ABSTRACT Objective: To conduct an epidemiologic review, analyzing treatment, evolution, and survival of soft tissue sarcomas. Methods: Retrospective study based on medical records of patient with STS treated by the Orthopedic Oncology... more
ABSTRACT Objective: To conduct an epidemiologic review, analyzing treatment, evolution, and survival of soft tissue sarcomas. Methods: Retrospective study based on medical records of patient with STS treated by the Orthopedic Oncology Group at the Santa Casa de São Paulo, from 2006 to 2019. Data from 121 patients were analyzed according to age, sex, histological type, tumor location, treatment, previous surgery in a non-specialized service, local recurrences, lung metastases, and survival analysis. Results: The most frequent location was the thigh. Patients who underwent surgery with a non-specialized group had higher rates of local recurrence and those with pulmonary metastasis had a lower survival rate. Conclusion: STS can occur at any age and the prevalence of the histological type depends on the patients’ age group. Level of Evidence II, Prognostic Study.
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Objetivo: Analisar os efeitos do tratamento com apocinina associado ao treinamento resistido na pressão arterial, resposta pressora à angiotensina II e respostas hipotensoras à acetilcolina e nitroprussiato de sódio em ratos... more
Objetivo: Analisar os efeitos do tratamento com apocinina associado ao treinamento resistido na pressão arterial, resposta pressora à angiotensina II e respostas hipotensoras à acetilcolina e nitroprussiato de sódio em ratos espontaneamente hipertensos (SHR). O estresse oxidativo plasmático e a expressão proteica da enzima óxido nítrico sintase (eNOS) e nicotinamida adenina dinucleotídeo fosfato oxidase subunidade 4 (NOX4) foram analisados em aortas de SHR. Principais métodos: Os machos SHR foram divididos nos grupos: sedentários (S); no treinamento resistido/com pesos em escada (T); sedentários em tratamento crônico com apocinina (30 mg/kg, p.o.) (SA) e em tratamento crônico com apocinina e em treinamento resistido (TA). Significância: O tratamento com apocinina foi capaz de prevenir o desenvolvimento de hipertensão e reduzir o estresse oxidativo. Quando associada ao treinamento resistido, a apocinina reduziu o estresse oxidativo, mas não foi capaz de reduzir a pressão arterial c...
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Objectives: To determine the proportion of traumatologists who investigate osteoporosis in elderly patients with fractures and recommend secondary prevention of osteoporotic fractures. Methods: We distributed questionnaires to 244... more
Objectives: To determine the proportion of traumatologists who investigate osteoporosis in elderly patients with fractures and recommend secondary prevention of osteoporotic fractures. Methods: We distributed questionnaires to 244 physicians attending the 2015 Brazilian Congress of Orthopedic Trauma. We determined the respondents’ profiles and assessed how they investigated and treated osteoporosis in elderly patients with fractures. Results: Overall, 32% of the respondents reported that their knowledge level regarding osteoporosis ranged from 0-5 (out of 0-10). In total, 42% of the participants reported that they usually requested DXA for elderly patients with fractures and less than 30% reported prescribing supplemental calcium and/or vitamin D. We considered physicians conducting a complete treatment for the patient as those who in addition to requesting DXA prescribed supplemental calcium, vitamin D, and specific medications for their elderly patients, and recommended non-pharma...
