Navegando por Palavras-chave "Arthroscopy"

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    Acurácia dos testes clínicos e ressonância magnética no diagnóstico das lesões do tendão supraespinal em pacientes submetidos à artroscopia cirúrgica do ombro
    (Universidade Federal de São Paulo (UNIFESP), 2020-07-01) Nicolao, Fabio Anauate [UNIFESP]; Tamaoki, Marcel Jun Sugawara [UNIFESP]; Universidade Federal de São Paulo
    Introduction: The shoulder clinical tests and magnetic resonance imaging are frequently performed in patients undergoing arthroscopic treatment of rotator cuff tears; however, the ability of these clinical tests to detect supraspinatus tendon lesions is a matter of debate in previous studies. Objective: To determine the diagnostic accuracy of clinical tests and magnetic resonance for the detection of the supraspinatus tendon lesions in patients undergoing shoulder arthroscopy. Methods: A total of 199 consecutive patients were prospectively evaluated in this multicenter study from April 2017 to April 2019, and eleven clinical tests and magnetic resonance imaging were compared with the results of the arthroscopy. We assessed the sensitivity, specificity, accuracy, the positive and negative predictive values, diagnostic odds ratio (DOR), and the positive and negative likelihood ratio for all tests. Results: For overall tears, the Jobe’s test showed the highest sensitivity (0.88) and DOR (29.96) and the weakness in the Jobe’s and full can tests presented the best positive predictive value and specificity. For the location of the lesion, the full can test showed the highest sensitivity in the anterior tears, and the Jobe’s test in the middle third tears. There were greater specificity and Positive Predictive Value on the combination of Jobe, full can and Hawkins tests than the same isolated tests. Magnetic resonance imaging showed high sensitivity (0.99) and specificity (0.98) for full-thickness tears. Conclusion: The Jobe’s test showed the highest sensitivity and the combination of the Jobe, full can and Hawkins tests proved to be more specific for the diagnosis of supraspinatus tears. Magnetic resonance imaging demonstrated high diagnostic accuracy.
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    Anterior cruciate ligament reconstruction after 10 to 15 years: Association between meniscectomy and osteoarthrosis
    (Elsevier B.V., 2007-06-01) Cohen, Moises [UNIFESP]; Amaro, Joicemar Tarouco [UNIFESP]; Ejnisman, Benno [UNIFESP]; Carvalho, Rogerio Teixeira de [UNIFESP]; Nakano, Kleber Kodi [UNIFESP]; Peccin, Maria Stella [UNIFESP]; Silva, Rogerio Teixeira da [UNIFESP]; Laurino, Cristiano Frota de Souza [UNIFESP]; Abdalla, Rene Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To evaluate the stability and arthrosis of the knee 10 to 15 years after arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction with patellar tendon graft. Methods: From July 1986 to March 1991, 82 patients underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft. of these, 62 returned for follow-up evaluation between November 2000 and April 2001. Four different physicians, blinded to each other's examination findings, evaluated the radiologic as well as surgical results according to the International Knee Documentation Committee criteria and the Lysholm knee scoring scale. Results: There were 47 male and 15 female patients. the mean period between injury and surgery was 16 months (range, 2 weeks to 8 years). Results of radiographs were compared with the finding of meniscal lesions during surgery and with International Knee Documentation Committee test results. A statistically significant association (P <.0001) was found between medial or lateral arthrosis of the knee and meniscal injury. in all patients the presence of tears in both menisci was associated with osteoarthrosis in both compartments (medial and lateral). Conclusions: in patients who underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft who also had medial or lateral meniscectomy (or both), arthrosis of the respective compartments developed by 10 to 15 years after reconstruction. Meniscectomy was also associated with poorer results on objective tests of knee function, even with a stable knee joint. Level of Evidence: Level IV, therapeutic case series.
