Artigos e Materiais de Revistas Científicas - FM/MOT

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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EVALUATION OF ANKLE MOVEMENTS ON A SUDDEN INVERSION PLATFORM
(2023) SANTOS, Leandro Dias dos; PEREIRA, César Augusto Martins; BOLLIGNER NETO, Raul; ALONSO, Angélica Castilho; GREVE, Júlia Maria D'Andrea
ABSTRACT Introduction: Ankle sprains are frequent in sports activities and can lead to joint instability with clinical and performance consequences. Sudden ankle inversion platforms have been used to study the mechanism of ankle sprain. Objectives: To test a static platform that simulates the movement of ankle sprain (sudden inversion) in soccer players. Methods: A platform was developed to perform the sudden movement of an ankle sprain dissociated in three axes: inversion, plantar flexion, and medial rotation. A computer program was also created to read the angular velocity and the time to reach the maximum amplitude of the three axes of movement, synchronized with the platform movements. Thirty soccer players without ankle sprains were evaluated on the sudden inversion platform. Each athlete performed 10 randomly initiated tests, with five per leg. Results: There was no statistical difference in angular velocity or time to reach maximum range of motion of plantar flexion and medial rotation between the tests. During the tests, the angular velocity of the inversion increased. Conclusion: The sudden static platform evaluated the movements performed by the ankle during the sprain reliably in the 10 tests with no difference in the mechanical behavior. Level of evidence I; Therapeutic studies - Investigation of treatment outcomes.
EPIDEMIOLOGICAL PROFILE IN A TERTIARY ADMISSION UNIT OF SPINE DISEASES
(2023) COIMBRA, BRIAN GUILHERME MONTEIRO MARTA; FREITAS, MATHEUS TRINDADE BRUXELAS DE; LIMA, RAFAELA PEREIRA DE; PERINI, DANIEL DUARTE; BARROS FILHO, TARCíSIO ELOY PESSOA DE; CRISTANTE, ALEXANDRE FOGAçA; MARCON, RAPHAEL MARTUS
ABSTRACT Introduction: In March 2020, WHO officially decreed that the world was going through a pandemic, that of Covid-19. In May 2022, in Brazil, the end of measures to deal with the pandemic was decreed. In 2022, there was a movement to return to normal care in the provision of care. Objective: In the present study, we carried out a retrospective descriptive analysis of the epidemiological scenario of the ward of the Spine Group at the Hospital das Clínicas of the Faculty of Medicine of the Universidade de São Paulo (HC-FMUSP). Method: Data analysis was performed from information gathered in patients’ medical records. Results: In the analyzed period, there were 152 consultations in hospitalization, with the main cause being spinal trauma. Of all the cases, only 23.68% were scheduled on an elective basis, which despite being a lower than expected number, was shaped by the demands of urgent care channeled to the service in question. Conclusion: Despite a higher number of cases hospitalized in the post-pandemic period, there is still the expectancy of more elective cases to be treated in the future. Level of Evidence III; Retrospective Case Series Study.
The social dimension of quality of life following spinal cord injury or disease: an international ICF-linking study
(2024) WIND, Aline J. Hakbijl-van der; ROHN, Edward J.; TATE, Denise G.; LEEUWEN, Christel M. C. van; FORCHHEIMER, Martin; STOLWIJK-SWUSTE, Janneke M.; CHARLIFUE, Susan; GREVE, Julia M. D.; NEW, Peter W.; POST, Marcel W. M.
Study designInternational Classification of Functioning, Disability and Health (ICF) linking study.ObjectiveAnalyze cognitive interview data using the ICF as an analytic framework, to examine aspects of social life relevant to quality of life (QoL) according to people with spinal cord injury or disease (SCI/D). This study builds upon results of an international study about the cross-cultural validity of the International SCI QoL Basic Data Set (QoL-BDS).SettingFour specialized outpatient clinics in SCI/D rehabilitation, from the US, Brazil and Australia.MethodsAnalysis of qualitative data from 39 cognitive interviews with SCI/D patients at least one year post onset. Participants were asked to define their concept of QoL, overall life satisfaction, physical health and psychological health, and other relevant matters. Four independent researchers coded text fragments related to the items, and fragments were linked to ICF chapters d6-d9, following established linking rules.ResultsThe proportion of text referring to social life was 35.8% (definition QoL), 24.9% (QoL life as whole), 6.0% (physical health) and 34.9% (psychological health). The most frequent ICF categories were d760 Family relationships, d770 Intimate relationships and d920 Recreation and leisure. Most frequent responded social topics to the 'other issues' item were d770 Intimate relationships, d760 Formal relationships, and d870 Economic self-sufficiency.ConclusionThe importance of social life aspects to the QoL was highlighted based on responses of SCI/D patients, clearly demonstrated through the ICF linking process. Adding a satisfaction with social life item to the QoL-BDS has made this instrument a more comprehensive measure.