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Os autores relatam os casos de quatro pacientes portadores de paralisia cerebral espastica tetraparetica com cinco quadris com luxacao anterior. Foram classificados clinicamente de acordo com Selva em tres tipos: o tipo 1 consiste em... more
Os autores relatam os casos de quatro pacientes portadores de paralisia cerebral espastica tetraparetica com cinco quadris com luxacao anterior. Foram classificados clinicamente de acordo com Selva em tres tipos: o tipo 1 consiste em pacientes com contratura em rotacao externa-extensao-aducao do quadril e contratura em extensao do joelho; o tipo 2, em pacientes com contratura em rotacao externa-abducao-extensao do quadril e contratura em flexao do joelho; e o tipo 3, em pacientes sem contraturas. Dois pacientes eram do tipo 1 e dois do tipo 2; nao havia criancas do tipo 3. As indicacoes para cirurgia foram: melhora da dor e do posicionamento do quadril. A idade media dos pacientes por ocasiao da cirurgia foi de seis anos e quatro meses (minima de dois anos e oito meses e maxima de 11 anos e dois meses). Todos os pacientes foram submetidos a: liberacao das partes moles contraturadas, reducao cruenta da articulacao do quadril, osteotomia femoral varizante e de rotacao e, quando da presenca de displasia acetabular, acetabuloplastia. O tempo medio de seguimento foi de tres anos (minimo de um ano e tres meses e maximo de quatro anos e oito meses). Um paciente foi a obito apos quatro anos da operacao por complicacoes pulmonares. Os resultados foram analisados clinica e radiograficamente. Clinicamente, dois pacientes evoluiram com melhora funcional, permitindo a posicao sentada, melhor adaptacao a cadeira de rodas e ausencia de dor; radiograficamente, os quadris mostraram-se centrados, segundo o indice de Reimers.
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Resumo Objetivo Fazer uma avaliação retrospectiva e transversal quanto à melhora da dor e do posicionamento de todos os pacientes portadores de paralisia cerebral (PC) espástica com deformidade grave no quadril submetidos ao procedimento... more
Resumo Objetivo Fazer uma avaliação retrospectiva e transversal quanto à melhora da dor e do posicionamento de todos os pacientes portadores de paralisia cerebral (PC) espástica com deformidade grave no quadril submetidos ao procedimento de McHale em nosso centro. Secundariamente, objetivou-se analisar as possíveis complicações do procedimento. Métodos Foram analisados todos os pacientes consecutivos tratados no período entre 1995 e 2017. Clinicamente, os pacientes deveriam apresentar dor à mobilização do quadril, dificuldade de posicionamento para se sentar e para os cuidados de higiene, e prontuário médico com dados completos; quanto ao grau de função motora, utilizou-se o Sistema de Classificação da Função Motora Grossa (Gross Motor Function Classification System, GMFCS, em inglês). A avaliação radiográfica no período pré-operatório analisou a porcentagem de migração (PM), o tipo de deformidade de acordo com a Escala de Classificação de Quadril na Paralisia Cerebral de Melbourne ...
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Objective: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery. Methods: Eighteen patients with a... more
Objective: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery. Methods: Eighteen patients with a traumatic injury to the brachial plexus (C5-C6 and C5-C7) were evaluated. Seventeen (94.4%) patients were males and one (5.6%) was female, with a mean age of 29.5 years (range 17-46 years). We evaluated the active range of motion, elbow flexion strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and determined the correlation between the procedural outcome and the patient's cognitive level, as assessed by the Mini-Mental State Exam (MMSE). Results: We found statistically significant correlations between the MMSE scale and strength recovery (84.4%, p<0.001), which was classified as excellent, and between the MMSE and British Medical Research Council (BMRC) scales (78.4%, p>0.001), which classified cognitive level as good. Conclu...
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Background: In anterior cruciate ligament (ACL) reconstruction, the transtibial (TT) technique often creates a nonanatomically placed femoral tunnel, which is a frequent cause of surgical failure and postsurgical knee instability. Several... more
Background: In anterior cruciate ligament (ACL) reconstruction, the transtibial (TT) technique often creates a nonanatomically placed femoral tunnel, which is a frequent cause of surgical failure and postsurgical knee instability. Several studies reported that drilling the femoral tunnel through an anteromedial portal (AMP) yields a more anatomic tunnel position compared with the TT technique. Purpose: To compare the effectiveness of these two surgical techniques in restoring the intact knee joint kinematics during a physiological loading situation. Study Design: Controlled laboratory study. Methods: Twenty-four patients (TT, n = 12; AMP, n = 12; sex, weight, and height matched, and half with dominant leg involved) who underwent unilateral single-bundle ACL reconstruction by the same surgeon were recruited. Twenty healthy patients with no history of lower limb injuries were recruited as the control group. Tibiofemoral joint motion in 6 degrees of freedom (3 translations and 3 rotati...
