Navegando por Palavras-chave "Traumatismos do joelho"
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- ItemAcesso aberto (Open Access)Effectiveness of electrical stimulation on rehabilitation after ligament and meniscal injuries: a systematic review(Associação Paulista de Medicina - APM, 2011-12-01) Imoto, Aline Mizusaki [UNIFESP]; Peccin, Maria Stella [UNIFESP]; Almeida, Gustavo Jerônimo Melo; Saconato, Humberto; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); University of Pittsburgh Department of Physical Therapy; Universidade Federal do Rio Grande do Norte Department of Clinical MedicineCONTEXT AND OBJECTIVE: Electrical stimulation (ES) is widely used to strengthen muscles following ligament and meniscal injuries. The aim of this study was to evaluate the effectiveness of ES for rehabilitation after soft tissue injuries of the knee treated surgically or conservatively. DESIGN AND SETTING: Systematic review at the Brazilian Cochrane Center. METHODS: We searched the Cochrane Central Register of Controlled Trials (2010, Issue 12), Medline (Medical Analysis and Retrieval System Online) via PubMed (1966 to December 2010), Embase (Excerpta Medica database, 1980 to December 2010), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde, 1982 to December 2010), and PEDro (Physiotherapy Evidence Database, 1929 to December 2010). The studies included were randomized controlled trials using ES to increase muscle strength for rehabilitation of patients with soft tissue injuries of the knee. Two authors independently evaluated studies for inclusion and performed data extraction and methodological quality assessment. RESULTS: Seventeen studies evaluating ES after anterior cruciate ligament reconstruction and two studies evaluating ES after meniscectomy were included. There was a statistically significant improvement in quadriceps strength through ES (mean difference, MD: -32.7; 95% confidence interval, CI: -39.92 to -25.48; n = 56) and in functional outcomes (MD -7; -12.78 to -1.22; n = 43) six to eight weeks after surgical reconstruction of the anterior cruciate ligament. CONCLUSION: There is evidence that ES coupled with conventional rehabilitation exercises may be effective in improving muscle strength and function two months after surgery
- ItemAcesso aberto (Open Access)Questionário específico para sintomas do joelho Lysholm Knee Scoring Scale - tradução e validação para língua portuguesa(Universidade Federal de São Paulo (UNIFESP), 2001) Peccin, Maria Stella [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)As doenças do joelho apresentam conseqüências variadas para a funçao e a qualidade de vida do indivíduo Para traduzir, validar e verificar as propriedades de medida do questionário específico para sintomas do joelho, "Lysholm Knee Scoring Scale" para a língua portuguesa, selecionamos 50 pacientes (29 homens e 21 mulheres, média de idade 38,7 anos) com lesao de joelho (lesao meniscal, lesao do ligamento cruzado, anterior, condromalácia ou artrose) O nível, de escolaridade foi distribuído em: ensino médio 16 pacientes; ensino superior 34 pacientes. A reprodutibilidade e a concordância ordinal inter e foram excelentes (a = 0,9). A concordância nominal inter-entrevistadores foi boa (Kappa = 0,7) e intra-entrevistador, excelente (Kappa = 0,8). No processo de validaçao, correlacionamos ó questionário Lysholm com a escala numérica da dor (r= -0,6; p=0,001) e com o índice de Lequesne (r= -0,8; p=0,001). As correlaçoes entre o Lysholm e a avaliaçao global da saúde pelo paciente e pelo terapeuta apresentaram-se fracas e nao significantes. As correlaçoes entre o questionário Lysholm e o SF-36 foram significantes nos aspectos físicos (r = 0,4; p = 0,04), de dor (r = 0,5; p = 0,001) e de capacidade funcional (r = 0,7; p = 0,0001). Concluímos que a traduçao e adaptaçao cultural do "Lysholm knee scoring scale" para o nosso idioma apresentou reprodutibilidade e validade em pacientes com lesao meniscal, lesao do ligamento cruzado anterior, condromalácia ou artrose do joelho.
- ItemAcesso aberto (Open Access)Questionário específico para sintomas do joelho Lysholm Knee Scoring Scale: tradução e validação para a língua portuguesa(Sociedade Brasileira de Ortopedia e Traumatologia, 2006-01-01) Peccin, Maria Stella [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Knee diseases present variable consequences for an individual s function and quality of life. For the purposes of translating, validating and checking the measurement properties of the specific questionnaire for knee symptoms - the Lysholm Knee Scoring Scale - into Portuguese, we selected, for convenience, 50 patients (29 males and 21 females, mean age = 38.7 years) with knee injuries (meniscal injury, anterior cruciate ligament injury, chondromalacia or arthrosis). Reproducibility and ordinal consistency inter- and intra-interviewer were excellent (alpha = 0.9). The nominal consistency inter-interviewers was good (Kappa = 0.7) and intra-interviewer was excellent (Kappa = 0.8). During validation process, we correlated the Lysholm questionnaire with the pain numerical scale (r=-0.6; p=0.001) and with he Lequesne index (r= -0.8; p=0.001). Correlations between Lysholm questionnaire and the global health evaluation by patient and by therapist were poor and not significant. The correlations between Lysholm questionnaire and SF-36 were significant for physical aspects (r = 0.4; p = 0.04), pain (r = 0.5; p = 0.001) and function (r = 0.7; p = 0.0001). We concluded that the translation and cultural adaptation of the Lysholm knee scoring scale into our language have proven to be reproducible and valid in patients with meniscal injury, anterior cruciate ligament injury, chondromalacia or knee arthrosis.
