Navegando por Palavras-chave "Osteoartrose"
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- ItemAcesso aberto (Open Access)Análise do músculo quadríceps femoral antes e após artroplastia total do joelho por meio do estudo imunohistoquímico(Universidade Federal de São Paulo, 2022-05-06) Kawatake, Ednei Haruo [UNIFESP]; Pochini, Alberto de Castro [UNIFESP]; Szeles, Paulo Roberto de Queiroz [UNIFESP]; http://lattes.cnpq.br/2833638807993559; http://lattes.cnpq.br/2476659894036430; http://lattes.cnpq.br/1753636670224624Background: The number of total knee arthroplasties (TKA) has increased steadily with the aging of the population. This surgical procedure is recognized for its success in pain relief and restoration of knee function. However, decreased quadriceps femoris (QF) muscle strength after TKA is frequently observed but with unknown etiology. Evidence suggests that the location of the operative incision (i.e., surgical access) can influence QF muscle structure and function. The present study aimed to assess the fiber type composition, structure and assembly of the QF's vastus medialis (VM) and vastus lateralis (VL) muscles before and after TKA. Methods: Muscle biopsies (VM and VL muscles) were collected from patients previously submitted to TKA via the medial parapatellar route and undergoing TKA revision (main group, n=9) and patients with osteoarthrosis (OA) who will undergo TKA (control group: n=18). The biopsied muscle tissue was prepared, stored, and then sectioned in a cryostat at -25ºC. The tissue sections were evaluated using routine staining techniques in pathological anatomy and histochemistry. Results: The normal mosaic pattern of the medial and lateral knee muscles was observed in the main and control groups, with no evidence of peripheral nerve damage. Notably, 88.9% of the patients exhibited mild to severe VL atrophy, while only 11.1% of patients in the control group presented this feature (p<0.001). Conclusions: The medial parapatellar incision for TKA surgical access does not generate definitive morphological changes in the VM and VL muscle fibers but may contribute to VL atrophy.
- ItemAcesso aberto (Open Access)Dosagem de ácido hialurônico sinovial em atletas com luxação anterior do ombro estudo preliminar(Universidade Federal de São Paulo, 2023) Rezende, Karina Levy Siqueira [UNIFESP]; Pochini, Alberto de Castro [UNIFESP]; Regatieri, Juliana Luporini Dreyfuss [UNIFESP]; http://lattes.cnpq.br/2390066977030420; http://lattes.cnpq.br/2476659894036430; http://lattes.cnpq.br/8498884684257618Introdução: Biomarcadores tornaram-se importante ferramentas para auxiliar no diagnóstico precoce e tratamento da osteoartrose, uma vez que não só identificam a doença, como também monitoram a progressāo e a eficácia de medicamentos. Dentre esses biomarcadores, o ácido hialurônico demonstrou ser um dos mais importantes para a detecção precoce e prognóstico da osteoartrose. Diversos estudos associaram a presença deste marcador em indivíduos com instabilidade de joelho à osteoartrose, porém nenhum estudo até o momento investigou a presença de biomarcadores em osteoartrose secundária à luxação do ombro. Objetivo: Comparar a quantidade do biomarcador ácido hialurônico no líquido sinovial do ombro de atletas com luxação anterior do ombro entre dois grupos de atletas: o primeiro grupo com até 6 meses de história do primeiro episódio, com o segundo grupo de atletas com história há mais de 6 meses do primeiro episódio, sem sinais de osteoartrite dos ombros aos exames de ressonância magnética e radiografias. Métodos: Foi coletado 3ml de líquido sinovial glenoumeral de 12 participantes que foram submetidos a tratamento cirúrgico da luxação anterior do ombro, no início do procedimento cirúrgico. Os pacientes são acompanhados no ambulatório de Ombro do Grupo de Medicina Esportiva da Unifesp, seguindo os protocolos de tratamento dessa instituição. A amostra de líquido sinovial do ombro foi analisada no laboratório de Biologia Molecular da Unifesp para quantificar a quantidade do ácido hialurônico. Resultados: Foram encontradas maiores concentrações de ácido hialurônico no grupo de pacientes com mais de 6 meses história do primeiro episódio (p<0,0303) em comparação com o grupo de pacientes < 6 meses do primeiro episódio de luxação anterior do ombro. Não houve relação da concentração de ácido hialurônico com a idade. Limitações do estudo: tamanho da amostra, estudo transversal. Conclusão: Atletas com instabilidade anterior crônica do ombro (primeiro episódio de luxação > 6 meses) tiveram uma maior concentração de ácido hialurônico no líquido sinovial dessa articulação em comparação com pacientes com instabilidade anterior aguda do ombro (primeiro episódio de luxação menor ou igual a 6 meses).