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Mechanical Engineering, Algorithms, Biomedical Engineering, Treatment Outcome, Medicine, and 14 moreAnterior Cruciate Ligament, Gait, Humans, Female, Male, Follow-up studies, Adult, Analysis of Variance, Knee injuries, Weight Bearing, Knee Joint, Case Control Studies, Biomechanical Phenomena, and Anterior cruciate ligament reconstruction
Objective: To use the measurement of migration percentage (MP) to evaluate the long-term radiographic results of soft tissue surgery as the first treatment for hip displacement in spastic bilateral cerebral palsy. A secondary objective... more
Objective: To use the measurement of migration percentage (MP) to evaluate the long-term radiographic results of soft tissue surgery as the first treatment for hip displacement in spastic bilateral cerebral palsy. A secondary objective was to identify predictive factors of stability (i.e., less than 30% of MP in the long term), after surgical correction. Methods: In this longitudinal cohort study, we reviewed the electronic medical records and radiographs of all consecutive patients with cerebral palsy operated for the correction of hip displacement between 1984 and 2013 in a referral orthopedic public hospital in Brazil. Patients were included if they had received, as the first surgical procedure, soft-tissue release. All surgeries were bilateral and symmetrical. We used the available radiographs to evaluate the migration percentage (MP), acetabular index (AI), pelvic obliquity (PO) angle, head-shaft angle (HSA), congruence and femoral head sphericity, and function using the GMFCS ...
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Objective: Nerve transfers are an alternative in the reconstruction of traumatic brachial plexus injuries. In this study, we report the results of branchial plexus reconstruction using accessory to suprascapular nerve transfer. Methods:... more
Objective: Nerve transfers are an alternative in the reconstruction of traumatic brachial plexus injuries. In this study, we report the results of branchial plexus reconstruction using accessory to suprascapular nerve transfer. Methods: Thirty-three patients with traumatic brachial plexus injuries underwent surgical reconstruction with accessory to suprascapular nerve transfers. The patients were divided into groups in which surgery was performed either within 6 months after the injury or more than 6 months after the injury. Results were assessed using the Constant score. Results: There was no significant difference between the groups with respect to the Constant score. Conclusion: Accessory to suprascapular nerve transfer was not an efficient method for recovering active ROM or strength in the shoulder. However, it effectively improved pain control and shoulder stability. Level of evidence II, Retrospective Study.
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For ACL reconstruction, the minimum length of the femoral tunnel and the flexor tendon graft length needed within the tunnel for proper integration have not been defined. The aim of this study was to assess whether a short tunnel is a... more
For ACL reconstruction, the minimum length of the femoral tunnel and the flexor tendon graft length needed within the tunnel for proper integration have not been defined. The aim of this study was to assess whether a short tunnel is a risk factor for poor prognosis and re-rupture by comparing the outcomes of patients with short femoral tunnels to those of patients with longer tunnels. A retrospective observational study of 80 patients who underwent ACL reconstruction using flexor tendons via the medial transportal or transtibial technique was performed. Patients were categorized according to the amount of graft within the tunnel: ≤1.5 versus >1.5 cm; ≤2 versus >2 cm; ≤2.5 versus >2.5 cm; and ≤1.5 versus >2.5 cm. Patients were evaluated 2 years after surgery by performing a physical examination (Lachman, pivot shift and anterior drawer tests), using a KT1000 arthrometer, calculating objective and subjective International Knee Documentation Committee scores, conducting the...
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In preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with... more
In preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with the meniscal length and width, (2) whether the heights of the meniscal segments are associated with the individual's anthropometric data, (3) whether the heights of the meniscal segments are associated with each other in the same meniscus, and (4) the degree of symmetry of the meniscal dimensions between the right and left knees. In this cross-sectional, observational study, two independent radiologists measured the meniscal length, width and height in knee magnetic resonance imaging scans obtained from 25 patients with patello-femoral pain syndrome. Reproducibility of measurements was calculated with intraclass correlation coefficients. Associations between the anthropometric data and the meniscal measurements, the meniscal length and width ve...
