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To assess the impacts of measures to face COVID-19 on total knee arthroplasty procedures in the country, based on data provided by the SUS Information and Informatics Department (DATASUS).Cross-sectional study of secondary data in the public domain, available on the website of the Department of Information and Informatics of SUS (DATASUS), containing information about hospital admissions in the SUS.Brazil suffered a 51.82% decrease, on average, in the performance of total knee arthroplasty by the Unified Health System (SUS) in 2020, due to measures to face COVID-19. The analysis by region offers more details on this reduction in the number of procedures. In the Northeast, the decrease was on average 48.02%, whereas in the Center-West it was 65.61%. Southeast, North, and South registered an average decrease of 49.38%, 51.81%, and 55.06%, respectively.COVID-19 impacted the realization of TKA in Brazil, with greater and lesser levels of decline observed in different Brazilian regions. In the Southeast region, for example, the states of São Paulo and Minas Gerais were the most affected, mainly due to the large population concentration, as well as Paraná, which has high numbers of procedures and a sharp decrease in 2020.Avaliar os impactos das medidas de combate à COVID-19 nos procedimentos de artroplastia total do joelho (ATJ) no país, com base nos dados fornecidos pelo Departamento de Informações e Informática do Sistema Único de Saúde (SUS).Estudo transversal realizado com dados secundários de domínio público, disponíveis no site do Departamento de Informações e Informática do SUS (DATASUS), contendo informações sobre as internações hospitalares realizadas no SUS.O Brasil sofreu uma queda de 51,82%, em média, na realização da artroplastia total do joelho pelo SUS em 2020, decorrente das medidas de combate à COVID-19. A análise por região oferece mais detalhes dessa redução no número de procedimentos. Na região Nordeste, a queda foi, em média, de 48,02%, enquanto no Centro-Oeste foi de 65,61%. Sudeste, Norte e Sul registraram queda, em média, de 49,38%, 51,81% e 55,06%, respectivamente.A COVID-19 impactou a realização de ATJ no Brasil, com níveis de maior e menor declínio observados nas diferentes regiões brasileiras. Na região Sudeste, por exemplo, os estados de São Paulo e Minas Gerais foram os mais afetados, devido principalmente à grande concentração populacional, assim como o Paraná, que apresenta números altos de procedimentos realizados e forte queda em 2020.

Objetivo: Verificar alterações na análise dos padrões computadorizados da marcha em pacientes com instabilidade anterior do joelho, comparando com pacientes sem instabilidade articular. Material e métodos: Vinte e sete pacientes diagnosticados com lesão do Ligamento Cruzado Anterior (LCA) do joelho (Grupo Instabilidade) e 20 indivíduos assintomáticos (Grupo Controle) foram submetidos à avaliação cinemática tridimensional da marcha. Foram comparadas a angulação média do quadril e joelho em quatro subfases, bem como as médias das angulações do quadril, joelho e tornozelo em toda a fase de apoio e balanço. Resultados: Observadas maiores médias de abdução do quadril, flexão e varo do joelho na subfase de contato inicial, maiores médias de flexão e varo do joelho no apoio médio, maiores médias de flexão do quadril e varo do joelho no balanço médio no Grupo Instabilidade. Em média, em toda a fase de apoio, maior flexão do quadril, maior varo e menor rotação interna do joelho, e maiores dorsiflexão e eversão do tornozelo no Grupo Instabilidade. Por sua vez, em toda a fase de balanço, maiores médias de flexão do quadril, maiores flexão, varo e rotação externa do joelho, e menores de flexão plantar e varo do tornozelo, no Grupo Instabilidade.Conclusão: Foram encontradas, no Grupo Instabilidade, alterações nos padrões computadorizados da marcha nos três planos espaciais, com a presença de um padrão de anulação do quadríceps, aumento do momento adutor e da rotação externa do joelho, que podem contribuir para a degeneração articular a médio e longo prazo.

