JOSE OTAVIO REGGI PECORA
Projetos de Pesquisa
Unidades Organizacionais
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- PROGNOSTIC FACTORS FOR CLINICAL OUTCOMES AFTER ROTATOR CUFF REPAIR(2015) PECORA, Jose Otavio Reggi; MALAVOLTA, Eduardo Angeli; ASSUNCAO, Jorge Henrique; GRACITELLI, Mauro Emilio Conforto; MARTINS, Joao Paulo Sobreiro; FERREIRA NETO, Arnaldo AmadoObjective: To identify prognostic factors of postoperative functional outcomes. Methods: Retrospective case series evaluating patients undergoing rotator cuff repair, analyzed by the UCLA score (pre and 12-month postoperative) and Magnetic Resonance Imaging (preoperative). Patients' intrinsic variables related to the injury and intervention were evaluated. Multivariate linear regression analysis was performed to determine variables impact on postoperative functional assessment. Results: 131 patients were included. The mean UCLA score increased from 13.17 +/- 3.77 to 28.73 +/- 6.09 (p < 0,001). We obtained 65.7% of good and excellent results. Age (r = 0.232, p = 0.004) and reparability of posterosuperior injuries (r = 0.151, p = 0.043) correlated with the functional assessment at 12 months. After multivariate linear regression analysis, only age was associated (p = 0.008). Conclusions: The surgical treatment of rotator cuff tears lead to good and excellent results in 65.6% of patients. Age was an independent predictor factor with better clinical outcomes by UCLA score in older patients.
- Study on implant stability in cementless total knee arthroplasty(2012) TIRICO, Luis Eduardo Passarelli; PASQUALIN, Thiago; PECORA, Jose Otavio; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; DEMANGE, Marco KawamuraObjetives: Determine the stability of tibial and femoral components of 20 cementless knee arthroplasties with rotating platform. Methods: The 20 patients (20 knees) underwent an analysis of dynamic radiographs with an image amplifier and maneuvers of varus and valgus which were compared to static frontal and lateral radiographs of the knees and analyzed by two experienced surgeons in a double-blind way. Results: We could observe in this study that both methods showed very similar results for the stability of the tibial and femoral components (p<0.001) using the Kappa method for comparison. Conclusion: The tibial component was more unstable in relation to the femoral component in both static and dynamic studies. Level of Evidence IV, Case Series.
- Tibial Tubercle Osteotomy With Distalization Is a Safe and Effective Procedure for Patients With Patella Alta and Patellar Instability(2021) LEITE, Chilan B. G.; SANTOS, Tarsis P.; GIGLIO, Pedro N.; PECORA, Jose R.; CAMANHO, Gilberto L.; GOBBI, Riccardo G.Background: Tibial tubercle osteotomy with concomitant distalization for the treatment of patellar instability remains controversial, as it may cause anterior knee pain and chondral degeneration. Purpose: To evaluate radiographic, clinical, and functional outcomes in patients who had patellar instability with patella alta and underwent tibial tubercle osteotomy with distalization (TTO-d) as well as medial patellofemoral ligament reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Included in this study were 25 patients (31 cases) (mean age at surgery, 28.7 years; range, 14-33 years) with patellar instability and patella alta who underwent TTO-d with minimum 1-year follow-up. The Caton-Deschamps index (CDI), tibial tubercle-trochlear groove (TT-TG) distance, and amount of distalization were assessed. Clinical and functional variables included J-sign, anterior knee pain, apprehension test, Tegner activity level, and Kujala score. Results: The mean follow-up period was 2.62 years. The mean TT-TG was 16.15 mm (range, 7-24 mm); the mean CDI changed from 1.37 (1.25-1.7) preoperatively to 1.02 (0.9-1.12) postoperatively (P = .001); and the mean amount of tibial tubercle distalization was 8.80 mm (range, 4-16 mm). Lateral release (22 cases; 71.0%), medialization of tibial tubercle (17 cases; 54.8%), and autologous chondrocyte implantation (4 cases; 12.9%) were other associated procedures. The J-sign improved in 30 cases (96.8%; P = .001), and there was a complete resolution of anterior knee pain in 22 cases (71.0%; P = .001). An exploratory analysis showed that patellar cartilage defect severity was correlated with persistent pain (P = .005). The apprehension test became negative in all cases (P = .001). The median Kujala score increased from 52 to 77 (P = .001), and the median Tegner activity level improved from 3 to 4 (P = .001). No cases of osteotomy nonunion were reported. One case (3.2%) of patellar instability recurrence and 3 cases (6.5%) with painful hardware were observed. Conclusion: TTO-d resulted in good radiographic, clinical, and functional outcomes providing proper patellar stability to patients with patella alta. TTO-d appears to be a safe and efficient procedure with low complication rates, providing an additional tool for the personalized treatment of patellar instability.
