Paulo Cezar Vidal Carneiro de Albuquerque

Estudo comparativo macroscópico dos defeitos osteocondrais produzidos em fêmures de coelhos preenchidos com gel de biopolímero da cana-de-açúcar

OBJECTIVE: To study the surface, coloring, consistency, continuity and healing of osteochondral defects produced in the femoral condyles of rabbits and filled with sugar cane biopolymer gel (SCBG), after 90, 120 and 180 days, and in comparison with a control group. METHOD: Sixteen adult New Zealand white rabbits aged 6 to 7 months, weighing between 2 and 2.5 kg and without locomotor system abnormalities were studied. In all the animals, a defect was made in the femoral condyles of the right and left knees, measuring 3.2 mm in diameter and 4 mm in depth, using a trephine. The animals were divided into two groups: study group formed by the right knees, in which the medial and lateral condyles received implants of SCBG; and control group formed by the left knees, in which the medial and lateral condyles were allowed to heal naturally. The knees were assessed 90, 120 and 180 days after the operation. After the animals had been sacrificed, the anatomical specimens were resected and placed in Bouins solution. They were then photographed with a Nikon Coolpix 5400® coupled to a Nikon SM2800® stereoscopic loupe, to analyze the surface, coloring, consistency, continuity and healing. RESULTS: The results were evaluated using the chi-square test. There were no significant differences in the macroscopic assessments of healing between the study and control groups. CONCLUSION: With regard to the surface, coloring, consistency, continuity and healing of the defects, the macroscopic appearance of the tissue repaired with SCBG was similar to that of the control group.

Comparative study of the areas of osteochondral defects produced in the femoral condyles of rabbits treated with gel of sugarcane biopolymer

PURPOSE To measure the healed areas of osteochondral defects produced in femoral condyles of rabbits filled with biopolymer sugar cane gel and to compare these with those of the control group at 90, 120 and 180 days. METHODS A study was made of 16 New Zealand rabbits, 6 and 7 months old, weighing between 2 and 2.5 kg. Defects of 3.2 x 4 mm were made, with trephine, in the femoral condyles of the right and left knees. As to the study group defects of the medial and lateral condyles of the right knee were used which were filled with Biopolymer Sugar Cane Gel; as to the Control Group defects of the medial and lateral condyles of the left t knees were used which were left open for natural healing. The defects were analyzed at 90, 120 and 180 days after surgery. After euthanasia, the knees were removed and fixed in Bouins solution for later digital photographic documentation with a digital camera. The areas healed were measured in both the study and control groups using the images obtained from an Image-J(®) program. Statistical analysis was conducted using the non-parametric Mann-Whitney test. RESULTS There were no significant differences between the means of the healed areas in the study and control groups at 90, 120 and 180 days after surgery. CONCLUSION The dimension of the healed areas of the defects treated with the biopolymer sugar-cane gel in the study group was similar to those of the control group, which healed naturally.

A comparative study of the areas of osteochondral defects produced in femoral condyles of rabbits treated with sugar cane biopolymer gel

PURPOSE To assess the histological response of damaged osteochondral tissue in the femoral condyles of rabbits after repairing the wounds with sugar cane biopolymer gel - compared to the control group. METHODS The study investigated 16 New Zealand rabbits, at 90, 120 and 180 days after surgery. In all the animals, a lesion of 3.2 mm in diameter and 4 mm deep was induced in each right and left femoral condyle. Each animal has provided both knees, divided into medial and lateral condyle, resulting in 64 samples. 32 knees were divided into two groups: Right knee, medial and lateral condyles, filled with biopolymer; Left knee, medial and lateral condyles, unfilled. The anatomical specimens were removed, and subjected to histological techniques and morphometric and statistical analysis. RESULTS In all the periods of the group under study an inflammatory reaction mediated by giant cells and mononuclear cells was found, while in the control group there was early healing produced by fibroblasts and few mononuclear cells with statistical significance between groups. CONCLUSION The biopolymer gel caused an inflammatory reaction mediated by giant cells and mononuclear cells while the control group there was cicatrization mediated by fibroblasts.

