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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Platelet-Rich Plasma in Rotator Cuff Repair A Prospective Randomized Study(2014) MALAVOLTA, Eduardo Angeli; GRACITELLI, Mauro Emilio Conforto; FERREIRA NETO, Arnaldo Amado; ASSUNCAO, Jorge Henrique; BORDALO-RODRIGUES, Marcelo; CAMARGO, Olavo Pires deBackground: Although platelet-rich plasma (PRP) has been used in rotator cuff repair, most authors have been unable to report the advantages of this method in clinical trials. Hypothesis: The use of PRP promotes better functional and structural results in arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This was a prospective, randomized, double-blind study with 2 groups of 27 patients each (PRP group and control group). Complete supraspinatus tears with retraction of less than 3 cm were subjected to arthroscopic single-row repair; at the end of the surgical procedure, liquid PRP prepared by apheresis was given to the patients in the PRP group with autologous thrombin. The outcomes were assessed by the University of California at Los Angeles (UCLA) and Constant scales, visual analog scale (VAS) for pain, and magnetic resonance imaging (MRI) before and 3, 6, 12, and 24 months after surgery. The significance level was 5%. Results: The 2 groups of patients exhibited significant clinical improvement (P < .001). Between the preoperative assessment and 24-month follow-up, the mean UCLA score increased from 13.63 3.639 to 32.70 +/- 3.635 and from 13.93 +/- 4.649 to 32.44 +/- 4.318 in the control and PRP groups, respectively (P = .916). The mean Constant score increased from 47.37 +/- 11.088 to 85.15 +/- 9.879 in the control group and from 46.96 +/- 11.937 to 84.78 +/- 14.048 in the PRP group (P = .498). The mean VAS score varied from 7.00 +/- 1.939 and 6.67 +/- 1.617 before surgery to 1.15 +/- 1.916 and 0.96 +/- 2.244 at the 24-month assessment in the control and PRP groups, respectively (P = .418). The only difference was in the mean UCLA score at 12 months, with 30.04 +/- 4.528 in the control group and 32.30 +/- 3.506 in the PRP group (P = .046). The control group exhibited 1 case of a complete retear and 4 partial retears, and the PRP group exhibited 2 cases of partial retears (P = .42). Conclusion: Platelet-rich plasma prepared by apheresis and applied in the liquid state with thrombin did not promote better clinical results at 24-month follow-up. Given the numbers available for analysis, the retear rate also did not change.
- EFFECTIVENESS OF GLOBAL POSTURAL REEDUCATION COMPARED TO SEGMENTAL EXERCISES ON FUNCTION, PAIN, AND QUALITY OF LIFE OF PATIENTS WITH SCAPULAR DYSKINESIS ASSOCIATED WITH NECK PAIN: A PRELIMINARY CLINICAL TRIAL(2014) AMORIM, Cinthia Santos Miotto de; GRACITELLI, Mauro Emilio Conforto; MARQUES, Amelia Pasqual; ALVES, Vera Lucia dos SantosObjective: The purpose of this study was to assess the effectiveness of global postural reeducation (GPR) relative to segmental exercises (SE) in the treatment of scapular dyskinesis (SD) associated with neck pain. Methods: Participants with SD and neck pain (n = 30) aged 18 to 65 years were randomly assigned to one of two groups: GPRand SE (stretching exercises). The upper extremity was assessed using the Disabilities of the Arm, Shoulder, and Hand questionnaire; function of the neck was estimated using the Neck Disability Index; pain severity was measured using a visual analogical scale; and health-related quality of life was assessed using the Short Form-12. Assessments were conducted at baseline and after 10 weekly sessions (60 minutes each). The significance level adopted was alpha < .05. Results: For pre-post treatment comparisons, GPR was significantly associated with improvements in function of neck and upper extremities, pain, and physical and mental domains of quality of life (P < .05). Segmental exercises improved function of upper extremities and of the neck and severity of pain (P < .05). When contrasting groups, GPR was significantly superior to SE in improving pain and physical domains of the quality of life. Conclusion: This study showed that GPR and SE had similar effects on function of the neck and upper extremity in patients with SD associated with neck pain. When comparing groups, GPR was superior to SE in improving pain and quality of life.
- 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.
- A stress fracture of the base of the acromion: a case report(2014) MALAVOLTA, Eduardo Angeli; ASSUNCAO, Jorge Henrique; SUNADA, Edwin Eiji; GRACITELLI, Mauro Emilio Conforto; FERREIRA NETO, Arnaldo AmadoBackground: Stress fractures of the base of the acromion are rare and tend to progress well when conservatively treated. The need for surgery due to this type of fracture has only been reported in two case reports. Case presentation: A 39-year-old patient, manual laborer, with a stress fracture at the base of the acromion that required surgical treatment due to persistent symptoms and consolidation failure. Conclusion: We described a new mechanism of injury for stress fractures of the base of the acromion. After the failure of conservative treatment, the patient exhibited good results with osteosynthesis with a plate and screws, with no need for a bone graft.
- 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.
- TRAPEZIUS MUSCLE TRANSFER FOR EXTERNAL SHOULDER ROTATION: ANATOMICAL STUDY(2014) GRACITELLI, Mauro Emilio Conforto; ASSUNCAO, Jorge Henrique; MALAVOLTA, Eduardo Angeli; SAKANE, Daniel Takashi; REZENDE, Marcelo Rosa de; FERREIRA NETO, Arnaldo AmadoObjective: To compare the viability of transferring the lower and transverse trapezius to the greater tuberosity using three different techniques. Methods: Twelve shoulders from six cadavers were used. The primary outcome was to assess the suture viability of the trapezius muscle transfer to the greater tuberosity in the insertion topography of the infraspinatus, with the arm adducted during internal rotation (hand on the abdomen) and maximum scapular retraction. Three transfers were applied to each shoulder: the lower and transverse trapezius distal insertion (Group 1); lower trapezius alone (Group 2); and lower trapezius insertion and origin (Group 3). Accessory nerve integrity was assessed before and after transfers. Results: Sutures were viable in 42% (5/12) and 58% (7/12) on Groups 1 and 3, respectively, with no statistically significant difference (Fisher's test, p = 0.558); Group 3 exhibited frequent neurologic injury (11/12). Group 2 was the least successful; the tendon did not reach the greater tuberosity, and no sutures were viable. Conclusion: Groups 1 and 3 exhibited the best nongrafting suture viability to the greater tuberosity; however, Group 3 was associated to frequent spinal accessory nerve injury.