INTRODUCTION: We evaluated the association between genetic polymorphisms in exon 1 (A/O alleles) and promoter regions at positions -550 (H/L variant, rs11003125) and -221 (X/Y variant, rs7096206) MBL2 and periportal fibrosis regression. METHODS: This was a retrospective cohort study involving 114 Brazilians infected with Schistosoma mansoni, who were subjected to follow-up for three years after specific treatment for schistosomiasis to estimate the probability of periportal fibrosis regression. RESULTS: A risk association was observed between polymorphism at the exon 1 MBL2 and periportal fibrosis regression. CONCLUSIONS: This study suggests that the polymorphism of exon 1 MBL2 may potentially be used to predict periportal fibrosis regression in this population.

Parsonage-Turner Syndrome is a rare disease that affects the musculature of the scapular girdle, leading to muscle atrophy and large motor deficit. The etiology is uncertain, but it is believed that infectious and autoimmune factors are involved. The diagnosis is made by exclusion, and the main differential diagnoses are cervical disc hernias, rotator cuff injuries and rheumatic diseases. During diagnostic investigations, we perform laboratory tests, radiographs and MRI on the shoulders and cervical spine, with emphasis on electroneuromyography to help in making a definitive diagnosis. This case report is presented because it shows a disease that is rarely associated with HIV seropositivity and the importance of early diagnosis for better treatment of these patients.

A piomiosite é uma infecção muscular profunda subaguda que pode originar abscessos intramusculares únicos ou múltiplos. Está associada a infecções sistêmicas, diabetes mellitus, terapia imunossupressora, AIDS e mieloma múltiplo. Descrevemos um caso de piomiosite tropical com acometimento da coluna vertebral que evoluiu para abscesso epidural, em paciente com história pregressa de espondilite anquilosante em tratamento com medicações imunossupressoras e apresentou trauma direto na coxa direita previamente ao início dos sintomas. O objetivo deste trabalho é descrever o acometimento raro da coluna vertebral em pacientes com piomiosite tropical, com apenas um caso descrito na literatura mundial, destacando a necessidade dos métodos complementares na investigação diagnóstica para o adequado tratamento e as possíveis complicações dessa doença. Os pacientes imunossuprimidos com dores musculares subagudas devem ser investigados quanto à piomiosite tropical e o diagnóstico precoce é fundamental para o sucesso do tratamento. The pyomyositis is a subacute deep muscle infection that can cause single or multiple intramuscular abscesses and is associated with systemic infections, diabetes mellitus, immunosuppressive therapy, AIDS and multiple myeloma. We describe a case of tropical pyomyositis with spinal involvement evolving to epidural abscess. The patient had a history of ankylosing spondylitis treated with immunosuppressive medications and presented direct injury in the right thigh prior to onset of symptoms. This article describes the unusual involvement of the spine in patients with tropical pyomyositis, with only one case reported in the world literature, highlighting the need for complementary methods of diagnostic investigation, for proper treatment and the possible complications of this disease. In conclusion, immunosuppressed patients with muscle pain should be investigated as to the tropical pyomyositis and the early diagnosis is crucial to the success of treatment. La piomiositis es una infección muscular profunda y subaguda que puede originar abscesos intramusculares únicos o múltiples. Se vincula a infecciones sistémicas, diabetes mellitus, terapia inmunosupresora, SIDA [AIDS] y mieloma múltiple. Describimos un caso de piomiositis tropical, con acometimiento de la columna vertebral, que evolucionó para absceso epidural, en paciente con historial anterior de espondilitis anquilosante en tratamiento con medicaciones inmunosupresoras y que presentó traumatismo derecho, en el muslo derecho, previamente al inicio de los síntomas. El objetivo de este trabajo es describir el acometimiento raro de la columna vertebral en pacientes con piomiositis tropical, con solamente un caso descrito en la literatura mundial, destacando la necesidad de los métodos complementarios, en la investigación de diagnóstico, para el apropiado tratamiento y las posibles complicaciones de esa enfermedad. Los pacientes inmunosuprimidos, con dolores musculares subagudos, deben ser investigados cuanto a la piomiositis tropical y el diagnóstico precoz es fundamental para el éxito del tratamiento.

Objective: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. Methods: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. Results: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. Conclusion: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentizacao graft.