Comparative macroscopic study of osteochondral defects produced in femurs of rabbits repaired with biopolymer gel cane sugar

Objective: To study the surface, coloring, consistency, continuity and healing of osteochondral defects produced in the femoral condyles of rabbits and filled with sugar cane biopolymer gel (SCBG), after 90, 120 and 180 days, and in comparison with a control group. Method: Sixteen adult New Zealand white rabbits aged 6 to 7 months, weighing between 2 and 2.5 kg and without locomotor system abnormalities were studied. In all the animals, a defect was made in the femoral condyles of the right and left knees, measuring 3.2 mm in diameter and 4 mm in depth, using a trephine. The animals were divided into two groups: study group formed by the right knees, in which the medial and lateral condyles received implants of SCBG; and control group formed by the left knees, in which the medial and lateral condyles were allowed to heal naturally. The knees were assessed 90, 120 and 180 days after the operation. After the animals had been sacrificed, the anatomical specimens were resected and placed in Bouins solution. They were then photographed with a Nikon Coolpix 5400® coupled to a Nikon SM2800® stereoscopic loupe, to analyze the surface, coloring, consistency, continuity and healing. Results: The results were evaluated using the chi-square test. There were no significant differences in the macroscopic assessments of healing between the study and control groups. Conclusion: With regard to the surface, coloring, consistency, continuity and healing of the defects, the macroscopic appearance of the tissue repaired with SCBG was similar to that of the control group.

Risk of Surgical Site Infection in Patients Undergoing Total Knee Arthroplasty

The aim of this study was to determine the participation of risk factors in the infection in patients who underwent total knee arthroplasty. This is a prospective longitudinal study, descriptive and analytical, that was carried out between January 2013 and December 2015. Eighty-one procedures were performed in 78 individuals, 16 males and 62 females. Three subjects underwent the procedure on both knees. The following predictive factors of infection were identified: Age, gender, comorbidities, evaluation of functional physical status using the American Society of Anesthesiologists Physical Status Classification System (ASAPS), length of hospital stay, use of prophylactic antibiotics and duration of surgery. The data was tabulated in a database using a Microsoft Excel spreadsheet. For statistical analysis, the chi-square test, chi-square test for independence and Fischer’s exact test were applied, all at a significance level of 5% (0.05). Surgical site infection was more prevalent in males (23.5%), age over 70 years (25.0%), for left gonarthrosis (17.9%), in the presence of comorbidities (17.9%), when hospital stay was 6 or more days (27.8%), in total arthroplasties of left knee (17,9%), in surgical times of up to 2 hours (20%), in the use of prophylactic antibiotics (16.7%) and in level II classification in the ASAPS (18.8%). The independence test was not significant in any of the evaluated factors (p-value greater than 0.05). The most prevalent bacteria identified in cases of infection was Staphylococcus aureus (33.2%). The risk factors studied were not statistically significant.

Concordance for curve type in idiopathic scoliosis among family members

ABSTRACT OBJECTIVE: To evaluate the concordance for the curve pattern, side and levels of the superior apical vertebrae, apex and inferior apical vertebrae of curves in patients and their relatives with idiopathic scoliosis. METHODS: Concordance according to the Lenke classification for curve pattern, side and levels of the superior apical vertebrae, apex and inferior apical vertebrae were evaluated comparative and prospectively in 243 pairs of patients and respective relatives with idiopathic scoliosis. RESULTS: The family concordance for the curve pattern and side was 51.4% (125 pairs). Among these pairs, the concordance of the levels of the vertebrae was 91.2% (114 pairs). The concordance rate for the curve pattern and side between parents/children was 51.6% and between siblings was 50.0% (p-value= 0.411). The concordance rates of the levels of vertebrae were 86.8% and 95.1%, respectively (p-value = 0.219). CONCLUSION: Curve shape in idiopathic scoliosis is related to family and degree of kinship, since the data showed a high concordance for the curve pattern, side and levels of the apical vertebrae and apex between patients and relatives with this deformity. The concordance was higher in those with a closer degree of kinship.Level of Evidence II, Lesser Quality Prospective Study.

CLINICAL DEMOGRAPHIC CHARACTERISTICS OF TOTAL KNEE ARTHROPLASTY IN A UNIVERSITY HOSPITAL

ABSTRACT Objective: To assess socio-demographic characteristics of patients undergoing total knee arthroplasty (TKA) in a public university hospital, evaluating the outcome infection and associated factors. Method: A retrospective study was carried out with 78 patients undergoing TKA, from 2013 to 2014. The socio-demographic and clinical characteristics of the patients were collected. Comparison between infected and non-infected patients was performed to find out which variables were possibly associated to this complication. Result: Of 81 arthroplasties performed, patients were older (mean age 64 years), women (79%), with primary osteoarthritis as main etiology (87.6%) and most had comorbidities (82.7%). Infection occurred in 16% of patients, and this outcome associated with age older than 65 years (p=0.023) and the occurrence of deep vein thrombosis (p=0.027). Conclusion: Patients undergoing TKA are mostly elderly women with primary osteoarthritis in the knee and comorbidities who developed infection in 16% of cases. More studies need to be conducted aimed at creating specific protocols in order to improve the quality of clinical practice. Level of Evidence III, Retrospective Comparative Study.