LUIZ RENATO AGRIZZI DE ANGELI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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- Feasibility of Magnetic Resonance Angiography in Patients With Legg-Calve-Perthes Disease(2021) GRANGEIRO, Patricia Moreno; RODRIGUES, Joao C.; ANGELI, Luiz R. A. de; LEAO FILHO, Hilton; MONTENEGRO, Nei B.; GUARNIERO, Roberto; DEMPSEY, Molly; KIM, Harry K. W.Background: The etiology of Legg-Calve-Perthes disease (LCPD) remains unknown; however, interruption of medial circumflex femoral artery (MCFA) supply to the femoral head is the key pathogenic factor. The main purpose of this study is to determine the feasibility of using magnetic resonance angiography (MRA) to evaluate the course of the MCFA in the normal and affected hips of patients with unilateral LCPD. Methods: We analyzed 24 patients with unilateral LCPD using a time-resolved imaging of contrast kinetics magnetic resonance angiography (TRICKS-MRA). The course of the MCFA was divided into 4 segments in the coronal plane and in 3 segments in the axial plane, based on its location with respect to the femoral neck. The visibility of each segment was studied in the normal and affected sides. The segments were defined as not visible when no contrast was seen within the vessel lumen or visible when the lumen was partially or completely visualized with contrast. The statistical analysis was done using the chi(2) test. Results: TRICKS-MRA provided well-defined images of the first 2 segments of the MCFA on both the normal and affected sides of patients with LCPD (P=1). In half of the patients, the third segment was also visible using TRICKS-MRA on both sides (P=1). The fourth segment of the MCFA, which was the ascending lateral epiphyseal segment, was not visible on either side (P=0.49). No significant difference was found between the normal and affected hips in terms of visibility of the 4 segments of the MCFA using TRICKS-MRA. Anastomosis of the MCFA with the inferior gluteal artery was found in 3 hips (2 hips with LCPD and 1 normal hip). Conclusions: TRICKS-MRA provides well-defined images of the arterial supply to the proximal femoral epiphysis in children with LCPD, presenting a noninvasive and radiation-free alternative to conventional angiography. However, the TRICKS-MRA method used did not allow visualization of the ascending lateral epiphyseal segment of MCFA in the affected and the contralateral normal side. We believe that further advancement of this noninvasive imaging technique may open new opportunities for research aimed at evaluating the vascular supply of the femoral head in children.
- MANAGEMENT OF INFANTILE BLOUNT'S DISEASE WITH MOLDED ORTHOSES: A NEW PERSPECTIVE (vol 24, pg 85, 2016)(2016) LUZO, Maria Candida de Miranda; MONTENEGRO, Nei Botter; MASSA, Bruno Sergio Ferreira; ANGELI, Luiz Renato Agrizzi de; CORDEIRO, Felippi Guizardi; GUARNIERO, Roberto
- MANAGEMENT OF INFANTILE BLOUNT'S DISEASE WITH MOLDED ORTHOSES: A NEW PERSPECTIVE(2016) MONTENEGRO, Nei Botter; MASSA, Bruno Sergio Ferreira; ANGELI, Luiz Renato Agrizzi deObjective: This retrospective study evaluated treatment with individually contoured molded bracing at early stages of the disease. Methods: We evaluated the medical records of patients undergoing treatment of Blount's disease with molded orthoses for medial decompression between 2010 and 2014. The deformity angle (Drennan's metaphyseal-diaphyseal angle) and Langenskiold classification were measured before and after treatment by a pediatric orthopedic surgeon with over 5 years of practice, blinded for the study and patients. Results: The mean age was 2.57 years old. Four patients were female and six male. Half of the total sample had bilateral disease. The average deformity angle showed a statistically significant reduction after treatment (p < 0.001). Gender and laterality did not statistically influence the change of the deformity angle after treatment (p>0.05). Conclusion: The nightly use of molded orthoses for medial decompression was effective in reducing the metaphyseal-diaphyseal angle in Blount's disease in children under 3 years of age, regardless of gender and bilateral disease. Patients over 3 years old did not benefit from bracing.
- MODIFIED DEGA OSTEOTOMY IN TREATING DEVELOPMENTAL DYSPLASIA OF THE HIP (vol 26, pg 30, 2018)(2018) GUARNIERO, Roberto; SANCHEZ, Fernando Barbosa; MASSA, Bruno Sergio Ferreira; MONTENEGRO, Nei Botter; GRANGEIRO, Patricia Moreno; ANGELI, Luiz Renato Agrizzi De
- EXPERIMENTAL MODEL STUDY OF ISCHEMIC NECROSIS INDUCTION OF THE GROWING FEMORAL HEAD(2022) GORIOS FILHO, Antonio; SANTOS, Gustavo Bispo Dos; GUARNIERO, Jose Roberto Bevilacqua; ANGELI, Luiz Renato Agrizzi De; GRANGEIRO, Patricia Moreno; GUARNIERO, RobertoMany experimental models exist to better understand the necrosis of the femoral head etiology, both in terms of the species variety in which necrosis is induced and in the operative techniques used for treatment. Objective: This study has two main objectives, the first is to review the literature concerning experimental models of avascular necrosis of the growing femoral head, the second, to demonstrate the experimental pig model's reproducibility using a pilot study. Methods: This was a bibliographic review to describe the attempts over time to find the best species and technique for induction that would reproduce ischemic necrosis of the growing femoral head in humans. Simultaneously, a pilot study was performed to verify the replication of induction in pigs, the species that has more similarities with the human hip. The pilot's methodological analysis consists of conventional radiology and verification of possible anatomical, pathological changes. Results: In imaging exams; lateral sub-dislocation of the femur head and triangular appearance of the head were observed, characterizing its flattening; in macroscopic examination, the femoral head flattening with femoral neck widening and shortening was identified; in histology, the proliferation of articular cartilage with the presence of vascular granulation regenerative tissue, with osteoclasts and fibrocartilaginous tissue in the metaphyseal femoral neck region was identified. Conclusion: The experimental pig model can be used as a valuable tool for the reproducibility of anatomical, pathological changes in ischemic necrosis of the growing femoral head. The model is reproducible and feasible and can be beneficial for future studies on the anatomical pathology of necrosis of the growing femoral head. Level of Evidence III, Literature Review.
