ALEXANDRE LEME GODOY DOS SANTOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
9 resultados
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- FLEXOR HALLUX TENDON TRANSFER: COMPARATIVE STUDY THROUGH DOUBLE OR SINGLE APPROACH(2014) SAKAKI, Marcos Hideyo; GODOY-SANTOS, Alexandre Leme; ORTIZ, Rafael Trevisan; ARAUJO, Antonio; FERNANDES, Tulio DinizObjective: To quantify the FHL length difference obtained through a single approach and by a double combined approach. Methods: 16 fresh cadavers, a total of 32 feet, were used to measure the FHL graft length. With the cadaver positioned in ventral decubitus, a posteromedial incision in the ankle and a second incision in the plantar cavus were performed. Results: The average gain of tendon's length (GTL) was of 42.43 mm, the lowest value being 32 mm and the largest 48 mm. The comparative analysis of the GTL on the right and left sides through the paired ""t"" Test does not show statistical differences, with a p-value = 0.463 and a statistical power of 0.1443. The height analysis of the sample and the right and left GTL performed through linear regression do not show statistically significant differences, with a p-value of 0.38311 and 0.82640, respectively. Conclusion: Harvesting the FHL graft using a double combined approach yields a 42.43 mm length gain in comparison to harvesting using the single approach.
- Charcot neuroarthropathy: realignment of diabetic foot by means of osteosynthesis using intramedullary screws – case report,(2014) SANTOS, Alexandre Leme Godoy dos; ALBINO, Rômulo Ballarin; ORTIZ, Rafael Trevisan; SAKAKI, Marcos Hideyo; CORSATO, Marcos de Andrade; FERNANDES, Tulio DinizDiabetes mellitus is a serious disease that affects a large portion of the population. Charcot neuroarthropathy is one of its major complications and can lead to osteoarticular deformities, functional incapacity, ulcers and ankle and foot infections. Realignment of the foot by means of arthrodesis presents a high rate of implant failure due to weight-bearing on an insensitive foot. The aim of this report was to describe successful use of intramedullary osteosynthesis with compression screws to stabilize the deformed foot, in a diabetic patient with neuroarthropathy.
- Epidemiological study on talus fractures(2014) SAKAKI, Marcos Hideyo; SAITO, Guilherme Honda; OLIVEIRA, Rafael Garcia de; ORTIZ, Rafael Trevisan; SILVA, Jorge dos Santos; FERNANDES, Túlio Diniz; SANTOS, Alexandre Leme Godoy dosObjective: To analyze the characteristics of patients with talus fractures and the injuries that they present. Methods: Retrospective analysis on patients hospitalized in the Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine of the University of São Paulo, between 2006 and 2011, with talus fractures. Patient profile parameters, risk factors, fracture characteristics, treatment data and acute complications were analyzed. Results: Analysis on 23 cases showed that men were more affected than women, with a ratio of 4.8:1. The most frequent trauma mechanism was traffic accidents, followed by falls from a height. The most frequent type of fracture was at the neck of the talus, with 17 cases. Among the 23 cases, seven had peritalar dislocation at the time of presentation, four had exposed fractures and 11 presented other associated fractures. The mean length of time between the trauma and the definitive treatment was six days, while the mean length of hospital stay was 11 days. Three patients presented acute postoperative complications. Conclusion: Talus fractures occurred most commonly in the region of the talar neck and most frequently in young males who suffered high-energy trauma. In almost half of the cases, there were other associated fractures. The length of hospital stay was 11 days.
