128 results match your criteria: "National Institute of Traumatology and Orthopedics.[Affiliation]"

Osteosarcoma (OS) is the most common malignant bone tumor affecting adolescents and young adults and it usually occurs in the long bones of the extremities. The detection of cancer-related genetic alterations has a growing effect in guiding diagnosis, prognosis and targeted therapies. However, little is known about the molecular aspects involved in the etiology and progression of OS, which limits options for targeted therapies.

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Li-Fraumeni syndrome (LFS) is one of the most common hereditary cancer predisposition syndromes in Brazil. The high frequency of the syndrome is due to a founding variant (R337H) in the country. LFS is characterized by a wide variety of malignant phenotypes.

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Background: Latarjet surgery has emerged as a prevalent option for managing anterior glenohumeral instability. Despite its efficacy, concerns persist regarding the development of postoperative osteoarthritis (OA), a significant complication. Understanding arthritis pathogenesis in patients undergoing this procedure proves challenging, as OA can manifest even in cases without surgical repair.

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Background: Differences in implant positioning between anatomical and reverse shoulder arthroplasties have raised concerns about the adequacy of assessing the global glenoid inclination (GGI) using the method described by Maurer to define the position of the metallic base in reverse shoulder arthroplasty. The reverse shoulder angle (RSA) has been proposed to measure the inclination of the lower half of the glenoid. This study aims to evaluate the interobserver agreement of manual measurements of the RSA using two-dimensional (2D) computed tomography (CT) images and its relationship with the automated measurement of the GGI.

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Background: The COVID-19 pandemic led to widespread social isolation and the suspension of sports activities, significantly impacting the physical and psychological performance of athletes worldwide, particularly soccer players. This study aims to evaluate the effects of pandemic-related training suspensions on the functional performance of U-20 soccer players from a first-division club in Rio de Janeiro.

Methods: Forty-one male U-20 soccer players were assessed during the preseason (PS) periods of 2020 and 2021.

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Purpose: To compare the amount of time used to perform meniscal suturing on a standardized lesion using either a traditional or continuous arthroscopic suturing technique.

Methods: A preclinical study was carried out with 21 medical doctors who underwent training in the 2 modalities of meniscal repair by arthroscopy in an animal model laboratory. Participants performed both types of sutures with a previously standardized lesion.

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Correction of the varus deformities in the tibia is necessary because of the excessive pressure exerted on the medial compartment of the knee, which intensifies the degenerative process. Correction strategies encompass a variety of approaches and depend on the patient's individual characteristics, age, soft tissue condition, and the orthopaedic surgeon's experience with different surgical materials. Size and location of the deformity, whether gradual or acute, play crucial roles in choosing the most appropriate material and shape.

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Factors associated with pseudoparalysis in patients with extensive chronic and atraumatic rotator cuff injury.

J Shoulder Elbow Surg

September 2024

Teaching and Research Division of the National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil; Department of Anatomy, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.

Article Synopsis
  • - The study investigates the relationship between specific shoulder muscle injuries and the occurrence of pseudoparalysis in patients with massive chronic rotator cuff injuries, suggesting that certain muscle conditions are linked to better active shoulder movement.
  • - A total of 68 patients were analyzed, with 41 showing good shoulder movement (No Pseudoparalysis group), while 29 had limited movement, leading to further assessments and injections, leading to a distinction between False and True Pseudoparalysis groups.
  • - Key findings indicate that the presence of certain signs and tear extensions in the shoulder muscles can increase the risk of pseudoparalysis, highlighting the importance of specific muscle health in shoulder functionality.
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Article Synopsis
  • Physical examination of knee ligament injuries can be subjective and unreliable, while MRI is expensive and doesn't provide functional insights.
  • Stress radiography is another option but involves radiation exposure and requires a physician.
  • Stress ultrasonography is a noninvasive and cost-effective alternative that helps evaluate knee injuries by assessing tibiofemoral openings, aiding in surgical decisions without adverse effects for patients.
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Introduction: Iliac crest autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures.

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Concern about the risk of aerosol contamination from ultrasonic scaler: a systematic review and meta-analysis.

BMC Oral Health

April 2024

Department of Periodontology, School of Dentistry, Fluminense Federal University, Rua Mário Santos Braga, nº 28, Centro, Niterói, Rio de Janeiro, CEP 24040-110, Brazil.

Background: Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention.

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Spontaneous rupture of the patellar (PTR) and quadriceps (QTR) tendon is infrequent. Systemic diseases such as diabetes mellitus, CKD, and secondary hyperparathyroidism (SHPT) are risk factors. The present cohort study aimed to evaluate risk factors associated with tendon rupture in hemodialysis (HD) patients with SHPT, as well as outcomes including surgical complications, re-ruptures, and fracture.

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Objective: To describe the epidemiology of injuries and illnesses sustained during the Beijing 2022 Paralympic Winter Games, organised in a closed-loop environment to adhere with COVID-19 restrictions.

Methods: Injuries and illnesses from all teams were recorded on a daily basis by team medical staff on a web-based form and by local organising committee medical (polyclinic) facilities and venue medical support. Duplicates recorded on both systems were removed.

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Micellar solution of [Ra]RaCl: Reaching renal excretion, potent efficacy in osteoblastic osteosarcoma in PDX model, biochemistry alterations and pharmacokinetics.

