MAURO EMILIO CONFORTO GRACITELLI
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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bookPart Infecção em prótese de ombro(2013) BOLLIGER NETO, Raul; PRADA, Flavia de Santis; MALAVOLTA, Eduardo Angeli; GRACITELLI, Mauro Emilio Conforto; FERREIRA NETO, Arnaldo Amado- Humeral internal rotation osteotomy for the treatment of Erb-Duchenne-type obstetric palsy: clinical and radiographic results(2013) ASSUNCAO, Jorge Henrique; FERREIRA NETO, Arnaldo Amado; BENEGAS, Eduardo; BOLLIGER NETO, Raul; PRADA, Flavia Santis; MALAVOLTA, Eduardo Angeli; GRACITELLI, Mauro Emilio Conforto; CAMANHO, Gilberto LuisOBJECTIVE: To evaluate the functional and radiographic results in patients undergoing shoulder anterior soft tissue stretching in association with open reduction and internal rotation osteotomy to centralize the humeral head as a treatment for Erb-Duchenne obstetric palsy sequelae. METHOD: A total of 35 patients underwent this surgical treatment, and the mean follow-up was 4.6 years. The Mallet scale was applied before and after the surgical procedure. A total of 20 patients underwent computed tomography to assess the glenoid version and humeral head subluxation. RESULTS: Functional improvement was achieved, as evidenced by an increase in the Mallet scale score from 12.14 to 16.46 (p<0.001). The correction of retroversion was achieved once the glenoid version ranged from 21.4 to - 12 degrees (p<0.001). The humeral head subluxation improved from 6.5 to 35.2% (p<0.001). Patients older than 6 years of age did not achieve glenohumeral joint improvement with respect to dysplastic abnormalities. CONCLUSION: Internal rotation osteotomy in association with the stretching of anterior soft tissues of the shoulder in patients under the age of 7 years provided improvements in the function, retroversion, and subluxation of the glenohumeral joint.
- Assessment of the function and resistance of sternoclavicular ligaments: A biomechanical study in cadavers(2014) NEGRI, J. H.; MALAVOLTA, E. A.; ASSUNCAO, J. H.; GRACITELLI, M. E. C.; PEREIRA, C. A. M.; BOLLIGER NETO, R.; CROCI, A. T.; FERREIRA NETO, A. A.Background: Few biomechanical studies have assessed the resistance of the ligamentous structures of the sternoclavicular joint, and none have reproduced the physiological movements of the joint. Determiningthe structures that are injured in sternoclavicular dislocations is important for the surgical planning of acute or chronic ligament reconstruction. Methods: Forty-eight joints from 24 human cadavers were studied, and they were divided into 4 groups of 12 joints each (retraction, protraction, depression and elevation). Biomechanical testing assessed primary and secondary failures. The mechanical resistance parameters between movements that occurred on the same plane (depression versus elevation, protraction versus retraction) were compared. Results: The posterior sternoclavicular ligament was the most injured structure during the protraction test, but it was not injured during retraction. The anterior sternoclavicular ligament was the most affected structure during retraction and depression. The costoclavicular ligament was the most affected structure during elevation. Joint resistance was significantly greater during protraction movements when compared to retraction (P < 0.05). Conclusion: The anterior sternoclavicular ligament was the most affected structure during retraction and depression movements. During protraction, lesions of the posterior sternoclavicular ligament were most frequent during elevation, and the costoclavicular ligament was the most frequently injured ligament. The resistance of the sternoclavicular joint was significantly greater during protraction movement when compared to retraction.
- Shoulder function after surgical treatment of displaced fractures of the humeral shaft: a randomized trial comparing antegrade intramedullary nailing with minimally invasive plate osteosynthesis(2014) BENEGAS, Eduardo; FERREIRA NETO, Arnaldo Amado; GRACITELLI, Mauro Emilio Conforto; MALAVOLTA, Eduardo Angeli; ASSUNCAO, Jorge Henrique; PRADA, Flavia De Santis; BOLLIGER NETO, Raul; MATTAR JR., RamesBackground: Minimally invasive plate osteosynthesis for humeral shaft fractures has been described recently, but there are no randomized studies comparing the clinical results for shoulder function between this technique and locking intramedullary nailing. Methods: A prospective randomized study was performed. Forty-one humeral shaft fractures (40 patients) were randomized to be treated with a minimally invasive plate (n = 21) or a locking intramedullary nail (n = 19). Clinical and radiographic outcome assessments were conducted at 1 year postoperatively. Shoulder function was the primary outcome, as measured by the University of California, Los Angeles Shoulder Scale. Elbow function was measured by the Broberg-Morrey score, and fracture consolidation and complications were the main secondary outcomes. Results: At 1 year postoperatively, no significant difference was found with regard to shoulder function according to the University of California, Los Angeles scale between the minimally invasive plate and locking intramedullary nail (31.4 points vs 31.2 points, P = .98). There was also no difference in elbow function (94.8 points vs 94.1 points, P = .96). Complications were similar between the groups, without significant differences regarding infection (P > .99), symptomatic shoulder stiffness (P = .488), and neurapraxia of the lateral cutaneous nerve of the forearm (P = .475). Fracture union was achieved in all but 1 patient (2.4%) in the intramedullary nail group within 1 year after the surgical procedure. Conclusion: There is no significant difference in shoulder function between antegrade intramedullary nailing and minimally invasive plate osteosynthesis for the treatment of displaced humeral shaft fractures, despite the limited power of our study. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.
- TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATION WITH BRISTOW-LATARJET PROCEDURE(2021) FERREIRA FILHO, Arnaldo Amado; MALAVOLTA, Eduardo Angeli; GRACITELLI, Mauro Emilio Conforto; ASSUNCAO, Jorge Henrique; SILVA, Fernando Brandao De Andrade E; BOLLIGER NETO, Raul; FILHO, Americo Zoppi; FERREIRA NETO, Arnaldo AmadoObjectives: To describe the clinical and radiographic results of patients with traumatic recurrent anterior shoulder dislocation treated with the Bristow-Latarjet procedure. Methods: Retrospective case series including 44 patients (45 shoulders) who underwent the Bristow-Latarjet procedure. The graft was fixed ""standing"" in 84% of the shoulders, and ""lying"" in 16%. Results: The follow-up was 19.25 +/- 10.24 months. We obtained 96% of good results, with 2 recurrences presented as subluxation. Graft healing occurred in 62% of cases. The graft was positioned below the glenoid equator in 84% of the cases, and less than 10 mm from its edge in 98%. The external rotation had a limitation of 20.7 degrees +/- 15.9 degrees, while the internal rotation was limited in 4.0 degrees +/- 9.6 degrees. The limitation of rotation and the position of the graft (""standing"" or ""lying"") did not correlate with graft healing (p>0.05). Bicortical fixation was positively correlated with healing (p<0.001). Conclusion: The Bristow-Latarjet technique is indicated for the treatment of recurrent anterior dislocations and subluxations of the shoulder. It is a safe treatment method, which can be used in people with intense physical activity. Limiting shoulder mobility does not prevent patients from returning to their usual occupations.
- Plasma rico em plaquetas no reparo artroscópico das roturas completas do manguito rotador(2012) MALAVOLTA, Eduardo Angeli; GRACITELLI, Mauro Emilio Conforto; SUNADA, Edwin Eiji; BENEGAS, Eduardo; PRADA, Flavia de Santis; BOLLIGER NETO, Raul; RODRIGUES, Marcelo Bordalo; FERREIRA NETO, Arnaldo Amado; CAMARGO, Olavo Pires deOBJECTIVE: To evaluate shoulder functional results and the re tear rate of arthroscopic repair of the rotator cuff augmented with platelet-rich plasma (PRP). METHODS: Prospective case series with single-row arthroscopic repair of the rotator cuff augmented with PRP. Only cases of isolated supraspinatus tears with retraction of less than 3 cm were included in this series. The PRP used was obtained by apheresis. It was applied on liquid consistency in its activated form, with the addition of autologous thrombin. Patients were evaluated after 12 months of the surgical procedure. The Constant-Murley, UCLA and VAS scales were used, and the retear rate was assessed using magnetic resonance imaging (MRI). RESULTS: Fourteen patients were evaluated (14 shoulders). The mean Constant-Murley score was 45.64 ± 12.29 before the operation and evolved to 80.78 ± 13.22 after the operation (p < 0.001). The UCLA score increased from 13.78 ± 5.66 to 31.43 ± 3.9 (p < 0.001). The patients' pain level decreased from a median of 7.5 (p25% = 6, p75% = 8) to 0.5 (p25% = 0, p75% = 3) (p = 0.0013) according to the VAS score. None of the patients presented complete retear. Three patients (21.4%) showed partial retear, without transfixation. Only one patient developed complica tions (adhesive capsulitis). CONCLUSION: Patients submitted to arthroscopic rotator cuff repair augmented with PRP showed significant functional improvement and none of them had com plete retearing.