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resumo Objetivo: A necessidade de opções terapêuticas para lesões musculares, cada vez mais fre quentes entre os esportistas, fundamentou este estudo experimental, cujo objetivo foi avaliar os efeitos histológicos do plasma rico em plaquetas (PRP) no reparo do tecido mus cular de ratos. Métodos: O PRP foi obtido por dupla centrifugação do sangue de cinco animais. Em 30 ratos, foi produzido um trauma no terço médio do ventre do músculo gastrocnêmio de cada mem bro traseiro. Essas lesões não receberam tratamento em seis ratos (12 patas). Em 24 ratos, injeções intralesionais de soro fisiológico a 0,9% e de PRP foram aplicadas nas patas esquer das e direitas, respectivamente. Amostras do tecido tratado e não tratado foram avaliadas histologicamente sete e 21 dias após os procedimentos. Resultados: A quantidade de colágeno nas lesões tratadas com PRP foi significativamente menor do que a das demais lesões na avaliação feita sete dias após o procedimento, mas se equiparou à dos demais grupos na avaliação feita no 21° dia. Houve aumento significativo (p < 0,001) na quantidade de colágeno do sétimo para o 21° dia nas lesões tratadas com PRP, o que não ocorreu nas lesões tratadas de outra forma. O processo inflamatório se mostrou mais intenso nas lesões tratadas com PRP em comparação com as lesões dos outros grupos de tratamento na avaliação feita sete dias após o procedimento; todavia, os aspectos mor fológicos dessas lesões se mostraram similares ao das lesões não tratadas 21 dias após o procedimento. Conclusão: OPRP promoveu completa restituição tecidual entre o sétimo e o 21° dia em lesões musculares experimentais. ABSTRACT OBJECTIVE: The need for therapeutic options for muscle injuries, which are increasingly frequent among sports practitioners, was the motivation for this experimental study, which had the aim of evaluating the histological effects of platelet-rich plasma (PRP) on repairs to muscle tissues of rats. METHODS: PRP was obtained by means of double centrifugation of blood from five animals. In 30 rats, an injury was produced in the middle third of the belly of the gastrocnemius muscle of each hind limb. These injuries did not receive any treatment in six rats (12 legs). In 24 rats, 0.9% physiological serum was injected into the injury in the left leg and PRP into the injury in the right leg. Samples from the treated and untreated tissue were evaluated histologically 7 and 21 days after the procedures. RESULTS: The quantity of collagen in the injuries treated with PRP was significantly lower than that in the other injuries, in the evaluation made 7 days after the procedure, but it became equal to the other groups in the evaluation done on the 21st day. There was a significant increase (p < 0.001) in the quantity of collagen from the 7th to the 21st day in the injuries treated with PRP, but this was not seen in the injuries treated using other methods. The inflammatory process was shown to be more intense in the injuries treated with PRP than in the injuries of the other treatment groups, in the evaluation done 7 days after the procedure. However, the morphological aspects of these injuries were seen to be similar to those of the untreated injuries, 21 days after the procedure. CONCLUSION: PRP promoted complete tissue restitution between the 7th and 21st days in experimental muscle injuries.

OBJETIVO: Avaliar o resultado clínico da técnica de transplante osteocondral autólogo (TOA) para tratamento das lesões osteocondrais do joelho de atletas. MÉTODOS: Em um seguimento médio de 52 meses (30 a 82 meses), 19 pacientes foram avaliados pré e pós-operatoriamente pelos protocolos do IKDC subjetivo, Cincinnati modificado e nível de retorno aos esportes. O prognóstico conforme idade, tempo de sintomatologia, presença de lesões associadas e local da lesão também foi avaliado. RESULTADOS: O valor de IKDC foi de 64,6 + 6,8 no pré-operatório e de 81,8 + 20,1 no pós-operatório. O Cincinnati modificado foi de 5,3 + 0,8 no pré-operatório e de 7,5 + 1,7 no pós-operatório. 53% dos pacientes retornaram aos esportes no nível anterior à lesão, 29% em nível inferior e 17% abandonaram a prática esportiva regular. Os melhores resultados clínicos foram observados em pacientes menores de 35 anos, com menos de um ano de sintomas, com lesões nos côndilos femorais e sem lesões menisco ligamentares associadas. Resultados piores foram observados nas lesões da tróclea quando comparados aos dos côndilos femorais. CONCLUSÃO: Joelhos submetidos ao TOA têm uma melhora subjetiva significativa após a cirurgia. O retorno ao esporte ocorre em um grupo específico de pacientes. OBJECTIVE: To evaluate clinical outcomes of the osteochondral autologous transplantation technique for treatment of osteochondral defects of the knee in athletes. METHODS: For an average follow-up period of 52 months (30 to 82 months), 19 patients were evaluated pre and post-operatively by using subjective IKDC scores, modified Cincinnati Scores, and rate of return to sports activities. Prognosis according to age, duration of symptoms and location of the lesion was also evaluated. RESULTS: Subjective IKDC scores were 64.6 + 6.8 pre-operatively and 81.8 + 20.1 post-operatively. Modified Cincinnati score was 5.3 + 0.8 pre-operatively and 7.5 + 1.7 post-operatively. Fifty-three percent of the patients returned to pre-operative level of sports activity, 29% returned to a lower level, and 17% did not return to sports. Better results were observed in patients younger than 35 years, with less than one year of symptoms, in patients with femoral condyle defects and without concomitant meniscus or ACL tear. Throclear lesions had inferior results to condylar defects. CONCLUSION: Osteochondral autologous transplantation promoted a subjective improvement of the knee in athletes. Return to sports activity occurred in a specific group of patients

Purpose The purpose of this study was to evaluate the clinical outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes. Methods Transphyseal ACL reconstruction was performed in 26 patients with open tibial and femoral physes (physis >2 mm) by use of autogenous quadrupled hamstrings as grafts. Meniscal tearing was found in 65.3% of the patients. Partial chondral defect injury on the medial femoral condyle was found 6 months after injury in only 2 patients (7.69% of all patients). The mean follow-up period was 45 ± 18.3 months. Clinical outcomes were evaluated by use of the International Knee Documentation Committee score and Lysholm Knee Scoring Scale, and the anteroposterior stability was objectively measured by use of KT-1000 arthrometer (MEDmetric, San Diego, CA). Possible length and angular discrepancies were observed by conventional radiography in a long film and scanograms of the lower limbs. Results The mean length discrepancy between the operated lower limb and the contralateral limb was 1.2 ± 3.2 mm (range, −7 to 7 mm). The mean angular deviation difference between the lower limbs was 0.46° ± 1.1°. New traumatic injuries developed in 3 patients, in whom surgical revision was performed; 1 patient underwent a late meniscectomy. The mean difference in KT-1000 measurement was 2.0 ± 1.0 mm. The mean subjective International Knee Documentation Committee score was 91.5 ± 5.7, and the mean score on the modified Lysholm scale was 93.5 ± 4. Of the patients, 3 (11.2% of all patients) could not return to the same level of physical activity as before injury. Conclusions ACL reconstruction by use of the transphyseal technique in an immature skeleton with a hamstring autograft, with careful attention being paid to the technique, resulted in good clinical outcomes and no growth abnormalities. Level of Evidence Level IV, therapeutic case series.