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... CELSO SVARTMAN, PATRÍCIA M. DE MORAES BARROS FUCS, PAULO F.KERTZMAN, POLA A. KAMPE, FÚLVIO ROSSETI ... Através de um acesso lateral no seio do tarso, realizamos talectomia, com o cuidado de retirá-lo por inteiro. ...
... DE MORAES BARROS FUCS, CELSO SVARTMAN, PAULO F. KERTZMAN, MARCELO CAPELA GOMES, VITOR MARQUES DE OLIVEIRA INTRODUÇÃO A artrodese extra-articular da articulação subtalar com a colocação de enxerto ósseo no seio do tarso foi... more
... DE MORAES BARROS FUCS, CELSO SVARTMAN, PAULO F. KERTZMAN, MARCELO CAPELA GOMES, VITOR MARQUES DE OLIVEIRA INTRODUÇÃO A artrodese extra-articular da articulação subtalar com a colocação de enxerto ósseo no seio do tarso foi primeiramente ...
The purpose of this study was to identify the frequency and type of intra-operative periprosthetic fractures and to describe risk factors in a single tertiary, public hospital, so that these events could be prevented, even among less... more
The purpose of this study was to identify the frequency and type of intra-operative periprosthetic fractures and to describe risk factors in a single tertiary, public hospital, so that these events could be prevented, even among less experienced surgeons. This is a cross-sectional study, based on medical records and imaging exams from the archives of a public, tertiary hospital, from April 1998 to October 2013. All consecutive patients submitted to total hip arthroplasty (THA) in the study period were evaluated, excluding unipolar or bipolar arthroplasty, surgery for the osteosynthesis of periprosthetic fractures, surgical procedure to clean infection site without component substitution and not arthroplastic surgery. Data were analyzed with chi-squared test and multivariate Cox regression. In the study period, 1,872 THA (1,728 patients) were performed and analyzed, with 144 bilateral cases. In 173 cases, patients had undergone surgical procedures other than THA previously, and in only 260 the surgery consisted of revision THA. There were only two cases of resection THA. Among all patients 101 intra-operative periprosthetic fractures occurred. The univariate analysis revealed a significantly higher risk of intra-operative fractures in female patients, aged more than 65 years, with indication of primary THA and the presence of a previous hip surgery. It indicated also that revision surgeries were associated with a 2.8-fold higher risk of intra-operative fracture, 2.18-fold risk in a previously operated hip and 3.9-fold in cases of resection THA or revision surgery in two stages. Intraoperative periprosthetic fracture is a rare event, and it is associated with revision type surgery and THA in a previously operated hip.
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Objective: To identify the epidemiological profile of patients undergoing orthopedic treatment for complications of the feet and ankles due to diabetes, and to try to establish the sequence of events that led to amputation of the limb.... more
Objective: To identify the epidemiological profile of patients undergoing orthopedic treatment for complications of the feet and ankles due to diabetes, and to try to establish the sequence of events that led to amputation of the limb. Method: The medical records of 300 diabetic patients treated from March, 1997 to July, 2006 were systematically reviewed. Results: The mean age of the patients was 61 years. Of these, two hundred and seventy three (91%) were diagnosed with type II diabetes, but only 49 (16.3%) had proper medical supervision and control of their glycemia levels. Problems affecting the function of the foot and ankle were found in 405 limbs, with: 102 osteoarticular deformities associated with Charcot’s neuroarthropathy (34%); 181 chronic ulcers (60.4%); and 97 infected limbs (32.4%). After the average follow-up time, 14 patients (4.6%) died. Conclusion: Ulceration of the sole of the foot was the most common complication in our series of patients, the majority of whom we...