Functional and morphological evaluation of the trapezius muscle after spinal accessory nerve transfer to brachial plexus nerves
(2024) SIMAO, Danielle Tiemi; HEISE, Carlos O.; RODRIGUES, Joao C.; YAMAUTI, Lucas S.; VILLEGAS, Robin I.; CHO, Alvaro B.; MATTAR JUNIOR, Rames
IntroductionThe main innervation of the trapezius muscle is provided by the spinal accessory nerve. Several studies describe the contributions of cervical plexus roots to the trapezius muscle innervation, either directly or through connections with the spinal accessory nerve. There is no adequate understanding of how the trapezius muscle is affected after using the spinal accessory nerve in nerve transfer procedures with the usual technique, preserving at least 1 branch for the upper trapezius.MethodsWe evaluated 20 patients with sequelae of traumatic brachial plexus injury who underwent surgical procedures for brachial plexus repair or free muscle transfer, which included the spinal accessory nerve transfer technique and were followed for a minimum of 1 year. The three portions trapezius muscle were evaluated by physical examination, magnetic resonance imaging (analysis of fatty degeneration) and electromyography.ResultsIn all evaluation methods, the middle and lower portions of the trapezius muscle showed more significant morphological and/or functional impairment than the upper portion, in most cases. There was a statistically significant difference in all the complementary exams results, between the affected side (with sacrifice of the nerve) versus the normal side, in the middle and lower portions of the trapezius muscle.ConclusionsPhysical examination alone is not sufficient to determine the residual functionality of the trapezius muscle. Magnetic resonance imaging and electromyography are useful tools to assess both morphological involvement of the trapezius muscle and nerve conduction impairment of the trapezius muscle, respectively. The results suggest that the middle and lower portions of the trapezius muscle are affected by previous SAN transfer and should be considered with caution for further muscle transfer procedures.
Atypical Cleft Hand: Surgical Technique for Grasping Improvement
(2024) BISNETO, Edgard de Novaes Franca; FERNANDES, Laura Filippini Lorimier; PAULA, Emygdio Jose Leomil de; MATTAR JUNIOR, Rames
Introduction:We present 6 cases of children with atypical cleft hand and discuss a surgical technique. Clinically, participants presented with a lack of pulp-to-pulp pinch due to metacarpophalangeal ligament insufficiency and difficulty grasping large objects because of the narrowed first web.Materials and Methods:Second metacarpal resection and Z-plasty, creating a wide first web. The second extensor digitorum communis tendon was transferred to improve the thumb metacarpophalangeal joint stability.Conclusions:The surgical technique presented in this paper did improve function in oligodactyly or type-IIA atypical cleft hand.