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    Arthroscopic Treatment of Glenohumeral Instability in Soccer Goalkeepers
    (Georg Thieme Verlag Kg, 2013-06-01) Terra, Bernardo Barcellos [UNIFESP]; Ejnisman, Benno [UNIFESP]; Figueiredo, Eduardo Antonio [UNIFESP]; Andreoli, Carlos Vicente [UNIFESP]; Pochini, Alberto de Castro [UNIFESP]; Cohen, Carina [UNIFESP]; Arliani, Gustavo Gonçalves [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The aim of this study was to report epidemiologic data and results of arthroscopic treatment of glenohumeral instability in soccer goalkeepers. We included 12 soccer goalkeepers with a mean age of 28.9 years (range 18-45 years) with acute or recurrent traumatic anterior instability who underwent an arthroscopic anatomic capsulolabral repair with bone anchors. Patients who underwent surgery within 4 weeks of the first episode of dislocation were classified as acute instability. the results were evaluated using the Rowe Scale and analyzed according to stability, range of motion and function. the mean follow-up was 3.8 years. the most common mechanism of injury (90% of the cases) was abduction, external rotation and extension. Associated injuries were present in 57.2% of recurrent cases and 20% of acute cases (p < 0.293). Excellent or good results were observed in 80% of the cases of acute instability and in 57.2% of cases in the group with recurrent instability (p < 0.586). From a total of 12 soccer goalkeepers who underwent the arthroscopic capsulolabral repair, good or excellent results were obtained in 66.6% of cases of glenohumeral instability. Surgical arthroscopic repair was possible in all cases of acute or recurrent instability based on well-established inclusion criteria, i.e., with well-defined exclusion criteria, such as HAGL lesion and significant glenohumeral bone loss, the arthroscopic capsulolabral repair can be carried out in soccer goalkeepers.
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    Artroscopia do quadril na epifisiólise grave
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2010-12-01) Dobashi, Eiffel Tsuyoshi [UNIFESP]; Blumetti, Francesco Camara [UNIFESP]; Pinto, Jose Antonio [UNIFESP]; Milani, Carlo [UNIFESP]; Ishida, Akira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We present a case report of a 12-year-old boy diagnosed with slipped capital femoral epiphysis grade III, with an acute-on-chronic presentation, associated with severe functional impairment and significant reduction in hip range of motion. The patient underwent a Dunn-type trapezoidal wedge femoral neck subtraction osteotomy by hip arthroscopy, followed by closed reduction and fixation with a 6.5mm percutaneous screw. There was significant improvement of the clinical picture on the first postoperative day, allowing for early rehabilitation. After a brief review of the literature, the authors propose this novel surgical technique as a viable method to treat severe slipped capital femoral epiphysis, encouraging the development of new studies on the subject.
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    Atualização no diagnóstico e tratamento das lesões condrais do joelho
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2012-02-01) Cavalcanti Filho, Marcantonio Machado da Cunha; Doca, Daniel; Cohen, Moises [UNIFESP]; Ferretti, Mario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The treatment of chondral knee injuries remains a challenge for the orthopedic surgeon, mainly owing to the characteristics of the cartilage tissue, which promote low potential for regeneration. Chondral lesions can be caused by metabolic stimulation, or by genetic, vascular and traumatic events, and are classified according to the size and thickness of the affected cartilage. Clinical diagnosis can be difficult, especially due to insidious symptoms. Additional tests, as Magnetic Resonance Imaging (MRI), may be needed. The treatment of these lesions usually starts with non-operative management. Surgery should be reserved for patients with detached chondral fragments, blocked range of motion, or the failure of non-operative treatment. The surgical techniques used for the treatment of partial thickness defects are Debridement and Ablation. These techniques aim to improve symptoms, since they do not restore normal structure and function of the cartilage. For full-thickness defects (osteochondral lesion), available treatments are Abrasion, Drilling, Microfracture, Osteochondral Autologous and Allogeneic Transplantation, and biological techniques such as the use of Autologous Chondrocyte Transplantation, Minced Cartilage and stem cells.