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The treatment of the spastic hip in Cerebral Palsy (CP) remains a challenge especially in cases of advance changes. Many options are available and the key for a good outcome is to find the best surgical procedure to an individualized... more
The treatment of the spastic hip in Cerebral Palsy (CP) remains a challenge especially in cases of advance changes. Many options are available and the key for a good outcome is to find the best surgical procedure to an individualized patient. The hip fusion is one of the surgical options. The authors presented a group of spastic CP with painful chronic hip subluxation and dislocation treated with hip fusion with a mean follow-up period of 14.5 years. Surgical technique, post-operative management and outcomes were shown, also with the observations done regarding the evolution of the contralateral hip after the hip fusion. They concluded that the hip arthrodesis is an option for patients with spastic CP with painful subluxation or dislocated hips with the goal of pain relief maintain or improve functional status, and facilitating the care. The best candidate is a young ambulatory patient with normal contralateral hip and normal spinal alignment.
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1 Médico Residentes do Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo Pavilhão Fernandinho Simonsen. 2 Médico Assistente do... more
1 Médico Residentes do Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo Pavilhão Fernandinho Simonsen. 2 Médico Assistente do Departamento de Ortopedia e Traumatologia da ...
Objetivo: Avaliar se num serviço de atendimento especializado, o membro superior é preterido ou negligenciado no tratamento das alterações motoras da Paralisia Cerebral. Casuística e métodos: Foram analisados 80 pacientes portadores de... more
Objetivo: Avaliar se num serviço de atendimento especializado, o membro superior é preterido ou negligenciado no tratamento das alterações motoras da Paralisia Cerebral. Casuística e métodos: Foram analisados 80 pacientes portadores de Paralisia Cerebral menores de dezessete anos tratados institucionalmente. Foram avaliados pelo mesmo examinador quanto à classificação e tratamentos (cirúrgico ou não) do aparelho locomotor. Resultados: O membro superior teve a seguinte abordagem terapêutica considerando o grupo de mão comprometida, 1 (2%) foi submetido a transferência tendinosa no punho e 53 (98%) não foram operados. Quanto a órteses, 9 (17%) usavam estabilizadores de punho e 45 (83%) não usavam. Quanto à toxina botulínica não houve aplicação nos membros superiores. Nos membros inferiores, considerando o total de pacientes, 16 (20%) foram submetidos à cirurgia e 64(80%) não foram operados. As cirurgias foram um tratamento cirúrgico de luxação do quadril, 7 a alongamentos múltiplos em...
Because the medial patellofemoral ligament (MPFL) is the primary restraint to lateral dislocation of the patella, we aimed, in this controlled study, to verify whether the MPFL with different measurements could be considered another... more
Because the medial patellofemoral ligament (MPFL) is the primary restraint to lateral dislocation of the patella, we aimed, in this controlled study, to verify whether the MPFL with different measurements could be considered another predisposing factor for patellar dislocation. A group of 100 consecutive individuals without the criteria for patellar dislocation (trochlear dysplasia, patella alta and lateral patellar tilt) was recruited as a control group and underwent magnetic resonance imaging (MRI) study and another group of 50 patients with patellar instability. Femoral condyles, interepicondylar distance, length and thickness of the MPFL were measured. In the control group, the MPFL was 38-60 mm long. Individuals with patellar instability who had no episode of patellar dislocation had a 4.11-mm longer ligament than controls (p = 0.032), while patients with instability with a previous history of dislocation had a 13.54-mm longer MPFL than controls (p < 0.001). Thickness of the...
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BackgroundIn the field of anterior cruciate ligament (ACL) reconstruction, there is still no consensus regarding the proper fixation method and position of the tunnels. The primary objective of this paper was to describe a new fixation... more
BackgroundIn the field of anterior cruciate ligament (ACL) reconstruction, there is still no consensus regarding the proper fixation method and position of the tunnels. The primary objective of this paper was to describe a new fixation device, the Endo Tunnel Device (ETD®), for both techniques (transtibial and transportal), as well as the associated difficulties and the intraoperative and postoperative intercurrences. The secondary objective was to describe a preliminary clinical evaluation (6 months of follow-up) comparing these techniques.MethodsThis was a prospective, randomized study involving 80 patients with ACL reconstructions using the ETD® for femoral fixation. Forty patients underwent the transtibial technique, and 40 patients underwent the transportal technique. Patients were evaluated by radiography, physical examination, the KT1000 arthrometer, and Lysholm and the International Knee Documentation Committee (IKDC) scores.ResultsThere were more intraoperative intercurrenc...