Optimised return to play: high treatment success rate in core muscle injury with surgical release of the anterior tendon of the rectus abdominis muscle and proximal tenotomy of the adductor longus muscle
(2024) PEDRINELLI, Andre; FERNANDAS, Joao Vitor de Castro; LEITE FILHO, Carlos Guilherme Dorile; ALMEIDA, Adriano Marques de; FERNANDES, Tiago Lazzaretti; HERNANDEZ, Arnaldo Jose
Objectives: Core muscle injury is a debilitating condition that causes chronic groin pain in athletes, particularly common in soccer players. The condition is characterised by pain in the inguinal region and can lead to a significant number of absences from high-intensity physical activity. It is caused by repetitive overload without proper counterbalance from the abdominal muscles, hip flexors, and adductors in susceptible athletes. Surgical indications for core muscle injury consider cases where non-surgical treatments have not provided sufficient relief. The aim of this study was to assess the results of surgical intervention for core muscle injury using the technique employed by the Sports Medicine Group of (Institute of Orthopedics and Traumatology of Hospital das Clinicas - Universidade de Sao Paulo). The procedure involves releasing the anterior portion of the tendon of the rectus abdominis muscle near the pubic symphysis, along with proximal tenotomy of the adductor longus muscle tendon. Methods: This study utilised a consecutive historical cohort analysis of the medical records of 45 male athletes, of which, 75.6% were professional soccer players, who underwent surgical treatment between January 1, 2002, and December 31, 2021. The participants included active athletes aged between 18 and 40 years, with a mean age of 23.9 years, and were diagnosed with myotendinous core muscle injury. These athletes experienced pain in the pubic symphysis and adductor tendon region and had previously undergone medical treatment and physical therapy for a duration of three to six months without significant improvement. Results: The average time for athletes to return to sport after surgery was 135 days, with a majority of participants being soccer and futsal players. The surgical intervention yielded promising results, with a positive correlation between unilateral injuries and the time taken to return to sport. The complication rate was low, at 6.7%. Notably, the rate of symptom resolution was high, at 93.3%. Furthermore, the analysis indicated that the player's position on the field significantly influenced the discharge period, suggesting that the game position plays a role in the recovery process. Conclusion: The combined surgical procedure involving the release of the rectus abdominis tendon and adductor longus muscle tenotomy demonstrates favourable outcomes for athletes with core muscle injury. This study provides strong support for the effectiveness of this surgical approach in managing the condition and offers a potential path to recovery and return to sports activities. Study design: Cross-sectional study.
CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION?
(2023) IAMAGUCHI, Raquel Bernardelli; DIAS, Guilherme Moreira; IWASE, Fernanda Do Carmo; REZENDE, Marcelo Rosa De; JR, Rames Mattar
We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Ob-jective: To analyze patients with traumatic proximal wrist upper limb amputations with prolonged ischemic time who underwent temporary artery catheterization to assess stump viability and results. Methods: A case-series study including all patients with a proximal wrist upper limb amputation and a cold ischemic time equal to or above six hours from 2017 to 2021. Results: In total, two surgeons operated eight patients who had experienced forearm amputation injuries. Median ischemia time totaled eight hours. All patients required additional surgeries, most commonly split-thickness skin graft or fixation revision (three patients). This study obtained five successful macroreimplan-tations. The mean cold ischemia time was longer in the group with successful macroreimplantations (7.4 hours) than of the unsuccessful group (9 hours). Conclusion: Macroreplantations require immediate referral to microsurgery and, although tem-porary artery catheterization helps surgical decision making, the technique seems to fail to influence outcomes. Level of Evidence IV, Retrospective Case Series.
Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
The Influence of Whey Protein on Muscle Strength, Glycemic Control and Functional Tasks in Older Adults with Type 2 Diabetes Mellitus in a Resistance Exercise Program: Randomized and Triple Blind Clinical Trial
(2023) SOARES, A. L. D. S.; MACHADO-LIMA, A.; BRECH, G. C.; GREVE, J. M. D.; SANTOS, J. R. dos; INOJOSSA, T. R.; ROGERO, M. M.; SALLES, J. E. N.; SANTAREM-SOBRINHO, J. M.; DAVIS, C. L.; ALONSO, A. C.
Objectives: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. Methods: The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. Results: There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. Conclusion: The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function.
Tibiotalocalcaneal Arthrodesis: A Retrospective Comparison Between Nails and Lateral Locking Plate Complications
(2023) ROSEMBERG, D. L.; MACEDO, R. S.; SPOSETO, R. B.; SAKAKI, M. H.; GODOY-SANTOS, A. L.; FERNANDES, T. D.
Background: Tibiotalocalcaneal arthrodesis is a well-established procedure to treat some hindfoot diseases. Currently, the most used implants are retrograde intramedullary nails and locking plates combined with lag screws, but there are few articles comparing differences regarding the complications. Methods: We have retrospectively analyzed the medical records and the radiographs of patients older than 18 years who underwent this procedure in our service between 2005 and 2019 through retrograde intramedullary nails or lateral locking plates and compression screws with at least 12 months of follow-up and with no history of osteomyelitis in these bones. Results: We evaluated a total of 67 patients; of these, 48 received retrograde intramedullary nail implants and 19 received locking plates and compression screws. The overall mean age was 48 years; the median follow-up time was 64.3 months. The complication rate was 60.4% for the intramedullary nail procedure and 52.6% for the locking plate combined with compression screws procedure. Conclusion: No significant differences were found in the complication rates between the 2 implants. Level of Evidence: Level V, Case series
Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms
(2023) SILVA, V. C.; DIAS, A. S.; GREVE, J. M. D.; DAVIS, C. L.; SOARES, A. L. D. S.; BRECH, G. C.; AYAMA, S.; JACOB-FILHO, W.; BUSSE, A. L.; BIASE, M. E. M. de; CANONICA, A. C.; ALONSO, A. C.
