LUIS EDUARDO PASSARELLI TIRICO
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
13 resultados
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- Effect of postoperative use of nasal oxygen catheter supplementation in wound healing following total knee arthroplasty(2014) HELITO, Camilo Partezani; JUNQUEIRA, Jader Joel Machado; GOBBI, Ricardo Gomes; ANGELINI, Fabio Janson; REZENDE, Marcia Uchoa; TIRICO, Luis Eduardo Passarelli; DEMANGE, Marco Kawamura; ALBUQUERQUE, Roberto Freire da Mota e; PECORA, Jose Ricardo; CAMANHO, Gilberto LuisOBJECTIVES: Healing is an event that is fundamental to the success of total knee arthroplasty. The aims of the present study were to compare the rates of complications related to wound healing between two groups of volunteers submitted to total knee arthroplasty and to evaluate the effects of postoperative oxygen supplementation by means of a nasal catheter. METHOD: A total of 109 patients who underwent total knee arthroplasty were randomized into two groups, namely, groups that did and did not receive postoperative oxygen supplementation via a nasal catheter. The surgical wound was monitored every day during the hospital stay and on the 7th, 14th, 21st, 30th and 42nd postoperative days. Characteristics related to healing were observed, including hyperemia, dehiscence, necrosis, phlyctenules and deep and superficial infection. RESULTS: There were no cases of deep infection. Hyperemia was statistically correlated with the total number of complications in the groups, with oxygen demonstrated to be a protective factor against hyperemia. Approximately 30% of the patients who exhibited hyperemia had other complications, independent of oxygen supplementation. CONCLUSION: Oxygen supplementation following total knee arthroplasty was shown to be effective in diminishing hyperemia around the operative wound. The development of hyperemia was a precursor to other complications, irrespective of whether oxygen supplementation was used.
- Trochlear dysplasia and patellar instability in patients with Down syndrome(2015) MOREIRA, Tiago Amaral Rebouças; DEMANGE, Marco Kawamura; GOBBI, Riccardo Gomes; MUSTACCHI, Zan; PÉCORA, José Ricardo; TÍRICO, Luis Eduardo Passarelli; CAMANHO, Gilberto LuisOBJECTIVE: To analyze occurrences of trochlear dysplasia in patients with Down syndrome in the presence and absence of femoropatellar instability. METHODS: Eleven knees with stable patellae and thirteen with unstable patellae in patients with Down syndrome were compared. Radiographs were produced to evaluate patellar height, trochlear angle and femoropatellar congruence angle. RESULTS: The prevalence ratio for a high patella between the unstable and the stable patients was 1.01 using the Insall-Salvati index and 0.68 using the Caton-Deschamps index. For an abnormal congruence angle, the prevalence ratio was 2.04. An increased congruence angle was only found in four cases, all presenting instability. CONCLUSIONS: Trochlear dysplasia was only found in cases of instability. The trochlear groove angle and the femoropatellar congruence angle correlated with the presence of patellar instability.
- Valor da avaliação radiográfica pré-operatória dos defeitos ósseos no joelho nas revisões de artroplastia(2012) IAMAGUCHI, Mauricio Masasi; HELITO, Camilo Partezani; GOBBI, Riccardo Gomes; DEMANGE, Marco Kawamura; TIRICO, Luiz Eduardo Passarelli; PECORA, Jose Ricardo; CAMANHO, Gilberto LuisOBJECTIVE: To evaluate the value of preoperative radiographic evaluations for total knee arthroplasty (TKA) revision. METHODS: Thirty-one knees that were operated between 2006 and 2008, in a consecutive series of cases of TKA revision surgery were analyzed retrospectively. THE FOLLOWING CRITERIA WERE EVALUATED: number of wedges or structured bone grafts used for filling the bone defects; locations of the wedges and bone grafts used; and mean thickness of the polyethylene used. The AORI classification was previously established based on preoperative radiographs, using preestablished criteria. After the analysis, the knees were divided into four groups (I, IIA, IIB and III). RESULTS: The mean number of wedges or grafts used in each knee progressively increased among the groups (group I: 1.33; group IIA: 2; group IIB: 4.33; and group III: 4.83) (P = 0.0012). The commonest locations were medial in the tibia and posteromedial in the femur. There were no statistically significant differences in the thickness of the polyethylene used. CONCLUSION: The AORI classification for bone defects in the knee, based on preoperative radiographs, showed a correlation with increasing need to use wedges and/or structured grafts in TKA revisions. However, up to 46% of the knees in groups I and IIA presented bone defects of up to 5 mm that were not diagnosed by means of preoperative radiographs.
