MARCIA UCHOA DE REZENDE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
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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conferenceObject RESIDUAL KNEE PAIN AND SYNOVITIS AFTER TOTAL KNEE ARTHROPLASTY TREATED WITH SELECTED EMBOLIZATION OF GENICULAR ARTERIES(2023) REZENDE, M. U.; VALLE, L. G. M.; ASSIS, A. M.; OCAMPOS, G. P.; CARNEVALE, F. C.; AFFONSO, B. B.; GALASTRI, F. L.; NASSER, F.- THE NATURAL HISTORY OF THE ANTERIOR KNEE INSTABILITY BY STRESS RADIOGRAPHY(2014) REZENDE, Marcia Uchoa de; HERNANDEZ, Arnaldo Jose; CAMANHO, Gilberto LuisObjective: To analyze the anteroposterior displacement of the knee by means of stress radiography in individuals with unilateral anterior knee instability and relate to time of instability. Methods: Sixty individuals with intact knees (control group) and 125 patients with unilateral anterior instability (AI group) agreed to participate in the study. Gender, age, weight, height, age at injury, time between injury and testing, and surgical findings are studied. Both groups are submitted to anterior and posterior stress radiographies of both knees. Anterior (ADD) and posterior displacement difference (PDD) were calculated between sides. Results: In the control group ADD and PDD are in average, zero, whereas in the AI group ADD averaged 9.8mm and PDD, 1.92mm. Gender, age, weight, height, age at trauma and presence of menisci's lesions do not intervene in the values of ADD and PDD. Meniscal injuries increase with time. ADD and PDD do not relate with the presence or absence of associated menisci's lesions. The ADD and the PDD are related to each other and increase with time. Conclusion: There is a permanent anterior subluxation of the injured knee that is related to the amount of anterior displacement that increases with time. Level of Evidence III, Study Types Case-control study.
article Transplante autólogo de condrócitos(2011) BARRETO, Ronald Bispo; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; REZENDE, Marcia Uchoa de; CAMANHO, Gilberto LuisThis literature review article describes the autologous chondrocyte implantation (ACI) process - its stages, clinical indications, surgical technique, laboratory protocol, rehabilitation and clinical outcomes. Since 1994, when the ACI was described for the first time, the procedure has improved to become one of the most important surgical alternatives for the treatment of chondral lesions of the knee.- Development of a Fresh Osteochondral Allograft Program Outside North America(2016) TIRICO, Luis Eduardo Passarelli; DEMANGE, Marco Kawamura; SANTOS, Luiz Augusto Ubirajara; REZENDE, Marcia Uchoa de; HELITO, Camilo Partezani; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; CROCI, Alberto Tesconi; BUGBEE, William DickObjective. To standardize and to develop a fresh osteochondral allograft protocol of procurement, processing and surgical utilization in Brazil. This study describes the steps recommended to make fresh osteochondral allografts a viable treatment option in a country without previous fresh allograft availability. Design. The process involves regulatory process modification, developing and establishing procurement, and processing and surgical protocols. Results. Legislation: Fresh osteochondral allografts were not feasible in Brazil until 2009 because the law prohibited preservation of fresh grafts at tissue banks. We approved an amendment that made it legal to preserve fresh grafts for 30 days from 2 degrees C to 6 degrees C in tissue banks. Procurement: We changed the protocol of procurement to decrease tissue contamination. All tissues were procured in an operating room. Processing: Processing of the grafts took place within 12 hours of tissue recovery. A serum-free culture media with antibiotics was developed to store the grafts. Surgeries: We have performed 8 fresh osteochondral allografts on 8 knees obtaining grafts from 5 donors. Mean preoperative International Knee Documentation Committee (IKDC) score was 31.99 +/- 13.4, improving to 81.26 +/- 14.7 at an average of 24 months' follow-up. Preoperative Knee Injury and Oseoarthritis Outcome Score (KOOS) score was 46.8 +/- 20.9 and rose to 85.24 +/- 13.9 after 24 months. Mean preoperative Merle D'Aubigne-Postel score was 8.75 +/- 2.25 rising to 16.1 +/- 2.59 at 24 months' follow-up. Conclusion. To our knowledge, this is the first report of fresh osteochondral allograft transplantation in South America. We believe that this experience may be of value for physicians in countries that are trying to establish an osteochondral allograft transplant program.