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    Avaliação clínica e por imagem da cirurgia artroscópica em articulação temporomandibular
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-23) Moreno, Roberto [UNIFESP]; Abrahão, Marcio [UNIFESP]; http://lattes.cnpq.br/4440305851848835; http://lattes.cnpq.br/3045207445564225; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the efficacy of surgical treatment with arthroscopy , the dysfunctions of the temporomandibular joints ( TMD ) . Method : We evaluated 450 patients with temporomandibular joint dysfunction (TMD ) , treated for 3 months with miorelaxante and physiotherapy board, after three months , only 32 patients had no improvement as local pain in the temporomandibular joint (TMJ ) and the mouth open . The 32 patients underwent physical examination , subjective assessment of pain using the Visual Analogue Scale (VAS ) , MRI and performed the arthroscopic lysis and washing. The data were compared with the same group after six months of surgery. Result: Arthroscopic surgery for TMD is effective and satisfactory results with improvement of pain in ATM and mouth opening , with no improvement regarding the evaluation of images , with a low complication rate .
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    Avaliação dos resultados do uso do hialuronato de sódio intra-articular no pós-operatório da artroscopia do joelho
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2014-01-01) Pereira Junior, Ayrton De Paula; Fasolin, Ricardo Pozzi; Sossa, Felipe Ayusso Correa; Lira Neto, Ozorio De Almeida; Navarro, Marcelo Schmidt; Milani, Antonio [UNIFESP]; Hospital Ifor Departamento de Ortopedia; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina do ABC
    Objective: to evaluate the efficacy of hyaluronic acid in the post-operative of knee arthroscopy. Methods: we have evaluated 49 patients undergoing arthroscopic procedure with the use of intra-articular hyaluronic acid (Group 1) and 49 patients undergoing arthroscopic procedure without the use of hyaluronic acid (Group 2). Patients were evaluated based on the Visual Analogue Scale, household analgesia, assessment of the Range of Motion with a goniometer, and the Lysholm questionnaire. Results: there were no substantial adverse effects on either group. Conclusion: the use of hyaluronic acid in the post-operative of knee arthroscopy is justified due/because it leads to a decrease in pain in the early stage, enabling faster recovery of the patient.
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    Comparação entre os resultados obtidos na reconstrução do ligamento cruzado anterior do joelho utilizando dois tipos de enxertos autólogos: tendão patelar versus semitendíneo e grácil
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2009-06-01) Abdalla, Rene Jorge [UNIFESP]; Monteiro, Diego Antico; Dias, Leonardo; Correia, Dárcio Maurício; Cohen, Moises [UNIFESP]; Forgas, Andrea; Universidade Federal de São Paulo (UNIFESP); Centro de Ortopedia e Reabilitação no Esporte Centro de Estudos; Universidade de São Paulo (USP)
    OBJECTIVE: this study aims to compare the arthrometric and isokinetic examination results from two types of autologous grafts: the central third of the patellar ligament and a graft formed by the tendons of the semitendinosus and gracilis muscles, within the same rehabilitation protocol, six months after the surgery. METHODS: the results from examinations carried out on 63 patients were analyzed. These patients were divided in two groups: one group of 30 patients who received a patellar tendon graft and another group of 33 patients who received a graft from the tendons of the semitendinosus and gracilis muscles. Both the grafts were attached in the same way, with EndobuttonTM for suspensory fixation to the femur and a bioabsorbable interference screw for fixation in the tibial tunnel. RESULTS: arthrometry 30 did not present any statistical difference between the two study groups. On the other hand, the isokinetic evaluation showed that the patellar tendon group had a larger mean peak torque of flexion and greater extension deficit, while the semitendinosus/gracilis group had a better mean flexion/extension ratio and greater percentage of flexion deficit. There was no statistically significant difference between the groups when measuring peak torque extension. CONCLUSION: therefore, when the patellar tendon was used, there was greater extensor deficit and, when the semitendinosus/gracilis tendons were used, there was greater flexor deficit.
