LIM/41 - Laboratório de Investigação Médica do Sistema Músculo-esquelético
URI Permanente desta comunidade
O Laboratório de Investigação Médica do Sistema Musculo-esquelético é ligado ao Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Linhas de pesquisa: alterações degenerativas e estruturais do aparelho locomotor; análise das performances de fixadores externos e osteossínteses na estabilização do sistema musculoesquelético; análise funcional do movimento; biomecânica do aparelho locomotor; desenvolvimento para ensaios e modelos de substituições articulares; ensaios sobre instabilidades articulares; regeneração e reparação musculoesquelética.
Site oficial: http://limhc.fm.usp.br/portal/lim41-laboratorio-de-investigacao-medica-do-sistema-musculo-esqueletico/
Linhas de pesquisa: alterações degenerativas e estruturais do aparelho locomotor; análise das performances de fixadores externos e osteossínteses na estabilização do sistema musculoesquelético; análise funcional do movimento; biomecânica do aparelho locomotor; desenvolvimento para ensaios e modelos de substituições articulares; ensaios sobre instabilidades articulares; regeneração e reparação musculoesquelética.
Site oficial: http://limhc.fm.usp.br/portal/lim41-laboratorio-de-investigacao-medica-do-sistema-musculo-esqueletico/
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- LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético
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- LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético
Submissões Recentes
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.
Photobiomodulation Associated With Conservative Treatment for Achilles Tendon Rupture: A Double-Blind, Superiority, Randomized Controlled Trial
(2022) OLIVEIRA, P. R. de; ARREBOLA, L. S.; STéFANI, K. C.; PINFILDI, C. E.
Objective: To investigate the effects of photobiomodulation on Achilles tendon rupture (ATR) treated conservatively. Design: Prospective, patient- and assessor-blinded, parallel, randomized controlled trial. Setting: Patients with acute ATR treated conservatively. Participants: Thirty-four male individuals with acute unilateral ATR treated conservatively (N=34), equally divided in 2 groups: photobiomodulation group (PBMG) and sham group, with mean age of 45.5±9.47 and 48.7±8.38 years, respectively. Intervention: All participants underwent through an immobilization period, followed by rehabilitation sessions (2 d/wk for 12 weeks) comprising strengthening, range of motion, and balance/weightbearing exercises. In PBMG, the tendon was irradiated with a photobiomodulation cluster (1 904 nm/50 mW infrared laser, 4 858 nm/50 mW infrared diodes, and 4 658 nm/40 mW red diodes; power density of 105 mW/cm2 per cluster area) during the immobilization period (2 d/wk for 8 weeks) and the sham group received a simulation of the procedure with no irradiation. Outcomes were assessed at the removal of the immobilization 12 and 16 weeks after tendon rupture. Main Outcome Measures: Primary outcome was the Achilles Tendon Rupture Score. Secondary outcomes included Numerical Pain Rating Scale at rest and during effort, plantar flexor strength, and ankle range of motion. Results: Both groups demonstrated an increase in the Achilles Tendon Rupture Score and improvements in range of motion, plantar flexor strength, and pain. There were no significant differences in outcomes between the 2 groups (P>.05) except in pain during walking, which was significantly lower in the PBMG in week 12 (P<.01, effect size=0.56) and week 16 (P<.01, effect size=0.55). Conclusion: Photobiomodulation associated with conservative treatment is not superior to conservative treatment alone for improving function in patients with acute ATR.
Staged reconstruction of the hallux for infected non-uniion using bulk autograft and a customized implant: Case report
(2023) GODOY-SANTOS, A. L.; PIRES, E. A.; FONSECA, F. C.; CESAR-NETTO, C. de; AUCH, E. C.; RAMMELT, S.
This case report illustrates the outcome of a deep infection following internal fixation of a fracture of the big toe. Hallux amputation could be avoided through staged salvage procedure. This paper can assist readers on how to effectively and safely recognize and treat this type of injury.
