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Background There are several studies comparing techniques and different materials, yet the results are not unanimous. We compared three methods of skin closure in total knee arthroplasty (TKA), including suture with single stitches and unabsorbable MonoNylon®, as well as continuous subcuticular suture with Monocryl® or barbed Stratafix® absorbable suture. Methods A prospective, randomized study was conducted with 63 patients undergoing TKA between March 2016 and December 2016. Patients were divided into three groups: traditional suture MonoNylon® (n 22), subcuticular continuous suture with Monocryl® (n 20), and another barbed with Stratafix® (n 21). The closure time, length of wire used, pain intensity, possible complications, and cosmeses were evaluated. Results Subcuticular continuous suture using Monocryl® was superior to traditional suture using MonoNylon® as less thread was used (p 0.01) and a better cosmetic effect was achieved (p Stratafix® aspects analyzed (p > 0.05). Complications were observed mostly in patients who used Stratafix®. Conclusions This study concluded that the subcuticular suture with absorbable monofilament Monocryl® proved to be advantageous compared to the others because it presented results equal to the barbed Stratafix®, however with fewer complications. Furthermore, Monocryl® was shown to be equal or superior to traditional MonoNylon® suture regarding in relation pain intensity, aesthetic result, and effective cost. Trial registration WHO ICTRP identifier RBR78dh5d. Retrospectively registered: 07/29/2020.

INTRODUÇÃO: A retirada da gordura retropatelar durante a artroplastia total do joelho é procedimento feito pela grande maioria dos cirurgiões a fim de facilitar a exposição da articulação, levando a maior precisão no posicionamento do componente tibial. Contudo, nas últimas décadas, autores concluíram que a manutenção da gordura retropatelar leva a melhores resultados clínicos, funcionais e menos complicações de ferida operatória. OBJETIVOS: Este estudo tem como objetivo avaliar se a manutenção da gordura retropatelar influencia no alinhamento rotacional do componente tibial, assim como no tempo cirúrgico, além de verificar o estado da inserção da gordura retropatelar na tíbia. MÉTODOS: Trata-se de estudo transversal, de intervenção, randomizado e duplo cego, com a participação de 50 pacientes divididos em dois grupos equivalentes, um com a manutenção da gordura retropatelar e outro com sua retirada completa. Foram avaliados o alinhamento rotacional de acordo com o método de Berger, o tempo cirúrgico e o grau de acometimento da inserção da gordura retropatelar na tíbia. RESULTADOS: Foi observado desinserção da gordura retropatelar na tíbia proximal parcialmente em 84% e completa em 16% na qual ela foi preservada, com maior rotação interna do componente tibial nos pacientes com desinserção parcial da gordura retropatelar na tíbia proximal em comparação aos pacientes com desinserção completa (p 0,02). Em joelhos com artrose mais avançada, o tempo cirúrgico foi maior com a manutenção da gordura retropatelar em comparação com sua retirada completa (p 0,002). Também foi identificado maior tempo cirúrgico nos joelhos com artrose mais avançada em comparação com artrose mais leve dentre os pacientes com a manutenção da gordura retropatelar (p 0,013). CONCLUSÃO: Concluiu-se que a manutenção da gordura retropatelar não interferiu no alinhamento rotacional do componente tibial, houve maior tempo cirúrgico nos pacientes com a manutenção da gordura retropatelar associado a artrose avançada e a gordura retropatelar foi desinserida, pelo menos parcialmente em todos os casos. INTRODUCTION: The removal of retropatellar fat pad during total knee arthroplasty is a procedure performed by most of the surgeons in order to facilitate joint exposure, leading to greater precision in the positioning of the tibial component. However, in recent decades, authors have concluded that maintenance of retropatellar fat pad leads to better clinical and functional outcomes and fewer surgical wound complications. OBJECTIVES: This study aims to evaluate whether the maintenance of retropatellar fat pad influences the rotational alignment of the tibial component, the surgical time and to verify the state of insertion of retropatellar fat pad in the tibia after the procedure. METHODS: This is a cross-sectional, randomized, double-blind intervention study involving 50 patients divided into two equivalent groups, one with the maintenance of retropatellar fat pad and the other with its complete removal. Rotational alignment according to the Berger method, surgical time and degree of involvement of the retropatellar fat pad insertion in the tibia were evaluated. RESULTS: Retropatellar fat pad had been partially injured in 84% and completely in 16% of the knees, and the greatest internal rotation positioning of the tibial component occurred in patients with partial injury of the fat pad compared to its complete disinsertion (p 0.02). In knees with more advanced arthrosis, surgical time was longer in patients in whom the retropatellar fat pad was preserved compared to its complete removal (p 0.002). Longer surgical time was also identified in knees with more advanced arthrosis compared with milder arthrosis among patients with maintenance of retropatellar fat pad (p 0.013). CONCLUSION: It was concluded that the maintenance of retropatellar fat pad did not interfere with the rotational alignment of the tibial component, there was a longer surgical time in patients with maintenance of retropatellar fat pad associated with advanced arthrosis and retropatellar fat pad was disinserted, at least partially in all cases.