- O uso do transplante osteocondral a fresco no tratamento das lesões osteocondrais do joelho(2012) TÍRICO, Luís Eduardo Passarelli; DEMANGE, Marco KawamuraTreatment of chondral and osteochondral knee lesions in young patients remains a challenge for orthopedic surgeons. The repair techniques currently available in Brazil, such as debridement, microfracture and autologous osteochondral transplantation are insufficient for treating large chondral and osteochondral lesions. Fresh homologous osteochondral transplants have been used in the knee joint in the United States with excellent results. This article had the aims of reviewing the basic science, indi cations, surgical techniques and possible complications and describing the technique of fresh homologous osteochondral transplantation in the knee joint, performed in the Institute of Orthopedics and Traumatology, Hospital das Clinicas, Univer sity of São Paulo.
- Study on implant stability in cementless total knee arthroplasty(2012) TIRICO, Luis Eduardo Passarelli; PASQUALIN, Thiago; PECORA, Jose Otavio; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; DEMANGE, Marco KawamuraObjetives: Determine the stability of tibial and femoral components of 20 cementless knee arthroplasties with rotating platform. Methods: The 20 patients (20 knees) underwent an analysis of dynamic radiographs with an image amplifier and maneuvers of varus and valgus which were compared to static frontal and lateral radiographs of the knees and analyzed by two experienced surgeons in a double-blind way. Results: We could observe in this study that both methods showed very similar results for the stability of the tibial and femoral components (p<0.001) using the Kappa method for comparison. Conclusion: The tibial component was more unstable in relation to the femoral component in both static and dynamic studies. Level of Evidence IV, Case Series.
- Anatomical study on the anterolateral ligament of the knee(2013) HELITO, Camilo Partezani; MIYAHARA, Helder de Souza; BONADIO, Marcelo Batista; TIRICO, Luis Eduardo Passareli; GOBBI, Riccardo Gomes; DEMANGE, Marco Kawamura; ANGELINI, Fabio Janson; PECORA, Jose Ricardo; CAMANHO, Gilberto LuisOBJECTIVE: Describe the knee anterolateral ligament (ALL) and establish its anatomical marks of origin and insertion. METHODS: Dissection of the anterolateral aspect of the knee was performed in six cadavers. After isolation of the ALL, its lenght, width and thickness were measured as its places of origin and insertion. The ALL origin was documented in relation to the lateral collateral ligament (LCL) origin and the insertion was documented in relation to the Gerdy tubercle, fibullar head and lateral meniscus. After the first two dissections, the ligament was removed and sent to histologycal analysis. RESULTS: The ALL was clearly identified in all knees. Its origin in the lateral epycondile was on average 0.5 mm distal and 2.5 mm anterior to the LCL. In the tibia, two insertions were observed, one in the lateral meniscus and another in the proximal tibia, about 4.5 mm distal to the articular cartilage, between the Gerdy tubercle and the fibullar head. The average measures obtained were: 35.1 mm lenght, 6.8 mm width and 2.6 mm thickness. In the ligament histological analysis, dense connective tissue was observed. CONCLUSION: The ALL is a constant structure in the knee anterolateral region. Its origin is anterior and distal to the LCL origin. In the tibia, it has two insertions, one in the lateral meniscus and another in the proximal tibia between the Gerdy tubercle and the fibullar head.