The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.
Health- Related Predictive Factors of Brazilian Children With Early Onset Scoliosis Using the EOSQ-24 and CHQ- PF50 Questionnaires
(2023) MENDONCA, Rodrigo Goes Medea de; MARTINS, Wesley Wilian Costa; MORAES, Patricia Maria de; FUCS, Barros; GOTFRYD, Alberto Ofenhejm; CAFFARO, Maria Fernanda Silber; LETAIF, Olavo Biraghi; MARCON, Raphael; CRISTANTE, Alexandre Fogaca; KIYOMOTO, Henry Dan; SILVA, Tania Fernanda Cardoso da; MATSUMOTO, Hiroko; VITALE, Michael G.; MEVES, Robert
Background: Assessing the quality of life (QOL) of children with early onset scoliosis (EOS) has been discussed recently. Therefore, the study aimed to apply and correlate the 24 -item Early Onset Scoliosis Questionnaire (EOSQ- 24) with the 50 -item Childhood Health Questionnaire (CHQ- PF50) to find predictive factors impacting QOL.Methods: Cross-sectional study involving a population of caregivers of patients with EOS. The sample consisted of 72 patients. Two research assistants applied the Portuguese version of the EOSQ- 24 and CHQ- PF50 in 3 treatment centers. The EOSQ- 24 assesses the subjective response of children with EOS from the parent's point of view. The CHQ is a self-administered questionnaire or parental proxy assessment of the psychological and social status of children aged 5 to 18 years.Results: Of 72 patients, 41 (56.9%) were females, mean age of 11.9 +/- 4.2 years. The most common scoliosis was of neuromuscular origin (32%). The CHQ- PF50 showed that family-related items had significant scores. The most affected subcategory was physical function (45.5), and the least affected was mental health (90.8). Thus, the CHQ- PF50 PhS summary index was 27, and the CHQ- PF50 PsS was 71.7. Moreover, the critical categories for the EOSQ- 24 questionnaire were daily life and physical function (45.1 and 47.8, respectively), and the least affected categories were transfer and pulmonary function (70.8 and 68.9, respectively). Four subcategories showed a strong correlation between both questionnaires: general health (r = 0.749, P < 0.001), physical function (r = 0.645, P < 0.001), bodily pain (r = 0.714, P < 0.001), and mental health (r = 0.424, P < 0.001). Using CHQ- PF50 as a dependent variable in multiple regression analysis (P = 0.028), the only variable affecting the scores was syndromic scoliosis (P = 0.019; 95% CI -27.4 to -2.5).Conclusion: A strong correlation between both questionnaires was seen for general health, physical function, bodily pain, and mental health. Syndromic scoliosis was a predictor of worse QOL according to the CHQ- PF50.Level of Evidence: 2.
Effect of 12-week rehearsal on cardiorespiratory fitness and body composition in Brazilian samba dancers
(2023) DUARTE, Cicera Claudinea; SANTOS-SILVA, Paulo Roberto; PALUDO, Ana Carolina; GRECCO, Marcus Vinicius; GREVE, Julia Maria D'Andrea
Objective: To investigate the effect of 12 weeks of rehearsals on cardiorespiratory parameters and body composition in Brazilian samba dancers belonging to a first-league samba school.Methods: Twenty-six women were divided into a Samba Group (n=13) and a Control Group (n=13). Cardiorespiratory parameters (cardiopulmonary exercise test) and body composition (skinfold assessment) were assessed before and after the 12 weeks of rehearsals. The Samba Group rehearsed three times per week for 30-60 minutes, and the Control Group participated in no physical activity. A comparison test was performed within and between groups, with p<0.05 indicating statistical significance.Results: Compared with the Control Group, the Samba Group showed a significant increase in maximal oxygen uptake (19%), oxygen pulse (13%), and lean body mass (3%) and a decrease in body fat percentage (11%) and fat mass (12%).Conclusion: Twelve weeks of samba dance rehearsals improved the cardiorespiratory and body composition parameters in women dancers compared with the Control Group. These findings suggest that dancing samba regularly can increase physical activity levels and positively affect the health parameters of samba dancers.