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    Desenvolvimento de guia para cirurgia de bloqueio ósseo na instabilidade do ombro baseado na análise tridimensional do processo coracoide
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-08) Rolim, Diogo Esmeraldo [UNIFESP]; Andreoli, Carlos Vicente [UNIFESP]; Figueiredo, Eduardo Antônio de [UNIFESP]; http://lattes.cnpq.br/2837820077224310; http://lattes.cnpq.br/0079323365496289; http://lattes.cnpq.br/0779420065933526; Universidade Federal de São Paulo (UNIFESP)
    Introdução: As cirurgias minimamente invasivas estão estabelecidas como meio seguro e efetivo em diversas técnicas cirúrgicas. A técnica de bloqueio ósseo consiste no método de intervenção terapêutica para o tratamento de pacientes com instabilidade de ombro, amplamente utilizada no mundo inteiro. Várias técnicas foram descritas para a cirurgia de bloqueio ósseo, existindo um interesse crescente no desenvolvimento de guias para execução das técnicas minimamente invasivas. Objetivo: Desenvolver um guia que auxiliasse a execução da cirurgia de bloqueio ósseo por técnica minimamente invasiva, a partir da análise tridimensional do processo coracoide. Método: 95 indivíduos, 50 homens e 45 mulheres, realizaram tomografia de tórax e tiveram esses quatro parâmetros analisados, a partir desses dados um guia foi proposto. Resultados: Verificamos um valor médio para a distância ponta-inserção escapular de 20,55 (mínimo 17,8 e máximo 22,4), altura de 8,505 (mínimo de 7,6 e máximo 9,7), largura de 12,632 (mínimo 10,2 e máximo 13,7) e ângulo de rotação de 21,43. Baseado neste achados sugerimos um novo guia para cirurgia de bloqueio ósseo. Conclusão: Um novo guia que auxilie a técnica de bloqueio ósseo é factível baseado em novos conceitos anatômicos como distância da ponta a inserção escapular e angulo de rotação do processo coracoide.
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    Estudo da precisão diagnóstica do artrômetro KT1000TM na lesões do ligamento cruzado anterior
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2005-01-01) Abdalla, Rene Jorge [UNIFESP]; Camanho, Gilberto Luís; Cohen, Moises [UNIFESP]; Dias, Leonardo; Jeremias Júnior, Sérgio Luíz; Forgas, Andrea; Universidade Federal de São Paulo (UNIFESP); Centro de Ortopedia e Reabilitação no Esporte do Hospital do Coração; Universidade de São Paulo (USP); Hospital Santa Marcelina; Centro de Estudos do Centro de Ortopedia e Reabilitação no Esporte do Hospital do Coração
    The main objective of this study was to verify the sensitiveness of the Electronic Arthrometer KT-1000TM in detecting ACL injuries. Thirty-six patients with knee sprain history and clinical tests compatible to ACL injury were evaluated. Group 1 was composed of 18 patients evaluated within less than four weeks after the sprain episode. Group 2 (two) was formed by 18 patients evaluated within more than 4 (four) weeks after the sprain episode. Both Groups were submitted to arthrometric (KT-1000TM) and magnetic resonance imaging (MR) evaluation. After the analysis of data obtained from imaging and arthrometric evaluations, the patients were submitted to arthroscopic procedures for injury evaluation and treatment, enabling the comparison of arthroscopic findings to the results of arthrometry and Magnetic Resonance Imaging. The diagnostic accuracy of the arthrometer KT-1000 TM was 100% for both groups, with the most sensible test regarding the presence of ACL injury being the Maximum Manual Traction Test. The diagnostic accuracy of the magnetic resonance imaging test was 94.4% for Group 1 and 100% for Group 2.