- A numerical study of the contact geometry and pressure distribution along the glenoid track(2022) TRICHEZ JUNIOR, Alexandre Neves; PECORA, Jose Otavio Reggi; FERREIRA NETO, Arnaldo Amado; ROESLER, Carlos Rodrigo de Mello; FANCELLO, Eduardo AlbertoThe glenoid track geometry and the contact forces acting on the glenohumeral joint at static positions of 30 degrees, 60 degrees, 90 degrees and 120 degrees of abduction with 90 degrees of external rotation were evaluated using a finite element model of the shoulder that, differently from most usual approximations, accounts the humeral head translations and the deformable-to-deformable non-spherical joint contact. The model was based on data acquired from clinical exams of a single subject, including the proximal humerus, scapula, their respective cartilages concerning the glenohumeral joint, and the rotator cuff and deltoid muscles. The forces acting on the glenohumeral joint were estimated using a simulation framework consisting of an optimization procedure allied with finite element analysis that seeks the minimum muscle forces that stabilize the joint. The joint reaction force magnitude increases up to 680.25 N at 90 degrees of abduction and decreases at further positions. From 60 degrees onward the articular contact remains at the anterior region of the glenoid cartilage and follows an inferior to superior path at the posterior region of the humeral head cartilage. The maximum contact pressure of 3.104 MPa occurs at 90 degrees abduction. Although translating inferiorly throughout the movement, the projection of the humeral head center at the glenoid plane remains at the central region of the glenoid surface. The model results qualitatively matched the trends observed in the literature and supports the consideration of the translational degrees of freedom to evaluate the joint contact mechanics.
- Glenoid track evaluation by a validated finite-element shoulder numerical model(2020) PECORA, Jose Otavio Reggi; NEVES JUNIOR, Alexandre T.; ROESLER, Carlos Rodrigo M.; FANCELLO, Eduardo Alberto; MALAVOLTA, Eduardo A.; GRACITELLI, Mauro Emilio C.; ASSUNCAO, Jorge Henrique; NETO, Arnaldo Amado F.Background: The limits of the glenoid track have been defined through methods that do not take properly into account the physiological articular forces involved in the articular contact, which may interfere with its size. Finite elements numerical models can simulate joint forces more realistically. Objective: To evaluate the glenoid track in a finite element numerical model of the shoulder. Methods: We developed a finite element numerical model of the shoulder, based on imaging exams of a volunteer, including the proximal humerus, scapula, their respective articular cartilages, and the rotator cuff muscles. An algorithm to balance the weight of the arm calculated muscle, wrapping, and articular reaction forces. The model has freedom of translation in three axes. The articular contact characteristics and glenoid track's dimensions according to the literature references were evaluated in 60 degrees, 90 degrees and 120 degrees of abduction, all at the 90 degrees external rotation. Results: The model's anatomy and physiology were validated. The value of the glenoid track (according to Yamamoto's parameters) was 86% of glenoid length at 90 degrees abduction before loading of forces, and 79% afterwards. The glenoid track at 60 degrees, 90 degrees and 120 degrees of abduction (Omori's parameters) corresponded, respectively, to 71%, 88% and 104% of glenoid length before loading of forces, and 76%, 84% and 103% afterward. Conclusion: The numerical model is suitable for the shoulder articular contact evaluation. The articular contact analysis ratifies the glenoid track concept and contributes to its evolution. This value is influenced by glenohumeral joint forces, which should be considered for the analysis.