- MMP-1 promoter genotype and haplotype association with posterior tibial tendinopathy(2014) BARONEZA, Jose Eduardo; GODOY-SANTOS, Alexandre; MASSA, Bruno Ferreira; MUNHOZ, Francielle Bocon de Araujo; FERNANDES, Tulio Diniz; SANTOS, Maria Cristina Leme Godoy dosPurpose: Posterior tibial tendon (PIT) is particularly vulnerable and its insufficiency is recognized as the main cause of adult acquired flatfoot. Some patients have a predisposition without clinically recognized cause, suggesting that individual characteristics play an important role in tendinopathy. The objective of the present study is to investigate the association of -519 (rs1144393) matrix metalloproteinase-1 (MMP-1) polymorphism and the -1607 (rs1799750) and -519 MMP-1 haplotypes and risk of PTT dysfunction. Methods: The test group included 50 females who presented PTT dysfunction Grade 2 or 3, and who were submitted to surgical treatment, with histopathological examination of the tendon and magnetic resonance image (MRI) confirming tendinopathy, while the control group was 100 asymptomatic women who present intact MT at MRI. We analyzed functional polymorphisms MMP-1 and their haplotypes using polymerase chain reaction and restriction fragment length analysis. Results: There was a significant difference in the presence of the different alleles and genotypes between the control group and test group for the MMP-1 gene (p <= 0.01). The G allele of the -519 MMP-1 polymorphism increased susceptibility to degeneration in the PTT tendon and seems to be a genetic risk factor. Global haplotype analysis indicated a significant difference between both groups (p < 0.0001). Haplotypes G-2G and A-2G had statistically significant risk effect on PTT insufficiency. G-2G, p < 0.001; OR = 5.72 (CI, 2.84-11.52) and A-2G p = 0.002, OR = 3.95 (CI, 1.65-9.44). Conclusion: According to our results, -519 MMP-1 isolated and -1607/-519 MMP-1 haplotypes are associated to tendinopathy in posterior tibial tendon. (C) 2014 Published by Elsevier B.V.
- EPIDEMIOLOGIC STUDY OF ANKLE FRACTURES IN A TERTIARY HOSPITAL(2014) SAKAKI, Marcos Hideyo; MATSUMURA, Bruno Akio Rodrigues; DOTTA, Thiago De Angelis Guerra; PONTIN, Pedro Augusto; SANTOS, Alexandre Leme Godoy dos; FERNANDES, Tulio DinizObjectives: To evaluate the epidemiology of ankle fractures surgically treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Universidade de Sao Paulo. Methods: Medical records of patients admitted with foot and ankle fractures between 2006 and 2011 were revised. Seventy three ankle fractures that underwent surgical treatment were identified. The parameters analyzed included age, gender, injured side, AO and Gustilo & Anderson classification, associated injuries, exposure, need to urgent treatment, time to definitive treatment and early post-operative complications. Study design: retrospective epidemiological study. Results: Male gender was predominant among subjects and the mean age was 27.5 years old. Thirty nine fractures resulted from traffic accidents and type B fracture according to AO classification was the most common. Twenty one were open fractures and 22 patients had associated injuries. The average time to definitive treatment was 6.5 days. Early post-operative complications were found in 21.3% of patients. Conclusions: Ankle fractures treated in a tertiary hospital of a large city in Brazil affect young people victims of high-energy accidents and present significant rates of associated injuries and post-operative complications.
- Cartilage lesions and ankle osteoarthrosis: review of the literature and treatment algorithm,(2014) SANTOS, Alexandre Leme Godoy; DEMANGE, Marco Kawamura; PRADO, Marcelo Pires; FERNANDES, Tulio Diniz; GIGLIO, Pedro Nogueira; HINTERMANN, BeatThe main etiology of ankle osteoarthrosis is post-traumatic and its prevalence is highest amongyoung individuals. Thus, this disease has a great socioeconomic impact and gives rise to significant losses of patients' quality of life. The objective of its treatment is to eliminate pain and keep patients active. Therefore, the treatment should be staged according to the degree of degenerative evolution, etiology, joint location, systemic condition, bone quality, lower-limb alignment, ligament stability and age. The treatment algorithm is divided into non-surgical therapeutic methods and options for surgical treatment. Joint preservation, joint replacement and arthrodesis surgical procedures have precise indications. This article presents a review on this topic and a proposal for a treatment algorithm for this disease.