Reproducibility of Digital Planning in Cementless Total Hip Arthroplasty Among Experienced and Novice Surgeons
(2023) FABRICIO, Marcelo Zerbetto; RUDELLI, Bruno Alves; MIYAHARA, Helder de Souza; EJNISMAN, Leandro; GURGEL, Henrique de Melo Campos; CROCI, Alberto Tesconi
Abstract Objective The present study aims to assess the reproducibility of digital planning for cementless total hip arthroplasty (THA) among surgeons with different levels of experience. In addition, it attempts to determine the degree of planning reliability based on a contralateral THA or on a spherical marker positioned at the greater trochanter for calibration. Methods Two evaluators with different experience levels (A1 and A2) performed independently the retrospective digital surgical planning of 64 cementless THAs. Next, we compared the planning with the implants used in the surgery. The reproducibility was excellent when planning and implants were identical; proper in case of a single-unit variation; and inappropriate if there was variation in two or more units. The present analysis also determined the calibration accuracy between the contralateral THA and the spherical marker at the greater trochanter level. Results The present study demonstrated greater success when the most experienced evaluator performed the planning and greater accuracy for the contralateral THA. When splitting the analysis per parameter (contralateral THA or spherical marker), there was a statistical difference only for the planning of A1 and the implants used in the surgery. This difference occurred in the excellent category, with 67.3% for contralateral THA compared with 30.6% for a spherical marker (p < 0.001), and in the inappropriate category, with 7.1% for contralateral THA compared with 30.6% for a spherical marker (p < 0.001). Conclusions Digital planning is more accurate when performed by an experienced evaluator. The contralateral prosthesis head was a better reference than a marker on the greater trochanter.
Contemporary reflection on the educational levels of high-performance soccer players in Brazil
(2023) SANTOS-SILVA, Paulo Roberto; GREVE, Julia Maria D'Andrea; SILVA, Renato Luis da; SPINOLA, Marcelo Mesquita
Objective: As the soccer culture in Brazil is more popular than schooling, this study reflected on the formal education levels of soccer (football) players through descriptive and quantitative analyses. Methods: We evaluated 179 national soccer players playing various positions on different teams across six seasons (2012, 2013, 2014, 2015, 2016, and 2022). Data were collected using a questionnaire comprising the following variables: age, position in the pitch, age of professionalization, and education (years of study). The data were distributed according to the pitch position. Results: The mean age, length of professional career, and professionalization age were 23 +/- 6 years, 7 +/- 5 years, and 17 +/- 2 years, respectively. In terms of education, 121 athletes (67%) completed high school, equivalent to 11 years of study. Only 5.5% completed higher education, with defensive players (goalkeepers and defenders) being the most educated at 37% (66/179). According to 2017 figures from the Pesquisa Nacional por Amostra de Domicilios Continua of the Federal Government of Brazil, the schooling rate is 31.7%, wherein 46.1% of Brazilians aged 25 years or over have completed education. In this study of 179 athletes, 67% had completed high school. Thus, players outrank the Brazilian population in terms of achieving a high school education. There were marked disparities in the relative proportions of goalkeepers (85%), defensive players (68%), midfielders (63%), and forward players (64%) in terms of their education. Conclusion: Our survey revealed that attending higher education remains a distant reality in Brazil.
