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- ItemAcesso aberto (Open Access)Análise cinemática do joelho ao subir e descer escada na instabilidade patelofemoral(Sociedade Brasileira de Ortopedia e Traumatologia, 2009-01-01) Reis, Júlia Guimarães; Costa, Gustavo De Carvalho Da [UNIFESP]; Cliquet Júnior, Alberto; Piedade, Sérgio Rocha; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To analyze and to identify possible gait adaptations by individuals with objective patellofemoral instability when climbing up/down stairs. METHODS: A control group (group A) composed by nine women with mean age = 25 years (±1.87), height = 1.62 m (±0.05) and weight = 56.20 kg (±7.34), and; nine women with objective patellofemoral instability (group B) with mean age = 24 years (±6.02), height = 1.62 m (±0.06) and weight = 60.33 kg (±10.31) were analyzed. The groups underwent kinematic analysis while climbing up/down stairs, in a previously determined area. Images were obtained by six cameras (Qualysis) and data analysis utilized the Q gait software program. RESULTS: Group B presented, in the support phase, less knee flexion when climbing up (p = 0.0268), and lower speed (p = 0.0076/ p =0.0243) and pace (p = 0.0027/ p = 0.0165) when climbing up and down stairs, respectively. CONCLUSION: It is suggested that group B used functional changes such as reduced knee flexion, speed and pace when climbing up and down stairs.
- ItemAcesso aberto (Open Access)Comparative validation of the radiographic and tomographic measurement of patellar height(Sociedade Brasileira de Ortopedia e Traumatologia, 2013-09-01) Schueda, Marco Antonio; Astur, Diego Costa; Arliani, Gustavo Goncalves; Hornburg, Gilberto; Serpa, Ricardo; Heinig Neto, Walter; Kaleka, Camila Cohen; Cohen, Moises [UNIFESP]; Instituto de Ortopedia e Traumatologia; Universidade Federal de São Paulo (UNIFESP); Hospital Dona Helena; IOT; Santa Casa de Misericordia Faculdade de Ciencias MedicasOBJECTIVE:To evaluate and validate the radiographic measurement of patellar height with computerized tomography scans.METHODS:Measured the patellar height through the lateral radiographic image supported by one foot and sagittal tomographic view of the knee in extension, flexion of 20°, and quadriceps contraction of 40 patients (80 knees), asymptomatic and no history of knee injuries using Insall-Salvati index. There were 20 adult females and 20 adult males.RESULTS:The height patellar index was higher in women of all images taken, in proportion. There was no statistical difference of patellar height index between the radiographics and tomographics images.CONCLUSION:The Insall-Salvati index in females was higher in all cases evaluated. Furthermore, it is possible to measure the patellar height index during tomographic study without distorting the results obtained, using to define the presence of patella alta or patella baja.
- ItemAcesso aberto (Open Access)INFLUENCE OF JOINT HIPERMOBILITY ON POSTOPERATIVE RESULTS OF KNEE SURGERY(Atha Comunicacao & Editora, 2018) Astur, Diego Costa [UNIFESP]; Schmidt Lara, Paulo Henrique [UNIFESP]; Santos, Marcelo Abdulklech [UNIFESP]; de Oliveira, Gabriel Taniguti [UNIFESP]; Arliani, Gustavo Goncalves [UNIFESP]; Cohen, Moises [UNIFESP]Objective: To evaluate the prevalence of joint hypermobility in patients undergoing knee surgery to treat traumatic injury to the meniscus and anterior cruciate ligament, and the influence of this hypermobility on postoperative results. Methods: This prospective study assessed joint hypermobility in patients who underwent surgical reconstruction of the anterior cruciate ligament (ACL), partial meniscectomy, or a procedure combining ACL reconstruction and partial meniscectomy during the period 2011-2015. The Beighton score was used to evaluate joint hypermobility and Tegner activity scale for postoperative assessment. Results: A total of 242 patients underwent surgery during the study period: 107 to treat ACL injuries, 75 to treat ACL injuries associated with meniscus injuries, and 60 to treat meniscus injuries. Of the total, 45 patients had joint hypermobility. We found no association between joint hypermobility and sex or type of injury. Postoperative Tegner scale results were not influenced by the presence of joint hypermobility. Conclusion: No association was found between joint hypermobility and the evaluated variables (gender and type of specific injury), and hypermobility did not have a negative impact on postoperative outcomes.
- ItemSomente MetadadadosRelationship between the lateral patellofemoral ligament and the width of the lateral patellar facet.(Atha Comunicacao & Editora, 2010-01-01) Navarro, Marcelo Schmidt [UNIFESP]; Beltrani Filho, Carlos Augusto; Akita Junior, Jorge; Navarro, Ricardo Dizioli [UNIFESP]; Cohen, Moises [UNIFESP]; Fac Med ABC; Universidade Federal de São Paulo (UNIFESP)Objective: The aim of this study, with cadavers, is to evaluate the relationship between the width and length of the lateral patellofemoral ligament (LPFL) and the size of the lateral patellar articular facet (LPAF). Patellofemoral instability is closely re ate to patellar morphology and the lateral retinacular layers. Studies evidence that the wider the lateral patellar facet and the more strained the lateral retinaculum, the greater the tendency for development of pathology in the patellofemoral joint. Methods: 20 knees were dissected in 20 cadavers. The parts were identified according to gender, age, dissected side, length and width of LPFL and width of LPAF In order to carry out the statistical analysis we adopted the significance level of 5% (0.050) and also used Spearman's Coefficient of Rank Correlation. Results: The LPFL presented a mean width of 16.05 millimeters (standard deviation 2.48) and 42.10 millimeters of length (standard deviation 8.84). The width of the LPAF varied from 23 to 37 millimeters (mean 28.1). It was observed that the relationship between the LPAF and LPFL widths is not statistically significant (p=0.271), whereas the relationship between the LPAF width and the LPFL length is statistically significant (p=0.009). Conclusion: The shorter the LPFL the greater the width of the LPAF.