The knee extensor mechanism is a complex structure formed by the quadriceps muscle and tendon, the patella, the patellar tendon and the ligaments that surround and help stabilize the knee. Through using a three-dimensional viewing technique on images of the knee extensor apparatus, we aimed to didactically show the structures that compose this bone-muscle-ligament complex. Anatomical dissection of the knee with emphasis on the structures of its extensor mechanism was performed, followed by taking photographs using a camera and lenses suitable for simulating human vision, through a technique for constructing three-dimensional images. Then, with the aid of appropriate software, pairs of images of the same structure from different angles simulating human vision were overlain with the addition of polarizing layer, thereby completing the construction of an anaglyphic image. The main structures of the knee extensor mechanism could be observed with a three-dimensional effect. Among the main benefits relating to this technique, we can highlight that in addition to teaching and studying musculoskeletal anatomy, it has potential use in training for surgical procedures and production of images for diagnostic tests.

The Parsonage-Turner Syndrome is a rare disease that affects the muscles of the scapular girdle, leading to muscular atrophy and a large motor deficit. The etiology is unknown, but it is believed that infectious and autoimmune factors are involved. The diagnosis is made by exclusion, and the main differential diagnoses are cervical disc hernias, rotator cuff injuries and rheumatic diseases. During diagnostic research, we conducted laboratory tests, radiographs and MRI of the shoulder and cervical spine, with particular reference to electroneuromyography to help generate a definitive diagnosis. This case report is presented because it shows a disease that is rarely associated with HIV seropositivity and the importance of early diagnosis for better treatment of these patients.

O mecanismo extensor do joelho é uma estrutura complexa formada pelo músculo e tendão quadricipital, a patela, o tendão patelar e os ligamentos que os circundam e auxiliam na estabilização do joelho. Através do uso de técnica de visualização tridimensional de imagens do aparelho extensor do joelho pretendemos mostrar de forma didática as estruturas que compõem este complexo ósteo-músculo-ligamentar. Dissecção anatômica do joelho com ênfase nas estruturas do seu mecanismo extensor foi realizada seguida de fotografias com câmera e lentes adequadas para simulação da visão humana através de técnica de construção de imagem tridimensional. Em seguida, com a ajuda de software apropriado, as duas imagens da mesma estrutura de diferentes ângulos simulando a visão humana são sobrepostas com adição de camada polarizante, concluindo a construção da imagem anaglífica. As principais estruturas do mecanismo extensor do joelho podem ser observadas com efeito tridimensional. Dentre os principais benefícios relacionados a esta técnica, destacamos, além do ensino e estudo da anatomia musculoesquelética, o potencial uso em treinamento de procedimentos cirúrgicos e a realização de imagens em exames diagnósticos. The knee extensor mechanism is a complex structure formed by the quadriceps muscle and tendon, the patella, the patellar tendon and the ligaments that surround and help stabilize the knee. Through using a three-dimensional viewing technique on images of the knee extensor apparatus, we aimed to didactically show the structures that compose this bone-muscle-ligament complex. Anatomical dissection of the knee with emphasis on the structures of its extensor mechanism was performed, followed by taking photographs using a camera and lenses suitable for simulating human vision, through a technique for constructing three-dimensional images. Then, with the aid of appropriate software, pairs of images of the same structure from different angles simulating human vision were overlain with the addition of polarizing layer, thereby completing the construction of an anaglyphic image. The main structures of the knee extensor mechanism could be observed with a three-dimensional effect. Among the main benefits relating to this technique, we can highlight that in addition to teaching and studying musculoskeletal anatomy, it has potential use in training for surgical procedures and production of images for diagnostic tests.

The use of cephalomedullary devices has gained popularity in the treatment of proximal femoral fractures. Despite their biomechanical advantages, several complications are well described in the literature. One of these complications, which is rarely reported, is the medial migration of the cephalic screw. The authors present this unusual complication in a case of a long-nail implant, which was treated with removal of the implants as a first step, and posterior osteosynthesis with a locked proximal femur plate as a second step, as well the outcome until fracture consolidation and resolution of the case.