PubMed/MEDLINE, desde setembro de 1999 a setembro 2019 baseado nas diretrizes PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). A estratégia de pesquisa foi: osteochondral [All Fields], AND ("talus" [MeSH Terms] OR "talus" [All Fields]) AND lesion [All Fields]. De 364 artigos, foram incluídos no estudo 166 (45%) e excluídos 198 (55%). Foram observadas 23 escalas de avaliação clínica utilizadas. Resultados: A escala AOFAS e EVA de dor foram as mais utilizadas, ocorrendo em 49,4% e 29,5% dos artigos, respectivamente. Foi observado aumento de uso de AOFAS e diminuição EVA nos últimos 6 anos (p = 0,046). Conclusão: As ferramentas Escala AOFAS e EVA para dor demonstraram ser as mais usadas na literatura para avaliação de resultados do tratamento da lesão osteocondral de tálus, tanto isoladamente, quanto combinadas. Nível de Evidência III, Revisão Sistemática de Estudos de Nível II.

WHICH CLINICAL OUTCOME SCORES ARE MORE FREQUENTLY USED IN THE LITERATURE ON OSTEOCHONDRAL LESIONS OF THE TALUS? A SYSTEMATIC REVIEW.

OBJECTIVE: This study aimed to identify the most used scales in the assessment of the clinical outcomes for the treatment of osteochondral lesions of the talus. METHODS: We performed a systematic review of the PubMed/MEDLINE databases from September 1999 to September 2019, based on the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research strategy was: osteochondral [All Fields], AND ("talus" [MeSH Terms] OR "talus" [All Fields]) AND lesion [All Fields]. Of the 364 articles found in the literature, 166 (45%) were included in the study and 198 (55%) excluded. In total, 23 clinical assessment tools were used in the studies. RESULTS: We found 49.4% of the studies to use the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS Ankle-Hindfoot Scale) and 29.5% the Visual Analogue Scale (VAS). CONCLUSION: The use of AOFAS increased in relation to VAS in the last 6 years (p = 0.046), and these two scales, either alone or combined, were the most used for studying osteochondral lesions of the talus. Level of Evidence III, Systematic Review of Level II studies.

OBJETIVO: Este estudo propõe revisar sistematicamente a literatura para identificar as escalas mais utilizadas da avaliação clínica de resultados do tratamento das LOTs. MÉTODOS: Foi realizada revisão sistemática das bases de dados do PubMed/MEDLINE, desde setembro de 1999 a setembro 2019 baseado nas diretrizes PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). A estratégia de pesquisa foi: osteochondral [All Fields], AND ("talus" [MeSH Terms] OR "talus" [All Fields]) AND lesion [All Fields]. De 364 artigos, foram incluídos no estudo 166 (45%) e excluídos 198 (55%). Foram observadas 23 escalas de avaliação clínica utilizadas. RESULTADOS: A escala AOFAS e EVA de dor foram as mais utilizadas, ocorrendo em 49,4% e 29,5% dos artigos, respectivamente. Foi observado aumento de uso de AOFAS e diminuição EVA nos últimos 6 anos (p = 0,046). CONCLUSÃO: As ferramentas Escala AOFAS e EVA para dor demonstraram ser as mais usadas na literatura para avaliação de resultados do tratamento da lesão osteocondral de tálus, tanto isoladamente, quanto combinadas. Nível de Evidência III, Revisão Sistemática de Estudos de Nível II.

Avaliação da reprodutibilidade da classificação de Sanders para fraturas do calcâneo / Assessment of reproducibility of sanders classification for calcaneal fractures

Objetivo: Avaliar a reprodutibilidade intra e inter observadores da Classificação Tomográfica de Sanders das fraturas do calcâneo entre observadores mais e menos experientes em cirurgia do pé e tornozelo.Métodos: Foram avaliadas imagens tomográficas de 46 pacientes com diagnóstico de fratura do calcâneo. Quatro observadores, dois com dez anos de experiência em cirurgia do pé e tornozelo e dois residentes do terceiro ano em Ortopedia e Traumatologia classificaram as fraturas independentemente. Após três semanas, os mesmos observadores classificaram as fraturas apresentadas em ordem alterada aleatoriamente.A concordância intra e inter observadores foi analisada através do índice Kappa. Resultados: Houve boa concordância intra observador para os dois observadores mais experientes e um observador menos experiente (valores de Kappa 0,640; 0,632 e 0,629, respectivamente). Quando analisada a concordância inter observador, houve concordância fraca entre os mais experientes (Kappa = 0,289) e moderada entreos menos experientes (Kappa = 0,527). Conclusões: A Classificação Tomográfica de Sanders apresentou boa concordância intra observador,porém reprodutibilidade inter observadores abaixo da ideal, tanto entre observadores mais experientes quanto aqueles menos experientes.Nível de Evidência III, Estudos Diagnósticos.