Letter to the editor entitled “fairness and scientific correctness is needed in the debate on transgender athletes”
(2023) PITSILADIS, Y.; HAMILTON, B.; GEISTLINGER, M.; BERMON, S.; BIGARD, X.; MIGLIORINI, S.; WOLFARTH, B.; LUIGI, L. Di; IONESCU, A.; SCHNEIDER, C.; BACHL, N.; MILLER, M.; SHROFF, M.; SINGLETON, P.; CONSTANTINOU, D.; SWART, J.; BELTRAMI, G.; ARROYO, F.; BADTIEVA, V.; KAUX, J.-F.; ROZENšTOKA, S.; DIENSTBACH-WECH, L.; CASAJUS, J. A.; ZELEKOVA, I.; STEINACKER, J. M.; ÜLKAR, B.; PAPADOPOULOU, T.; WEBBORN, N.; CASASCO, M.; FOSSATI, C.; BARRETT, J.; BILZON, J. L. J.; DOHI, M.; LI, G.; AK, E.; PEDRINELLI, A.; PIGOZZI, F.
In the joint position statement signed by members of the International Federation of Sports Medicine (FIMS) and European Federation of Sports Medicine Associations (EFSMA) on the International Olympic Committee (IOC) framework on fairness, inclusion and non-discrimination based on gender identity and sex variations, more than 35 experts proposed approaches to integrate transgender women and female athletes with differences of sex development (DSD) into elite competition (1).
Rotator cuff repair in patients 50 years of age or younger: A comparative study of functional outcomes in relation to older patients
(2023) ASSUNçãO, J. H.; SILVEIRA, E. C.; TAKAYANAGI, O. M.; SILVA, F. B. de Andrade e; MALAVOLTA, E. A.; FERREIRA NETO, A. A.
Background: Few studies have evaluated the clinical results of surgical treatment of rotator cuff tears in young patients and most of the publications are only case series and with a small number of evaluated individuals. The aim of this study is to compare the clinical outcomes of patients undergoing arthroscopic rotator cuff repair according to age at the time of the procedure. Hypothesis: Patients with 50 years of age or younger undergoing surgical treatment of rotator cuff tear have similar clinical outcomes to older patients. Materials and methods: Retrospective cohort study comparing results obtained after surgical treatment of rotator cuff tears between patients aged 50 years or younger and the older patients by the ASES and UCLA functional scales. Patients undergoing arthroscopy full-thickness rotator cuff repair were included. Results: We evaluated 390 shoulders (377 patients), 94 aged 50 years or younger (median = 46.5 years) and 296 aged over 50 years (median = 60 years). Both groups significantly improved with the procedure after 24 months of follow-up, according to the ASES and UCLA scales (p < 0.001). The groups did not differ in the scores obtained in the preoperative assessments and at 24 months of follow-up. The scores obtained on the ASES scale at 24 months of follow-up had a median of 87.2 (IQR = 38) among patients aged 50 years or younger and 90 points (IQR = 26.4) among older patients (p = 0.253). The scores obtained by the UCLA scale were 31 points (IQR = 9) and 33 points (IQR =7) respectively (p = 0.156). Discussion: Our results showed that, after 24 months, the functional results of arthroscopic full-thickness rotator cuff repair did not differ between patients younger than 50 years and older patients. These results are similar to those found by others authors. Both groups of patients achieved significant improvement after the surgical procedure, achieving approximately 90 points on the ASES scale and 32 points on the UCLA scale. Level of evidence: III Retrospective cohort study.
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.
Synthesis And Characterization Of Carbonaceous Derivate With Potential Application In Suture Anchors, Interference Screws In The Surgical Area
(2023) ALMEIDA FILHO, S. A.; GARNICA, D. F.; PEREYRA, I.; CARRENO, M. N. P.; SAITO, M.; FERNANDES, T. Lazzaretti
Potential Applications Of Carbonaceous Derivatives In Surgical Implants, With A Focus On Suture Anchors And Interference Screws
(2023) ALMEIDA FILHO, S. A.; REGO, L. Souza; GARNICA, D.; PEREYRA, I.; CARRENO, M. N. P.; ALEXANDRE, G. Bispo; SAITO, M.; PEREIRA, R. Rodrigues; BRAGANCA, C. R.; FERNANDES, T. Lazzaretti