IVAN CARVALHO GIAROLA

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FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico

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Agora exibindo 1 - 4 de 4
  • article 1 Citação(ões) na Scopus
    Risks of injury in distal metatarsal minimally invasive osteotomy when comparing standard and modified techniques: A cadaveric study
    (2022) AUCH, Elijah; MANSUR, Nacime Salomao Barbachan; LALEVEE, Matthieu; MALY, Connor; MARTINS, Fernando; GIAROLA, Ivan; LI, Shuyuan; GODOY-SANTOS, Alexandre Leme; NETTO, Cesar de Cesar
    Background: The objectives of the study were to evaluate the structures at risk in distal metatarsal mini -invasive osteotomy (DMMO) and to compare standard and intraosseous approaches. Methods: DMMO was performed on the second and fourth metatarsals of 11 fresh-frozen cadaveric spe-cimens. The standard technique was performed in 11 metatarsals. It was then compared to a modified intraosseous technique that entails starting inside the bone in 11 other metatarsals. The cadavers were dissected to identify unintentional injury to soft tissue structures. Results: In the standard group the most injured structures were the metatarsal joint capsules (MJC) (27%), extensor digitorum longus (EDL) (18%), and extensor digitorum brevis (EDB) (9%). The modified intraosseous group injured the EDL (27%), not the MJC (0%) and the EDB (0%). Distances between osteotomies and the dorsal metatarsal head articular surface (DMHAS) were 6.08 +/- 3.99 mm in the standard and 9.92 +/- 3.42 mm in the modified (p = 0.02). Conclusion: The DMMO techniques most frequently injured the EDL. Intra-articular positioning of the os-teotomy was more observed in the standard. Overall, it appears the modified method could be an alter-native to the standard DMMO. Clinical relevance: The modified minimally invasive DMMO has a comparable rate of potential iatrogenic in-juries. This intraosseous procedure may present as an option when planning surgery to the lesser metatarsals. Level of Evidence: Level III. Comparative Cadaveric Study.
  • article 2 Citação(ões) na Scopus
    Changes in cartilage, synovial cells and synovial fluid after malleolar fractures: What its importance for post-traumatic ankle osteoarthitis?
    (2019) GODOY-SANTOS, A.L.; LOPES, D.; GIAROLA, I.; CESAR NETTO, C. de; RAMMELT, S.
    Background: Despite advances in malleolar fractures treatment, the overall risk to develop posttraumatic ankle osteoarthritis after 20 years is almost 40%, especially bimalleolar Weber type B and C fractures and fractures involving the posterior tibial rim. Methods: We performed a systematic literature review of clinical studies targeting the changes in cartilage, synovial cells and synovial fluid after malleolar fractures. Results: The acute ankle injury initiates a sequence of biological events potentially leading to progressive articular surface damage resulting from inflammatory changes in cartilage, synovial tissue and synovial fluid. Conclusion: A better understanding of the molecular and histological changes induced by acute trauma may potentially lead to novel, targeted treatment of malleolar fractures besides anatomical reduction and adequate stabilization. © 2019
  • article 3 Citação(ões) na Scopus
    PROFILE OF PATIENTS WITH OSTEOPOROTIC FRACTURES AND FACTORS THAT DECREASE PREVENTION
    (2019) XAVIER, Renato Martins; GIAROLA, Ivan Carvalho; CAMPOS, Guilherme Pereira; PLAPLER, Perola Grinberg; CAMARGO, Olavo Fires de; REZENDE, Marcia Uchoa de
    Objective: To evaluate the epidemiological profile of patients with osteoporotic fractures compared to patients with osteoarthritis (OA) and identify factors that diminish adherence to secondary prevention. Methods: A total of 108 patients with osteoporotic fractures (OF) were compared to 86 patients with OA. Results: Patients in the OF group were older (p < 0.001); had a lower body mass index (p < 0.001); were less literate (p = 0.012); were more frequently Caucasian (p = 0.003); were less frequently married (p < 0.001); experienced more falls, cognitive deficiency, previous fractures, old fracture, falls in the last year, and fall fractures; needed more help and took more medicine for osteoporosis (p < 0.05); and showed less pathology in the feet, muscle weakness, less vitamin D intake, and lower Katz & Lawton scores (p < 0.001). Factors that increased the chance of nonadherence included older age (p = 0.020), falls (p = 0.035), cognitive deficiency (p = 0.044), and presence of depression/apathy/confusion (p < 0.001). Conclusion: Patient age, ethnicity, marital status, previous falls, foot pathologies, muscle weakness, previous fractures, use of vitamin D, use of osteoporosis drugs, and lower Katz & Lawton scale score defined the OF group. Factors that increased the chance of nonadherence included older age, sedative use, cognitive disorders, and symptoms of depression/apathy/confusion.
  • conferenceObject
    EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH OSTEOPOROTIC FRACTURES COMPARED TO OA PATIENTS AND FACTORS THAT DECREASE SECONDARY PREVENTION OF OSTEOPOROTIC FRACTURES
    (2019) OCAMPOS, G. P.; REZENDE, M. U. De; XAVIER, R. M.; GIAROLA, I. C.; PLAPLER, P. G.; CAMARGO, O. P. De