Objective: To assess intra- and interobserver reproducibilityof Sanders Classification System of calcaneal fracturesamong experienced and less experienced observers. Methods:Forty-six CT scans of intra-articular calcaneal fractureswere reviewed. Four observers, two with ten years ofexperience in foot and ankle surgery and two third-year residentsin Orthopedics and Traumatology classified the fractureson two separate occasions three weeks apart from eachother. The intra and inter-observer reliability was analyzedusing the Kappa index. Results: There was good intraobserverreliability for the two experienced observers and oneless experienced observer (Kappa values 0.640, 0.632 and0.629, respectively). The interobserver reliability was fairbetween the experienced observers (Kappa = 0.289) andmoderate among the less experienced observers (Kappa= 0.527). Conclusions: The Sanders Classification Systemshowed good intraobserver reliability, but interobserver reproducibilitybelow the ideal level, both among experiencedand less experienced observers. Level of Evidence III,Diagnostic Studies.

ASSESSMENT OF REPRODUCIBILITY OF SANDERS CLASSIFICATION FOR CALCANEAL FRACTURES.

OBJECTIVE: : To assess intra- and interobserver reproducibility of Sanders Classification System of calcaneal fractures among experienced and less experienced observers. METHODS: : Forty-six CT scans of intra-articular calcaneal fractures were reviewed. Four observers, two with ten years of experience in foot and ankle surgery and two third-year residents in Orthopedics and Traumatology classified the fractures on two separate occasions three weeks apart from each other. The intra and inter-observer reliability was analyzed using the Kappa index. RESULTS: : There was good intraobserver reliability for the two experienced observers and one less experienced observer (Kappa values 0.640, 0.632 and 0.629, respectively). The interobserver reliability was fair between the experienced observers (Kappa = 0.289) and moderate among the less experienced observers (Kappa = 0.527). CONCLUSIONS: : The Sanders Classification System showed good intraobserver reliability, but interobserver reproducibility below the ideal level, both among experienced and less experienced observers. Level of Evidence III, Diagnostic Studies.

Endoscopic treatment of the posterior ankle impingement syndrome on amateur and professional athletes.

PURPOSE: To determine whether professional and amateur athletes showed differences in ankle function when treated with endoscopic technique for posterior ankle impingement syndrome, to verify the impact of the presence of associated lesions in clinical evolution and to assess time to return to sport (we hypothesize that time will be the only difference between groups). METHODS: Thirty-two athletes with a diagnosis of posterior impingement syndrome underwent surgery endoscopically. The American Orthopaedics Foot and Ankle Society (AOFAS) scale was used to compare functional results between amateur (15) and professional athletes (17). The satisfaction, time to return to sport, operative time, intraoperative findings and complications were evaluated, and the presence of associated injuries interfering in these results was verified. RESULTS: The preoperative AOFAS score range for the professional group was 62.9 ± 14 preoperatively and 92.3 ± 7.7 postoperatively, and for the amateur group was 67.9 ± 19.7 and 94 ± 9.3. The satisfaction was excellent or good in 94 % of all cases and fair in 6%. The average time of surgery was 48.3 + 25 min. Bone involvement was present in 100% of cases and complications in three cases. Time to return to sports was similar (n.s.) in both groups, and the mean time was 15.6 ± 13.7 and 16.3 ± 9 weeks, respectively. CONCLUSION: No significant difference regarding functional results and time to return to sports between professionals and amateur athletes operated was found. Athletes showed mainly good and excellent results and low complication rate. The presence of associated injuries did not significantly influence the results. With these results, the high-level athlete can better programme their surgeries so they can fully recover and perform better in the most important competitions. LEVEL OF EVIDENCE: Level III.

Comparacao da resistência à tracao da âncora metálica rosqueada inserida no osso cortical e no osso esponjoso / Comparison of the tensile strength of threaded metal anchors inserted on cortical and spongy bones

A rotura do manguito rotador é uma afeccao freqüente com repercussao na vida diária do paciente causando incapacidade funcional e dor. Um número considerável de pacientes necessita de reparacao tendínea. A tendência atual na cirurgia do ombro é a utilizacao de técnicas minimamente invasivas com menor morbidade operatória e reabilitacao mais precoce. A partir dos anos 90 houve um grande desenvolvimento da artroscopia do ombro e na utilizacao de âncoras para fixacao das suturas tendíneas. Essa evolucao técnica tem permitido resultados da cirurgia artroscópica comparáveis aos da cirurgia aberta. Um dos possíveis problemas do uso de âncoras nas cirurgias artroscópicas do ombro é sua soltura da superfície óssea. O presente estudo tem o objetivo de comparar a resistência à tracao das âncoras metálicas rosqueadas inseridas no osso cortical e no osso esponjoso.