Comparative analysis of cancellous graft and cortico-cancellous graft in osteosynthesis of scaphoid pseudoarthrosis with plate
(2023) WATAYA, Erick Yoshio; MENEGHEL, Guilherme Henrique; MORES, Victor; NAKAMOTO, Joao Carlos; XAVIER, Renato Martins; JR, Rames Mattar
IntroductionScaphoid is the most fractured carpal bone, with a 5-10% nonunion rate. Treatment challenges include choosing the implant and graft that best corrects humpback deformity and carpal malalignment with higher chances of bony healing.ObjectiveCompare cortico-cancellous and cancellous grafts between two groups of patients treating scaphoid nonunion with locking plates using autologous bone graft and evaluate bone healing rates and radiographic, tomographic, and functional parameters before and after surgery.MethodsNon-randomized prospective study including 20 cases of scaphoid nonunion. Groups were divided into Group A (ten patients treated with cortico-cancellous iliac graft) and Group B (ten patients treated with cancellous iliac graft). Patients underwent pre- and postoperative radiographs, computed tomography, and functional evaluation.ResultsIn postoperative analysis, Group A showed a statistically significant difference in intrascaphoid angle (p = 0.002) and scapholunate angle (p = 0.011) correction when comparing the pre- and postoperative periods. Group B showed a statistically significant difference in intrascaphoid angle (p = 0.002) and scapholunate angle correction (p = 0.0018), grip strength (p = 0.002), and tip pinch strength (p = 0.001) when comparing the pre- and postoperative periods. By comparing both groups, Group B showed a statistically significant difference in intrascaphoid angle correction (p = 0.002), grip strength (p = 0.002), tip pinch strength (p = 0.002), and radial deviation (p = 0.0003). There was no statistical difference when comparing bony healing between groups.ConclusionScaphoid nonunion treatment with a locking plate was effective, showing a high bony healing rate and improved carpal alignment in imaging tests for both graft types. However, results for intrascaphoid angle correction, grip strength, tip pinch strength, and radial deviation were better in Group B.
Patellar Tilt and Patellar Tendon-Trochlear Groove Angle Present the Optimum Magnetic Resonance Imaging Diagnostic Reliability for Patients With Patellar Instability
(2023) GOBBI, Riccardo Gomes; CAVALHEIRO, Camila Maftoum; GIGLIO, Pedro Nogueira; HINCKEL, Betina Bremer; CAMANHO, Gilberto Luis
Purpose: To describe, in controls and in a population with patellar instability, magnetic resonance imaging values of measurements representing major associated factors for patellar instability (patellar height, trochlear dysplasia, and extensor mechanism alignment), as well as their cutoff values. Methods: In total, 323 knee magnetic resonance imaging scans, 142 with patellar instability and 181 controls without patellofemoral complaints (anterior cruciate, medial collateral ligament, meniscus ruptures or normal) were evaluated. Means, normality values in the control population, ideal cutoff values through receiver operating characteristic curves analysis, and interobserver reliability (intraclass correlation coefficient) were described for a series of measurements. Results: All measurements were statistically different in control and instability patients, except for the patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance. The interobserver intraclass correlation coefficient was good or excellent (above 0.75) only for the patellotrochlear index, patellar tendon-trochlear groove (PTTG) angle, and patellar tilt. The optimal cutoff value for each measurement was: PTTG angle >= 25.3(degrees) with sensitivity (S) of 70% and specificity (E) of 89%, patellar tilt >= 16o (S: 69% and E: 84%), trochlear sulcus angle >= 153(degrees) (S: 75% and E: 76%), Carrillon <= 12.8(degrees) (S: 62% and E: 87%), PTTG distance >= 11mm (S: 71% and E: 78%), Caton-Deschamps index >= 1.23 (S: 72% and E: 76%) and trochlear bump >= 3.95 mm (S: 76% and E: 65%). Conclusions: Caton-Deschamps index (>= 1.23), trochlear sulcus angle (>= 153(degrees)), ventral prominence of the trochlea (>= 3.95 mm), PTTG distance (>= 11 mm), PTTG angle (>= 25.3o), Carrillon angle (<= 12.8(degrees)), and patellar tilt (>= 16(degrees)) presented better diagnostic performance for patellar instability. Patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance were not related to patellar instability. The interobserver reliability of the factors related to patellar instability was excellent only for the PTTG angle and lateral patellar tilt. Level of Evidence: Level III, retrospective case-control study.
Muscle function, Lysholm score and hop performance in individuals with clinical indications for the combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: A cross-sectional study
(2023) CARVALHO, Adriana; NOVAES, Marilia; SAUER, Juliana; DEMANGE, Marco Kawamura; HELITO, Camilo Partezani; JOAO, Silvia Maria Amado
Objective: To evaluate hip and knee muscular function, knee patient-reported outcome measures and hop performance in patients with a clinical indication for combined ACL+ALL reconstruction surgery compared to patients with an isolated ACL reconstruction surgery indication (preoperative phase) and to a control group. Design: Cross-sectional study. Methods: The sample was composed of male individuals, aged between 18 and 59 years, divided into three groups (ACL, ACL+ALL and Control). Isokinetic dynamometry was performed for the flexor and extensor knee muscles and for the hip abductors and adductors. SLHT, COHT and the Lysholm score were performed. Pain, swelling, and thigh trophism were also measured. Results: The study participants were 89 male individuals: 63 in the injury group and 26 in the control group. After applying the criteria for an ALL reconstruction indication, 33 patients were assigned to the ACL Group and 30 patients to the ACL+ALL Group. Regarding knee and hip muscle function, both groups presented worse results when compared to the control group, however, did not show significant differences compared to each other. Regarding the functional variables, the ACL+ALL group showed a significantly shorter distance achieved in the Crossover Hop Test than the other groups, as well as more pain during the tests. Conclusion: Knee and hip muscular functions are impaired after an ACL injury and do not seem to be influenced or worsened in individuals with greater rotational instability with clinical indications for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee.
