LUIS EDUARDO PASSARELLI TIRICO

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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

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Autor e Coautores FMUSP-HC Normalizados: ALBERTO TESCONI CROCI ×

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  • article 12 Citação(ões) na Scopus
    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 Dick
    Objective. 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.
  • article 2 Citação(ões) na Scopus
    Fresh osteochondral knee allografts in Brazil with a minimum two-year follow-up
    (2017) TÍRICO, Luís Eduardo Passarelli; DEMANGE, Marco Kawamura; SANTOS, Luiz Augusto Ubirajara; PÉCORA, José Ricardo; CROCI, Alberto Tesconi; CAMANHO, Gilberto Luís
    ABSTRACT OBJECTIVE: The present study aimed to report the results of the first series of cases of fresh ostechondral allografts in the knee joint in Brazil with a minimum follow-up of two years. METHODS: A protocol of procurement, harvesting, processing, and utilization of fresh osteochondral allografts in the knee joint was established, beginning with legislation modifications, graft harvesting techniques, immediate processing, storage of fresh grafts, and utilization of two surgical techniques of osteochondral transplantation. Eight patients were treated and followed-up for a minimum of two years. RESULTS: Patients were evaluated with subjective IKDC, KOOS, and modified Merle D'Aubigne and Postel questionnaires. Mean subjective IKDC score was 31.99 ± 13.4 preoperative and 81.26 ± 14.7 at the latest follow-up; preoperative KOOS score was 46.8 ± 20.9 and postoperative was 85.24 ± 13.9, indicating a significant improvement over time (p < 0.01). Mean modified Merle D'Aubigne-Postel score was 8.75 ± 2.25, preoperatively, and 16.1 ± 2.59 postoperatively. Friedman test for non-parametric samples demonstrated a significant improvement in postoperative scores (p < 0.01). CONCLUSION: The use of fresh osteochondral allografts in Brazil is a safe procedure, with good clinical results in the short- and medium-term for the treatment of osteochondral lesions greater than 4 cm2 in the knee joint.