ALBERTO TESCONI CROCI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Ortopediae Traumatologia, Faculdade de Medicina - Docente
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
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- Development of a Fresh Osteochondral Allograft Program Outside North America(2016) TIRICO, Luis Eduardo Passarelli; DEMANGE, Marco Kawamura; SANTOS, Luiz Augusto Ubirajara; REZENDE, Marcia Uchoa de; HELITO, Camilo Partezani; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; CROCI, Alberto Tesconi; BUGBEE, William DickObjective. To standardize and to develop a fresh osteochondral allograft protocol of procurement, processing and surgical utilization in Brazil. This study describes the steps recommended to make fresh osteochondral allografts a viable treatment option in a country without previous fresh allograft availability. Design. The process involves regulatory process modification, developing and establishing procurement, and processing and surgical protocols. Results. Legislation: Fresh osteochondral allografts were not feasible in Brazil until 2009 because the law prohibited preservation of fresh grafts at tissue banks. We approved an amendment that made it legal to preserve fresh grafts for 30 days from 2 degrees C to 6 degrees C in tissue banks. Procurement: We changed the protocol of procurement to decrease tissue contamination. All tissues were procured in an operating room. Processing: Processing of the grafts took place within 12 hours of tissue recovery. A serum-free culture media with antibiotics was developed to store the grafts. Surgeries: We have performed 8 fresh osteochondral allografts on 8 knees obtaining grafts from 5 donors. Mean preoperative International Knee Documentation Committee (IKDC) score was 31.99 +/- 13.4, improving to 81.26 +/- 14.7 at an average of 24 months' follow-up. Preoperative Knee Injury and Oseoarthritis Outcome Score (KOOS) score was 46.8 +/- 20.9 and rose to 85.24 +/- 13.9 after 24 months. Mean preoperative Merle D'Aubigne-Postel score was 8.75 +/- 2.25 rising to 16.1 +/- 2.59 at 24 months' follow-up. Conclusion. To our knowledge, this is the first report of fresh osteochondral allograft transplantation in South America. We believe that this experience may be of value for physicians in countries that are trying to establish an osteochondral allograft transplant program.
- Are femoroacetabular impingement tomographic angles associated with the histological assessment of labral tears? A cadaveric study(2018) EJNISMAN, Leandro; DOMB, Benjamin G.; SOUZA, Felipe; JUNQUEIRA, Consuelo; VICENTE, Jose Ricardo Negreiros; CROCI, Alberto TesconiPurpose This study sought to investigate the association between tomographic femoroacetabular impingement (FAI) angles and histologically evaluated labral tears. The authors hypothesized that cadavers presenting with cam and pincer morphologies would present a higher prevalence of acetabular labral tears. Methods Twenty fresh cadavers were submitted to computed tomography. Standard FAI angles were measured, including the alpha angle, femoral version, acetabular version, Tonnis angle and center-edge angle. A cam lesion was defined as an alpha angle greater than 50 degrees. A pincer lesion was defined as a center-edge angle greater than 40 degrees, a Tonnis angle less than 0 degrees or acetabular version less than 0 degrees. After dissection, three fragments of each acetabulum, corresponding to the antero-superior, superior and postero-superior acetabular rim, were obtained. These fragments were submitted to routine histological preparation. Each slide was evaluated for possible labral tears. Tears were classified according to their Seldes type. Results The mean age of the cadavers was 50.2 years (SD: 7.4; 13 males). Sixteen (80%) of the cadavers had a cam lesion, and eight cadavers (40%) had a pincer lesion. Histologically, 16 (80%) of the cadavers had a labral tear in at least one region. According to the Seldes classification, 60.7% and 28.6% of these labral tears were type 1 and type 2, respectively. A mixed type of labral tear (10.7%), which represented a new form of Seldes tear, was described. Cadavers with a labral tear had significantly higher alpha angles than other cadavers (53.29 degrees vs 49.33 degrees, p = 0.01). Pincer lesions were not associated with labral tears. We found no association between pincer or cam lesions and Seldes classification. Conclusion Cadavers presenting with higher alpha angles had a higher incidence of labral tears. No association was found between FAI and Seldes classification. Clinical relevance This study demonstrated a high prevalence of FAI abnormalities associated with histological alterations in a cadaveric sample. Joint damage may be present in the early stages of FAI.