ANDRE PEDRINELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
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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Resultados de Busca
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- The influence of femoral tunnel position in single-bundle ACL reconstruction on functional outcomes and return to sports(2014) FERNANDES, Tiago Lazzaretti; FREGNI, Felipe; WEAVER, Kayleen; PEDRINELLI, Andre; CAMANHO, Gilberto Luis; HERNANDEZ, Arnaldo JoseThe purpose of this study was to radiographically investigate the influence of femoral tunnel placement in ACL reconstruction on early outcomes and return to sports due to anatomic and nonanatomic positioning. A prospective study was conducted from 2008 to 2010, with 86 athletes who underwent ACL reconstruction between anteromedial (AM) footprint and high AM position. Knee functional outcomes (IKDC objective and subjective, Tegner score, and Lysholm scale) return to sports and complications were analyzed at 6- and 12-month follow-up. At follow-up, it was observed that tunnel projection along Blumensaat's line was correlated with functional outcomes on Tegner scale (at 6 and 12 months) and IKDC subjective (at 12 months). There was a significant difference in mean tunnel projection along Blumensaat's line when analyzing return to sports (73 +/- A 1.4 and 79 +/- A 1.7 %, respectively, for projections on return vs. no return to sports, p = 0.02) and complications (73 +/- A 1.3 vs. 78 +/- A 1.6 %, respectively, for projections on no complications vs. complications, p = 0.03). No differences were stated on coronal view. These correlations between tunnel positioning on functional outcomes could not be explained by demographic or baseline characteristics. The clinical relevance of this study is that tunnel positioning along AM footprint and high AM position represented by tunnel projection along Blumensaat's line is associated with early return to sports on previous Tegner level and better functional outcome in athletes. III.
- A BIOMECHANICAL COMPARISON OF MATCHED FOUR-STRAND AND FIVE-STRAND SEMITENDINOSUS-GRACILIS GRAFTS(2021) BARROS, Marcos Amstalden; COSTA, Sandokan Cavalcante; JARAMILLO, Diego Eduardo Rubio; ALMEIDA, Adriano Marques de; PEREIRA, Cesar Augusto Martins; FERNANDES, Tiago Lazzaretti; NARDELLI, Julio Cesar Carvalho; ANNICHINO, Marcel Fruschein; PEDRINELLI, Andre; HERNANDEZ, Arnaldo JoseIntroduction: Recent studies have shown that the likelihood of semitendinosus-gracilis graft rupture is inversely correlated to its diameter. A graft can be prepared in a five-strand or four-strand fashion to increase its diameter. However, the biomechanical superiority of five-strand semitendinosus-gracilis grafts is still under debate. Objective: This study aimed to evaluate the biomechanical characteristics of matched four-strand and five-strand human semitendinosus-gracilis grafts. Methods: We evaluated semitendinosus-gracilis tendons harvested from ten fresh human male and female cadavers, aged 18-60 years. Four-strand or five-strand grafts were prepared with the tendons and fixed to wooden tunnels with interference screws. Each graft was submitted to axial traction at 20 mm/min until rupture; the tests were donor matched. Data were recorded in real time and included the analysis of the area, diameter, force, maximum deformation and stiffness of the grafts. Results: The diameter, area and tunnel size were significantly greater in the five-strand grafts than in the four-strand grafts. There were no significant differences in biomechanical properties. The area and diameter of the graft were positively correlated to stiffness, and inversely correlated to elasticity. There was no significant correlation between graft size and maximum force at failure, maximum deformation or maximum tension. Conclusion: Five-strand hamstring grafts have greater area, diameter and tunnel size than fourstrand grafts. There were no significant differences in biomechanical properties. In this model using interference screw fixation, the increases in area and diameter were correlated with an increase in stiffness and a decrease in elasticity.
- COMPARISON BETWEEN RENDERING 3D-CT AND TRANSPARENT 3D-CT IN ACL TUNNEL POSITIONING(2017) BARROS, Marcos Amstalden; FERNANDES, Tiago Lazzaretti; DIMITRIOU, Dimitris; PEDRINELLI, Andre; HERNANDEZ, Arnaldo JoseObjective: To compare the transparent 3D computed tomography (CT) image protocol against conventional 3D-CT image-rendering protocol to assess femoral tunnel position in anatomic anterior cruciate ligament (ACL) reconstructions. Methods: Eight knee CT scans from cadavers were analyzed by image rendering 3D-CT protocol, using Rhinoceros (R) software. The central point of the ACL tunnel was set using the sagittal plane. Same CT scans were analyzed using transparent 3D-CT measurement protocol with OsiriX (R) software. Central point of the ACL tunnel was set using sagittal, coronal and axial planes. The grid system described by Bernard and Hertel was used to compare tunnel positions between protocols, using height and length parameters. Results: There was a significant difference between measurements using image rendering 3D-CT and transparent 3D-CT protocol for height (23.8 +/- 7.9mm and 33.0 +/- 5.0mm, respectively; p=0.017) and no differences for length (18.6 +/- 4.2mm and 18.3 +/- 4.5mm, respectively; p=0.560). Conclusion: Height in transparent CT protocol was different and length was the same as compared to 3D-CT rendering protocol in Bernard and Hertel method for tunnel measurements.
- The biomechanical effects of graft rotation on ACL reconstruction tunnel mismatch(2017) OLIVEIRA, Danilo Ricardo Okiishi de; GARCIA, Eduardo Takahashi; FUSO, Fernando Augusto Freitas; PEREIRA, Cesar Augusto Martins; LAGES, Marco Martins; ALMEIDA, Adriano Marques de; FERNANDES, Tiago Lazzaretti; PEDRINELLI, Andre; HERNANDEZ, Arnaldo JoseBone block protrusion out of the tibial tunnel due to a relatively long graft is a common complication in anterior cruciate ligament surgical reconstruction with a patellar tendon. One possible solution is to shorten the patellar tendon graft already fixed in the femur by applying external rotation. This study aimed to evaluate the degree of shortening and biomechanical changes in porcine patellar grafts subjected to relatively higher degrees of rotation. Data obtained with rotations of 0A degrees, 540A degrees, 720A degrees, and 900A degrees were compared. Forty patellar porcine ligaments were subjected to biomechanical tests of degree of shortening, modulus of elasticity and maximum tension in the tendon before rupture. Tests were conducted using a universal mechanical testing machine and a computerized system for acquiring strength and deformation data. Progressive shortening of the patellar ligament occurred with rotations of 0A degrees, 540A degrees and 720A degrees. However, the degree of shortening showed no statistically significant difference as rotation increased from 720A degrees to 900A degrees. Decreased modulus of elasticity was observed compared with the graft rotation at 0A degrees in all groups tested, but no statistically significant differences were observed among 540A degrees, 720A degrees and 900A degrees. The maximum tension of the patellar tendon showed no change before rupture, regardless of the degree of rotation. Rotating the patellar tendon is an efficient method for shortening a relatively long graft; however, more biomechanical studies are necessary to recommend this technique in clinical practice owing to the resulting decrease in graft stiffness that could compromise knee stability.