- Correlation between skin patch testing and clinical outcome in total knee arthroplasty, a serial prospective study(2023) TIRICO, Maria Claudia Carvas Passarelli; REIS, Vitor Manuel da Silva; AOKI, Valeria; DEMANGE, Marco Kawamura; TIRICO, Luis Eduardo Passarelli
- Dor na ponta da haste após revisão de artroplastia total de joelho(2012) ALBINO, Rômulo Ballarin; SANTOS, Lívia Souza; GOBBI, Riccardo Gomes; IAMAGUCHI, Maurício; DEMANGE, Marco Kawamura; TIRICO, Luis Eduardo; PÉCORA, José RicardoOBJECTIVE: To correlate parameters of implants with incidence of pain. METHODS: 32 knees (31 patients) operated on between 2006 to 2008 in a serie of cases of TKA revision surgery were monitored for evidence of pain at the tip of the stem.In all we used uncemented stem Scorpio TS Total Knee® Revision System (Stryker®). Criteria assessed: pain in the leg or thigh without other causes, diameter and length of the nail; position of the rod in the medullary canal, intramedullary canal diameter. RESULTS: Mean age was 66.7 years and mean follow-up was 2.6 years.21,87% of patients reported leg pain, 9.37% thigh pain. The group of pacients with leg pain presented with shaft diameter 14.7 mm, length 80 mm in 71.42% and 155 mm in 28,58%, stem diameter/ intramedullary canal diameter average relation of 0,76, 42.8% had stem malalignment. The group without leg pain presented with shaft diameter 15.2 mm, length 80 mm in 68% and 155 mm in 32%, diameters average relation of 0.80, 20.8% had stem malalignment. The group with thigh pain presented with shaft diameter 18.3 mm, length 80 mm in 66.67% and 155 mm in 33,33%,diameters average relation of 0.75, 0% had stem malalignment The group without thigh pain presented with shaft diameter 16.56 mm, length 80 mm in 70.37% and 155 mm in 29,63%, diameters average relation of 0.79, 14,2% had stem malalignment. CONCLUSION: There was no association between the assessed criteria and pain in the tip of the stem.
- Results of revision total knee arthroplasty using press-fit cementless stem(2013) IAMAGUCHI, Maurcio Masasi; CASTRO FILHO, Fernando Bley Vicente de; GOBBI, Riccardo Gomes; TIRICO, Luis Eduardo Passarelli; PECORA, Jose Ricardo; CAMANHO, Gilberto LuisObjective: To show our experience with press-fit cementless stem and metaphyseal fixation with cement in a selected series of patients who underwent revision total knee arthroplasty. Methods: Thirty-four patients (35 knees) underwent revision total knee arthroplasty using the press-fit technique. Minimum follow-up was one year (mean 2.2 years) with a maximum length of three years. Results: Of 34 patients, 20 were women and 14 were men. There was one death due to causes not related to arthroplasty and one patient dropout. There were no cases in which further review was necessary. Patients who underwent revision had clinical and functional improvement demonstrated by the results of the KSS, results of the SF-36 quality of life questionnaire, through gains in range of motion and improved limb alignment. Conclusion: There was postoperative clinical and functional improvement in comparison to the preoperative status in revision total knee arthroplasty with press-fit cementless stem. Level of Evidence IV, Case Series.
- Epidemiology of septic arthritis of the knee at Hospital das Clinicas, Universidade de Sao Paulo(2014) HELITO, Camilo Partezani; NOFFS, Guilherme Guelfi; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; TIRICO, Luis Eduardo Passarelli; LIMA, Ana Lucia Munhoz; OLIVEIRA, Priscila Rosalba de; CAMANHO, Gilberto LuisBackground: Septic arthritis is an infrequent disease although very important due to the possibility of disastrous outcomes if treatment is not adequately established. Adequate information concerning the epidemiology of septic arthritis is still lacking due to the uncommon nature of the disease as well as the struggle to establish a correct case-definition. Objective: To epidemiologically characterize the population seen at Hospital das Clínicas, University of São Paulo with a diagnosis of septic arthritis between 2006 and 2011. Methods: Sixty-one patients diagnosed with septic arthritis of the knee between 2006 and 2011 were retrospectively evaluated. The patients' clinical and epidemiological characteristics, the microorganisms that caused the infection and the patients' treatment and evolution were analyzed. Results: Septic arthritis of the knee was more common among men, with distribution across a variety of age ranges. Most diagnoses were made through positive synovial fluid cultures. The most prevalent clinical comorbidities were systemic arterial hypertension and diabetes mellitus, and the most commonly reported joint disease was osteoarthritis. Staphylococcus aureus was the prevailing pathogen. Fever was present in 36% of the cases. All patients presented elevation in inflammatory tests. Gram staining was positive in only 50.8% of the synovial fluid samples analyzed. Six patients presented complications and unfavorable evolution of their condition. Conclusion: S. aureus is still the most common pathogen in acute knee infections in our environment. Gram staining, absence of fever and normal leukocyte count cannot be used to rule out septic arthritis.