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    Estudo prospectivo randomizado entre as fixações transversas e extracorticais nas reconstruções do ligamento cruzado anterior
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2012-01-01) Guarilha, Eduardo Da Silva; Caldeira, Paulo Roberto De Andrade Fígaro; Lira Neto, Ozorio De Almeida [UNIFESP]; Navarro, Marcelo Schmidt; Milani, Antonio; Carneiro Filho, Mario [UNIFESP]; Hospital IFOR; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina do ABC Grupo de Traumatologia Esportiva
    OBJECTIVE: This study had the objective of prospectively comparing transverse fixation (Cross-PinTM) with extracortical fixation (EZLocTM) for the femur, in surgical reconstruction of the anterior cruciate ligament, from a clinical, biomechanical and functional point of view. METHODS: Between April 2007 and November 2009, 50 patients with acute or chronic anterior cruciate ligament injuries underwent arthroscopic reconstruction using the homologous flexor tendons (gracilis and semitendinosus). Randomization of the femoral fixation method was done by means of a draw at the time of the procedure. Patients were excluded if they presented multiple ligament lesions, fractures, previous surgery, autoimmune disease and impairment of the contralateral knee. The Lysholm scale, SF36 quality-of-life questionnaire and KT1000TM arthrometer were used. RESULTS: After a mean follow-up of 18.1 months, there were no statistically significant differences between the groups regarding the Lysholm scale and KT1000TM measurements. However, the SF36 questionnaire showed a statistical difference such that transverse fixation was superior regarding pain and vitality. CONCLUSION: Both techniques were shown to be efficient for transfemoral fixation, but with almost no statistically significant difference between them. We believe that new studies will be necessary for better understanding of these differences.
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    Estudo randomizado, comparativo, duplo encoberto do efeito analgésico da pregabalina pré e pós-operatória para correção ligamentar artroscópica de joelho
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Tobias, Alexandro Ferraz [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]; Leal, Plinio da Cunha [UNIFESP]; http://lattes.cnpq.br/2150178332757393; http://lattes.cnpq.br/9796401471904195; http://lattes.cnpq.br/2023042604389377; Universidade Federal de São Paulo (UNIFESP)
    Background and Objectives: The effect of pregabalin for postoperative analgesia is controversial. There is a need to evaluate whether pregabalin promotes better pain control after anterior cruciate ligament surgery, enabling better and earlier return to activities and greater comfort for performing physical therapy. The aim of this study was to evaluate the pre and postoperative analgesic effect of pregabalin in patients undergoing arthroscopic anterior cruciate ligament correction of knee and adverse effects. Methods: The study was prospective, randomized, placebo-controlled, and double-blinded conducted with 60 patients, of both genders, with 18 years age or older, physical status ASA I or II, who underwent knee anterior cruciate ligament (ACL) correction, by arthroscopy. The participants were divided into two groups: group 1 (pregabalin) received 14 capsules with 75mg and group 2 received 14 placebo capsules and were instructed to take 1 capsule daily, starting 7 days before surgery until 7 days after. Spinal anesthesia was with 0.5% hyperbaric bupivacaine (15 mg). If analgesic supplementation was required for pain control, patients with pain intensity of 1 to 3 received iv. dipyrone 1g; with no pain control after 30min, iv. ketoprofen 100mg was administered; and if no effect after 30min, iv. tramadol 100mg; and in cases of non-pain control, iv. morphine 5mg was administered, followed by 5mg doses, until pain control. There were evaluated: pain intensity at T0 (surgery completion), after 12h, 24h, 1week, 2week, 1month and 2months, by numerical scale from zero to 10; and postoperative complementary analgesic consumption. Data were submitted to statistical analysis. Results: There was no statistically significant difference in pain intensity between the groups. Morphine consumption was lower in the pregabalin group, 12 and 24h after surgery; ketoprofen and tramadol consumption was lower after 24h in pregabalin group. The adverse effects observed were nausea, vomiting and dizziness; the last was more frequent in the pregabalin group. Conclusions: The reduced need for analgesic supplementation in pregabalin group shows that this drug promotes analgesic effect. However, the patients in pregabalin group presented more dizziness, which should be taken into consideration when it is using the drug.