ANTEROMEDIAL OR CENTRAL ANATOMIC ACL RECONSTRUCTION? A CADAVERIC HIP-TO-TOE STUDY
(2023) FERNANDES, Tiago Lazzaretti; SOUZA, Michel Oliveira; NETO, Cyro Albuquerque; ARAUJO, Paulo Henrique; PEDRINELLI, Andre; HERNANDEZ, Arnaldo Jose
Objective: To compare anatomic anterior cruciate ligament (ACL) reconstruction between two tunnel positions in knees with isolated ligament tears. Methods: Anatomic ACL reconstruction was performed, from hip-to-toe, on 15 fresh cadaveric specimens. No associated lesions were created to enhance knee instability. The protocol was conducted in three states: (1) complete isolated ACL deficiency; (2) anatomic femoral and tibial anteromedial ACL reconstruction (AM REC); and (3) anatomic femoral and tibial central ACL reconstruction (Central REC). The reconstruction protocols were randomly assigned. The continuous mechanized pivot-shift test was recorded dynamically with a tracking system. Results: The Central REC group showed a smaller degree of internal rotation (0.6 & DEG; & PLUSMN; 0.3 & DEG; vs. 1.8 & DEG; & PLUSMN; 0.3 & DEG;, respectively, P < 0.05) and no difference in anterior translation (4.7 mm & PLUSMN; 0.4 mm vs. 4.5 mm & PLUSMN; 0.4 mm, respectively, P > 0.05) in the pivot-shift test, compared with the AM REC group. Conclusion: The central anatomic ACL reconstruction resulted in greater restriction of internal rotation than the anteromedial anatomic ACL reconstruction. Experimental Study on Cadaver.
Responsiveness of the international spinal cord injury quality of life basic data set V2.0: An international longitudinal study
(2023) POST, Marcel W. M.; FORCHHEIMER, Martin; CHARLIFUE, Susan; GREVE, Julia D'Andrea; NEW, Peter; TATE, Denise G.
Context/ObjectiveExamine the sensitivity of the International Spinal Cord Injury Quality of Life Basic Data Set V2.0 (QoL-BDS V2.0) to reflect changes in mobility and secondary health conditions (SHCs) between inpatient rehabilitation and one-year follow-up.DesignInternational longitudinal study. Questionnaires were administered at baseline (Median 6 weeks, inter-quartile range 4-10 weeks post-onset) and after 12 months.SettingSpinal cord rehabilitation institutions in the US, Brazil, Australia and the Netherlands.Participants: Individuals with recent onset of spinal cord injury or disease (SCI/SCD) admitted to inpatient rehabilitation.Outcome measuresThe QoL-BDS V2.0, comprises four items on satisfaction with 'life as a whole', 'physical health', 'psychological health', and 'social life'. Mobility level was measured with a single item and SHCs with the SCI Secondary Conditions Scale (SCI-SCS).ResultsOf the 160 participants, 61% had SCI, 48% had tetraplegia and 82% were wheelchair-users. Scores on 'life as a whole', 'physical health' and the total scale were significantly higher at follow-up compared to baseline in the total sample and the SCD subgroup, but not in the SCI subgroup. Increases in 'physical health', 'psychological health', 'social life' and the total score were significantly associated with improvements in the SCI-SCS or mobility scores. Participants with improved SCI-SCS and mobility at follow-up showed significantly more improvement in satisfaction with social life and the total score compared to participants without such favorable changes.ConclusionThe results of this study provide partial evidence of responsiveness of the QoL-BDS V2.0 total score as a measure of QoL among individuals with SCI/SCD.

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