- ItemAcesso aberto (Open Access)Farmacocinética da associação de glucosamina e sulfato de condroitina em humanos sadios do sexo masculino(Sociedade Brasileira de Ortopedia e Traumatologia, 2005-01-01) Toffoletto, Odaly; Tavares, Agostinho [UNIFESP]; Casarini, Dulce Elena [UNIFESP]; Redublo, Beata Marie [UNIFESP]; Ribeiro, Artur Beltrame [UNIFESP]; Fundação Oswaldo Ramos Hospital do Rim e Hipertensão; Universidade Federal de São Paulo (UNIFESP)Osteoarthrosis is a chronic joint disease that, once patent, leads to a progressive functional disability. As proteochondroitin sulfates are the major contents of the cartilage, it is expected that the ingestion of glucosamine and chondroitin might improve the biological status of that tissue. As we could not find any studies on the pharmacokinetic profile of this association by oral administration route in human beings, the objective of this study was to evaluate it by using the association of glucosamine sulfate (GS) and chondroitin sulfate (CS) given to two groups of twelve healthy male volunteers (group I: one capsule containing 500 mg of GS and 400 mg of CS; group II: four capsules with the same content). Blood samples were collected at pre-determined time intervals up to 48 hours post-dosing. GS and CS were measured in plasma by the DMMB (1,9,dimethyl-dimethilene blue) method. Maximum concentration was achieved within 2 hours (average ± SE; 0.893±0.093 µg/ml, group I; and 2.222±0.313 µg/ml, group II). Areas under curve up to 48 hours were 10.803±0.965 µg-hr/ml and 38.776±2.981 µg-hr/ml for groups I and II, respectively. Both groups showed a second peak after 18 hours, indicating an enterohepatic flow. Our results indicate that this association is absorbed through the oral route by a saturable mechanism, which can enable its use in clinical treatments.
- ItemSomente MetadadadosIdentificação e caracterização de perfis de marcha em indivíduos com osteoartrose do joelho – uma abordagem com Inteligência Artificial e análise de movimento 3D(Universidade Federal de São Paulo (UNIFESP), 2021) Gonzalez, Felipe Fernandes [UNIFESP]; Luzo, Marcus Vinicius Malheiros [UNIFESP]; Universidade Federal de São PauloObjectives: To identify different gait profiles in patients with advanced knee osteoarthritis and verify differences in clinical and radiographic characteristics of the profiles found. Methods: 42 individuals were selected from the total knee arthroplasty waiting list. The volunteers had data collected from the 3D kinematics of the knee during gait using an 8-camera optoelectronic system. Principal component analysis, self-organizing maps and k-means technique were used to identify gait profiles. The Kruskal-Wallis test was used for comparison between groups and the Tukey test for multiple comparison. The data collected from knee strength, knee range of motion, tibial slope, femorotibial angle, radiographic severity, anthropometric measurements and self-reported measures of functionality were compared between groups using the Kruskal-Wallis test (continuous and ordinal variables) and Fisher (nominal variables). Dunn's test with Sidák adjustment was used for multiple comparisons. The level of significance was set at 5%. The results were also presented in common language effect size. Results: Four different gait profiles were found. Profile 1 (n = 6, 14%) showed a gait pattern with increased knee adduction in the coronal plane and increased maximum and minimum knee flexion in the sagittal plane (p <0.01). From a clinical perspective, profile 1 presented gait in knee flexion and varus, without passive extension restriction and with increased tibial slope. Profile 2 presented a gait pattern with excessive maximum and minimum knee external rotation (n = 11, 26%; p <0.001). Clinically, a gait in external rotation of the knee, with no differences regarding clinical functionality and radiographic severity. Profile 3 (n = 17, 40%) showed a decreased knee range of motion in the sagittal plane (p <0.001). This profile can be clinically characterized, as a stiff gait in extension and with less strength of the quadriceps. Profile 4 (n = 8, 19%) showed an excessive range of motion in the coronal plane and decreased range of motion in the transverse plane (p <0.05). From a clinical point of view, a gait with varus thrust and with alteration of the screw-home mechanism, with higher levels of pain and higher BMI. Among the clinical and radiographic characteristics, only the BMI was statistically different between the profiles (p: 0.01). Conclusions: We identified four distinct gait profiles in a homogeneous population from the point of view of radiographic severity and prognosis, that were not associated with most of the clinical and radiographic characteristics commonly measured in clinical practice. 3D biomechanical assessment of gait and stratification of samples into gait profiles could be important in research involving advanced knee osteoarthritis.