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    Functional outcomes of traumatic and non-traumatic rotator cuff tears after arthroscopic repair
    (Baishideng Publishing Group Inc, 2017) Kitagaki Abechain, Jose Jorge [UNIFESP]; Godinho, Glaydson Gomes; Matsunaga, Fabio Teruo [UNIFESP]; Netto, Nicola Archetti [UNIFESP]; Daou, Julia Pozzetti [UNIFESP]; Sugawara Tamaoki, Marcel Jun [UNIFESP]
    AIM To compare the functional outcomes of traumatic and non-traumatic rotator cuff tears after arthroscopic repair. METHODS Eighty-seven patients with rotator cuff tears following arthroscopic treatment were divided into traumatic and non-traumatic tear groups. Postoperative muscle strength and outcomes using the modified University of California, Los Angeles score were evaluated. Sex, age, affected limb and dominant limb were correlated between groups. Muscle strength of the repaired and unaffected shoulders was compared. Rotator cuff injury size was measured. RESULTS Of the 87 patients who underwent rotator cuff repairs, 35 had traumatic tears and 52 had non-traumatic tears. In patients with non-traumatic tears, the average age was 59 years, 74.5% were female, 96.1% were righthand dominant and 92.3% had their dominant shoulder affected. Patients with traumatic tears were 59.5 years hand dominant and 88.5% had their dominant shoulder affected. No difference existed in the mean modified University of California, Los Angeles score between patients with traumatic tears (33.7) compared with those with non-traumatic tears (32.8). No strength differences were observed between groups: The strength difference between the non-affected and affected sides was 1.21 kg in the non-traumatic group and 1.39 kg in the traumatic group (P = 0.576), while the strength ratio between the non-affected/affected sides was 0.805 in the nontraumatic group and 0.729 in the traumatic group (P = 0.224). CONCLUSION The functional results of traumatic rotator cuff repairs are similar to non-traumatic tears. Both outcomes are satisfactory.
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    Medidas cefalométricas e polissonográficas em pacientes com deficiência transversal e sagital da maxila tratados cirurgicamente
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-30) Carvalho, Rogerio Teixeira De [UNIFESP]; Abdalla, Rene Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: The bicruciate knee lesion is considered disabling and can take to a loss of anteroposterior and rotational knee stability. The comprehension of different stages of ligamentous damage is crucial for the proper diagnosis. Purpose: To quantify the effects of sequential sectioning of ACL and PCL bundles on knee stability in translation and rotational, in human cadaveric models, in different angles of flexion Methods: Using a custom testing system mounted with a universal machine for mechanical tests, with 20 N of axial compression and loads applied (40-N anterior and posterior tibial load + 2.8 Nm tibial torque for internal and external rotation + 8.5-Nm tibial torque for varus and valgus rotation) were independently and continuously applied during flexion of twelve fresh-frozen cadaveric knees. Kinematics data was recorded using a Microscribe 3DLX digital system for four experimental knee states: intact, ACL cut, incomplete bicruciate tear (ACL cut + AL bundle cut or PM bundle cut of the PCL) and complete bicruciate tear (ACL and PCL cut) in the angular position at 0°, 30º, 60º and 90º of knee flexion. A repeated measures analysis of variance (ANOVA) with a post-hoc Tukey correction was used to analyze the variations in kinematics and forces at 0º, 30º, 60º, and 90º of knee flexion. Significance was set at p <0.05. Results: In comparison to the intact knees, incomplete BI and complete BI showed a significant increase of total anteroposterior tibial translation (p <0,001). The largest significant increase was observed at 90° of flexion after a complete bicruciate resection (p < 0,001). A threshold difference greater than 15 mm from the intact could be used to identify a complete BI from na incomplete BI evaluating the total antero-posterior translation at 90°. All sectioned states had significant increases compared with intact condition in internal - XV external rotation and varus-valgus stability at all tested flexion angles, mainly at 90°, but changes were small in comparison with total anteroposterior tibial translation. Conclusion: There was a significant progressive increase in total AP tibial translation after incomplete and complete BI at all angles tested, with 0° was the most stable position and 90° the most unstable. The internal and external rotation, varus and valgus rotation only small increments in knee laxity were verified after the sequential sectioning cuts of the ACL and PCL. The largest increase in kinematics was verified in total AP tibial translation after complete BI at 90° of flexion above 15mm that can be indicative of complete bicruciate lesion in comparison with intact knee condition.