- INTENSITY, DURATION AND TYPE OF PHYSICAL ACTIVITY REQUIRED TO IMPROVE FUNCTION IN KNEE OSTEOARTHRITIS(2017) KIRIHARA, Ricardo Akihiro; CATELAN, Fellipe Bravim; FARIAS, Fabiane Elize Sabino de; SILVA, Cleidneia Aparecida Clemente da; CERNIGOY, Claudia Helena de Azevedo; REZENDE, Marcia Uchoa deObjective: To evaluate the effects of physical activity intensity, type and duration in patients with knee osteoarthritis (KOA). Methods: A retrospective study of 195 KOA patients who were followed for two years after receiving educational material about KOA with or without attending classes. The patients were evaluated at baseline and 24 months. At the evaluations, the patients answered questionnaires pertaining to pain and function (WOMAC, Lequesne, VAS and SF-36); reported the intensity, duration and type of exercise performed per week; and performed the Timed Up & Go (TUG) and Five Times Sit-to-Stand (FTSST) tests. Results: Increased age affected improvements in the TUG results (p=0.017). The type, intensity and duration of physical activity did not correlate with pain, function or quality of life improvements (p>0.05), but the TUG results were on average 4 seconds faster among the patients who practiced intense physical activity and/or exercised for more than 180 minutes per week and/or performed isolated weight training or swam compared with those who remained sedentary after 2 years (p=0.01; p<0.001; p=0.01; p=0.04, respectively). Conclusions: Patients with KOA should aim for intense physical activity and/or more than 180 minutes of exercise per week and/or weight training (bodybuilding) for relevant pain reduction and functional improvement.
- BRAZILIAN CONSENSUS STATEMENT ON VISCOSUPPLEMENTATION OF THE HIP (COBRAVI-Q)(2022) SOUSA, Eduardo Branco De; HAMDAN, Paulo Cesar; MENEGASSI, Zartur Jose Barcelos; ALCHAAR, Adrieni Antunes Do Amaral; TIEPPO, Antonio Martins; SOUZA, Caio Goncalves De; PINHEIRO, Carlos Bruno Reis; ALMEIDA, Cyro Scala De; ROCHA, Eduardo De Melo Carvalho; CUNHA, Fabiano Goncalves; PACHECO, Ivan; REZENDE, Marcia Uchoa De; SOUZA, Marcio Passini Goncalves De; SILVA, Marcos Britto Da; CAMPOS, Gustavo Constantino DeObjective: The Brazilian Consensus on Hip Viscosupplementation aims to generate a referential and consensual source from the theoretical knowledge and clinical experience of specialists in the field. Methods: A multidisciplinary panel was formed with 15 specialists (sports medicine, orthopedists, physiatrists and rheumatologists), based on clinical and academic experience in the use of viscosupplementation of the hip. 12 statements were prepared, discussed and voted. Each panelist gave a value between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several aspects of viscosupplementation of the hip, with emphasis on the following statements: best indication is for mild to moderate hip arthrosis; it may be indicated in severe osteoarthritis; results may vary according to the characteristics of the viscosupplement used; Viscosupplementation should not be performed as an isolated procedure, but in conjunction with other rehabilitation and pharmacological measures; best injection technique should be based on anatomical references coupled with imaging guidance; it is a cost-effective procedure. Conclusion: Viscosupplementation is a safe and effective therapy for hip osteoarthritis, even in severe cases. Guided injection is recommended.
- BRAZILIAN CONSENSUS STATEMENT ON VISCOSUPPLEMENTATION OF THE KNEE (COBRAVI)(2019) CAMPOS, Gustavo Constantino de; SOUSA, Eduardo Branco de; HAMDAN, Paulo Cesar; ALMEIDA JUNIOR, Cyro Scala de; TIEPPO, Antonio Martins; REZENDE, Marcia Uchoa de; ALCHAAR, Adrieni Antunes do Amaral; PINHEIRO, Carlos Bruno; ROCHA, Eduardo de Melo Carvalho; CUNHA, Fabiano Gocalves; PACHECO, Ivan; VIEIRA, Mario Sergio Rossi; ANTONIO, Silvio Figueira; MENEGASSI, Zartur Jose BarcelosObjective: The aim of this consensus statement on viscosupplementation is to serve as a reference document based on relevant literature and clinical experience in the treatment of knee osteoarthritis using an intra-articular injection of hyaluronic acid, covering key aspects such as clinical indications, effectiveness, and tolerability. Methods: A multidisciplinary panel including two sports medicine physicians, six orthopedists, four physiatrists, and two rheumatologists were selected based on their clinical and academic experience of viscosupplementation. Sixteen statements were prepared and discussed, after which a vote was held. Each member of the panel gave a score between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several issues. Specifically, the panel agreed that the best indication is for mild to moderate knee arthrosis; prior or concomitant use of intraarticular triamcinolone hexacetonide may optimize the effect of hyaluronic acid; viscosupplementation should not be performed as an isolated procedure but in conjunction with other rehabilitative and pharmacological measures; viscosupplementation has analgesic, anti-inflammatory, and chondroprotective effects; and viscosupplementation is cost-effective. Conclusion: This consensus statement provides clear information and guidance for both individuals and payers.