- ItemAcesso aberto (Open Access)Impacto da inclinação posterior dos planaltos tibiais na gênese da osteoartrose dos joelhos em ex-jogadores profissionais de futebol(Universidade Federal de São Paulo (UNIFESP), 2018-12-14) Narahashi, Erica [UNIFESP]; Arliani, Gustavo Goncalves [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; http://lattes.cnpq.br/5802740927050065; http://lattes.cnpq.br/6509085647085311; http://lattes.cnpq.br/0121567544301830; Universidade Federal de São Paulo (UNIFESP)Introduction: Osteoarthrosis (OA) is the most common chronic injury due to soccer, and the knee is one of the most affected regions. More recent studies cite a relation between anatomical features, such as the inclination of the tibial plateaus (tibial slope, TS), and the genesis of ostearthrosis of the knees. Objectives: To evaluate the association of posterior slope of the tibial plateau and diagnosis of osteoarthrosis on radiography and severity of osteoarthrosis on magnetic resonance imaging in former retired professional soccer players. Methods: crosssectional study with 27 former retired professional soccer players and 30 recreational sports individuals. The diagnosis of OA was based on the KellgrenLawrence classification (KL), on the radiographs. The severity of OA was determined by WORMS (WholeOrgan Magnetic Resonance Imaging Score) classification. The TS measurement was performed by Hudek's method(2) on magnetic resonance imaging (MRI). Mean values of WORMS, TSL, TSM, Delta TS (difference between TSL and TSM values) were compared between groups, and between individuals with arthrosis and without arthrosis for both knees. Based on the study of Hudek et al.(2), cutoff values of 9 degrees for TSL and 7 degrees for TSM were established, and mean values of WORMS values were compared in individuals with slopes higher than cut values with the others, in the control and explayers, with osteoarthrosis and without osteoarthrosis, to both knees. Results: Former players with TSL greater than 9 in the dominant knees presented WORMS significantly higher in relation to the other individuals. Conclusion: Greater values of posterior inclination of the lateral tibial plateau of the dominant knees of explayers are related to the greater severity of osteoarthrosis in MRI. More studies are needed to establish correlation of TS and the genesis of osteoarthrosis in nonsports or recreational sports subjects.
- ItemAcesso aberto (Open Access)Osteoartrose no joelho e qualidade de vida após aposentadoria em ex-jogadores de futebol profissional do Brasil(Universidade Federal de São Paulo (UNIFESP), 2014) Arliani, Gustavo Gonçalves [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introdução: O futebol tem sofrido muitas mudanças, principalmente em função das exigências físicas cada vez maiores, o que obriga os atletas a trabalharem perto do limite máximo, com maior predisposição a sobrecarga nas articulações. Objetivos: Determinar a prevalência de osteoartrose nos joelhos em um grupo de ex-jogadores profissionais de futebol do Brasil e o impacto na função da articulação e na qualidade de vida destes ex-atletas quando comparados a um grupo controle. Métodos: Participaram deste estudo transversal, divididos em dois grupos, 27 ex-jogadores de futebol profissional e 30 voluntários do sexo masculino de diferentes áreas profissionais. Todos os participantes foram submetidos a radiografias e ressonâncias magnéticas bilaterais do joelho. Além disso, foram avaliados e comparados em relação a qualidade de vida, dor e função da articulação através de questionários específicos (Short-form 36, Escala Visual Analógica da dor e Knee Injury and Osteoarthritis Outcome). Para comparação entre os grupos, foram utilizados os testes qui-quadrado, teste exato de Fisher, teste de Mann- Whitney e teste t-student. Em todas as análises foi levado em consideração um p<0.05. Resultados: A prevalência de osteoartrose radiográfica nos ex-jogadores de futebol foi 66,6%. A comparação entre os grupos revelou diferenças significativas: nas subescalas de dor, sintomas e qualidade de vida relacionada ao joelho do Knee Injury and Osteoarthritis Outcome Score; na subescala de Aspectos físicos do Short-form 36; na pontuação total do Whole-Organ Magnetic Resonance Imaging Score. Os ex- jogadores de futebol tiveram piores resultados do que os controles em todas estas comparações. Conclusão: Ex- jogadores de futebol desta amostra têm pior qualidade de vida relacionada ao joelho e em relação aos aspectos físicos incluindo mais dor, sintomas e alterações em imagens de ressonância magnética e radiografias do joelho em comparação com um grupo controle.
- ItemAcesso aberto (Open Access)Treatment of pain associated to knee osteoarthritis in the elderly: a randomized double-blind clinical trial with lysine clonixinate(Sociedade Brasileira para o Estudo da Dor, 2011-03-01) Santos, Fânia Cristina [UNIFESP]; Souza, Polianna Mara Rodrigues De [UNIFESP]; Toniolo Neto, João [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) is the most common arthropathy and one of the major causes of chronic pain in the elderly population, which may lead to major functional incapacity of these individuals. Aiming at treating pain of elderly patients with knee OA, we have used lysine clonixinate (LC) and have evaluated its effectiveness METHOD: Randomized, double-blind, placebo-controlled clinical trial with 109 elderly patients with knee OA-related pain. Participants were distributed in two groups: Group LC and Group P (placebo), who received tablets to be used three times a day for 30 days. Evaluations were performed initially, 15 days after and at study completion, as to pain intensity at rest, at initial movement, ambulation and joint compression; and the need for additional analgesia, morning stiffness; pain-related functional incapacity, adherence, tolerability and global treatment evaluation. RESULTS: LC has significantly decreased pain at initial movement and ambulation already in the first 15 days, with 30% decrease in protokinetic pain and 31.6% in ambulation, but best results were seen after 30 days, when reductions were 42.3% and 45.5%, respectively. Additional analgesia was significantly lower with LC: 2.6% and 9.5% for groups LC and P, respectively. There were no differences between groups in morning stiffness and functional incapacity. There has been major adherence and tolerability. Global evaluation was favorable to LC, being excellent or good for 50% of patients. CONCLUSION: Lysine clonixinate was effective to treat knee OA-related pain in elderly people.