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    Meniscal repair by all-inside technique with Fast-Fix device
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2013-09-01) Albertoni, Leonardo Jose Bernardes; Schumacher, Felipe Conrado; Ventura, Matheus Henrique Araujo; Franciozi, Carlos Eduardo da Silveira [UNIFESP]; Debieux, Pedro [UNIFESP]; Kubota, Marcelo Seiji; Granata Junior, Geraldo Sergio de Mello; Luzo, Marcus Vinicius Malheiros [UNIFESP]; Queiroz, Antonio Altenor Bessa de; Carneiro Filho, Mario; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE:The objective of this study is to evaluate the results and effectiveness of the technique of meniscal repair type all-inside using Fast-Fix device.METHODS:A retrospective cohort study evaluating 22 patients with meniscal surgery between January 2004 and December 2010 underwent meniscal repair technique for all-inside with the Fast-Fix device with or without ACL reconstruction. Function and quality of life outcomes were chosen by the IKDC and Lysholm score, before and postoperatively, and reoperation rates, relying to the time of final follow-up. Statistical analysis was performed using the Student's t test.RESULTS:The mean follow-up was 59 months (16-84). The Lysholm score showed 72% (16 patients) of excellent and good results (84-100 points), 27% (6 patients) fair (65-83 points) and no cases classified as poor (<64 points). According to the IKDC: 81% (18 patients) of excellent and good results (75-100 points), 18% of cases regular (50-75 points) and no patient had poor results (<50 points). There were no failures or complications.CONCLUSION:The technique of meniscal repair type all-inside using the Fast-Fix device is safe and effective for the treatment of meniscal lesions in the red zone or red-white with or without simultaneous ACL reconstruction, with good and excellent results in most patients Level 4 Study.
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    Prevalência das lesões associadas na luxação recidivante traumática do ombro
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2011-01-01) Carrazzone, Oreste Lemos [UNIFESP]; Tamaoki, Marcel Jun Sugawara [UNIFESP]; Ambra, Luiz Felipe Morlin [UNIFESP]; Neto, Nicola Archetti [UNIFESP]; Matsumoto, Marcelo Hide [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the prevalence of lesions associated with traumatic anterior shoulder instability and the relationships between the prevalence of these lesions and the number of episodes and time since symptoms started. METHOD: Fifty-seven patients aged 18 to 40 years, with traumatic anterior shoulder instability, more than one episode of shoulder dislocation and at least six months since the first dislocation, who required surgery to treat the instability, were selected. Arthroscopic inspection was performed on all the patients to assess any associated lesions. RESULTS: The prevalence of lesions was assessed, and Bankert lesions were the most prevalent, followed by Hill-Sachs lesions, while rotator cuff injuries were the least prevalent. There was no correlation from comparison between the number of episodes of dislocation and the prevalence of associated lesions. On the other hand, in relation to the time since symptoms started, the patients who had had symptoms for longer times had fewer Hill-Sachs lesions. CONCLUSION: It was not possible to affirm that, in patients with chronic shoulder instability, the numbers of associated lesions increased with the time since symptoms started, or with the number of episodes of dislocation.
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    Pseudoaneurisma de artéria genicular após cirurgia artroscópica de joelho: Relato de dois casos
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Pereira Junior, Edgard Dos Santos [UNIFESP]; Mestriner, Luiz Aurélio [UNIFESP]; Pereira, Edgard Dos Santos; Domingues, Ricardo Perez; Cardoso, Marcos Prado Alves; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro Departamento de Ortopedia e Traumatologia Grupo de Cirurgia do Joelho
    Arthroscopy of the knee is a very safe surgical procedure, with relatively few complications. Here we present the cases of two patients submitted to arthroscopic surgery for partial meniscectomy and reconstruction of the anterior cruciate ligament with femoral transverse screw and tibial interference screw that developed a superior lateral genicular artery pseudoaneurysm. Doppler ultrasonography was performed for diagnostic purposes and the patients were treated by direct arterial suture. One patient developed a large haematoma requiring volemic replacement. These cases illustrate a rare, and not always benign vascular complication, in a minimally invasive arthroscopic surgery.
