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Anterior Cruciate ligament (ACL)
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Anterior Cruciate Ligament

Anterior Cruciate Reconstruction


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10-12-2012
Carpal Tunnel Syndrome (2)
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Frequent pathology

Carpal tunnel syndrome is an entrapment neuropathy of the median nerve, causing pain and numbness due to nerve compression at the wrist.

The main symptom of CTS is intermittent numbness of the thumb, index, middle and ring finger of the palmar area. The loss of sensation that often occurs at night, especially if kept flexed wrists during sleep. The persistence of symptoms leads to permanent nerve damage with loss of sensitivity constant, atrophy of some of the muscles.

A combination of the above symptoms, clinical findings and electrophysiological tests used by most surgeons for diagnosis. Scientifically established treatment is surgery, the goal is to divide the transverse carpal ligament in two. When the surgeon cuts through the pressure is relieved ligament to the nerve. The surgery has a high success rate, up to 90% of patients are able to return to the job after surgery.


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09-17-2012
Knee arthroplasty (1) (2)
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New materials
The prosthetic knee replacement surgery is a technique that is performed for more than 50 years, although the complexity of this articulation only began to be understood 30 years ago. Because of this, in the beginning the total knee arthroplasty was not as successful as the hip. However, dramatic advances in the understanding of the mechanics of the knee have resulted in design modifications that extend the length of this.

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Savings blood prosthetic knee surgery
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The goal is to lower the number of units of allogeneic blood

In surgery, prosthetic surgery demand for blood transfusions is common, due to both the surgery itself as comorbidity of patients and the development of increasingly complex surgical techniques.

In total hip arthroplasty are intraoperative blood loss. However in the total knee arthroplasty, intraoperative bleeding with the use of managot ischemia is scarce. However, the release of ischemia at the end of the procedure as a consequence, increased fibrinolytic activity, resulting in the immediate postoperative rebound effect with an increase in bleeding. In this sense, the implementation of a total knee can lead to a loss of up to 2000 mL of blood, which requires transfusions in many cases. In recent years, many patients receive transfusions as saving measure in Orthopedic Surgery and Traumatology, tranexamic acid.

Tranexamic acid:

Tranexamic acid is a synthetic lysine derivative with pure Antifibrinolytic activity. Its mechanism of action is based on the ability of TPA to join a reversiblemente other lysine plasminogen, just the place where plasminogen binds to fibrin. The TPA prevents the conversion of plasminogen to plasmin.
Much remains to be done, studies with tranexamic acid in orthopedic surgery show that it is effective and safe if used properly. Design protocols using hospital tranexamic acid may be a useful measure of savings in the period intraoperative transfusion in primary knee prosthetic surgery.


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09-17-2012
The intra-cystic tumors of the knee can be removed by arthroscopy (2)
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Functional recovery is faster

Arthroscopy is a minimally invasive surgical procedure through small incisions, which can perform both the evaluation and treatment of many orthopedic conditions through the arthroscope, including injuries floating cartilage, torn surface cartilage, the anterior and posterior cruciate ligament reconstruction, as well as in our case, in which the patient presented with a mucous cyst affecting the posterior cruciate ligament, and arthroscopic removal of it.


The main advantage of arthroscopy over traditional open surgery is that by not being open, the joint is not expose. This reduces recovery time and may increase the rate of surgical success due to less trauma to the connective tissue, reducing the risk of infections.


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