ARNALDO AMADO FERREIRA NETO
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
15 resultados
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- Accuracy of preoperative MRI in the diagnosis of disorders of the long head of the biceps tendon(2015) MALAVOLTA, Eduardo A.; ASSUNCAO, Jorge H.; GUGLIELMETTI, Cesar L. B.; SOUZA, Felipe F. de; GRACITELLI, Mauro E. C.; FERREIRA NETO, Arnaldo A.Objetives: To evaluate the accuracy of magnetic resonance imaging (MRI) in the detection of disorders of the long head of the biceps tendon (LHBT). The secondary objective was to investigate predictive factors for tears and instability. Methods: This retrospective case series involved patients undergoing shoulder arthroscopy due to rotator cuff injury. MRI was performed in a 1.5 T scanner and was evaluated by a musculoskeletal radiologist. The findings were compared with those of arthroscopic inspection. Results: A total of 90 shoulders were analyzed. Regarding tears, there was 67% sensitivity and 98% specificity. Regarding instabilities, the values were 53% and 72%, respectively. Tears and fatty degeneration of the infraspinatus are predictive factors for tears of the LHBT. Tears of the subscapularis and infraspinatus, retraction of the supraspinatus and infraspinatus equal to or greater than 30 mm, and fatty degeneration of the infraspinatus and subscapularis are predictive factors for instability. Conclusion: Compared to arthroscopy, the shoulder MRI has a sensitivity of 67% and a specificity of 98% for the detection of complete tears of the LHBT. For instability, the values are 53% and 72%, respectively.
- Correlation between the UCLA and Constant-Murley scores in rotator cuff repairs and proximal humeral fractures osteosynthesis(2018) MALAVOLTA, Eduardo Angeli; ASSUNÇÃO, Jorge Henrique; GRACITELLI, Mauro Emilio Conforto; SIMÕES, Pedro Antonio Araújo; SHIDO, Danilo Kenji; FERREIRA NETO, Arnaldo AmadoABSTRACT Objective: To evaluate the correlation between the UCLA and Constant-Murley scores in the surgical treatment of rotator cuff tears and proximal humeral fractures (PHF). Methods: Retrospective study evaluating patients submitted to arthroscopic rotator cuff repair and surgical treatment of PHF with 2-year follow-up. Patients were evaluated by the UCLA and Constant-Murley scores in the preoperative period for the rotator cuff repairs, and 3, 6, 12 and 24 months after surgery for both diagnoses. Pearson's correlation coefficient (r) was calculated to measure the degree of correlation between the two clinical scales. Results: We evaluated 109 patients: 54 with rotator cuff tear and 55 with PHF. Twenty-four months after surgical treatment, the scores according to the UCLA and Constant-Murley scores were 32.6 ± 4.0 and 85.0 ± 12.0 for the rotator cuff tears and 30.3 ± 5.3 and 73.8 ± 13.9 for the PHF, demonstrating significant improvements in both, in relation to the initial evaluation (p < 0.001). The scales demonstrated high correlation (r = 0.88, p < 0.001). The scores obtained in the two scales showed high or very high correlation in all the postoperative clinical evaluations (r = 0.79-0.91, p < 0.001). The correlation was high in the preoperative evaluation (r = 0.73, p < 0.001). Conclusion: The UCLA and Constant-Murley scores presented high or very high correlation in the evaluation of surgical treatment of rotator cuff tears and PHF. The correlation in the preoperative evaluation was high.
- Rotator cuff repair in patients 50 years of age or younger: A comparative study of functional outcomes in relation to older patients(2023) ASSUNçãO, J. H.; SILVEIRA, E. C.; TAKAYANAGI, O. M.; SILVA, F. B. de Andrade e; MALAVOLTA, E. A.; FERREIRA NETO, A. A.Background: Few studies have evaluated the clinical results of surgical treatment of rotator cuff tears in young patients and most of the publications are only case series and with a small number of evaluated individuals. The aim of this study is to compare the clinical outcomes of patients undergoing arthroscopic rotator cuff repair according to age at the time of the procedure. Hypothesis: Patients with 50 years of age or younger undergoing surgical treatment of rotator cuff tear have similar clinical outcomes to older patients. Materials and methods: Retrospective cohort study comparing results obtained after surgical treatment of rotator cuff tears between patients aged 50 years or younger and the older patients by the ASES and UCLA functional scales. Patients undergoing arthroscopy full-thickness rotator cuff repair were included. Results: We evaluated 390 shoulders (377 patients), 94 aged 50 years or younger (median = 46.5 years) and 296 aged over 50 years (median = 60 years). Both groups significantly improved with the procedure after 24 months of follow-up, according to the ASES and UCLA scales (p < 0.001). The groups did not differ in the scores obtained in the preoperative assessments and at 24 months of follow-up. The scores obtained on the ASES scale at 24 months of follow-up had a median of 87.2 (IQR = 38) among patients aged 50 years or younger and 90 points (IQR = 26.4) among older patients (p = 0.253). The scores obtained by the UCLA scale were 31 points (IQR = 9) and 33 points (IQR =7) respectively (p = 0.156). Discussion: Our results showed that, after 24 months, the functional results of arthroscopic full-thickness rotator cuff repair did not differ between patients younger than 50 years and older patients. These results are similar to those found by others authors. Both groups of patients achieved significant improvement after the surgical procedure, achieving approximately 90 points on the ASES scale and 32 points on the UCLA scale. Level of evidence: III Retrospective cohort study.