- Association of acute pancreatitis or high level of serum pancreatic enzymes in patients with acute spinal cord injury: a prospective study(2014) PIROLLA, E. H.; BARROS FILHO, T. E. P. de; GODOY-SANTOS, A. L.; FREGNI, F.Background: Spinal cord injuries has increased together with urban violence and show a high rates of incidence. Besides the onus to patient and society, it can also cause other serious complications to victims. Acute pancreatitis has an important impact on this disease and has been underdiagnosed in several patients. Objectives: The aim of this study was investigate the association of acute pancreatitis in acute spinal cord injuries. The secondary aim was to propose an investigation protocol to early diagnose and prevent it. Methods: A prospective observational study was conducted in 78 patients who presented acute spinal cord injury (SCI) at our emergency department, confirmed by clinical and imaging examination, in according to the American Spinal Injury Association (ASIA) Classification. Exclusion criteria were chronic or associate diseases in spinal cord, pancreatic direct trauma, alcoholism and chronic pancreatic disease. Results: The association of acute pancreatitis in patients with SCI was 11.53%. The occurrence of pancreatitis or high levels of serum pancreatic enzymes in patients with ASIA A was 41.7% and only 4.17% in patients with ASIA E. In all, 55.2% of patients who presented pancreatitis or high levels of serum pancreatic enzymes had cervical level of SCI and 34.5% had thoracic level. Adynamic ileus was observed in 68.96% of this group. Conclusion: We concluded that, in acute spinal cord injuries, the occurrence of acute pancreatitis or high serum levels of pancreatic enzymes are more frequent in patients with ASIA A Classification, cervical/thoracic level of spinal injury and adynamic ileus.
- Kager's fat pad inflammation associated with HIV infection and AIDS: MRI findings(2014) GODOY-SANTOS, Alexandre Leme; BORDALO-RODRIGUES, Marcelo; ROSEMBERG, Laercio; FERNANDES, Tulio Diniz; LIMA, Ana Lucia Lei Munhoz; CAMANHO, Gilberto Luis; MAFFULLI, NicolaTo describe magnetic resonance imaging (MRI) features of Kager's fat pad inflammation in HIV-positive patients with lipodystrophy due to protease inhibitor treatment and posterior ankle pain. A case-control, cross-sectional study; group 1 included 14 HIV-positive patients using protease inhibitors, presenting lipodystrophy syndrome and having posterior ankle pain; group 2 (CGHIV-) included 112 HIV-negative patients without lipodystrophy syndrome who were being evaluated for posterior ankle pain; group 3 (CGHIV + 1) included 23 HIV-positive patients not using a protease inhibitor, without lipodystrophy syndrome and with posterior ankle pain; group 4 (CGHIV + 2) comprised 18 HIV-positive patients who were being treated with a protease inhibitor and had lipodystrophy syndrome but did not have posterior ankle pain. Images were evaluated for the presence of edema by two radiologists who were blinded to clinical features. Fisher's exact test was used to evaluate differences among the groups. Interobserver variation was tested using Cohen's kappa (kappa) statistic. The presence of edema within Kager's fat pad was strongly associated with symptoms in HIV-positive patients who had lipodystrophy (p a parts per thousand currency signaEuro parts per thousand 0.0001). Concordance between observers was excellent (kappa > 0.9). MRI findings of Kager's fat pad inflammation related to HIV/AIDS is a source of symptoms in HIV patients with posterior ankle pain using protease inhibitors and having lipodystrophy syndrome.
- MMP-8 polymorphism is genetic marker to tendinopathy primary posterior tibial tendon(2014) Godoy-Santos, A.; Ortiz, R. T.; Mattar Junior, R.; Fernandes, T. D.; Santos, M. C. L. G.Posterior tibial tendon is particularly vulnerable and is responsible for much morbidity in sportspersons. Some patients have a predisposition without a clinically recognized cause, suggesting that individual characteristics, inclusive genetic inheritance, play an important role in tendinopathy. Matrix metalloproteinase (MMP)-8 is a proteinase capable of degrading a large amount of extracellular proteins, and influence degradation and remodeling of collagen. To determine whether the -799 polymorphism in the promoter of MMP-8 gene is associated with tendinopathy in posterior tibial tendon, 50 patients undergoing surgical procedures and anatomopathological diagnosis of degenerative lesions of the posterior tibial tendon and 100 control patients with posterior tibial tendon integrity and without signs of degeneration in magnetic resonance imaging were evaluated for the -799 MMP-8 polymorphism. There was a significant difference in the presence of the different alleles (P=0.001) and genotype (P=0.003) between the control group and the test group for the MMP-8 gene. The polymorphism at position -799 of the gene for MMP-8 is associated with tendinopathy primary posterior tibial tendon in the population studied. The results suggest that individuals with the T allele are at greater risk of developing tendinopathy.