Int J Pharm

March 2024

Brazilian Nuclear Energy Commission, Nuclear Engineering Institute, Laboratory of Nanoradiopharmaceuticals and Synthesis of Novel Radiopharmaceuticals, Rio de Janeiro 21941906, Brazil; State University of Rio de Janeiro, Laboratory of Radiopharmacy and Nanoradiopharmaceuticals, Rio de Janeiro 23070200, Brazil. Electronic address:

Despite the successful use of the radiopharmaceutical radium-223 dichloride ([Ra]RaCl) for targeted alpha therapy of castration-resistant prostate cancer patients with bone metastases, some short-term side effects, such as diarrhea and vomiting, have been documented, causing patient discomfort. Hence, we prepared a nanosized micellar solution of [Ra]RaCl and evaluated its biodistribution, pharmacokinetics, and induced biochemical changes in healthy mice up to 96 h after intraperitoneal administration as an alternative to overcome the previous limitations. In addition, we evaluated the bone specificity of micellar [Ra]RaCl in patient-derived xenografts in the osteosarcoma model.

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Introduction: Post-operative pain is the most prevalent type of acute pain. Nurses are the health care professionals who most frequently assess pain, as well as evaluating the patient's response to pain management treatment and monitoring for the occurrence of adverse events. Thus, to improve outcomes and quality of care, the interventions used by nurses should be based on best practices.

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Objectives: To implement the Formal Consensus Method among a group of experts in shoulder surgery in Latin America, in order to establish appropriate indications for the surgical treatment of massive and irreparable rotator cuff injuries.

Methods: The Formal Consensus Method was used to develop surgical treatment recommendations for massive and irreparable rotator cuff tears (MIRCT). Three independent groups of experts in shoulder surgery were confirmed.

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Three-dimensional (3D) bioprinting, a promising advancement in tissue engineering technology, involves the robotic, layer-by-layer additive biofabrication of functional 3D tissue and organ constructs. This process utilizes biomaterials, typically hydrogels and living cells, following digital models. Traditional tissue engineering uses a classic triad of living cells, scaffolds, and physicochemical signals in bioreactors.

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Background: Tourniquet is widely used in total knee replacement surgery because it reduces intraoperative hemorrhage and provides a comfortable surgical area for the surgeon. It's possible that its use could lead to impaired postoperative functional and motor recovery, as well as local and systemic complications. Our goal was to compare the outcomes of total knee replacement without ischemia using an optimized protocol, consisting of tourniquet inflation before skin incision and deflation after cementing, with a pressure of one hundred millimeters above systolic blood pressure and without postoperative articular suction drains.

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Background: Biomechanical assessment of meniscal repairs is essential for evaluating different meniscal suturing methods and techniques. The continuous meniscal suture technique is a newer method of meniscal repair that may have biomechanical differences compared with traditional techniques.

Purpose: To evaluate the displacement, stiffness after cyclical loading, and load to failure for a continuous vertical inside-out meniscal suture versus a traditional vertical inside-out meniscal suture in a porcine medial meniscus.

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Gradual Correction of Valgus Deformities of the Tibia Using a Monolateral External Fixator.

Strategies Trauma Limb Reconstr

January 2023

Center for Specialized Care of the Treatment Area of Dysmetry and Deformities of the Locomotor System, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.

Objective: To present a review of patients subjected to gradual correction of a valgus deformity of the tibia using a monolateral external fixator.

Method: This retrospective review included patients from January 2012 to May 2022 who met the following inclusion criteria: deviation of mechanical axis of the limb due to valgus deformity of the tibia; tibial deformity in the coronal plane on radiographic examination; a documented outpatient pre-operative evaluation by an orthopaedic surgeon and age between 10 and 70 years. The following exclusion criteria were applied: the presence of another tibia deformity preventing gradual correction using the proposed assembly; skin conditions incompatible with the surgical procedure; inadequate pre- or post-operative radiological evaluation; and insufficient information in the medical records.

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Placement of pedicle screw in the subaxial cervical spine is a challenging and complex technique but provides significant biomechanical advantages. Despite its potential complications, the role and use of cervical pedicle screw (CPS) are growing. A literature review of the significant articles on applying pedicle screws in the subaxial cervical spine was done (articles between 1994 and 2020).

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Purpose: Abnormal leptin bioavailability has play key roles in the etiology of adolescent idiopathic scoliosis (AIS). Both leptin and its receptor levels may be modulated by the presence of genetic polymorphisms. This study aimed to evaluate the role of polymorphisms in the leptin (LEP) and its main receptor (LEPR) genes in the AIS susceptibility in girls.

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The literature has shown a significant decrease in failure rates when the anterior cruciate ligament (ACL) reconstruction was associated with an extra-articular reinforcement technique such as the anterolateral ligament (ALL) or the iliotibial band tenodesis (ITBT) using the modified Lemaire technique. As much as there is a progressive decrease in the failure rates of ACL reconstructions when the ALL reconstruction technique is associated, there are still and will be cases that will result in graft rupture. These cases will require more alternatives for revision, which are always challenging for the surgeon, where the lateral approaches represent complicating factors, especially because of the distortion of the lateral anatomy (by the previous approach for ALL reconstruction), previous reconstruction tunnels, and the presence of fixation materials.

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The indications for combining anterior cruciate ligament reconstruction with anterolateral ligament reconstruction have increased considerably in recent years since several anatomical, clinical, and biomechanical studies have proven the importance of the anterolateral periphery in knee rotational stability. Much is still being discussed on how to combine these techniques in terms of which grafts and fixation options to use, as well as avoiding tunnel convergence. This study aims to describe anterior cruciate ligament reconstruction with a triple-bundle semitendinosus tendon graft all-inside technique combined with an anterolateral ligament reconstruction maintaining the gracilis tendon insertion on the tibia, using independent anatomical tunnels.

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The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of medial meniscal injury, called a ramp lesion, has received greater attention for identification and treatment because of its considerable incidence and diagnostic difficulty. Based on their location, these lesions may be arthroscopically "hidden" during traditional anterior visualization.

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