- ItemSomente MetadadadosShoulder rotator strength and torque steadiness in athletes with anterior shoulder instability or SLAP lesion(Elsevier B.V., 2014-09-01) Saccol, Michele Forgiarini; Zanca, Gisele Garcia; Ejnisman, Benno [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Mattiello, Stela Márcia; Universidade Federal de São Carlos (UFSCar); Universidade Federal de São Paulo (UNIFESP)Objectives: To investigate shoulder rotator strength and steadiness in athletes with anterior instability and superior labrum anterior posterior (SLAP) lesion.Design: Cross-sectional laboratory study.Methods: Athletes with anterior shoulder instability (instability group, n=10) and a SLAP lesion (SLAP group, n = 10) were compared with healthy athletes matched by age, anthropometrics and sport (control group for shoulder instability, n = 10 and control group for SLAP, n = 10). Torque steadiness was evaluated with three 10 s submaximal isometric contractions (35% of peak torque) with the arm at 900 of shoulder abduction and 900 of external rotation. the mean isometric torque, standard deviation and coefficient of variation were measured from the steadiness trials. To evaluate shoulder rotator strength, concentric isokinetic tests (90 degrees/s, 180 degrees/s) were performed at the 90-90 degrees position and peak torque to body mass and shoulder external to internal rotation ratio variables were analyzed. the variables were tested with the instability and control groups with respect to shoulder instability and between the SLAP and control groups for SLAP lesion using the Mann-Whitney test.Results: the SLAP group presented a higher coefficient of variation than the SLAP control group (p = 0.003). Regarding shoulder strength, the internal and external shoulder rotators were weaker in the instability group than in the instability control group (p <0.05).Conclusions: Athletes with anterior shoulder instability presented shoulder rotation weakness, while athletes with a SLAP lesion showed higher torque fluctuation during internal rotation. These results indicate that there are different alterations to strength and sensory motor control in each condition. (C) 2013 Sports Medicine Australia. Published by Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosTradução, adaptação cultural, validação, confiabilidade e responsividade da versão brasileira do questionário Identification of Functional Ankle Instability (IDFAI)(Universidade Federal de São Paulo (UNIFESP), 2016) Martinez, Bruna Reclusa [UNIFESP]; Yi, Liu Chiao [UNIFESP]; http://lattes.cnpq.br/6106154677645509; http://lattes.cnpq.br/9573749027888508; Universidade Federal de São Paulo (UNIFESP)Objectives: Translate and cross-cultural adapt the questionnaire IdFAI to Brazilian Portuguese language (IdFAI-Brazil); even analyze the validity, reliability and responsiveness. Methods: Translation and cross-cultural adaptation of IdFAI to Brazilian-Portuguese version process, was accomplished using standard guidelines and was applied in 50 university students. The reliability and validity was tested in 50 volunteers (100 lower limbs). The reliability was tested thru the reproducibility evaluation (test-retest inter and intra-observer), internal consistency, standard error of measurement and minimal detectable change. The validity was made using the Portuguese version of visual analogic scale to instability (VAS-I), Cumberland Ankle Instability Tool Questionnaire (CAIT) and Lower Extremity Functional Scale (LEFS). Correlation among IdFAI and VAS-I, CAIT and LEFS was analysed by Spearman’s correlation coefficient. For responsiveness measurement, the questionnaire IdFAI and 11 assessments were used before and after an eight week treatment period in 25 patients with functional ankle instability. The internal responsiveness was tested with the usage of paired t-test, effect size, standardized response mean and floor and ceiling effects. Results: IdFAI-Brazil presented high internal consistency (Cronbach α=0.90), excellent reproducibility (intraclass correlation coefficient=0.98 for inter and 0.96 for intra-observer); and excellent agreement (standard error of measurement, 0.94 and 1.46 points for inter and intra-observer; minimal detectable change at the 90% confidence level, 2.20 points for inter and 3.40 for intra-observer). Moreover, the questionnaire showed a strong correlation (r=0.74 and -0.78; p<0.001) with specific tools that measure ankle instability VAS(I) and CAIT, and poor correlation (r=-0.21; p=0.033) with LEFS scale. When analyzed the clinical changes after the physical therapy intervention, IdFAI-Brazil showed high responsiveness with significant changes (p<0,001) in the score, large effect size (1.34), large standardized response mean (1.28) and no floor and ceiling effects. Conclusion: The Brazilian Portuguese version of IdFAI questionnaire has shown to be a valid, reliable and responsive tool to evaluate ankle functional instability and it may be used in clinical and scientific fields.
- ItemAcesso aberto (Open Access)Visualização radiológica intraoperatória da região occipitocervical e coluna cervical superior: nota técnica(Sociedade Brasileira de Coluna, 2009-06-01) Mudo, Marcelo Luis [UNIFESP]; Amantéa, Andrea Vieira [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Joaquim, Andrei Fernandes; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)We report a technical note to obtain a better intraoperative radiological view in surgeries of the craniocervical junction and upper cervical spine.