- ONE-YEAR RESULTS OF BRACING FOR PATELLO-FEMORAL OSTEOARTHRITIS. PROSPECTIVE RANDOMIZED STUDY(2021) MERINO, Matheus Garcia Lopes; MORALE, Victor; OCAMPOS, Guilherme Pereira; LUZO, Maria Candida Miranda; CAMARGO, Olavo Pires de; REZENDE, Marcia Uchoa deObjective: To compare the long-term effects of a brace designed to stabilize the patellofemoral (PF) joint in comparison to a standard neoprene sleeve for the knee with patellar hole in patients with patellofemoral osteoarthritis (PFOA). Methods: 38 patients with PFOA and comorbidities received either a functional PF brace (Study Group, SG) or a neoprene sleeve for the knee (Control Group, CG). Both groups received clinical treatment to OA and comorbidities according to a program from the institution. Patients were evaluated with Western Ontario and MacMaster (WOMAC) and Lequesne questionnaires, 30-second chair stand test (30CST), Timed Up and Go (TUG), anthropometric measures and self-reported physical activity in minutes/week at inclusion, one, three and twelve months after placing the brace. X-Rays were taken to measure the angles. Results: At one year there was more abandonment in the CG without differences in weight and body mass index between groups during the study. The SG maintained improvements in Lequesne and WOMAC total and subsets during the year, whereas the CG returned to baseline values for pain, function and total (p < 0.01). TUG and 30CST results were always better in the study group without any clinically important improvement in both groups. Conclusion: Long-term use of functional brace added to self-management program improves pain and function in patients with PFOA.
- PARQVE: PROJECT ARTHRITIS RECOVERING QUALITY OF LIFE THROUGH EDUCATION: TWO-YEAR RESULTS(2017) REZENDE, Marcia Uchoa de; FRUCCHI, Renato; PAILO, Alexandre Felicio; CAMPOS, Gustavo Constantino de; PASQUALIN, Thiago; HISSADOMI, Marcelo IssaoObjective: To evaluate the effects of a multi-professional educational program in patients with knee osteoarthritis (KOA). Methods: Prospective randomized controlled trial with 195 KOA patients. One group was submitted to two-day lectures and received educational material about KOA (Class group), and the control group received the educational material only. Patients were evaluated at baseline, twelve and 24 months. At evaluation, patients answered pain and functional questionnaires (WOMAC, Lequesne, VAS and SF-36); reported the intensity of exercise per week; measured the body fat percentage, weight and height to estimate body mass index (BMI); and performed Timed Up & Go (TUG) and Five-Times-Sit-to- Stand (FTSST) tests. Results: The groups presented similar results in all time points with respect to pain (VAS and WOMAC pain), WOMAC, BMI and body fat percentage (p>0.05). The Class group exhibited improved function according to the Lequesne questionnaire, whereas the control group worsened (p=0.02) during follow-up (p<0.02). TUG (p=0.01) and FTSST (p<0.001) improved in the Class group. A higher percentage of patients in the Class group performed regular physical activity (p=0.045). Conclusions: The educational program with classes improved the consistency of physical activity and the subjective and objective function of patients with KOA.
conferenceObject ONE-YEAR RESULTS OF GENICULAR ARTERIES EMBOLIZATION AS TREATMENT OF KNEE OA(2023) REZENDE, M. U.; VALLE, L. G. M.; ASSIS, A. M.; OCAMPOS, G. P.; CARNEVALE, F. C.; AFFONSO, B. B.; GALASTRI, F. L.; NASSER, F.
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