HENRIQUE MELO DE CAMPOS GURGEL
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
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- Femoroacetabular Impingement and Acetabular Labral Tears - Part 3: Surgical Treatment(2020) QUEIROZ, Marcelo C.; RICIOLI JUNIOR, Walter; EJNISMAN, Leandro; GURGEL, Henrique Melo de Campos; MIYAHARA, Helder de Souza; POLESELLO, Giancarlo CavalliAbstract In the last 15 years, the diagnosis of femoroacetabular impingement has become more frequent; with the advance of surgical indications, different techniques have been developed. Surgical treatment includes a wide variety of options, namely: periacetabular osteotomy, surgical hip dislocation, arthroscopy with osteochondroplasty via a small incision, modified anterior approach technique, and exclusively arthroscopic technique. The type of approach should be chosen according to the complexity of the morphology of the femoroacetabular impingement and to the surgeon's training. The techniques most used today are arthroscopy, surgical dislocation of the hip, and periacetabular osteotomy. The present article aims to describe the current main surgical techniques used to treat femoroacetabular impingement, their indications, advantages and disadvantages, complications and clinical results.
- IMPROVEMENTS IN HIP OSTEOARTHRITIS WITH LAVAGE, TRIAMCINOLONE AND HYLAN G-F20(2020) REZENDE, Marcia Uchoa De; GURGEL, Henrique Melo Campos; OCAMPOS, Guilherme Pereira; CAMPOS, Gustavo Constantino De; FRUCCHI, Renato; PAILO, Alexandre Felicio; PASQUALIN, Thiago; VICENTE, Jose Ricardo Negreiros; CAMARGO, Olavo Pires DeObjective: To verify whether the use of Hylan G-F20 improves saline lavage and triamcinolone injection results in the treatment of hip osteoarthritis (HOA). Methods: 82 patients with HOA categorized as grades II and III severity, according to Kellgren and Lawrence criteria, were randomized into the groups: lavage and triamcinolone (G0); lavage, triamcinolone, and 2 mL of hylan G-F20 (01); lavage, triamcinolone, and 4mL of hylan G-F20 (02); lavage, triamcinolone, and 6mL of hylan G-F20 (03). The VAS, range of motion (ROM), WOMAC, and Lequesne questionnaires were administered at baseline, one, three, six, and twelve months post-injection. Results: All groups showed clinically relevant improvements (> 20%) between baseline and first month post-injection, maintaining subjective results throughout the study period (p < 0.001). We found no differences between groups in any subjective evaluations (p > 0.05, for all). G2 and G3 obtained improved flexion results up to a year (p = 0.028). Hylan groups presented an improved external rotation since the first postoperative month and maintained the results up to a year (01, p = 0.041; G2, p = 0.007), whereas G0 showed no improvement (p = 0.336). Conclusion: Hip lavage and triamcinolone injection, with or without the use of hylan, improves pain, function, and quality of life up to a year in HOA. Hylan may improve ROM up to one year.
- Bacteria drug resistance profile affects knee and hip periprosthetic joint infection outcome with debridement, antibiotics and implant retention(2020) RUDELLI, Bruno Alves; GIGLIO, Pedro Nogueira; CARVALHO, Vladimir Cordeiro de; PECORA, Jose Ricardo; GURGEL, Henrique Melo Campos; GOBBI, Ricardo Gomes; VICENTE, Jose Riccardo Negreiros; LIMA, Ana Lucia Lei Munhoz; HELITO, Camilo PartezaniBackground Evaluate the effect of bacteria drug resistance profile on the success rates of debridement, antibiotics and implant retention. Methods All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistantStaphylococcus aureus(MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics. Results Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistantStaphylococcus aureus(MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p < 0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p = 0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p < 0.05). Conclusion DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.