- Rotator cuff repair in patients 50 years of age or younger: A comparative study of functional outcomes in relation to older patients(2023) ASSUNCAO, Jorge Henrique; SILVEIRA, Eric Curi; TAKAYANAGI, Oscar Makoto; SILVA, Fernando Brandao de Andrade e; MALAVOLTA, Eduardo Angeli; FERREIRA NETO, Arnaldo AmadoBackground: Few studies have evaluated the clinical results of surgical treatment of rotator cuff tears in young patients and most of the publications are only case series and with a small number of evaluated individuals. The aim of this study is to compare the clinical outcomes of patients undergoing arthroscopic rotator cuff repair according to age at the time of the procedure.Hypothesis: Patients with 50 years of age or younger undergoing surgical treatment of rotator cuff tear have similar clinical outcomes to older patients.Materials and methods: Retrospective cohort study comparing results obtained after surgical treatment of rotator cuff tears between patients aged 50 years or younger and the older patients by the ASES and UCLA functional scales. Patients undergoing arthroscopy full-thickness rotator cuff repair were included.Results: We evaluated 390 shoulders (377 patients), 94 aged 50 years or younger (median = 46.5 years) and 296 aged over 50 years (median = 60 years). Both groups significantly improved with the procedure after 24 months of follow-up, according to the ASES and UCLA scales (p < 0.001). The groups did not differ in the scores obtained in the preoperative assessments and at 24 months of follow-up. The score obtained on the ASES scale at 24 months of follow-up had a median of 87.2 (IQR = 38) among patients aged 50 years or younger and 90 points (IQR = 26.4) among older patients (p = 0.253). The scores obtained by the UCLA scale were 31 points (IQR = 9) and 33 points (IQR =7) respectively (p = 0.156).Discussion: Our results showed that, after 24 months, the functional results of arthroscopic full-thickness rotator cuff repair did not differ between patients younger than 50 years and older patients. These results are similar to those found by other authors. Both groups of patients achieved significant improvement after the surgical procedure, achieving approximately 90 points on the ASES scale and 32 points on the UCLA scale.(c) 2023 Elsevier Masson SAS. All rights reserved.
- Osteoid osteoma of the glenoid: Arthroscopic treatment(2015) MALAVOLTA, E. A.; ASSUNCAO, J. H.; REBOLLEDO, D. C. S.; GRACITELLI, M. E. C.; CORREIA, L. F. M.; FERREIRA NETO, A. A.; CAMARGO, O. P. deOsteoid osteoma is a benign tumor that is rarely found in the scapula. We report a clinical case involving a 36-year-old female patient who suffered from progressive pain in her right shoulder for 1 year. This patient was initially diagnosed with impingement syndrome and was treated unsuccessfully with medication and physical therapy for approximately 2 months. Based on imaging exams, a juxta-articular osteoid osteoma of the glenoid was identified. The patient underwent a shoulder arthroscopy that included tumor removal and treatment of the resulting chondral lesion. At 6-, 12- and 36-month assessments, the patient was asymptomatic, with a normal range of motion and experienced a pain intensity corresponding to 0 points on the Visual Analog Scale (VAS) and 35 points on the University of California, Los Angeles (UCLA) Scale. A postoperative MRI indicated the absence of any residual tumor tissue or inflammatory signs. We believe that the approach described in this paper allows juxta-articular osteoid osteomas to be accessed in a minimally invasive manner and permits not only adequate resection but also the treatment of chondral lesions that could remain after tumor resection.
- MESENCHYMAL CELLS IN ROTATOR CUFF REPAIR -TECHNIQUE DESCRIPTION AND CASE REPORTS(2023) MALAVOLTA, Eduardo Angeli; MICELI, Vinicius Lamboglia; ASSUNCAO, Jorge Henrique; ANDRADE-SILVA, Fernando Brandao; GRACITELLI, Mauro Emilio Conforto; TATSUI, Nelson Hidekazu; ESPIRANDELLI, Luiz Cesar; NETO, Arnaldo Amado FerreiraObjective: To describe a protocol of obtention of mesenchymal stem cells and to report their use as a biological adjuvant in three patients undergoing arthroscopic rotator cuff repair. Methods: Case series of patients who underwent arthroscopic repair of isolated full-thickness supraspinatus tear using mesenchymal stem cells obtained from the bone marrow as a biological adjuvant. All patients were operated on at the same institution, by a surgeon with 13 years of experience. The cells were applied at the end of the procedure, at the tendon-bone interface, at an approximate concentration of 2,000,000 mesenchymal cells/mm3 and a total volume of 5 ml. Results: All patients improved with the procedure, with one excellent and two good results. All cases overcame the minimally important clinical difference. All cases reached tendon healing, without partial or complete re-tears. We observed no complications. Conclusion: Arthroscopic rotator cuff repair with added mesenchymal cells obtained from bone marrow and submitted to a cell expansion process led to good functional results and healing in all cases in the sample, with no complications. Level of Evidence IV, Case Series.