- Evaluation of cardiovascular risk biomarkers after moderate consumption of red wine and cacha?a in a randomized crossover trial: The Wine and Cacha?a Study (WICAS)(2022) CELLIA, Pedro Henrique de Moraes; LIMA, Eduardo Gomes; ANGELI, Luiz Renato Agrizzi de; MARTINS, Eduardo Bello; RACHED, Fabiana Hanna; PITTA, Fabio Gruspun; STRUNZ, Celia Maria Cassaro; JR, Carlos Vicente SerranoIntroduction: Moderate daily consumption of alcohol (MDCA) is associated with cardiovascular risk (CVR) reduction in observational studies. Some researches have suggested that this benefit may be associated not only with red wine consumption but also with other beverages. However, there are no clinical trials evaluating the possible CVR benefit of Brazilian spirit (cachaca) in humans. Methods: This is a prospective, randomized, crossover study including healthy individuals initially assigned to a MDCA of cachaca or red wine for a period of 4 weeks. After a one-week abstinence period, the type of drink was changed for another 4 weeks of intervention. The MDCA for both beverages was determined as a dose equivalent to 28 g of ethanol per day for men and 14 g for women. CVR biomarkers analyses were performed before and after each intervention to assess the serologic status of C-reactive protein, lipid profile, platelet aggregation and glycemic profile. This study is registered on the ISRCTN platform under number 15978506. Results: Of the 42 subjects initially randomized, 2 refused to continue in the study. The median age was 44.3 +/- 10.3 years and 19 were male (47.5%). Adherence to the protocol was considered ideal with 100% regular use in both interventions and only 3 individuals in each intervention group reported alcohol abuse. There was no significant variation in anthropometric measurements during the study, except for weight gain (0.7 kg) in the red wine group (p = 0.005). The median of the delta of platelet aggregation for MDCA of cachaca was 1.2% (-1.1 to 5.3) and the median of the delta to the MDCA of wine was -1.6% (-4.5 to 2) (p = 0.02). The other biomarkers didn't show any statistically significant variation. Conclusion: Moderate consumption of wine and cachaca was related to variation in laboratory biomarkers of CVR related to atherosclerosis. There was significant weight gain during the period of wine consumption and there was observed a difference between platelet aggregation values after both interventions.
- MODIFIED DEGA OSTEOTOMY IN TREATING DEVELOPMENTAL DYSPLASIA OF THE HIP(2018) GUARNIEIRO, Roberto; SANCHEZ, Fernando Barbosa; MASSA, Bruno Sergio Ferreira; MONTENEGRO, Nei Botter; GRANGEIRO, Patricia Moreno; ANGELI, Luiz Renato Agrizzi DeObjective: To retrospectively evaluate the preliminary postoperative results of modified Dega-type acetabular osteotomy to treat developmental dysplasia of the hip, confirming the efficacy and reproducibility of this technique. Methods: This retrospective study included patients older than 18 months. A total of 19 hips underwent modified Dega osteotomy. Results: Satisfactory results were obtained, with an average decrease of the acetabular index from 39.2 to 20.6 degrees. The final average center edge angle was 29.6 degrees. Hip joint congruence was reestablished in all cases, and as of this writing, only one case developed necrosis in the femoral head during follow-up. Conclusion: Modified Dega osteotomy demonstrated good initial results, as well as the potential for use in treating developmental dysplasia of the hip.
- Myelomeningocele: a new functional classification(2021) DIAS, Luciano S.; SWAROOP, Vineeta T.; ANGELI, Luiz R. A. de; LARSON, Jill E.; ROJAS, Ana-Marie; KARAKOSTAS, TasosPurpose In myelomeningocele, several classifications have been used. The present manuscript proposes a new functional classification to better assess the prognosis and management of these patients. Methods The manual muscle test is what defines the actual group in which the patient should be included. Furthermore, this new classification brings information about the bracing and external supports recommended to each functional level. We also recommend that the patient's Functional Mobility Scale should always be mentioned together with their functional level. Results The four levels in this classification are MMFC1, MMFC2, MMFC3 and MMFC4. The MMFC1 group includes patients with significant muscle weakness. They need to use high braces crossing the hip joint with a walker to achieve some ambulation. The MMFC2 group includes patients who have functional hip flexors, knee extensors and knee flexors. However, the hip abductors are quite weak. These patients usually need to use a walker - or crutches - and Ankle-Foot Orthosis (AFOs). The MMFC3 group includes patients with functional hip flexors, knee extensors, knee flexors and hip abductors. However, the ankle plantar flexion function is absent. Most of them are able to walk independently, only using AFOs without any external support. The MMFC4 group includes patients who have preserved function in the entire lower limb musculature. These patients don't need any assistive devices to achieve an adequate ambulation pattern. Conclusions We hope that this new classification is a system that is simple to understand, serves as a gait prognosis guide and facilitates communication among healthcare professionals.