This case report presents a 15-year-old football player who was diagnosed with a pubis stress fracture and underwent conservative treatment with satisfactory results. After a review of the literature, the clinical picture, diagnosis and treatment are described. The importance of this paper comes from the rarity of finding reports about this kind of injury in the literature.

Objective: Eighty-three soccer players aged between 14 and 19 years, in the basic category of a professional soccer club in the city of Belo Horizonte, were followed up during the 2009 season. Methods: A prospective observational cohort study was conducted, in which these soccer players were divided randomly into two groups. The first consisted of individuals with joint hypermobility syndrome (JHS), totaling 22 players, and the second was a control group with 61 players without this syndrome, determined through a physical examinati. Results: Both groups were studied with regard to incidence of ankle sprains. At the end of this period, the data were compiled and statistical analysis was performed. A total of 43 cases of ankle injury due to sprains were recorded, of which nine episodes were in players with JHS, thus making p = 0.106. The significance level was 5%. Conclusion: We were able to conclude that in our study there was insufficient evidence to assert that there is an association with increased incidence of ankle sprains among patients with JHS.

INTRODUÇÃO: A artroplastia total do joelho (ATJ) é um procedimento que resulta em índices de satisfação excelentes, por restaurar, mesmo que parcialmente, a função articular de maneira pouco dolorosa. Contudo, os resultados insatisfatórios impactam negativamente na vida dos pacientes, sendo que grande causa de insucesso está relacionada a queixas da articulação femoropatelar. Apesar disso, poucos são os estudos com boa evidência que avaliam a influência da gordura retropatelar sobre os resultados desse procedimento cirúrgico. OBJETIVOS: comparar o resultado clínico-funcional, o tempo cirúrgico e o posicionamento do componente tibial na ATJ com a manutenção ou a ressecção da gordura retropatelar. MÉTODOS: o presente estudo prospectivo, randomizado, duplo-cego contou com a participação de 40 pacientes, sendo que 22 foram submetidos à manutenção da gordura retropatelar (MG) e 18 à sua ressecção (RG). Foram feitas avaliações do grau máximo de flexão, medição da dor pela escala visual analógica da dor (EVA), mensuração do Knee Society Score (KSS) do joelho e função, altura da patela pelo índice de Insall-Salvatti no pré-operatório e no primeiro, sexto e décimo segundo mês pós-operatório, sendo também analisados duração da cirurgia e posicionamento radiográfico do componente tibial. RESULTADOS: os valores médios para o tempo cirúrgico foi de 98,32 minutos no grupo MG e 96,78 minutos no grupo RG (p=0,892). As médias foram de 103,2° vs. 100° (p= 0,466) para grau máximo de flexão; para a altura da patela foi de 1,10 vs. 1,07 (p= 0,20), KSS do joelho com 83,41 vs. 83,06 (p=0,46), KSS funcional com 73,95 vs. 78,06 (p=0,39), intensidade da dor pela EVA com 2,41 vs. 1,56 (p=0,19) e posicionamento do componente tibial no AP com 91,18° vs. 91,17° e no perfil 94,86° vs. 94,56°. Em nenhuma das variáveis foi evidenciada diferença estatística entre os grupos. CONCLUSÃO: não houve diferença entre os aspectos avaliados na comparação entre os pacientes submetidos à manutenção ou à ressecção da gordura retropatelar durante a artroplastia total do joelho. INTRODUCTION: Total knee arthroplasty (TKA) is a procedure that results in excellent satisfaction ratings to restore, even partially, painless joint function. However, the unsatisfactory results negatively impact the lives of patients, and major cause of failure is related to complaints of the patellofemoral joint. Nevertheless, there are few studies with good evidence that evaluate the influence of fat pad on the results of this surgical procedure. OBJECTIVES: compare the clinical and functional outcome, surgical time and the placement of the tibial component in TKA with maintaining or resection of retropatellar fat pad. METHODS: The present prospective, randomized, double blind, with the participation of 40 patients, 22 underwent maintenance of retropatellar fat pad (MG) and 18 to resection (RG). Evaluations were made of the maximum degree of flexion, measuring the pain by visual analog pain scale (VAS), measurement of the Knee Society Score (KSS) and function of the knee, patellar height by Insall-Salvatti index preoperatively, first, sixth and twelfth postoperative month and also analyzed the duration of surgery and radiographic positioning of the tibial component. RESULTS: The mean values for the surgical time was 98.32 min. MG group and 96.78 min. the RG group (p = 0.892). The averages were 103.2 ° vs. 100 ° (p = 0.466) to the maximum degree of flexion, the patella to the height was 1.10 vs. 1.07 (p = 0.20), with knee KSS vs. 83.41 83.06 (p = 0.46), with functional KSS vs. 73.95 78.06 (p = 0.39), pain intensity by VAS with 2.41 vs. 1.56 (p = 0.19) and positioning the tibial component with the AP vs. 91.18 ° 91.17 ° and 94.86 ° vs. profile 94.56 °. None of the variables was observed statistical difference between the groups. CONCLUSION: there is no difference between the aspects evaluated when comparing patients undergoing maintenance or resection fat pad during total knee arthroplasty.