BRUNO SEIKI KUBOTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
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- Medial Patellofemoral Ligament, Medial Patellotibial Ligament, and Medial Patellomeniscal Ligament: Anatomic, Histologic, Radiographic, and Biomechanical Study(2017) HINCKEL, Betina B.; GOBBI, Riccardo G.; DEMANGE, Marco K.; PEREIRA, Cesar Augusto M.; PECORA, Jose Ricardo; NATALINO, Renato Jose M.; MIYAHIRA, Luciana; KUBOTA, Bruno S.; CAMANHO, Gilberto LuisPurpose: To describe the anatomy (quantitative macroscopic and histologic), radiographic parameters of the insertions, and biomechanical characteristics of the medial ligamentous restrictors of the patella (medial patellofemoral ligament [MPFL], medial patellotibial ligament [MPTL], and medial patellomeniscal ligament [MPML]) in cadaveric knees. Because the MPTL and the MPML are not as well known as the MPFL, they were the focus of this study. Methods: MPFLs, MPTLs, and MPMLs from 9 knees were dissected. Histologic evaluations were conducted. Length, width, and insertion relations with anatomic references were determined. Metallic spheres were introduced into the insertion points of each ligament, and anteroposterior and lateral radiographs were taken. The distances of the insertions from the baselines were measured on radiographs. Tensile tests of the ligaments were performed. Results: All the samples showed dense connective tissue characteristic of ligaments. The MPTL was inserted into the proximal tibia (13.7 mm distal to the joint line) and in the distal end of the patella (3.6 mm proximal to the distal border). The MPTL had a length of 36.4 mm and a width of 7.1 mm. The MPML was inserted into the medial meniscus and distally in the patella (5.7 mm proximal to the distal border). Per radiography, on the anteroposterior view, the tibial insertion of the MPTL was 9.4 mm distal to the joint line and in line with the medial border of the medial spine. On the lateral view, the patellar insertions of the MPTL and MPML were 4.8 and 6.6 mm proximal to its distal border, respectively. The MPTL was stiffer than the MPFL (17.0 N/mm vs 8.0 N/mm, P =.024) and showed less deformation in the maximum tensile strength (8.6 mm vs 19.3 mm, P =.005). Conclusions: The MPTL inserts into the proximal tibia and into the distal pole of the patella. The MPML inserts into the medial meniscus and into the distal pole of the patella. They present with identifiable anatomic and radiographic parameters. Grafts commonly used for ligament reconstructions should be adequate for reconstruction of the MPTL. Clinical Relevance: The study contributes to the anatomic, radiographic, and biomechanical knowledge of the MPTL to improve the outcomes of its reconstruction.
- RADIOGRAPHIC EVALUATION OF IMMEDIATE LOADING SAFETY AFTER SURGICAL REDUCTION IN ACETABULAR FRACTURES center dot center dot A COMPARATIVE-RETROSPECTIVE STUDY(2022) KOJIMA, Kodi Edson; MUNARI, Bruno Mendes; KUBOTA, Bruno Seiki; ZANESCO, Leonardo; PROENCA, Daniel Sonnewend; LEONHARDT, Marcos de Camargo; SILVA, Jorge Dos SantosObjective: Radiographically evaluate the quality of reduction over six weeks of follow-up in patients with surgically treated deviated acetabular fractures who underwent rehabilitation with immediate loading as tolerated and compare this with the results of the unloaded protocol. Methods: We retrospectively evaluated the records of 137 patients with deviated acetabular fractures treated with open reduction and internal fixation. Sixty-six (48.2%) patients underwent postoperative rehabilitation with immediate loading as tolerated, while 71 (51.8%) patients completed rehabilitation using a no-load protocol. The quality of the reduction was assessed radiographically by measuring the fracturing step and gap on radiographs taken immediately after surgery and three and six weeks after surgery. Results: Comparing the joint step, group 1 had an average of 0.44 +/- 1.4 mm, 0.47 +/- 1.5 mm, and 0.51 +/- 1.6 mm immediately, three and six weeks after surgery, respectively. Group 2 had a mean step of 0.24 +/- 0.8 mm, 0.27 +/- 0.9 mm, and 0.37 +/- 1.2 mm immediately, three, and six weeks after surgery. No statistically significant differences were observed between the groups. With a joint gap, group 1 had a mean of 1.89 +/- 1.7 mm, 2.12 +/- 1.8 mm, and 2.36 +/- 2.1 mm; and group 2 had a mean of 2.16 +/- 2.4 mm, 2.47 +/- 2.6 mm, and 2.67 +/- 2.8 mm in the immediate postoperative period, three, and six weeks, respectively. There was also no statistical difference between groups in these measurements. Conclusion: Immediate loading after surgical treatment of deviated acetabular fracture had no negative impact on radiographic reduction parameters and had similar results to the protocol without weight bearing. Level of evidence III; Therapeutic Retrospective Cohort Study.
bookPart Dor subaguda e crônica do joelho(2017) CRUZ, Andrey Oliveira da; KUBOTA, Bruno Seiki; NORDON, David Gonçalves