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.
- Multiple deep tissue cultures in primary total hip arthroplasty: prognostic value for periprosthetic infection(2022) FERRO, Fernando P.; BESSA, Felipe S.; MIYAHARA, Helder; EJNISMAN, Leandro; VICENTE, Jose R. N.; CROCI, Alberto T.Background: The risk of infection after total hip replacement (THR) is significant, with negative impact on quality of life and high costs. Bacteria can contaminate the surgical site despite aseptic techniques; however, there is debate regarding the benefit of identifying bacteria during the primary procedure. Although taking multiple samples for culture is a well-established practice in revision arthroplasty, doing so in primary cases remains controversial. We aimed to investigate whether there is a prognostic value in the culture of samples taken during primary THR, seeking a correlation between the positivity of the cultures and subsequent prosthetic joint infection (PJI). Methods: Deep samples (capsule, femoral and acetabular bone) were collected from 426 patients undergoing elective primary THR. Follow-up was at least 3 years. Microbiological profiles of cultures were analysed. Patient data were reviewed for the identification of risk factors presumably associated with a higher risk of PJI. Results: 54 surgeries (12.6%) had positive cultures. 16 cases (3.8%) developed infection, of which 5 had a positive culture in the primary surgery. Infection rate was 9.3% in patients with positive culture and 3% in those with negative culture (p < 0.05), with an odds ratio of 3.34 (95% CI, 1.09-10.24). Patients with previous hip surgery had an infection rate of 8.5%, compared to 2.9% in patients with no previous surgery (p < 0.05). Conclusions: Routinely harvesting microbiologic samples in primary THR is not justified, as it has no consequence in clinical decision for most patients. It might be recommended in selected cases that are suspected to be at high risk for infection, especially previously operated patients (conversion arthroplasty).
- Stability of implants placed simultaneously or in a delayed manner on fresh frozen onlay allografts in rabbits(2013) FRAGUAS, Erica; RIBEIRO, Marna; CROCI, Alberto; SANTOS, Luiz; PALLOS, Debora; SENDYK, WilsonObjectivesThis study evaluated the stability of implants installed simultaneously and in a delayed manner in fresh frozen onlay allografts in the tibiae of rabbits. Material and methodsAnalyses of the resonance frequency (ISQ) and removal torque were performed. The calvarium of three rabbits was used as donor site. Ten New Zealand female rabbits received four allografts of the same dimensions, two in each tibia. The tibiae were randomly allocated into the following two groups: Group 1, the tibiae that received implants after 84days of healing, and Group 2, those who received the implants simultaneously with the grafts. Both groups were followed for 126days. Proximal implants in each group were evaluated by resonance frequency (ISQ) on days 0 and 126, and the distal ones with removal torque on day 126. ResultsIn both groups, an increase in the ISQ value of day 0-126 was observed, with a statistically significant difference (Group 1 P=0.049 and Group 2 P=0.021). When comparing the resonance frequency at day 0 to day 126, and the gain of stability between these days, no statistically significant difference between groups could be observed. The removal torque showed a statistically significant difference between groups 1 and 2 (P=0.042). ConclusionThere was an increase in stability in groups according to the analysis of resonance frequency. Implants installed in a delayed manner in allografts showed higher shear force, according to the removal torque analysis.
- Acetabular Component Positioning in Total Hip Arthroplasty With and Without a Computer-Assisted System: A Prospective, Randomized and Controlled Study(2014) GURGEL, Henrique M. C.; CROCI, Alberto T.; CABRITA, Henrique A. B. A.; VICENTE, Jose Ricardo N.; LEONHARDT, Marcos C.; RODRIGUES, Joao CarlosIn a study of the acetabular component in total hip arthroplasty, 20 hips were operated on using imageless navigation and 20 hips were operated on using the conventional method. The correct position of the acetabular component was evaluated with computed tomography, measuring the operative anteversion and the operative inclination and determining the cases inside Lewinnek's safe zone. The results were similar in all the analyses: a mean anteversion of 17.4 degrees in the navigated group and 14.5 degrees in the control group (P = .215); a mean inclination of 41.7 degrees and 42.2 degrees (P = .633); a mean deviation from the desired anteversion (15 degrees) of 5.5 degrees and 6.6 degrees (P = .429); a mean deviation from the desired inclination of 3 degrees and 3.2 degrees = .783); and location inside the safe zone of 90% and 80% (P = .661). The acetabular component position's tomography analyses were similar whether using the imageless navigation or performing it conventionally.
- Assessment of the function and resistance of sternoclavicular ligaments: A biomechanical study in cadavers(2014) NEGRI, J. H.; MALAVOLTA, E. A.; ASSUNCAO, J. H.; GRACITELLI, M. E. C.; PEREIRA, C. A. M.; BOLLIGER NETO, R.; CROCI, A. T.; FERREIRA NETO, A. A.Background: Few biomechanical studies have assessed the resistance of the ligamentous structures of the sternoclavicular joint, and none have reproduced the physiological movements of the joint. Determiningthe structures that are injured in sternoclavicular dislocations is important for the surgical planning of acute or chronic ligament reconstruction. Methods: Forty-eight joints from 24 human cadavers were studied, and they were divided into 4 groups of 12 joints each (retraction, protraction, depression and elevation). Biomechanical testing assessed primary and secondary failures. The mechanical resistance parameters between movements that occurred on the same plane (depression versus elevation, protraction versus retraction) were compared. Results: The posterior sternoclavicular ligament was the most injured structure during the protraction test, but it was not injured during retraction. The anterior sternoclavicular ligament was the most affected structure during retraction and depression. The costoclavicular ligament was the most affected structure during elevation. Joint resistance was significantly greater during protraction movements when compared to retraction (P < 0.05). Conclusion: The anterior sternoclavicular ligament was the most affected structure during retraction and depression movements. During protraction, lesions of the posterior sternoclavicular ligament were most frequent during elevation, and the costoclavicular ligament was the most frequently injured ligament. The resistance of the sternoclavicular joint was significantly greater during protraction movement when compared to retraction.
article 22 Citação(ões) na Scopus Osteoblastlike Cell Adhesion on Titanium Surfaces Modified by Plasma Nitriding(2011) SILVA, Jose Sandro Pereira da; AMICO, Sandro Campos; RODRIGUES, Almir Olegario Neves; BARBOZA, Carlos Augusto Galvao; ALVES JR., Clodomiro; CROCI, Alberto TesconiPurpose: The aim of this study was to evaluate the characteristics of various titanium surfaces modified by cold plasma nitriding in terms of adhesion and proliferation of rat osteoblastlike cells. Materials and Methods: Samples of grade 2 titanium were subjected to three different surface modification processes: polishing, nit riding by plasma direct current, and nitriding by cathodic cage discharge. To evaluate the effect of the surface treatment on the cellular response, the adhesion and proliferation of osteoblastlike cells (MC3T3) were quantified and the results were analyzed by Kruskal-Wallis and Friedman statistical tests. Cellular morphology was observed by scanning electron microscopy. Results: There was more MC3T3 cell attachment on the rougher surfaces produced by cathodic cage discharge compared with polished samples (P < .05). Conclusions: Plasma nitriding improves titanium surface roughness and wettability, leading to osteoblastlike cell adhesion. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:237-244- Regarding ""Global Discrepancies in the Diagnosis, Surgical Management, and Investigation of Femoroacetabular Impingement""(2015) EJNISMAN, Leandro; MIYAHARA, Helder de Souza; GURGEL, Henrique Melo de Campos; VICENTE, Jose Ricardo Negreiros; CROCI, Alberto Tesconi