- ARTHROSCOPIC LATARJET PROCEDURE: SAFETY EVALUATION IN CADAVERS(2013) GRACITELLI, Mauro Emilio Conforto; FERREIRA NETO, Arnaldo Amado; BENEGAS, Eduardo; MALAVOLTA, Eduardo Angeli; SUNADA, Edwin Eiji; ASSUNCAO, Jorge HenriqueObjective: To evaluate the safety of arthroscopic Latarjet procedure in cadavers. Methods: Twelve cadaveric shoulders underwent arthroscopic Latarjet procedure in our laboratory for arthroscopy, by four different surgeons. Following surgery, the specimens were subjected to radiographic examination and evaluated by an independent examiner. Nineteen parameters were evaluated, including the coracoid graft fixation, positioning and angulation of the screws, neurological damage and integrity of tendons. Results: Four procedures were considered to be satisfactory, with no difference among the surgeons. The mean angulation of the screws was 27.2 degrees. The subscapularis splitting was, on average, 17.8mm from the upper edge. The coracoid graft was properly positioned relative to equator of the glenoid in 11 cases. There was no injury to the axillary or musculocutaneous nerves. The main complications were: interposition of soft tissue, suprascapular nerve injury, articular deviation of the graft, diastasis and conjoined tendon injury. Conclusion: The arthroscopic Latarjet procedure is a complex technique in which each step must be precise to reduce the risk of complications. Our study showed a high risk of failure of the procedure. Level of Evidence IV, Case Series.
article 1 Citação(ões) na Scopus ANTERIOR INSTABILITY OF THE SHOULDER. RETROSPECTIVE STUDY ON 159 CASES(2011) FERREIRA NETO, Arnaldo Amado; CAMANHO, Gilberto Luis; FELIX, Alessandro Monterroso; BENEGAS, Eduardo; BITAR, Alexandre Carneiro; RAMADAN, Lucas Busnardo; MALAVOLTA, Eduardo AngeliObjective: To analyze the results of 159 patients with anterior instability of the shoulder submitted to arthroscopic treatment from January 2001 to December 2005. Methods: Retrospective study of complete patient records. Results: In 108 patients the Bankart lesion was found, while in 62 patients, SLAP type lesions were found. An average of 2.7 anchors was used. 42 cases presented complications; 14 had pain on effort, 12 had some degree of reduction of external rotation, and 16 had recorrence. The patients who developed complications used an average of 2.5 anchors, while those without complications used an average of 2.8 anchors (p<0.05). Of the 35 patients with anterior glenoid bone lesion, 8 had recorrence, while of the 124 patients without fractures, 8 had recorrence (p<0.05). Of the 113 patients with first-time traumatic dislocations, 12 developed limitation of external rotation, while in 46 atraumatic cases none developed limitation (p<0.05). Of the patients with SLAP lesion, 11 developed pain, while in the cases without this lesion, only 3 presented pain (p<0.05). Conclusion: There were more recurrences (deveria ser plural e recurrences, nao recurrence) in cases of anterior glenoid bone lesion. Post-operative pain was more frequent when the lesion type was SLAP Limitation of external rotation is associated to traumatic instability.- 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.
- EFFECT OF SUBSCAPULARIS TEARS ON FUNCTIONAL SCORES OF PATIENTS UNDERGOING ROTATOR CUFF REPAIR(2019) MALAVOLTA, Eduardo Angel; CHANG, Veronica Yulin Prieto; CASTRO, Marcello Traeallibozzi Pinto de; ANDRADE-SILVA, Fernando Brandao; ASSUNCAO, Jorge Henrique; GRACITELLI, Mauro Emilio Conforto; FERREIRA NETO, Arnaldo AmadoObjective: To evaluate the influence of partial- and full-thickness upper third subscapularis tendon tears on the functional scores of patients undergoing arthroscopic rotator cuff repair. Methods: Patients who underwent arthroscopic rotator cuff repair were divided into three groups according to the subscapularis tendon condition: intact, partial-thickness tear, or full-thickness upper third tear. Functional scores were compared among groups. Second, the influence of biceps and infraspinatus tears on the scores was tested using multivariate regression analysis. Results: We evaluated 307 shoulders in 297 patients. Full-thickness upper third subscapularis tears presented significantly worse scores than intact tendons. Partial-thickness tears had scores that did not differ significantly from those of the other groups. Patients with full-thickness upper third tears presented a greater rate of injured and unstable biceps tendons. The multivariate analysis showed that biceps and infraspinatus tendon tears did not influence the scores or the intergroup comparison. Conclusion: Full-thickness upper third subscapularis tendon tears presented worse functional scores than intact subscapularis tendons among patients undergoing posterosuperior rotator cuff repair. Patients with full-thickness subscapularis tears were more likely to suffer biceps tears, but this fact did not influence functional scores.