- ItemAcesso aberto (Open Access)Reabilitação pós-operatória dos ligamentos cruzado anterior e posterior: estudo de caso(Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Silva, Kelson Nonato Gomes da [UNIFESP]; Imoto, Aline Mizusaki [UNIFESP]; Cohen, Moises [UNIFESP]; Peccin, Maria Stella [UNIFESP]; Universidade São Marcos; Instituto Cohen - Ortopedia, Reabilitação e Medicina do Esporte; Universidade Federal de São Paulo (UNIFESP)Knee ligament injuries are among the most common sports lesions. However, injuries associated with the cruciate ligaments are rare, and normally occur as a result of high impact traumas. In these cases, surgical intervention is necessary, due to the high level of functional instability. PURPOSE: to develop and apply a postoperative rehabilitation protocol for reconstruction of cruciate ligaments, and to record their evolution by means of regular evaluations with validated functional questionnaires. METHOD: case report of a patient submitted to reconstruction of the cruciate ligaments until return to sports. The functional capacity was evaluated using knee function questionnaires (Lysholm and IKDC); range of movement (goniometer), anteroposterior displacement (arthrometer KT1000TM), strength (isokinetic dynamometer) and movement analyses (walking gait and running gait). CONCLUSION: the protocol was effective for improving functional stability, strength, and a safe return to sports.
- ItemAcesso aberto (Open Access)Reconstrução combinada intra e extra-articular versus reconstrução intra-articular isolada do ligamento cruzado anterior: revisão sistemática(Universidade Federal de São Paulo (UNIFESP), 2016-12-30) Rezende, Fernando Cury [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; http://lattes.cnpq.br/0981211406387862; http://lattes.cnpq.br/7735986333638050; Universidade Federal de São Paulo (UNIFESP)Introduction: Anterior cruciate ligament reconstruction (ACL) aims to restore knee function and stability; however, rotational stability may not be completely restored by use of standard intraarticular reconstruction alone. This systematic review assesses whether combining extraarticular with intraarticular ACL reconstruction may show better results than intraarticular reconstruction alone. Purpose: To verify, through meta- analysis, the effects of combined intra- and extra-articular reconstruction compared to isolated intraarticular ACL reconstruction. Methods: To identify randomized controlled trials (RCTs) comparing combined intra- and extrarticular ACL reconstruction (combined reconstruction) with intraarticular ACL reconstruction only, we searched MEDLINE, EMBASE, SPORTDiscus, Latin American and Caribbean Health Sciences (LILACS), and the Cochrane Central Register of Controlled Trials, and followed the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) criteria. The main outcomes we sought were patient function and stability and complications after ACL reconstruction. Results: Of 386 identified studies, eight RCTs were included (n = 682 participants; followup, 12?84 months; men to women ratio, 2.17:1) in our meta-analysis. Study quality (internal validity) was assessed using the Cochrane risk-of- bias tool. When functional outcomes were compared, we found no difference between patients who underwent intraarticular ACL reconstruction only and those who underwent combined reconstruction (IKDC, return-to-activity, and Tegner Lysholm scores). However, patients who underwent combined reconstruction were more likely to show improved stability based on the pivot shift test (risk ratio [RR], 0.95; 95% CI, 0.91?0.99; p = 0.02) and Lachman test (RR, 0.93; 95% CI, 0.88?0.98; p = 0.01). In addition, our meta-analysis found no difference between the two treatments in terms of general complications or adverse events (RR, 1.31; 95% CI, 0.70?2.34; p = 0.40) and the proportion of patients whose reconstructions failed (RR, 2.88; 95% CI, 0.73?11.47; p = 0.13). Conclusions: Combined intra- and extraarticular ACL reconstruction provided improved knee stability and comparable failure rates but no difference in patient reported functional outcomes scores. Complications and adverse events such as knee stiffness may be underreported and technical factors such as graft placement were difficult to evaluate. In general, we found a moderate quality of evidence of the included randomized controlled trials.
- ItemAcesso aberto (Open Access)Reconstrução do ligamento cruzado anterior com duplo feixe utilizando os tendões dos músculos semitendíneo e grácil: fixação com dois parafusos de interferência(Sociedade Brasileira de Ortopedia e Traumatologia, 2009-10-01) Carneiro, Mario [UNIFESP]; Navarro, Ricardo Dizioli [UNIFESP]; Nakama, Gilberto Yoshinobu [UNIFESP]; Barretto, João Mauricio; Queiroz, Antonio Altenor Bessa De [UNIFESP]; Luzo, Marcus Vinicius Malheiros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa do Rio de Janeiro Serviço de Ortopedia e TraumatologiaSurgical procedures for double-bundle reconstruction of anterior cruciate ligament, which currently use semitendinous and gracilis tendon grafts, have been described in the last decade. Most of the techniques utilize twice the hardware used in single-bundle reconstructions. We report an original anterior cruciate ligament double-bundle reconstruction technique using semitendinous and gracilis tendon grafts, maintaining their tibial bone insertions with two tibial and two femoral tunnels. A simplified and precise outside-in femoral drilling technique is utilized, and the graft fixation is made utilizing only two interference screws.