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    Resultados do reparo artroscópico do primeiro episódio de luxação glenoumeral em atletas
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-08) Terra, Bernardo Barcellos [UNIFESP]; Ejnisman, Benno [UNIFESP]; http://lattes.cnpq.br/1124807952912223; http://lattes.cnpq.br/0612347056064419; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A articulação glenoumeral é caraterizada pelo amplo grau de movimento e consequentemente é a articulação mais suscetível a luxações. Considerando a alta taxa de recorrência, retorno ao esporte e a artropatia pós instabilidade, diversos autores advogam o tratamento cirúrgico após o primeiro episódio de luxação, obtendo assim um reparo mais anatômico e com um risco menor de recorrência. Há uma escassez de estudos com atletas jovens e primeiro episódio de luxação do ombro. Objetivo: Relatar os resultados do tratamento cirúrgico artroscópico após o primeiro episódio de luxação glenoumeral em atletas jovens. Método: Trata-se de um estudo retrospectivo com dados coletados de forma prospectiva de 53 pacientes (54 ombros) menores que 40 anos operados com um tempo médio entre o primeiro episódio de luxação e o ato cirúrgico de 59 dias (2-360 dias). O seguimento mínimo foi de 2 anos com uma média de 844 dias. A análise estatística foi realizada pelo software SPSS versão 20. O nível de significância utilizado foi de de alfa menor que 0,05. Resultados: A idade média dos atletas foi de 30,8 anos. A média do EROE foi de 93,8, sendo 98% de resultados bons e excelentes. Quanto ao escore de Rowe, 98,2% tiveram resultados bons e excelentes, com uma média de 95. A escala visual analógica de dor teve uma média menor que 1. A taxa de reincidência da luxação foi de 2% (um caso). Não existiu correlação entre o tempo para a cirurgia após a lesão com o resultado cirúrgico [EROE total (p = 0,16), Rowe total (p = 0,13)] e EVA (p = 0.68). Foi observado uma diferença significativa entre retorno ao esporte e resultado cirúrgico, escore EROE (p = 0,001) e Rowe total (p = 0,008). A taxa de retorno ao esporte foi de 83%, sendo que os pacientes com lesão labial superior associada tiveram menores taxas de retorno ao esporte (p = 0,001) e dos escores EROE (p = 0,017) e Rowe (p = 0,019). Conclusão: O presente estudo mostrou resultados favoráveis no tratamento cirúrgico artroscópico após o primeiro episódio de luxação em atletas jovens, sendo uma forma de tratamento eficaz e segura nesta população. O tempo de espera para a cirurgia e idade não mostraram diferença nos resultados dos escores funcionais.
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    Rotura da placa plantar da segunda e terceira metatarsofângicas: desempenho diagnóstico dos sinais diretos e indiretos na ressonância magnética, utilizando achados cirúrgicos como referência
    (Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Yamada, Andre Fukunishi [UNIFESP]; Fernandes, Artur da Rocha Correa [UNIFESP]; http://lattes.cnpq.br/5802740927050065; http://lattes.cnpq.br/0690763303891559; Universidade Federal de São Paulo (UNIFESP)
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    Sinovite Vilonodular Pigmentada Localizada do joelho: tratamento por via artroscópica
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2005-01-01) Hernandez, Arnaldo José; Camanho, Gilberto Luis [UNIFESP]; Laraya, Marcos Henrique [UNIFESP]; Fávaro, Edimar; Martinelli Filho, Maurício; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    The authors present a series of seven case reports of Localized Pigmented Villonodular Synovitis (LPVNS) treated by arthroscopy resection between June of 1994 and October of 2001. At the baseline evaluation, symptoms ranged from diffuse pain to localized swelling of the knee, with or without mechanical blockage of the joint. Magnetic Resonance helped in localizing the lesion and in the follow up evaluation. Diagnosis was confirmed through anatomicopathological examination. By the end point evaluation, none of the patients presented recurrence of the pre-operative symptoms referred before. Magnetic resonance imaging also showed absence of symptoms. Despite of the small number of patients, typical of this affection, the authors believe that arthroscopic excision of the LPVNS is an effective method, with low morbidity, providing remission of the symptoms and a low recurrence potential.