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CONTEXT AND OBJECTIVEFemoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. However,... more
CONTEXT AND OBJECTIVEFemoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. However, in some situations, a surgical approach is recommended. The objective here was to compare treatments for femoral shaft fractures using intramedullary nails (titanium elastic nails, TEN) versus traction and plaster casts in children. The hypothesis was that TEN might provide better treatment, with good clinical results in comparison with plaster casts.DESIGN AND SETTINGThis retrospective comparative study was conducted in a public university hospital.METHODSSixty children with femoral fractures were evaluated; 30 of them underwent surgical treatment with TEN and 30 were treated conservatively using plaster casts. The patients' ages ranged from 5 to 13 years (mean of 9 years).RESULTSThe mean duration of hospitalization was nine days for the surgic...
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We evaluated 16 children with congenital pseudoarthrosis of the tibia treated with contralateral fibular graft, with the aim to report the difficulties and clinical results in the affected limb after consolidation. Sixty-three percent of... more
We evaluated 16 children with congenital pseudoarthrosis of the tibia treated with contralateral fibular graft, with the aim to report the difficulties and clinical results in the affected limb after consolidation. Sixty-three percent of the children had characteristics of neurofibromatosis. Consolidation was achieved after the main surgery in 37%of patients, and the remainder, after multiple procedures. Consolidation time was longer for male patients. Refracture was observed in six patients and recurrence of the anterior bowing in six; four of these patients were submitted to correction. Four patients presented femur overgrowth. The average shortening of the affected leg was 3.6 cm. The proposed procedure leads to a long treatment course with many reoperations for correction of possible complications.
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The purpose of this study was to evaluate 14 painful dislocated hips in patients with spastic cerebral palsy, treated with hip arthrodesis and internal fixation. The mean age at the surgical procedure was 15 years and 5 months. The mean... more
The purpose of this study was to evaluate 14 painful dislocated hips in patients with spastic cerebral palsy, treated with hip arthrodesis and internal fixation. The mean age at the surgical procedure was 15 years and 5 months. The mean follow-up period was 5 years and 3 months. All patients showed bone union, pain relief, and postural improvement. Hip arthrodesis is a reasonable option in treating painful spastic subluxated and dislocated hips in patients with cerebral palsy, especially if it is unilateral and the patient has weight-bearing function.
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Purpose To evaluate the safety and period of hospitalization of the treatment of femoral shaft fractures with titanium elastic nails (TEN) in the age range 5 to 14 years. The hypothesis was that TEN might be a low-cost treatment, with... more
Purpose To evaluate the safety and period of hospitalization of the treatment of femoral shaft fractures with titanium elastic nails (TEN) in the age range 5 to 14 years. The hypothesis was that TEN might be a low-cost treatment, with good clinical results and short length of hospitalization. Methods Thirty children with femur fractures were surgically treated with TEN. Results The patients spent an average of 9.4 days in hospital. The average period for the healing process was 7.7 weeks. Partial weight bearing was permitted 3.3 weeks after surgery. The incidence of overgrowth was 60%, with an average of 0.40 cm. Conclusions The surgical method brings few complications and results in good limb alignment, with a short period of hospitalization and early return to daily activities and school.
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This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases. In this historically controlled study,... more
This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases. In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital. The two groups were similar for pre-operative mechanical axis (mean 8.10 ± 3.14 for the control and 6.60 ± 2.50 for the navigated group), pre-operative tibial slope (mean 8.95 ± 3.47 versus 8.17 ± 3.11, respectively) and Lyshom score (40.85 ± 15.46 and 44.83 ± 16.86). After surgery, the control group presented mean mechanical axis of 3.35 ± 3.27, tibial slope of 13.75 ± 3.75 and Lyshom score of 87.60 ± 11.12. The navigated group showed a postoperative mechanical axis mean of 3.06 ± 1.70, tibial slope of 10.11 ± 0.18 and Lyshom score of 91.94 ± 11.61. The navigation system allowed a significantly better control of tibial slope. Patients operated with the navigation system had significantly better Lysholm scores.