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Background: Posterolateral knee injuries can occur in 16% of patients with acute ligament injuries, and up to 70% have a combined anterior cruciate ligament (ACL) tear. Studies have shown that, in different populations, the distance between the insertion of the popliteus tendon and the lateral collateral ligament (LCL) may be smaller than the 18.5 mm previously reported in the literature. When we have an associated injury of the ACL and the posterolateral corner (PLC), the confluence of tunnels in the lateral femoral condyle can be a potential problem during reconstruction surgery. Indications: The indication of this technique is the combined injury of the ACL and the PLC. Technique Description: The reconstruction is performed with 2 semitendinosus tendons and 1 gracilis tendon. The technique consists of making a tunnel in the lateral wall of the femur, from the outside-in, at the isometric point between the origin of the LCL and insertion of the popliteus tendon, and emerging in the inner wall of the lateral femoral condyle at the anatomic point of the ACL. The graft is passed from the tibia to the femur with the doubled gracilis tendon and the 2 simple semitendinosus tendons for the ACL graft. The remaining portions of the semitendinosus tendons are left for reconstruction of the PLC structures, with one of them going straight to the posterolateral tibial tunnel (reconstructing the popliteus tendon), and the other passing through the fibular head tunnel (reconstructing the LCL) and continuing from the fibular head to the posterolateral tibial tunnel (reconstructing the popliteofibular ligament). Results: Patients undergoing this technique achieved good functional outcomes and a failure rate similar to that reported in the literature for combined ACL and PLC reconstruction. Discussion/Conclusion: This technique is an excellent option for patients with the combined injury of the ACL and the PLC, avoiding the confluence of tunnels in the lateral femoral condyle. It presents good results and acceptable complication rates, compatible with the severity of this lesion. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. Graphical Abstract This is a visual representation of the abstract. [ABSTRACT FROM AUTHOR]

Background: This is a case report of a 41-year-old man with torsional knee trauma in 2019 and chondral lesions. Previous microfracture had failed, and the patient presented with a dull pain and knee effusion. Imaging revealed multiple focal lesions including trochlea, patella, medial condyle, and lateral condyle. Fresh osteochondral allograft (OCA) transplantation is a versatile treatment for large defects as it is based on mature, living hyaline cartilage attached to a bone interface. A patient with multiple chondral lesions is rare, and this report presents a case with multiple symptomatic large focal lesions in the knee that underwent a fresh OCA in all 3 knee compartments. Indications: Osteochondral allograft is indicated for patients who present with activity-related pain and recurrent knee effusion. Contraindications are patient clinical conditions that may lead to complications, such as tobacco use, inflammatory arthritis, or septic arthritis. Technique Description: After the chondral defect is exposed, an appropriate allograft Mega-OATS sizer (15-30 mm) is chosen. Cartilage and the subchondral bone are drilled until the desired depth. The donor allograft is drilled in the desired diameter, and excess bone is removed according to the previous measurements of the recipient site. The graft is advanced with firm pressure into the created socket. Postoperative rehabilitation includes a limited range of motion and proprioceptive weightbearing in the first 2 weeks but expected total weightbearing and a full range of motion by the sixth week. Results: Range of motion was full by 6 weeks of surgery. The effusion lasted for 2 months after the surgery. Fresh OCA is a good surgical option for patients with multiple large chondral defects. Discussion/Conclusion: Patient satisfaction is high since the mature cartilage leads to a fast rehabilitation compared with the other surgical procedures for large chondral defects. This technique appears to be effective also for multiple focal lesions as presented in this article. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form. Graphical Abstract This is a visual representation of the abstract. [ABSTRACT FROM AUTHOR]

Graphical Abstract This is a visual representation of the abstract. [ABSTRACT FROM AUTHOR]

Objective  To evaluate the incidence of symptomatic cyclops lesions requiring surgical treatment after anterior cruciate ligament (ACL) reconstruction and to establish possible intraoperative risk factors related to it. Methods  Three hundred and eighty-nine patients aged between 18 and 50 years who underwent primary ACL reconstruction were retrospectively evaluated. Patients were divided into groups according to the presence or absence of symptomatic cyclops lesions, and their characteristics were compared. Patients with associated lesions that required additional surgical procedures (except anterolateral extra-articular procedures) were not included. The rate of symptomatic cyclops lesions was recorded and the following parameters were evaluated: age, gender, time from injury to surgery, graft type and diameter, femoral tunnel perforation technique, fixation type, presence of knee hyperextension, preservation of the ACL remnant, associated anterolateral extra-articular procedure, associated meniscal injury and participation in sports. Results  389 patients were evaluated and 26 (6.7%) patients developed cyclops. The patients with and without cyclops lesions did not differ in age, time from injury to surgery, graft type or diameter, surgical technique, femoral fixation method, presence of knee hyperextension, remnant preservation and associated meniscal injury. The group with cyclops lesion had a higher proportion of females (10 (38.4%) vs 68 (18.7%); OR = 2.7; p  = 0.015), higher proportion of extra-articular reconstruction (18 (11.8%) vs 8 (3.4%); OR = 3.8; p  = 0.001) and higher proportion of sports practice (23 (8.6%) vs 3 (2.5%); OR = 3.6; p  = 0.026). Conclusion  In our series, 6.7% of the patients required arthroscopic removal of cyclops lesions. Female gender, associated extra-articular reconstruction and sports practice were factors related to this lesion. Remnant preservation had no relationship with cyclops lesion formation., Competing Interests: Conflito de Interesses Os autores não têm conflitos de interesses a declarar., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Objective  To evaluate major complications after a minimum of 5 years of follow-up after acute or recurrent patellar dislocation treated with medial patellofemoral ligament (MPFL) reconstruction with the medial third of the patellar tendon, with or without associated medialization of the tibial anterior tuberosity (TAT). Methods  A total of 50 patients were included, with a minimum follow-up of 5 years. The patients were evaluated regarding complications such as joint stiffness, recurrence of patellar dislocation, subjective instability reported by patients, and inability to return to the previous level of physical activity. Results  The mean follow-up was of 8.9 ± 2.6 years, with a minimum of 6 and maximum of 15 years; 64% of the patients were women, with a mean age of 27 ± 11.2 years old; 24% were submitted to TAT osteotomy for simultaneous medialization; and 46% were acute cases. Only 9 poor results (18%) were found, all resulting from recurrence of dislocation (12%) and complaint of subjective instability (6%) at between 36 and 60 months of follow-up. No other complications occurred. Among the poor results, five occurred in cases of acute dislocation, and four in recurrent cases, and only one had undergone TAT osteotomy. Conclusion  Reconstruction of the MPFL with the medial third of the patellar tendon, associated or not with TAT medialization osteotomy, is an alternative in the treatment of acute or chronic patellar instability, with a failure rate of only 18% in at least 5 years of follow-up. In addition, it is safe treatment, that does not present other complications., Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)